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It may seem intuitive, even obvious to experienced ICPs, but acquiring an infection during hospitalization is about as bad as it gets for a patient. Even patients with a host of maladies that compromise their recovery fared significantly better in outcomes than patients who acquired infections.
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Having worked with a "physician champion" and greatly lowered infection rates by adopting an industrial process model, an infection control professional has joined the chorus that say infections are not an inevitable byproduct of medical care.
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Empowering nurses and other clinicians to speak up when they perceive a patient safety problem may be the most important component of emerging new programs designed to drive infection rates to zero, emphasizes Sara Cosgrove, MD, hospital epidemiologist at John Hopkins in Baltimore.
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Sandiumenge and colleagues evaluated the effects of three strategies of antibiotic prescribing in a 14-bed ICU. The strategies were applied serially, beginning with an initial 10-month period during which patients with suspected ventilator-associated pneumonia received "patient-specific therapy" in which multiple antibiotic regimens, chosen on the basis of length-of-stay and recent antibiotic exposure, were used.
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Infection control practices and other "hospital factors" specific to individual institutions appear to be a greater influence on infection risk than a patient's severity of illness, researchers found.
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The program developed at Johns Hopkins University Hospital in Baltimore that pushed catheter-related bloodstream infection rates to zero in some intensive care units is based on the following four overriding principles. Sara Cosgrove, MD, hospital epidemiologist, comments on each one as follows:
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Clostridium difficile diarrhea and colitis have now emerged as common nosocomial infections in hospitals throughout the developed world. Alarmingly, recent epidemiological studies in ambulatory settings have documented C. difficile infection in both adults and children who lack the usual risk factors of prior antibiotic use or hospitalization.
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Given its lack of benefit, possible harms, and expense, magnesium sulfate should not be used for tocolysis.
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RFA should be considered a first-line therapy even after the first episode of symptomatic AFL. There is a better long-term success rate, the same risk of subsequent AF, and fewer secondary effects.
