GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    429. Infection Prevention During Use of a Warm Zone Model in Cohort Patient Care Locations during the COVID-19 Pandemic
    Oxford University Press (OUP) ; 2021
    In:  Open Forum Infectious Diseases Vol. 8, No. Supplement_1 ( 2021-12-04), p. S316-S316
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 8, No. Supplement_1 ( 2021-12-04), p. S316-S316
    Abstract: The COVID-19 pandemic required hospitals to care for influxes of patients in cohort locations during critical shortages of personal protective equipment (PPE). Safety zones can be used to protect healthcare workers caring for patients with infectious pathogens. During the COVID-19 pandemic, our hospital developed a Warm Zone model (WZM) to streamline the care of patients with COVID. We established specific areas in our COVID cohort units where staff were permitted to bridge between rooms without doffing gowns, but still doffing gloves and performing hand hygiene between patients. We recognized that a WZM could inadvertently increase risk of nosocomial transmission of pathogens if gowns acted as fomites. For this reason, patients with known infectious pathogens were excluded from the WZM. To measure for unintended harmful consequences of the WZM, our Infection Prevention (IP) department performed surveillance for hospital onset (HO) Clostridioides difficile (CDI), Carbapenem-resistant enterobacteriaceae (CRE) and Methicillin-resistant Staphyloccocus aureus (MRSA) bloodstream infections on units that implemented the WZM. Methods Two intensive care units and 3 wards where COVID positive patients were cohorted were included in surveillance. The timeframe for this analysis was 7/1/2020 - 3/31/2021. An electronic surveillance system was used to measure HO infections. The National Healthcare Surveillance Network (NHSN) LabID definitions were used when determining HO CDI and MRSA bloodstream infections (BSI). Results During the study period, there were no HO CRE, 1 HO CDI, and 2 HO MRSA BSI in cohort units. There was no evidence to suggest that the HO CDI or HO MRSA BSI were associated with use of a WZM. During this time period, there were 14 cases of community onset (CO) CDI, 2 cases of CO MRSA BSI, and one CO CRE. Conclusion During use of a WZM in COVID cohort units, IP did not identify significant increase in HO CDI, CRE, or MRSA BSI compared to non-cohort units. We were limited in our ability to measure acquisition of pathogens because active surveillance screening for colonization was not performed. However, we were able to safely employ a WZM to streamline patient care in COVID cohort areas without evidence of causing nosocomial infections via patient-to-patient transmission. Disclosures All Authors: No reported disclosures
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofab466.629
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2757767-3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    STOP-BSI: Reducing Methicillin-Resistant Staphylococcus aureus Bloodstream Infections in Oncology Patients
    Cambridge University Press (CUP) ; 2020
    In:  Infection Control & Hospital Epidemiology Vol. 41, No. S1 ( 2020-10), p. s391-s391
    Details
    In: Infection Control & Hospital Epidemiology, Cambridge University Press (CUP), Vol. 41, No. S1 ( 2020-10), p. s391-s391
    Abstract: Background: Hospital-acquired methicillin-resistant Staphylococcus aureus bloodstream infections (MRSA BSIs) are associated with serious morbidity and mortality in immunocompromised patients. Of all MRSA BSIs at our academic medical center, 63% occurred in the oncology units. A multidisciplinary team was formed to address the improvement opportunity: the clinical nurse specialist, hospital epidemiologist, unit leaders, nurse champions and representatives from infection prevention, pharmacy and information technology. The goal was to decrease the incidence of hospital-onset MRSA BSI in the oncology wards by 10 infections in 2016 by implementing daily chlorohexidine (CHG) bathing and weekly nasal povidone-iodine antisepsis in July 2016. Methods: The strategically targeting oncology with povidone-iodine nasal antisepsis and bathing with CHG Staph reduction initiative (STOP-BSI) was a quality improvement project consisting of daily CHG baths for all oncology patients and nasal povidone-iodine on admission and weekly thereafter. Nurses and patient care technicians were trained on how to administer CHG treatments. Education was also provided to patients on how to use CHG bath wipes to self-administer the nasal antisepsis. Education resources were created to help answer concerns of the staff, patient, or family, and an escalation process was developed for treatment refusal. CHG bath audits were performed to measure compliance and to identify barriers to the process. Results: By the end of 2016, the number of infections decreased by 5 on the oncology units. The number of infections continued to decrease each year. The bone marrow transplant (BMT) unit decreased from 8 infections in 2015 to 3 in 2018. The hematology oncology unit infections decreased from 5 infections in 2015 to 0 in 2018. The medical oncology unit infections decreased from 2 infections in 2015 to 0 in 2018. The CLABSI rates per 1,000 line days trended downward after some time. Conclusions: Implementing daily CHG baths and weekly povidone-iodine nasal antisepsis reduced the number of MRSA BSI infections in the oncology population. The CLABSI rates decreased after barriers to the process were removed. Funding: None Disclosures: None
    Type of Medium: Online Resource
    ISSN: 0899-823X , 1559-6834
    URL: Article
    DOI: 10.1017/ice.2020.1029
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2106319-9
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    Impact of Expansion of Vascular Access Team on Central-line–Associated Bloodstream Infections
