Pathogenic organisms are like international travelers with unrestricted passports; they can flourish everywhere — acute-care, ambulatory care and long-term care settings.
“As the boundaries between all segments of the continuum of care (inpatient, ambulatory, long term) continue to blur, the priorities for each are becoming more closely aligned,” says Sue Barnes, RN, BSN, CIC, national leader of infection prevention and control/patient safety at Kaiser Permanente. “For this year, I would say that the most problematic pathogen is Clostridium difficile, due to the increasing virulence, incidence and associated morbidity and mortality. This pathogen is directly related to antibiotic use and contaminated environmental surfaces which are present in all three care settings.”
Barnes says there are several urgent infection prevention-related issues at work in these three care settings; the first is adequate resourcing for infection prevention in all segments of the care continuum, especially this year with the new burden of mandatory reporting of infection rates. “Although this will help the drive to zero infections eventually, in the short term is only serving to divert already constrained infection control staff from infection prevention activities, in order to create reports,” Barnes says. The second is environmental cleaning and disinfection, specifically supporting reducing Clostridium difficile infection transmission. The third is finding a way to automate infection surveillance, which is directly related to the aforementioned lack of staffing and resources.
Barnes says that no matter the care setting, there are several critical best practices relating to infection prevention that are appropriate: hand hygiene and appropriate glove use; environmental cleaning and disinfection; and respiratory etiquette (covering your cough with mask, tissue and cleaning hands frequently).
We take a look at infection prevention issues in outpatient care and long-term care facilities.
