HAIs

This is a story about nursing education – both academic and clinical. It’s a powerful example of how one can impact the other, and how both can lead to a new evidence-based best practice that benefits patients and their providers. It’s also about nursing compassion, and a willingness to change a culture in order to prevent patient suffering.

Two approaches to infection prevention that are being used in hospitals today bear continued scrutiny as multidrug-resistant organisms proliferate, emphasize experts writing in a recent commentary in the journal Infection Control and Hospital Epidemiology. Edward Septimus, MD, of the Texas A&M Health Science Center College of Medicine in Houston, Texas, and of Hospital Corporation of America in Nashville, Tenn. and his co-authors urge clinicians to carefully consider the clinical advantages and cost-related disadvantages to each strategy.

As many of you know, recent studies have shown that infection rates are lower than previously estimated. The “Multistate Point-Prevalence Survey of Health Care-Associated Infections” published in the March 27 edition of the New England Journal of Medicine (NEJM) found that on any given day, 1 in 25 inpatients in the U.S. have at least one healthcare-associated infection (HAI). In addition, about 75,000 patients who have an HAI will die during hospitalization. While the current estimates of infections are lower than previous estimates, it is hard to draw direct conclusions from these comparisons because of the differences in patient populations studied, changes in surveillance definitions of HAIs, and varied data collection methods.  However, what is clear is that there is still much work to be done.

The Centers for Disease Control and Prevention (CDC)'s Checklist for Prevention of Central Line Associated Blood Stream Infections (CLABSI) lists as its No. 1 task for clinicians: Perform daily audits as to whether each central line is still needed. However, if the daily audit is not done with a clear and current knowledge of what constitutes a valid indication for central venous access, and if that knowledge is not acted on promptly, what’s the point?