Becker's Clinical Quality & Infection Control

46 INFECTION CONTROL & PATIENT SAFETY 3 Ways to Get Safe Surgical Attire Protocol to Stick By Heather Punke T hrough a 2012 audit, Hanford, Ca- lif.-based Central Valley Network, part of Roseville, Calif.-based Adventist Health, found compliance with safe surgical attire pro- tocols were low, and then took action to improve them. eir process was detailed in the Association of periOperative Registered Nurses' Periop Insider newsletter. A six-month audit period uncovered the follow- ing common surgical attire errors: • Incorrect head covering • Jackets unavailable, in the wrong size or removed while on shi • Jewelry not removed • Masks worn under the chin outside of the practice area • Scrubs worn outside the facility Aer altering surgical attire inventory to address those deficiencies, Central Valley Network also took a strategic approach to instill best practices with the staff. "We knew we needed to take a bold approach that really put safe attire practices directly in front of every team member in a very visual way, while also driving home the evidence behind the prac- tices," Cheryl Curcin, BSN, Central Valley Net- work's clinical education coordinator for periop- erative services, told AORN. ey did so with a three-pronged approach: 1. Using a well-respected physician champion who models safe operating room practices and is a known leader who is concerned about safe- ty. Central Valley Network chose an orthopedic surgeon who was chief of staff at the time. "In my OR, if someone sees something that is not right, I want them to speak up because everyone is on the same team and we all have an equal re- sponsibility to feel comfortable speaking up; we also have an equal responsibility to listen when a team member voices a concern," Lancy Allyn, MD, the surgeon in question, told AORN. 2. Using visual cues to encourage correct attire. Central Valley Network's marketing team collabo- rated to create a life-size poster of Dr. Allyn wearing correct attire that bore the heading, "Are you ready to cross the red line?" e team also created anoth- er poster with Dr. Allyn in scrubs in the parking lot. Designed to look like a "Wanted" poster, it served as a reminder that the practice didn't fit protocols. ose posters were posted by every major exit at the facility. 3. Tailoring educational material and training for front-line staff and leadership so everyone's roles were clear. Central Valley Network also regularly updates the materials and reminds new staff of policies. n Multidrug-Resistant Bacteria Can Cause HAIs, but How Do They Come Into the Hospital? By Anuja Vaidya M ultidrug-resistant bacteria play a big role in thou- sands of hospital-acquired infection-related deaths every year. A study conducted by Germany-based University of Cologne examined the source that carries these pathogens into the hospital. Researchers tested more than 4,000 adults for multidrug-resistant En- terobacteriaceae on admission into hospital by means of stool samples or rectal swabs. Enterobacteriaceae are a normal part of the gut flora and are not pathogenic when they are in the gut. However, they can cause infections in other organs that are difficult to treat. For this study, researchers played close attention to third-generation cephalosporin-resistant Enterobac- teriaceae, a group of problematic multidrug-resistant bacteria. Here are four notes: 1. Researchers found 4,376 adults tested positive for third-generation cephalosporin-resistant Enterobacte- riaceae pathogens on admission to a participating hospital. Of this figure, 416 were carriers. 2. Thus, researchers found every 10th patient admitted to a participating hospital was colonized with multi- drug-resistant pathogens. 3. Researchers also discovered pa- tients who had taken antibiotics and traveled outside Europe prior to hos- pital admission are at a higher risk. 4. The study researchers recommend- ed improving hygiene measures, using antibiotics rationally and in- creasing antibiotic resistance training for physicians. n Brazil Reports First Case of Superbug Resistant to Last-Resort Antibiotics By Max Green M cr-1, the gene that enables dead- ly bacteria to become resistant to even last-resort antibiotics, such as colistin, has been identified in a Brazilian patient for the first time, according to research published in Antimicrobial Agents and Chemotherapy. The gene was first isolated in China in late 2015, followed by cases in Denmark, Canada and eventually the U.S. The latest case in Brazil was identified in a 60-year- old patient with diabetes. The patient tested positive for a type of E. coli carry- ing the mcr-1 gene. After going through multiple courses of antibiotic treatment for a foot infection, which did not im- prove, the patient's foot was amputated, according to the paper. The researchers used whole genome anal- ysis to determine that cell structures within the the resistant E. coli are surprisingly similar to those found in other bacteria that have been found to carry mcr-1. This strongly suggests the parts of infectious bacteria that are able to self-replicate may be contributing to the spread of the resis- tant gene, the authors concluded. n

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