Becker's Clinical Quality & Infection Control

7 INFECTION CONTROL & PATIENT SAFETY Hospital privacy curtains are breeding MRSA, study finds By Megan Knowles P rivacy curtains in hospitals can pose a threat to patient safety, with high percentages of curtains testing positive for methicillin-resistant Staphylococcus aureus, a study published in the American Journal of Infection Control found. The researchers tracked the contamination rate of 10 freshly laundered privacy curtains at a hospital in Winnipeg, Canada. The curtains had minimal contamination when they were first hung, but became increasingly contaminated over time. By day 14 of the study period, 87.5 percent of the curtains tested positive for MRSA. Curtains that were not placed in patient rooms, however, stayed clean the entire 21 days of the study. None of the rooms where the curtains were placed were occu- pied by patients with MRSA. The researchers took samples from areas where people hold curtains, which suggests increasing contamination resulted from direct contact. "We know that privacy curtains pose a high risk for cross-contamination because they are frequently touched but infrequently changed," said lead study author Kevin Shek, a researcher at University of Manitoba in Winnipeg. "The high rate of contamination that we saw by the 14th day may represent an opportune time to intervene, either by cleaning or replacing the curtains." n Hospitals lead healthcare worker vaccinations, CDC says By Harrison Cook A bout 92 percent of hospital workers reported receiving a flu vaccine during the 2017-18 flu season, compared to 75 percent of ambulatory care workers and 67 percent of long-term care workers, according to a survey released Sept. 28 by the CDC. The CDC polled 2,265 healthcare personnel across the U.S. via an online survey between March 27 and April 17. Here are four things to know: 1. In total, 78.4 percent of healthcare workers reported receiving a flu shot last year. 2. In hospitals with a vaccine requirement, vaccination coverage was 97 percent among employees. 3. Physicians (96 percent), pharmacists (92 percent) and nurses (90 percent) reported the highest rates of vaccine coverage. Other clinical healthcare personnel (81 percent), assistants and aides (71 percent) and non- clinical healthcare personnel (73 percent) reported the lowest coverage rates. 4. The CDC's Advisory Committee on Immunization Practices continues to recommend annual flu vaccina- tion for all healthcare personnel to reduce flu-related illness and deaths. n Care concerns emerge from Missouri's 'assistant physician' licensure program By Megan Knowles A er the Missouri legislature created a category of physician licensure to curb primary care physician shortages in rural areas, researchers voiced concerns these assistant physicians' low first- time pass rates on licensing exams could lead to worse clinical outcomes, JAMA reported. e assistant physician must be a citizen or legal resident of the U.S., a graduate of a rec- ognized medical school, have English-lan- guage proficiency, have passed steps one and two of the U.S. medical licensing examina- tion, but not have finished a residency. Assistant physicians are limited to providing primary care services in underserved areas and can only practice under collaborative practice agreements with fully licensed physicians. ey have a scope of practice and responsibilities consistent with physician assistants and advanced practice nurses. To assess the qualifications of assistant physicians and the care quality they provide, the researchers looked at data on all assis- tant physician licensees from Jan. 1, 2017, through Dec. 31, 2017, from the Missouri Board of Healing Arts. e researchers raised concerns about assistant physician licensure based on assistant physicians' first year of experience in Missouri. e study found assistant physicians were considerably less likely to pass steps one and two of the medical licensing examination on the first attempt than all graduates of U.S. medical schools from 2012-16. Failure of step two is linked to increased disciplinary action and worse clinical outcomes, the researchers said. Only 25 percent of the licensees secured col- laborative agreements during the first year, meaning they were the only ones who could practice. Additionally, despite requirements that the collaborative practice be in under- served areas, 20 percent were not in areas facing a primary care shortage. e study is limited by a lack of data on licensees, practice settings and employers as well as the fact that data was available only for one year, the researchers said. "Future research should study the quality and safety of the care that assistant physi- cians provide and their clinical roles and ca- reer path, as well as patient perceptions," the researchers wrote. "e Missouri legislature recently broadened the licensure beginning in 2019; however, it is unclear what effect these changes will have." n

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