This article will appear in the upcoming July-August print issue of Surgical Products.

Surgical Products recently spoke with Linda Homan, RN, BSN, CIC, Senior Manager, Clinical and Professional Service, Ecolab Healthcare, to talk about the medical community's efforts to prevent healthcare-associated infections.

SP: Why are healthcare-associated infections such a significant and costly problem for hospitals today?

Homan: Pathogens such as Clostridium difficile, MRSA, and VRE can survive in the environment for extended periods of time and can be very difficult to eliminate. If surfaces are not cleaned and disinfected appropriately, these pathogens can be passed on to patients and hospital staff and cause significant health complications. In addition, by their nature, hospitals are constantly exposed to pathogens from incoming patients, which makes infection prevention a constant battle. Hospitals are getting more aggressive with programs to prevent infections for multiple reasons ranging from increased quality reporting requirements to reimbursement changes, which incent better care and fewer readmissions.

SP: Is this a problem on the rise or on the decline? Why?

Homan: Infection prevention requires constant vigilance. A recent CDC report on the prevalence of HAIs shows a moderate decrease in the prevalence of central-line associated bloodstream infections and surgical-site infections. It’s interesting to note that 52 percent of the reported HAIs were not in patients with indwelling devices or who had undergone operative procedures, which means there is still work to do to decrease the spread of dangerous pathogens among this subset of patients. Fundamental infection prevention measures, such as hand hygiene and environmental hygiene, when implemented in a programmatic and measureable way, can help prevent HAIs.

SP: In what ways have facilities attempted to protect their patients from these infections?

Homan: In addition to targeted interventions aimed at specific pathogens and types of infections, diligent hand hygiene compliance and thorough environmental hygiene practices are two fundamental lines of defense that hospitals can use to protect patients from these dangerous pathogens. Many are also employing multiple approaches that include process, products, and measurement to achieve and sustain lower infection rates.

SP: Why haven't these measures (in many cases) had the desired effect?

Homan: Infection prevention measures are hard to sustain and require constant refreshing in order to keep people engaged. It’s important to implement programs that are sustainable through training and positive reinforcement and that also fit into an organization’s culture. We have heard from hospitals that some of the challenges they face in sustaining infection prevention programs include staff turnover, difficulty standardizing processes across departments, and unclear roles among clinical and EVS staff. Also, some hospitals don’t measure and track their performance to know where they could improve, which is a missed opportunity.

SP: What is it going to take for facilities to be able to get better results?

Homan: Often a “back to basics” approach that focuses on the things we know work, like better hand hygiene and environmental cleaning, is a good first line of defense to prevent HAIs. Monitoring and measuring these can help hospitals understand their hand hygiene compliance and environmental cleaning performance and identify where there is opportunity to improve. Once hospitals identify which areas need more attention, they can implement training and education, standardized processes, and use the right products and tools to support better infection prevention.

SP: What technology or products can they invest in to make that happen?

Homan: Every hospital has a unique set of requirements for infection prevention, so there’s no perfect shopping list that will work across the board. Using the right products and tools can go a long way. Such products could include environmental monitoring programs. In addition, broad spectrum, multi-use products clean and disinfect hard surfaces in a variety of areas within operating rooms, patient rooms, and common areas to help hospitals reduce the risk of infections from C. difficile and other dangerous pathogens.

SP: How do you see HAI prevention evolving with time? What does the future hold for hospital facilities trying to deal with this problem?

Homan: The major trends impacting HAIs, such as new MDROs, ongoing financial penalties, and public reporting, are unlikely to change, meaning hospitals will have more reason to focus on prevention. To help solve this we expect to see hospitals trying new combinations of interventions, such as innovative cleaning products and processes, objective monitoring, and training and education programs, to cover all bases.

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