Becker's Hospital Review

53 FINANCE CMO / CARE DELIVERY The Joint Commission Now Cites Individual Hand Hygiene Noncompliance as Deficiency By Anuja Vaidya T he Joint Commission announced that starting Jan. 1 if surveyors observe any individual failures to perform hand hy- giene in the process of direct patient care, it will be cited as a deficiency. e body will also continue surveying organizations with regard to their hand hygiene programs, as per Patient Safety Goal NPSG.07.01.01. e deficiency will result in Requirement for Improvement under Infection Preven- tion and Control Standard IC.02.01.01, EP 2: "e [organization] uses standard precau- tions, including the use of personal protective equipment, to reduce the risk of infection." e new rule is applicable to all accreditation programs. Previously, surveyors issued an RFI for fail- ure to implement hand hygiene improvement programs and make progress in these pro- grams. With the exception of home care and ambulatory care accreditation programs, in- dividual failure to perform hand hygiene was not cited as a deficiency if there was evidence of increased hand hygiene compliance via the organization's program. However, organizations have had nearly 14 years to implement successful hand hy- giene programs, since e Joint Commis- sion introduced national patient safety goal centered on complying with CDC or World Health Organization hand hygiene guide- lines. e Joint Commission has determined that organizations have had enough time to train all healthcare workers involved in di- rect patient care. "While there are various causes for HAI, e Joint Commission has determined that failure to perform hand hygiene associated with di- rect care of patients should no longer be one of them," the accreditation body noted in a statement. n Study: 3 Best Practices for Improving Patient Safety Culture By Anuja Vaidya A study, published in The Joint Commission Journal on Quality and Patient Safety, examined promis- ing best practices to improve patient safety cul- ture in a hospital. Researchers studied the Agency for Healthcare Research and Quality Surveys on Patient Safety Culture's Hospital Survey, which included longitudinal results from 536 hos- pitals that submitted data to the Hospital SOPS database from 2007 to 2014. They measured composite-level and aggregate improvement in patient safety culture, using that to identify "top-improving" hospitals. They then con- ducted interviews with one to three clinical leaders from six "top-improving" hospitals. The study shows that the mean change in the all-compos- ite percent positive culture score was a 1.7 percentage point increase. The six hospitals included in interviews had an average increase of 8.6 percentage points. The three most common practices for improving culture gleaned from the interviews were: • Goal setting and strong action planning for quality improvement • Implementation of well-known patient safety initia- tives and programs • Rigorous survey administration methods n 84% of US Cooling Towers Contain Legionella Bacteria By Brian Zimmerman D NA evidence of Legionella bacteria is present in 164 cooling towers throughout eight of the nine climate regions in the United States, according to a study published in PLOS One. Legionella bacteria can cause a virulent form of pneumonia called Legionnaires' disease. The illness can be contracted by inhaling mist from infected water sources, such as cool- ing towers, steam rooms and plumbing systems. As cooling towers have been linked to multiple outbreaks of Legionnaires' around the country, researchers sought to de- termine the presence of Legionella bacteria in the nation's cooling towers. The team obtained water samples from 196 cooling towers around the nation between July and Sep- tember 2016 — 84 percent (164) contained DNA evidence of Legionella. Researchers conducted culture tests on Le- gionella isolates from 78 of the towers. The team identified 144 unique Legionella isolates, 76 of which were Legionella pneumophilia. "[T]he potential exists for [Legionnaires' disease] cases and outbreaks to occur across the continental U.S. wherever a colonized [cooling towers] and a susceptible population co- incide," concluded the study's authors. "However, CT waters specifically associated with outbreaks may have differences in Legionella abundances and types and may contain al- tered microbial communities compared to our findings. … Detailed examination of the microbiome and physical pa- rameters such as water quality metrics may help elucidate what factors cause Legionella in a CT to shift from environ- mental bacteria to outbreak pathogens." n

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