HAIs

The neonatal intensive care unit (NICU) at MedStar Washington Hospital Center reached a remarkable safety milestone on July 31 -- three years with zero central line-associated bloodstream infections (CLABSIs) in its tiniest and most vulnerable babies. While three years CLABSI-free is extraordinary for any intensive care unit, what makes this accomplishment so remarkable is that these babies “are so small and fragile it makes it easier for infection to spread,” says Zacharia Cherian, MD, chairman of neonatology at MedStar Washington Hospital Center. “In addition, their immune systems are still immature, so fighting off infection is much more difficult than for a healthy baby.”

An upset in the body's natural balance of gut bacteria that may lead to life-threatening bloodstream infections can be reversed by enhancing a specific immune defense response, UT Southwestern Medical Center researchers have found. In the study, published online in Nature Medicine, scientists identified how a certain transcription factor -- a protein that that turns genes on and off -- works in partnership with a naturally occurring antibiotic to kill infection-causing fungi called Candida albicans.

If you have ever watched a fibrin sheath progress to a thrombus on the surface of a catheter -- a process that initiates instantly upon entry into the bloodstream and proceeds quickly, often in just minutes -- you will understand why the presence of contaminating bacteria on the surface of a catheter is something to be rigorously avoided. The rapidly forming fibrin sheath encases such surface bacteria, both shielding them and facilitating biofilm formation.

Slips, trips, falls and sharps are widely recognized as potential occupational risks in the healthcare industry.  However, there is another dangerous hazard that often goes unnoticed and underreported-splashes.

A UC Irvine research team will receive up to $5 million to further develop a bloodstream infection detection system that speeds up diagnosis times with unprecedented accuracy – allowing physicians to treat patients with potentially deadly ailments more promptly and effectively. The five-year federal award is part of a National Institute of Allergy & Infectious Diseases program to fund nine institutions that will create tools to identify certain pathogens that frequently cause infections in healthcare settings – especially those that are resistant to most antimicrobials.

Sometimes the most commonly used tools for stopping infections are not quite enough to combat the ongoing struggle against hospital-acquired infections. As outlined in the recent Consumer Reports article, “Deadly hospital infections are still too common,” prevention measures such as hand hygiene, wound care and limiting use of central lines and urinary catheters are hugely important. But infection control can and should go far beyond these steps. One million Americans suffer from hospital-acquired infections each year – with a mortality rate of 100,000 per year and a price tag many times that, healthcare facilities must take advantage of every available tool to control and reduce the spread of disease.

This is a story about nursing education – both academic and clinical. It’s a powerful example of how one can impact the other, and how both can lead to a new evidence-based best practice that benefits patients and their providers. It’s also about nursing compassion, and a willingness to change a culture in order to prevent patient suffering.