Monday Medical: Preventing infections a team effort
August 30, 2010
We're all in it together.
That's the infection-prevention message that Yampa Valley Medical Center is sharing with employees, physicians, patients and visitors.
Hospitals across the country are faced with the difficult challenge of preventing infections. YVMC has designed a coordinated program to protect everyone who comes into our hospital, including patients, health care workers and the public.
"Patient safety is the goal and responsibility of everyone who works at YVMC," Infection Prevention Coordinator Steve Hilley said. "The No. 1 defense against infection is intensive hand washing. We teach hand hygiene, emphasize it through constant reminders and track compliance monthly."
YVMC pays special attention to surgical patients.
"Preventing surgical-site infections begins well before the patient comes into the hospital," said Judy Zuccone, YVMC chief quality and compliance officer.
"Patients can reduce the risk of developing an infection by being in the best possible health prior to surgery."
Smoking, excessive drinking, obesity, and a history of infection or chronic illness decrease the body's ability to fight infection.
YVMC encourages every surgical patient to meet with a pre-operative nurse to establish a medical history. Tests may be ordered to determine if any medical intervention is needed before surgery.
"Following national guidelines, certain high-risk patients and those who are planning joint replacement or spine surgery are screened within the week before surgery to determine whether they are 'colonized' or carrying methycillin-resistant staph aureus, or MRSA," Zuccone said.
Resistant to many antibiotic medications, MRSA bacteria reside in the nose or on the skin of some people and can enter the skin through a cut or surgical incision.
If MRSA test results are positive, YVMC surgical patients are pre-medicated with antibiotic drugs to help minimize the risk of infection.
Inpatients who remain hospitalized after surgery are closely monitored for signs of infection. YVMC asks family members and friends who are ill to refrain from visiting.
Efforts to prevent an infection must continue at home, Hilley said. Patients are strongly advised to take precautions against infection throughout the recovery process, which could be weeks to months after surgery.
It is essential that patients avoid contact with those who are sick or who have skin infections. Hand washing and keeping the wound and/or dressing clean is of the utmost importance.
"Don't overdo your physical activity, avoid hot tubs, eat nutritiously, take all medications as ordered and be very careful when changing bandages," YVMC Chief Medical Officer Larry Bookman said.
"These precautions should be maintained throughout the recovery process, which may be several weeks or even months, depending on the type of surgery," he added. "Any sign of infection — swelling, redness or drainage from the wound — should be reported to the surgeon immediately."
"Unfortunately, despite our best efforts, infections can still occur," Zuccone said. "This is why, during the pre-operative consent process, your surgeon will always discuss the risk of infection."
When even the best precautions and healthiest habits are not enough to prevent a health-care-associated infection, Hilley investigates to find the cause.
"We look at the surgery preparation, staff members, surgeons, length of surgery, sterile processing of instruments, which operating room was used and our compliance with standards," he said.
YVMC complies with regulations from state and local health departments, the Occupational Safety and Health Administration, the Centers for Medicare and Medicaid Services and The Joint Commission, Hilley said. The hospital also follows evidence-based practices from leading authorities, including the Centers for Disease Control and Prevention.
Essential elements to prevent health-care-associated infections, including central-line bloodstream infections, include:
■ Rigorous hand hygiene practices that ensure health care providers clean their hands before and after providing patient care and after having contact with the patient's environment
■ Asking everyone, including patients and visitors, to practice good hand hygiene
■ Use of barrier precautions, such as gloves, gowns, masks and caps, by health care workers and visitors
■ Separating patients with serious infections from other patients to prevent the transmission of infection
■ Proper disinfection of the patient's skin before medical and surgical procedures
■ Environmental cleaning and decontamination of equipment, especially frequently touched items such as bedrails and bedside equipment
Any patient who has concerns or questions about an infection after surgery is encouraged to call his or her physician. Hilley also is available at 970-871-2430.
Christine McKelvie is public relations director at Yampa Valley Medical Center. She can be reached at firstname.lastname@example.org.