A threat to patient safety could be lurking right near the bedside, according to a recent study in the American Journal of Infection Control, published by the Association for Professionals in Infection Control and Epidemiology.
The study found privacy curtains can be breeding grounds for resistant bacteria such as MRSA, an APIC news release stated. Researchers looked at the contamination rate of 10 freshly laundered privacy curtains in the Regional Burns/Plastics Unit of the Health Services Center in Winnipeg, Canada.
Alarmingly, they discovered the curtains hung in patient rooms increasingly became contaminated over the 21-day period, with 87.5% of the curtains testing positive for methicillin-resistant Staphylococcus aureus by day 14, according to the study. The pathogen is associated with significant morbidity and mortality.
The curtains had minimal contamination when they were first hung. Control curtains that were not placed in patient rooms stayed clean the entire 21 days, the news release said.
“We know that privacy curtains pose a high risk for cross-contamination because they are frequently touched but infrequently changed,” Kevin Shek, BSc, the study’s lead author in the article said in the APIC news release. “The high rate of contamination that we saw by the 14th day may represent an opportune time to intervene, either by cleaning or replacing the curtains.”
None of the rooms where the curtains were hung were occupied by patients with MRSA, according to the release. Samples were taken from areas where people hold curtains, which indicated the contamination was happening through direct contact.
“Keeping the patient’s environment clean is a critical component in preventing healthcare-associated infections,” 2018 APIC President Janet Haas, PhD, RN, CIC, FSHEA, FAPIC, said in the release.“Because privacy curtains could be a mode of disease transmission, maintaining a schedule of regular cleaning offers another potential way to protect patients from harm while they are in our care.”
The problem is bigger than curtains
It’s not just on curtains that researchers have discovered lingering germs. A study conducted in the United Kingdom and published Oct. 18 in Infection Control & Hospital Epidemiology found even washing hospital bed sheets at high temperatures in commercial washers with commercial detergent failed to remove all traces of Clostridium difficile, a bacteria that causes infectious diarrhea.
“The findings of this study may explain some sporadic outbreaks of C. difficile infections in hospitals from unknown sources, however, further research is required in order to establish the true burden of hospital bed sheets in such outbreaks,” Katie Laird, PhD, head of the Infectious Disease Research Group, School of Pharmacy, De Montfort University, Leicester, United Kingdom, and lead author of the study, said in a news release. “Future research will assess the parameters required to remove C. difficile spores from textiles during the laundry process.”
Researchers in the C. difficile study found not only did contaminated swatches used for the study retain germs, bacteria from contaminated linens also was transferred to non-contaminated linens.
After one organization — Providence St. Peter Hospital in Olympia, Wash. — saw an increase in healthcare-associated infection rates, curtains were identified as the culprit, according to an Oct. 11 article in Becker’s Hospital Review.
Employees did not have enough time to change curtains because immediately following discharge and cleaning, another patient was admitted. The hospital began using a method to allow employees to change curtains within seconds, the article said.
When HAI rates increased again, the hospital turned to an ultraviolet light cleaning system as part of its standard cleaning protocol.
“With infection prevention, there is no smoking gun,” Angie Dickson, manager of quality and infection prevention for Providence St. Peter said in the Becker’s article. “It takes a different pronged approach to infection prevention, and tapping into technology is one of those key prongs that we felt we needed to get to zero patient harm.”
Takes these courses on infection control!
MRSA: More Work to be Done
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Methicillin resistant Staphylococcus aureus is an important pathogen in healthcare facilities and the community and is asymptomatically carried by people who are healthy, have chronic diseases, are hospitalized, or are in long-term care facilities. It also can cause serious infections, including bloodstream infections, pneumonia, wound infections, skin and soft tissue infections, urinary tract infections, and meningitis. MRSA has been associated with higher rates of serious infection and mortality in some studies. All healthcare team members must play an active role in adopting, modeling, and encouraging practices to prevent the spread of MRSA in healthcare facilities. These include consistently performing hand hygiene, using contact precautions for patients with MRSA, and ensuring appropriately disinfected equipment.This module discusses hospital and community acquired MRSA infections, the history of MRSA, transmission, treatment, and prevention methods.
C. Difficile Threatens Hospitalized Patients
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Clostridium difficile, a gram-positive, anaerobic, spore-forming bacteria, is the major cause of nosocomial diarrhea. The organism is clearly infectious and is transmitted via the fecal-oral route. The number of cases of nosocomial C. difficile, as well as the proportion of cases with severe and fatal complications, has been increasing in hospitals. The Centers for Disease Control and Prevention reports 250,000 infections per year with 14,000 deaths. It is estimated that C. difficile creates an excess of at least $1 billion to $4.9 billion in medical costs per year. Healthcare professionals play a vital role in preventing transmission of this pathogen to our patients when we pay careful attention to infection-control measures and ensure that everyone in contact with infected patients follows contact (barrier) precautions.
Antimicrobial Resistance and Healthcare Acquired Infections
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Rising trends in antimicrobial resistance is a costly and significant contributor to negative health consequences in the United States and worldwide. The Center for Medicare and Medicaid Services (CMS) recognizes this impact and will now penalize hospitals with high rates of acquired Methicillin-resistant S. aureus (MRSA) and C. difficile infections in an effort to promote proper antimicrobial stewardship and infection control policies. With proper education, development and use of effective protocols, and close monitoring, the interprofessional care team can have a substantial impact on improving patient outcomes and reducing healthcare costs.
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