Becker's Clinical Quality & Infection Control

18 INFECTION CONTROL & PATIENT SAFETY Healthcare workers buy $882k radio ad to highlight high infection rates at Stanford University Medical Center By Mackenzie Bean H ealthcare workers rolled out an $882,000 radio ad campaign March 19 to increase awareness about high infection rates and healthcare costs at Stan- ford (Calif.) University Medical Center. The minute-long ad will air on 11 radio stations through- out the Bay Area. "As Stanford Health Care has expanded in the Bay Area, they've lost track of the basics like preventing patient infections," the ad's narrator says. "Patients shouldn't have to worry about contracting infections when treated at Stanford Hospital." High infection rates rest at the center of a monthslong contract dispute between Stanford University Medical Center and SEIU-United Healthcare Workers West, which represents more than 1,800 Stanford employees. Union members released a report last July citing federal data to highlight patient safety and infection control concerns at the hospital. For example, CMS data showed nearly 700 patients acquired Clostridium difficile at Stanford Universi- ty Medical Center from 2013 through 2016, according to the union. However, hospital officials said the hospital's infection rates are actually above the national benchmark. "As we communicated to the union previously, Stanford Health Care's Standardized Infection Ratio score actually exceeds the industry benchmark at preventing infections. … Stanford Health Care's current quality score on the Hos- pital Compare website is four stars, and only 22.4 percent of the more than 4,500 hospitals rated achieved four or five stars," a spokesperson for Stanford Health Care said in a statement emailed to Becker's Hospital Review. "Our rankings are a testament to our dedicated employees and their commitment to quality care and ongoing improve- ment efforts," the spokesperson said. "We feel it is unfortu- nate and disrespectful to our employees and the community that SEIU-UHW continues to distort the facts." n Harvard, Boston Children's scientists develop model to improve sepsis treatment By Megan Knowles S cientists at the Wyss Institute at Cam- bridge, Mass.-based Harvard Universi- ty and Boston Children's Hospital are developing a model for clinical monitoring designed to measure sepsis responses in pigs, according to a paper published in Advances in Critical Care Medicine. Standard sepsis treatment involves giving patients antibiotics and fluids. Despite the prevalence of sepsis in hospitalized patients, no new therapies have been developed in the last three decades because sepsis treatments frequently fail in clinical trials. Mice and baboons are regularly used to test drug candidates in preclinical trials. However, these animals are poor models for how humans respond to sepsis since they are oen resistant to the pathogens that cause sepsis-inducing infections in humans. e researchers chose to use pigs as their model since pigs' immune systems and blood clotting is similar to humans and their large size allows their vitals to be monitored in real time. However, even in studies involving pigs, the animals' responses to sepsis are not currently measured with the same criteria used in human clinical practice. To solve this issue, the scientists developed a new approach for clinical monitoring created to measure sepsis responses in pigs. e scientists looked at several physiological signs and organ failure in pigs rather than analyzing whether the pigs died to help provide a more accurate preview of how sepsis drugs affect humans. Animal models are typically evaluated by whether the animal dies as a result of illness. To evaluate sepsis in living infected pigs in a manner similar to human clinical assess- ment, the researchers created a swine-spe- cific Sepsis-3 protocol with swine-specific Sequential Organ Failure Assessment, a measure that classifies the severity of sepsis. To analyze the responses of the pigs' various organs in real time, the scientists infused Escherichia coli bacteria into 18 young York- shire pigs' blood and used the new protocols for evaluation. e researchers gave six pigs the bacteria while conscious, six while under anesthesia and six did not receive the bacteria but had the same procedures (four conscious and two anesthetized). e scientists found increases in the total swine-specific SOFA scores among the con- scious and anesthetized pigs were largely due to kidney and blood clotting failure, with two of the conscious animals developing acute kidney failure. Of the anesthetized animals, three pigs were categorized as experiencing septic shock, which is the highest severity level in the ss-SOFA system. ese findings suggest the effects of anesthesia need to be considered when evaluating responses to sepsis. "Our system goes beyond simply measuring the effects of pathogen injection on inflam- mation and animal survival," said Mike Super, PhD, co-author and lead senior staff scientist at the Wyss Institute. "Because it mimics the life-threatening organ failure that is also seen in sepsis patients, it also might provide a better prediction of how sepsis therapies will perform in humans." n

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