Susan Jain RN, who is now the Infection Prevention and Control Clinical Nurse Consultant at Prince of Wales hospital, highlighted the impacts of HAI and MDRO on the hospital and the importance of hand hygiene at the 4th annual infection prevention and control conference 2017.
Below are Susan’s Findings:
HAI’s and its impacts:
In Australia 200,000 patients suffer from HAIs that prolong hospital stay using 2 million additional bed days annually (ACSQH, 2012).
One additional bed day = $1659 (2013-14 Australian Public Hospitals Cost Report)
Costs related to HAI impacts in hospitals are:
- Staph Aureus Bacteraemia (SAB)= $22,000
- Vancomycin Resistant Enterococci (VRE) infection= $17,287
- MDR Gram Negative infection= $13,027
- Superficial SSI (cardiac)= $12,419
- Deep SSI (cardiac)= $31,579
- Joint Replacement SSI= $40,940
Emerging Threats and Challenges in Healthcare:
● Antibiotic/Antimicrobial Resistance
● Management of MDROs- isolation/additional precautions
● Surveillance and Reporting
● Hand Hygiene
● Cleaning of shared equipment and environmental cleaning
● Education and Research
Susan found that MDRO Transmission in Healthcare Patients can acquire a new microorganism in three ways:
- Directly through contact with other patients (an uncommon occurrence in the hospitals)
- By means of intermediary – e.g. HCWs hands
- Through environment or shared equipment such as toilet seats/commodes, sinks, stethoscopes etc.
What do we need to do?
1. Hand Hygiene:
● Perform hand hygiene
● Donning gloves and gown upon entry to the patient-care area
● Ensure that clothing and skin do not contact potentially contaminated environmental
● Remove gown and gloves and perform hand hygiene before
● leaving the patient-care area.
2. Take transmission based Precautions
3. Source Isolation
4. Personal Protective Equipment
5. Environmental Cleaning
6. Antimicrobial Stewardship
Controlling MDROs-What works?
● Larson (2000) – increased handwashing associated 85% risk reduction of VRE infection
● Pittet (2000)- increased hand disinfection compliance 48% to 66% (P <0 .001) over a
3-year period associated with decrease in the HAI prevalence 16.9% to 9.9% (P =0.04)
Don’t miss the case study on “Approaches to the detection, investigation & management of patients with Candida Auris, CPE & other emerging MRO’s“By Paul Griffin Director of Infectious Disease, Mater Health Services at the Infection Prevention & Control Conference Tuesday 9th April 2019, in Melbourne.