Sunday, October 8, 2017
Infection Control
Infection Control is a huge concern in hospitals that must be taken into account. I had the opportunity to see the infection control protocol for an emergency depart at a local hospital in New Hampshire. This opportunity really opened my eyes to how important managing the spread of infectious disease in hospitals and health care settings really is. Hospitals are one of the most dangerous places because there are so many sick people around. I looked at a protocol specifically for the spread of Ebola for this hospital. There were multiple different guidelines for each different department. For example, there were different guidelines for the ED walk in, coagulation clinic, obstetrical department, offsite locations, and outpatient walk in. With each different guideline there is another layer of details and steps that must be followed when a patient presents with the disease. It was interesting to see that with Ebola, a patient can be more or less severe and this is determined by the patient's symptoms. These protocols range from initial screening questions to treating a patient who is showing symptoms and has been infected. I never thought about how much work goes into these protocols in case there is an outbreak. Infection control is a very important aspect of managing hospitals that looks out for the patient's overall health and is essential to keeping a well managed and healthy organization. There are many different pieces that come together to make a well managed health care organization run successfully and I believe it is important to have different people focus on each different area to specialize and act as a liaison. I have found that education in different departments with a special focus on things like infection control is paramount to the success of a healthy organization.
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Nosocomial infections can be a hospital's Achilles heel. All it takes is one worker (whether bedside clinician, housekeeping, dietary, biomedical repair, etc.) not paying scrupulous attention to vector control practices and suddenly you have a nightmare on your hands. Bacteria are sneaky and quite adept at developing resistance to antibiotics. MRSA (Methcillin-resistant staphylococcus aureus) can turn an otherwise pesky skin boil into a life-threatening issue. "C. Diff" (clostridium difficile) is an especially hardy bacteria, quite difficult to control in susceptible patients.
ReplyDeleteAnd Medicare is now reducing reimbursement to hospital with poor infection control results. See:
http://www.npr.org/sections/health-shots/2016/12/22/506489368/medicare-penalizes-hospitals-in-crackdown-on-antibiotic-resistant-infections
The on-going management challenge is keeping all workers educated and motivated to constantly employ ALL infection control practices, and to not "just go through the motions."
One more acronym you hopefully never witness in a patient: "VRE" which is vancomycin resistant enterococcus. Vanco is considered the "last line of defense."
ReplyDeleteHi Kayli,
ReplyDeleteI find the area of nosocomial infections to be very interesting. I recently wrote a law research paper on the topic for one of my courses last semester. If you use google scholar, you can actually read about real cases where patients have tried to sue for these. One of the major takeaways from my research is that it is nearly impossible to sue for a hospital acquired infection because infections are basically considered inevitable and it is difficult to prove without a doubt that a person's particular actions caused the infection.
Inefficient handwashing is a major cause of many hospital-acquired infections, which is why it is so important for hospitals to take these initiatives seriously and enforce them amongst staff. It has even been suggested that Medicare offer incentives to programs based upon the effectiveness of their infection control programs, because often it takes financial incentives to really implement major change.
To your comment about Ebola prep - I work in the ED at BCH, and we actually have an entire room that is considered the "Ebola room." It has it's own airflow and bathroom, and everything in the room is designed to be burned if necessary. This was created a few years ago when the threat of the Ebola crisis was very real. One very important aspect of our protocol was that we had designated staff throughout the hospital, NOT just ED staff, so that if a patient needs significant care it would not deplete an entire department of its staff, thereby leaving it vulnerable.
Your ebola room is fascinating - makes sense for a big city hospital to have.
DeletePatient protocols! Just like we read about!
ReplyDelete