Infection Control

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• Hand hygiene rates improved through variety of reinforcement styles

  Editor's note: This article was originally published in the December 2009 Briefings on The Joint Commission.
  
  It takes more than one method to bring a hospital's hand hygiene compliance rate above 90%. At Barnes-Jewish St. Peters (MO) Hospital (BJSPH), it took trial and error to reach its compliance goal.

  "We started collecting hand hygiene observations back in 2004," says Kathleen Dougherty, RN, MSN, manager of professional practice and leadership development at BJSPH. "We wanted to see where we were with compliance for guidelines from the Centers for Disease Control and Prevention."

  What BJSPH found was not good news. Taking 100 observations per quarter, the organization found that its hand hygiene compliance rate was 57%. Conversations began on how to reach the CDC goal. The 2004 numbers illustrated the need for increased compliance; the renewed awareness alone caused a significant jump in compliance in 2005. "We got our rates up to 79% [in 2005]," Dougherty says. "This came about just based on a general heightened awareness of hand hygiene. We didn't have a pointed focus or implementation plan."

  Although the jump was encouraging, it still didn’t bring the organization's compliance numbers to an acceptable level. But the organization was collecting data. The facility has seen significant rates of improvement each year since this time—remaining over 90% and at times regularly hitting 99% compliance in 2009.

• New concerns arise with antibiotic-resistant organisms

  Over the past several years, MDROs have become a leading concern for IPs attempting to reduce their hospital’s healthcare-associated infection (HAI) rate.

  Although MRSA is the most common drug-resistant organism, other bacteria, including VRE and certain Gram-¬negative bacilli, have also evolved to become less susceptible to drug treatments. Additionally, diseases such as TB are becoming resistant to drugs, leading to potentially dire situations. In December 2009, the first U.S. case of extremely drug-resistant TB was discovered in Florida. The World Health Organization (WHO) says that about 5% of TB cases are resistant to the two primary drugs traditionally used to treat TB: rifampin and isoniazid. Worldwide, there are about 40,000 new cases of extensively drug-¬resistant TB, according to the WHO.

  A new study published in the February Infection Control and Hospital Epidemiology indicates that drug-resistant strains of Acinetobacter have increased more than 300% from 1999 to 2006. The study was conducted by Extending the Cure, a research project under Resources for the Future that studies the growing problem of antibiotic resistance. The findings suggest that this new bacteria is becoming resistant to nearly every drug, leaving doctors with fewer treatment options, says Michael R. Eber, BSE, researcher for the Center for Disease ¬Dynamics, Economics and Policy at Resources for the Future in Washington, DC, who was involved with the study.

• Montana facility deals with repercussions of required flu shots

  RiverStone Health, a public health agency for Yellowstone County in Billings, MT, is one of a few facilities across the country that has took a hard stance on required flu vaccines, and felt some of the repercussions as a result.

• Household disinfectants can kill H1N1 virus

  A new study published in the February issue of Plos One indicates common household disinfectants can reduce the viability of the H1N1 virus.

• Ditch your broom for a mop to reduce infections

  Brooms might be a useful household cleaning appliance, but there’s no place for them in the medical setting, says OSHA Healthcare Advisor blogger and IC expert Peg Luebbert.

• New law forces New Jersey ACSs to report infections

  A new and last-minute New Jersey state law requires ambulatory surgery centers (ASC) to begin reporting their infection rates to the New Jersey Health Department. The infection rates will also be made public by the state, according to the bill that was recently signed into law by outgoing New Jersey Governor Jon Corzine.

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