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Article Title

Interventions to Reduce Hospital-Associated Infections: Comparative Efforts at One HMORN Site and a Local Veterans Affairs Facility

Publication Date

4-30-2015

Keywords

hospital-associated infections, novel technology, implementation

Abstract

Background/Aims: Health care-associated infections (HAI) affect 1.7 million patients and cause 100,000 deaths annually, yet preventive strategies are only partially effective. HAI are often transmitted between health care workers and patients; the sharp increase of antibiotic-resistant organisms compounds the problem. Fortunately, numerous efforts to reduce HAI incidence are being adopted, targeting clinical and environmental cleaning polices. We document current infectious disease work by investigators uniquely positioned within Scott & White and nearby Central Texas VA. Our involvement in several disinfection strategies and research protocols utilizes evidence-based findings to transform patient care while reducing unnecessary treatment costs.

Methods: Besides aggressive hand-washing and antibiotic stewardship programs at both institutions, ongoing VA initiatives focus on novel pulsed-xenon ultraviolet ray (UV) technologies to eliminate patient room pathogens. Supported by laboratory experiments, this ongoing project examines the clinical efficacy and cost-effectiveness of portable UV devices, gauging implementation challenges. Other decontamination or preventive efforts include air disinfection in operating suites to target surgical site infections (Scott & White), and copper-infused room surfaces to thwart microbial build-up in high-touch areas (VA). A new veterinary medicine partnership is exploring MRSA transmission via animal contact, a major facet of rural Central Texas life.

Results: Research and quality improvement findings highlight potential barriers in bridging technological advances and health care delivery realties, yet are quite promising. We found a 99.4% reduction in MRSA microbial counts with evidence of HAI declines where UV devices are routinely deployed; other tests suggest these machines work even absent manual cleaning and without bacteria developing resistance. Carbapenemase-resistant infections dropped 75% with higher overall treatment response since Scott & White initiated better HAI screening, selective antibiotic combination therapies (e.g. minocycline plus amikacin) and other infection control precautions.

Discussion: Pragmatic clinical efforts paired with insightful research simultaneously tackle universal health care system concerns, as HAI perniciously evolve with containment strategies. However, mounting evidence provides optimism, encouraging future collaborative endeavors. Our work demonstrates a crucial need to involve multiple stakeholders (clinical leadership, housekeeping, researchers) spurring practical hygiene programs, educational training and creative advances to combat HAI. Future efforts will spotlight implementation and translational progress as we continue pursuing effective models across multiple health systems.

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