|
From MRSA to H1N1, strains of tiny organisms are putting an ever-increasing strain on healthcare organizations, contributing to both human and financial costs and elevating the complexity of infection control. The high stakes and small margins for error associated with healthcare-acquired infections mean many facilities are augmenting their infection control programs with technology that can help keep the daunting task manageable - and to ensure nurses' efforts are successful. 
"The literature is full of data about the cost of healthcare-associated infections, and it's not insignificant," explained Marsha Barnden, MSN, RN-BC, director of standards and infection control for Adventist Health, Roseville. "Now there's mandatory reporting. We have a hospital-acquired condition list the federal government requires us, as a healthcare organization, to report. If certain infections are healthcare-associated, [the Centers for Medicare & Medicaid Services] is not going to reimburse for those, so that's a big deal."
With public access to information about facilities' performance, infection control is crucial to a hospital's success and reputation, as well as to patient and staff safety - perhaps more than ever.
"There's so much more quality reporting going on," Barnden confirmed. "Folks can choose their hospital based on its quality and safety data; they can go on the Internet and pull up a hospital and find out what [its] infection rates are. So, we're educating our nurses that the quality of care they're providing is publicly reported - we're raising that awareness."
It's a situation that demands hospitals not only pay attention, but also be proactive about implementing improvements.
"There are no low-risk patients anymore," Barnden continued. "There are high-risk patients, certainly, but everyone is at risk for infection when they come into the hospital."
Seeking Solutions
"Handwashing reigns," Barnden said, simply. And, indeed, at the crux of any effort to control the spread of infectious disease lies this low-tech practice.
Yet, for Adventist Health, a 17-facility system with more than 2,600 beds, approximately 17,500 employees and numerous clinics, outpatient facilities and hospitals throughout California, Hawaii, Oregon and Washington, best practices are now being augmented with a new computer technology.
The Web-based software program aids surveillance efforts systemwide, in turn supporting individual patient infection control measures at the bedside.
Implementation of surveillance software piloted at Sonora Regional Medical Center, Sonora, last October is nearly complete throughout the Adventist system, Barnden said, with the final facility, in Portland, OR, to be brought online in September. With the new program, streamlining surveillance throughout each hospital is a boon for patient safety. By monitoring lab culture results and generating alerts with each positive culture, the program keeps key personnel - infection control practitioners, pharmacists and the affected units' nurses - apprised of results that require swift action. The real-time data, flagging positive culture results and antibiotic/organism mismatches, allows early identification of patients requiring prompt intervention, e.g., isolation, contact precautions and antibiotic administration. The system facilitates timely and proper prevention and control best practices, protecting the safety of patients, staff and visitors. In addition, the program's "drug/bug mismatch" alert ensures appropriate antibiotic selection and use.
A major benefit, Barnden noted, is time savings for infection control practitioners due to the ease of reporting the system provides. The systems' efficiency in providing specific reports to the infection control team means a streamlined workflow - and more time out on the units with bedside nurses supporting the training and education that improves patient outcomes.
Big Picture
Barnden explained the flexible surveillance program allows each facility to tailor reports and alerts to its needs based on the population served and organisms commonly seen in each community. But by implementing the program in each of Adventist's facilities, the system also gains the consistency in reporting, enabling highly efficient evaluation of trends.
|