By ROB W. ANDERSON
Infection control at health care facilities is a priority, as one out of every 20 hospital patients will acquire an infection during their stay.
Tens of thousands of patients die every year as a result of hospital-born infections, and many public health facilities combat the problem with new-patient screening measures and other infection-control practices.
A study published in May in the New England Journal of Medicine of more than 70,000 ICU patients housed in more than 40 U.S. hospitals suggests decontaminating every patient receiving intensive care will reduce bloodstream infections like MRSA, or methicillin-resistant staphylococcus aureus. Patients were randomly assigned one of three treatments: MRSA screening and isolation; screening, isolation and decontamination of MRSA carriers only; and universal decontamination without screening.
All patients admitted to the Intensive Care Unit at W.W. Hastings Hospital are given a bath with a chlorhexidene wipe as part the screening process, said W.W. Hastings Infection Preventionist Jennifer Tredway.
“These wipes kill a broad spectrum of microorganisms and leaves a residual that inhibits their growth. We have further instituted a program ensuring mouth care and oral decontamination occurs,” she said. “Providing proper oral care for intubated or unconscious patients is essential in decreasing their risk of ventilator-associated pneumonia. We have accomplished decreasing bacterial colonization of the oropharangeal area by utilizing a CHG oral care kit.”
Patients targeted in the study were ICU patients who were older, sicker, weaker and more likely to become infected with dangerous bacteria, like the drug-resistant staph germ MRSA. The decontamination method included a five-day approach of providing ICU patients with a nose swab twice a day with bacteria-fighting ointment, as well as a once-a-day bath with antiseptic wipes. According to the researchers, the method made patients 40 percent less likely to acquire a bloodstream infection compared to patients who had been screened and isolated for MRSA.
Patients admitted to the Tahlequah City Hospital ICU receive a nasal swab to screen for MRSA colonization, said TCH Infection Control Officer Cheri Oglesbee.
“At TCH, the safety of every single patient and the success of their treatment is our top priority. Many in the community could have MRSA in their nose or on their skin and not know it [and] we do this simple swab to find out if it’s there. If the nasal culture is positive for MSRA, we offer decolonization,” she said.
For patients who are going to have a surgery like an open heart or total joint replacement, TCH surgeons will conduct the MRSA test a week or so before the scheduled procedure to allow time for decolonization, said Oglesbee.
“Decolonization takes five days. TCH follows the CDC recommendations for decolonization,” she said. “This includes putting antibiotic cream in the nose twice a day and bathing with chlorhexadine soap daily for five days.”
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