Issue link: https://beckershealthcare.uberflip.com/i/774606
7 PATIENT SAFETY PRIORITIES IN 2017 tions around the world. In one such instance in the Netherlands, sinks were removed from all patient rooms to inhibit the spread of bacteria. To avoid this, Michael Gardam, MD, director of infection control at Toronto-based University Health Networks, suggested, "Don't have the gooseneck [faucet] drain directly into the drain; have it drain off to the side of the bowl. Don't allow it to splash. Make sure it's deep enough that it can't splash on you and splash on your clothing. Make sure that the stuff around [the sinks] is waterproof." Vaccine coverage. Low adherence to immunization schedules re- sulted in outbreaks of preventable illnesses in 2016. Multiple mumps outbreaks brought cases of the resurgent virus to a 10-year high, ac- cording to the CDC. As of Dec. 3, 46 states and Washington, D.C., had reported 4,258 mumps cases combined. Influenza is also largely preventable with a vaccine, but few Americans are vaccinated. Flu shots prevented an estimated 5 million illnesses and more than 70,000 hospitalizations in 2015, but the percentage of people inoculated against the potentially deadly virus remained low in 2016. Approximately two in five Americans received a flu shot this past year, which is comparable to the rate in 2015. "We have a tool that is proven to prevent flu illness and hospitalization but millions of people are not taking advantage of it. Too many people are unprotected," said Nancy Messonnier, MD, director of CDC's Na- tional Center for Immunization and Respiratory Diseases. ough misinformation surrounding vaccines remains abundant, the healthcare community must remain vigilant in educating patients and families about the protective power of vaccination in 2017. Behavioral health management protocols. When patients suffering from mental illness or substance abuse end up in emergency rooms, the experience can be trying for both the patient and providers, and these encounters can sometimes culminate in violence. In 2016, e New York Times reported an instance of a patient shot at St. Joseph Medical Center in Houston. e incident involved Alan Pean, an unarmed, bipolar patient experiencing mental distress who was shot in his hospital room by security. Aer being hospitalized, Mr. Pean began repeatedly walking into the hallway naked and employees would then guide him back into the room. e patient was reportedly not aggressive or threatening, but aer nurses got him into a gown, he refused to fasten it. e nurses, following protocol, alerted the off-du- ty Houston police officers providing security that morning. Aer the officers arrived at Mr. Pean's room, they entered and closed the door behind them, and a struggle with the officers ensued. Mr. Pean was Tased, shot and handcuffed. e case helped fuel the debate over the necessity and safety of staff- ing armed security guards in hospitals. e Times article also cited a study by Gabor Kelen, MD, director of emergency medicine at Balti- more-based Johns Hopkins Medical School. e study found 23 per- cent of all emergency department shootings involved guns stolen from hospital security. Hospital administrators can protect their organizations and patients from such situations by ensuring that hospital security is adequately trained to handle crises involving confused or aggressive patients. Catheter-associated urinary tract infections. A report on the CDC's Winnable Battles initiative released Dec. 5 showed strong prog- ress in the reduction of hospital-associated infections, with one excep- tion: catheter-associated urinary tract infections. Although previous studies suggest as many as 69 percent of CAUTIs are preventable, the infection continues to prove problematic for hospitals. CDC began Winnable Battles in 2010 and set ambitious goals to be reached by 2015. e results show targets of 60 percent reductions in both central line-associated bloodstream infections and invasive methicillin-resistant Staphylococcus aureus infections are on track to be achieved. Additionally, achieving the target of a 30 percent reduc- tion in surgical site infections appears to be feasible. However, the tar- get of reducing CAUTIs in acute care hospitals by 30 percent was not reached. While CDC data did show a 24 percent decrease of CAUTIs in hospital wards, hospital intensive care units saw a 16 percent increase in CAUTI occurrence. However, a recently published study examining the efficacy of a CAU- TI reduction collaborative effort supported by the Agency for Health- care Research shows promise. e initiative provided Quality Com- prehensive Unit-based Safety Program toolkits for CAUTI reduction to physicians and nurses across 603 hospitals. Program adherence was associated with a reduction of approximately one-third for CAUTIs in general wards. Emerging diseases/new outbreaks. e Zika virus captured the attention of both the public and infectious disease experts alike in 2016. As of Nov. 30, the CDC had tallied 1,172 Zika infections among pregnant women in the United States. e infections have resulted in the delivery of 32 infants with birth defects. An additional five fetuses with birth defects were lost in pregnancy due to Zika. In October, Dr. Frieden, director of the CDC, described the spread of pathogens like Zika as the "new normal" in an age of global travel and trade, dense metropolises and climate change. Emerging diseases like Zika in 2016 and Ebola in 2014 will continue to present problems for hospitals as they encounter communities where immunities have yet to be developed. Infectious disease experts should do their best to keep themselves apprised of emerging viruses like Ma- yaro, Ri Valley fever or Usutu that could cause outbreaks in the future. An emerging pathogen to watch in 2017 is a deadly yeast infection that made its way to the U.S. for the first time in 2016, infecting 19 people thus far. e CDC expects more cases in the future. Some strains of the yeast infection, called C. auris, have developed resistances to all three major classes of antifungal drugs. e deadly yeast has caused outbreaks in healthcare settings in multiple countries across several continents. n "The end of the road isn't very far away for antibiotics…we may be in a situation where we have patients…for which we do not have antibiotics." - Tom Frieden, MD