Becker's Clinical Quality & Infection Control

29 Infection Prevention support. IPs are most often infectious disease specialists, microbiologists or nurses who have received training through organizations such as the Society for Healthcare Epidemiology of America and the Association for Profession- als in Infection Control and Epidemiology. The most effective approach to a quality-driven IPC program will leverage a combination of easily accessible policies and procedures with up-to-date con- tent supported by an advanced infrastructure of surveillance technology. When rule-based, advanced surveillance technology is deployed in tandem with evi- dence-based HAI prevention strategies, IPs have the ability to efficiently moni- tor the effect of interventions. For example, a clinical rule can be built into a surveillance system that locates patients at risk upon admission for C. diff by flagging medications often prescribed for treatment of this infection. Conclusion High-performing IPC programs are critical to success in today's pay-for-per- formance healthcare climate, and the commitment must start with executive leadership to create a culture of patient safety and personal accountability. Consistent feedback provided to key stakeholders on HAI and MDRO out- come metrics process metrics focused on compliance with evidence-based reduction practices will promote their engagement and enhance collabora- tion to meet reduction targets. To be successful in meeting defined performance improvement goals, IPs must be provided with the resources and technology infrastructure that sup- port a proactive approach to HAI and MDRO detection and real-time inter- vention. n Patient Engagement in HAI Reduction Strategies: 3 Takeaways By Shannon Barnet S lowly but surely, hospitals have been trying to encourage more active engagement of patients and families in preventing healthcare-associated infections. It turns out, the key to low- ering HAI rates may be more patient education, according to a study published in the American Journal of Infection Control. Researchers conducted a pilot study to examine the receptiveness of hospital patients toward a new empowerment tool aimed at increasing awareness and engagement of patients in preventing HAIs. Patients were recruited from two surgical wards of a hospital and ran- domized into two groups: One group of patients received empower- ment tools — an educational flip chart and brochure — while the other did not, and surveys were administered to all participants. At the baseline survey, slightly more than half of the participants were highly willing to assist with infection control strategies. Highlighted below are three findings from the surveys. 1. Overall, all the participants at the baseline agreed they were sig- nificantly more likely to ask a physician or nurse a factual question then a challenging question. 2. After discharge, 23 of the 60 total patients reported discussing a health concern with a staff member, with a roughly even split among the active and control groups. 3. Only three participants in the whole study asked a staff member to wash their hands. The study did not specify to which group (ac- tive or control) these three participants belonged. "Our results suggest that patients would like to be more informed about HAIs and are willing to engage with staff members to assist with the prevention of infections while in the hospital setting," wrote the study authors. "Further work is going to need to be undertaken to as- certain the best strategies to promote engagement and participation in infection control activities." n 8 Ways to Prevent Duodenoscope Infections By Shannon Barnet T he American Gastroenterological Association convened a meeting with experts in gastroenterology, epidemiology and infectious dis- ease to discuss how to prevent duodenoscope infections. Duodenoscopes have been linked to a growing number of antibiotic-resistant infections, including an outbreak at Ronald Reagan UCLA Medical Center in Los Angeles that resulted in two deaths. Present at the AGA meeting were representatives from the U.S. Food and Drug Administration, Centers for Disease Control and Prevention and the ECRI In- stitute, as well as experts from endoscope manufacturers Fuji and Pentax. Together, the meeting participants came up with the following eight recommen- dations for physicians to improve patient safety associated with duodenoscopes. 1. Treat all elevator-channel endoscopes — including both endoscopic ultrasound-guided fine-needle aspiration echoendoscopes and duo- denoscopes — the same when disinfecting. 2. Continue to heed recently enhanced manufacturer reprocessing guide- lines while the FDA works with endoscope manufacturers to validate their enhanced reprocessing protocols. 3. Track elevator-channel endoscopes by patient and by device serial number to enable retrospective identification in cases of infection. 4. Establish an infection surveillance program with two steps: tracking all patients who have undergone a procedure with an elevator-channel endoscope and periodically collecting culture surveillance of all eleva- tor-channel endoscopes. 5. Get a baseline culture of all elevator-channel endoscopes. Be sure to thoroughly review reprocessing technique if a culture comes up positive. 6. Develop a standardized reprocessing training program and audit re- processing competency of the staff every six months, as well as when new model endoscopes are introduced. 7. Contact the CDC immediately if you suspect a breach or infection to aid in the investigation. 8. Looking long-term, further study should review alternative scope de- signs that might mitigate the risk of infection transmission. n

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