Becker's Clinical Quality & Infection Control

49 INFECTION CONTROL & PATIENT SAFETY Too Much of a Good Thing? Not Possible for Hand Hygiene Compliance, Study Finds By Heather Punke T he well-known idiom that having too much of a good thing can be harmful doesn't apply when it comes to hand hygiene compliance, according to a study in Emerging Infectious Diseases — boosting hand hygiene compliance from an already high rate (85 percent) to higher than 95 percent was associated with a decrease in health- care-associated infections. In fact, the study out of Chapel Hill-based University of North Carolina Health showed a 10 percent improvement in hand hy- giene was associated with a 6 percent decrease in overall HAIs and a 14 percent reduction in Clostridium difficile infections. Researchers believe improved hand hygiene was associated with 197 fewer infections and 22 avoided deaths during the 17-month study period. The improved hand hygiene compliance was the result of a hospitalwide hand hygiene program in which compliance was measured upon entering and leaving patient rooms, and all healthcare personnel were asked to make instant obser- vations and give feedback to one another in the moment, as opposed to using covert observations. "A program designed to improve hand hygiene compliance among hospital staff successfully engaged all healthcare per- sonnel in monitoring and improving their own hand hygiene compliance," the study concluded. "This pursuit of excellence for hand hygiene compliance led to substantial HAI reduc- tions hospitalwide." n FDA: Custom Ultrasonics' AERs Can Be Used for Cleaning Flexible Endoscopes, But Not Duodenoscopes By Anuja Vaidya T he Food and Drug Administration is continuing to advise healthcare facilities to forgo using Custom Ultrasonics' System 83 Plus Automated Endoscope Reprocessors for reprocessing of duodenoscopes. However, providers can use the AERs to clean other endoscopes that are not duodenoscopes. Custom Ultrasonics notified healthcare facilities the AERs are not suit- able for use in May 2016. e FDA's most recent safety communication reiterates that recommendation and also notes providers can still use the AERs for other endoscopes. In February 2016, the FDA issued a safety communication recom- mending healthcare facilities using Custom Ultrasonics' System 83 Plus AERs should "transition to alternative methods to reprocess flexible endoscopes." Aer that, the agency reviewed reprocessing validation data from Custom Ultrasonics as well as literature on the AERs. is culminated in Custom Ultrasonics issuing an urgent medical device re- call for all System 83 Plus, System 83 Plus 2 and System 83 Plus 9 AERs. e recall stated "they should not be used for cleaning and/or high-level disinfection of duodenoscopes until further notice." e FDA is continuing to work with Custom Ultrasonics on additional reprocessing validation studies. us far, there has been no indication that providers should not use the company's AERs to clean flexible endoscopes that are not duodenoscopes. n 3 Key Risk Factors for Patient- to-Patient Transmission of Resistant Bacteria By Heather Punke R esearchers have identified three key factors that increase the risk for patients to pass on carbapene- mase-producing carbapenem-resistant Enterobac- teriacecae to another patient, helping explain why some contacts get the bacteria but others do not. "The spread of CP-CRE is a major public health concern because it is extremely drug resistant; however, the research on these pathogens is very limited, and so is our knowledge of their transmission," said Vered Schech- ner, MD, lead author of the study published in Infection Control & Hospital Epidemiology. "Identifying high-risk groups helps us to avoid excessive screening that can be risky and expensive, and to determine who should be screened and who might be a candidate for pre-emptive isolation or antibiotics." Dr. Schechner and the team discovered that 96 percent of patient-to-patient transmission of CP-CRE had at least one of the following three risk factors: • Contact for more than three days with an infected person • Mechanical ventilation • Infection with another multidrug-resistant bacteria They also discovered patients who take cephalosporins were less likely to acquire CP-CRE than patients who took other types of antibiotics. n

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