OPERATING ROOM “As part of our longstanding commit-
ment to quality and safety, Virginia Mason Medical Center has a multi-disciplinary effort focused on preventing HAIs, which can include surgical site infections. Our effort brings together leadership, clini- cians and non-clinicians and frontline staff to use evidence-based practices to prevent adverse events, such as central line-associated blood stream infection; catheter-induced urinary tract infection; hospital-onset C. diffi cile infection; colon surgery site infection; hospital-onset MRSA bacteremia; and abdominal hysterectomy surgical site infection,” she shared. “Also, we will continue to track our success through our comprehensive HAI surveil- lance methods and performance quality measures. This allows us to document our progress against internal and external benchmarks.”
Fighting antibiotic resistance Another emerging threat to patients con- tracting SSIs and HAIs is the medicine used to treat and protect them – antibiotics. They are growing less effective based on several factors. Noam Emanuel, Ph.D., Co-founder and Chief Scientific Officer, PolyPid, explains, “In addi- tion to breaking the skin’s natural defense against bacteria, surgery requires stopping blood fl ow and thus attenuates the recruit- ment of the body’s primary defense against infections
Noam Emanuel
via the immune system to the area being operated on. Blood flow remains inter- rupted for several days following surgery, until it fully resumes and reaches the inci- sional site, potentially exposing a patient to the rapid growth and the establishment of invasive bacteria. While antibiotics admin- istrated shortly prior to surgery would help patients stave off incoming bacteria, only a small fraction of systemically administered antibiotics reach the wound before being cleared through the kidneys and liver. These limitations can render systemically admin- istered antibiotics inadequate in preventing SSIs and therefore require localized admin- istration to eradicate any residual bacteria.” He continued, “Local antibiotic solutions often use either polymer- or lipid-based formulations. Over the years, neither polymer-based nor lipid-based solutions have individually provided anchored, localized drug delivery at customizable and prolonged release rates needed for healing in critical indications. The key is to fi nd the right formulation that combines the key elements of both solutions.”
Additionally, he explained, “Antibiotic resistance bacteria can be generated follow- ing the use of systemic administration of antibiotics, including systemic antibiotics that are given before surgery. COVID-19 has led to an upsurge in the use of antibiotics, further accelerating the development and the establishment of antibiotic resistance bacteria strains in hospitals and therefore raising much concern.”
Joining together to tackle the ongoing anti- biotic resistance crisis, “A coalition of orga- nizations representing clinicians, scientists, patients, public health professionals and animal agriculture experts as well as mem- bers of the pharmaceutical and diagnostics industries are asking congressional leaders to signifi cantly increase U.S. investments to combat the growing threat of infections resistant to existing antibiotics, and build arsenals of new infection-fi ghting drugs,” announced Infectious Diseases Society of America earlier this year.
The society added, “At least 35,000 lives
in the United States and 00,000 lives glob- ally are lost each year to infections that can’t be treated with available medicines. Drug-resistant infections, which sicken at least 2 million people in the U.S. each year, add at least $20 billion to American health care costs, the letters note, and as much as $1.2 billion globally. Modern medical advances that include cancer chemotherapy, transplantation, cesarian sections and other surgeries rely upon the availability of safe and effective antibiotics…The COVID-19 pandemic, leading to high levels of antibiotic use as well as increased exposure to resis- tant infections among hospitalized patients severely ill from the coronavirus, also has highlighted the critical importance of con- trolling antibiotic resistance and developing new antibiotics to be better prepared for future health threats.3
Striving to develop new drug treatments, “A clinical trial to test the antibiotic dalba- vancin for safety and effi cacy in treating complicated Staphylococcus aureus (S. aureus) bacteremia has begun. The trial will enroll 200 adults hospitalized with compli- cated S. aureus infection at approximately 20 trial sites around the United States. The trial is being sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health,”4
reported the National Institutes of Health recently.
The agency continued, “S. aureus is a lead- ing cause of antibiotic-resistant infection. S. aureus infections led to nearly 20,000 deaths in 201 in the United States, according to the U.S. Centers for Disease Control and Preven- tion (CDC). This bacterium is of particular concern in healthcare-associated infections.
16 June 2021 • HEALTHCARE PURCHASING NEWS •
hpnonline.com
S. aureus bacteremia—an infection of the blood — often requires inserting a central intravenous (IV) catheter to deliver long courses of antibiotics, an invasive procedure that can involve long-term care in healthcare facilities.”
Ensuring surgical safety What measures can staff take to support sterile equipment, rooms and patients’ bod- ies during procedures and care? Trinity Guardion’s Rippe commented, “The Joint Commission recently stated that staff must familiarize themselves with manufacturer’s instructions for use for all medical devices as it pertains to cleaning and disinfection as well as other required preventative maintenance. Mattresses are a semi-critical medical device and represent a signifi cant capital investment. All team members must acknowledge the risk associ- ated with a contaminated environment and recognize their unique role in preventing SSIs and HAIs as well as the impact that improper cleaning processes may have on the expected mattress life. Medical facilities must use the latest peer reviewed research and data to determine if current infection prevention measures are out of date and if new strategies should be employed. Facili- ties should also consider recommendations and guidelines provided by the FDA and CDC.” GP PRO’s Jungslager points to other practices staff can take, including, “estab- lishing hand hygiene compliance initiatives, antibiotic stewardship programs and other patient safety protocols that work together to improve patient outcomes. In addition, whether those patient outcome practices are in place or not, I believe that every health- care worker has a personal responsibility to follow hygiene and infection prevention best practices and guidelines as set forth by the Centers for Disease Control and Prevention.” In procedural and care areas, Goossen of Ansell Healthcare, adds, “The CDC recommends use of disposable patient-care equipment for preventing transmission of infectious agents.5
Disposable linens and
patient positioning straps are two areas where there is an ongoing shift to dispos- able products to help ensure the safest environment for patients and staff in the perioperative setting.”
Further strengthening infection control protocols is another tactic moving forward, advises Rea of PDI Healthcare. “The COVID-19 pandemic disrupted healthcare tremendously,” Rea stated. “This undoubtedly caused breakdowns in basic infection prevention practices. Now we are seeing some outcomes of these breakdowns,
Page 18
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66