    Cambridge University Press (CUP) ; 2020
    In:  Infection Control & Hospital Epidemiology Vol. 41, No. S1 ( 2020-10), p. s260-s260
    Details
    In: Infection Control & Hospital Epidemiology, Cambridge University Press (CUP), Vol. 41, No. S1 ( 2020-10), p. s260-s260
    Abstract: Background: Through participation in a system-wide healthcare-associated infection-reduction task force, we leveraged our ability to standardize best practices across hospitals in a university-owned healthcare system to reduce central-line–associated bloodstream infection (CLABSI) rates. Methods: Our multidisciplinary team had representation from all hospitals in our healthcare system. The team benchmarked practices in place and compared CLABSI standardized infection ratios (SIRs). One hospital had a robust vascular access team (VAT) and consistently low CLABSI SIRs; expanding and standardizing VAT across the hospitals in the system became the primary goal of the team. We developed a business case to justify VAT expansion that considered savings from decreasing CLABSIs and benefits to interventional radiology revenue by decreasing PICC insertion and comparing costs for added full-time equivalents (FTEs). CLABSI rates before and after VAT team expansion at 2 large hospitals were compared to the hospital with existing robust VAT. Other process improvement activities were implemented across all hospitals. The expanded VAT assumed responsibility for central-line maintenance, promoted removal of unneeded lines, expanded education efforts, and enhanced capacity for insertions. Results: The VAT expansion from 5.4 FTEs to 15.9 FTEs at 2 large hospitals (1,100 total beds) began in April 2017 and was phased over ~6 months. CLABSI SIRs for the 15 months preceding expansion were compared to the SIRs for the 15-month period after expansion for the 2 hospitals with expanded VAT (hospitals A and B) and for hospital C with preexisting robust VAT (Table 1). We observed a 33% decrease in PICC insertions in interventional radiology department in hospitals A and B. Overall return on investment (ROI) estimates using lower and upper cost per CLABSI ranged from a loss of $156,000 to a net gain of $623,000. Conclusions: A significant decrease in CLABSI rates temporally related to expansion of VAT occurred in 2 hospitals, whereas the hospital with existing robust VAT demonstrated a modest decrease in CLABSI rates. We were able to demonstrate a favorable ROI from the VAT expansion without an impact on HAC penalties. Using the model of standardizing best practices across a system and creative ROIs may help justify the addition of scarce resources. Funding: None Disclosures: None
    Type of Medium: Online Resource
    ISSN: 0899-823X , 1559-6834
    URL: Article
    DOI: 10.1017/ice.2020.825
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2106319-9
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 4
    Online Resource
    Online Resource
    776. Reducing Central Line Associated Bloodstream Infections (CLABSI) in a High-Risk Cohort of Patients by Standardizing Skin Preparation Prior to Pulmonary Artery Catheter Insertion
    Oxford University Press (OUP) ; 2021
    In:  Open Forum Infectious Diseases Vol. 8, No. Supplement_1 ( 2021-12-04), p. S485-S485
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 8, No. Supplement_1 ( 2021-12-04), p. S485-S485
    Abstract: Central line associated bloodstream infections (CLABSI) are a recognized complication of all central venous access devices including pulmonary artery catheters (PAC). At our institution, PACs are utilized frequently, often for prolonged durations, for patients with advanced heart failure in the cardiac care unit (CCU) who are awaiting heart transplant. In early summer 2018, our hospital infection prevention (IP) department detected an uptick in CLABSI attributable to the CCU. After 9 months of zero CLABSI, two CLABSIs attributable to the CCU were identified during a 3 month period from November 2017-January 2018. Four additional CLABSIs were identified between May-July 2018 prompting an investigation by IP. Review of the 9 CLABSIs attributed to the CCU from May 2018 – June 2019 led IP to prioritize improving PAC insertion practices in our cardiac catheterization lab as a mean to reducing CLABSI (see table 1). Methods IP performed 5 observations of PAC insertion in the cath lab. During the observations of skin preparation, the prep time was performed correctly 40% of the time, correct application 60% of the time and dry time 60% of the time (see table 2, Figure1). Interventions included scheduling a training day for all cath lab staff with the skin prep vendor, performing competency check-offs, and identifying super-users to train future staff. Furthermore, skin antiseptic utilization according the manufacturer's instructions for use was implemented, the coverage area for the applicator was reviewed and a chart for reference was provided.The staff was provided with posters on correct skin prep technique as a visual cue in the procedure room. Results Since the project was implemented in September 2019, there has been 1 CLABSI identified that was possibly related to a PAC inserted in the cath lab. During this time 3 CLABSIs were identified in the CCU but were felt to be unrelated to cath lab insertion. Conclusion Since the project was implemented in September 2019, there has been 1 CLABSI identified that was possibly related to a PAC inserted in the cath lab. During this time 3 CLABSIs were identified in the CCU but were felt to be unrelated to cath lab insertion. Disclosures All Authors: No reported disclosures
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofab466.973
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2021
    detail.hit.zdb_id: 2757767-3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...