AJIC: American Journal of Infection Control

Martin S. Favero, PhD

Syed A. Sattar, William A. Rutala — 2010-06-01

It is an honor to recognize the outstanding career of Dr Martin S. Favero and to salute his remarkable and sustained contributions to infection prevention for more than 4 decades. We have known Dr Favero for more than 20 years, and have had the distinct privilege to work with him as a lecturer, researcher, and infection preventionist. As a result of Martin's leadership, research, and teaching at the US Centers for Disease Control and Prevention (CDC), the discipline of infection control flourished. All infection control professionals have benefited immensely from Martin's developmental work—indeed, as has the world itself. Martin's expertise in environmental microbiology, dialysis-associated infections, viral hepatitis, sterilization and disinfection, and health care-associated infections has resulted in more than 230 publications and invited speaker engagements at more 300 seminars, including 80 international symposia and scientific meetings.

Notes from the Decennial

2010-06-01

This March, 3100 clinicians, practitioners, and researchers gathered in Atlanta to attend the Fifth Decennial, more properly known as the International Conference Healthcare-Associated Infections 2010. The conference, held every 10 years, aims to set the agenda for research and practice in health care-associated infections for the succeeding decade.

Environmental culturing for Legionella: Can we build a better mouse trap?

Janet E. Stout, Victor L. Yu — 2010-06-01

The drinking water of hospitals has been directly linked to the occurrence of hospital-acquired legionellosis. In addition, the mode of transmission is now known to be primarily aspiration rather than aerosolization. Legionellosis is now recognized as a patient safety concern for nosocomial infection. In 2009, Centers for Medicaid and Medicare Services raised the issue that hospitals might no longer be reimbursed for charges incurred when caring for patients with health care-associated legionellosis based on the argument that this infection is largely preventable. Unfortunately, opposition from the US Centers for Disease Control and Prevention (CDC) and other organizations prevented the measure from passing, but the issue will be revisited next year.

Effective environmental sampling strategies for monitoring Legionella spp contamination in hot water systems

2010-01-18

Background: The prevention and control of legionellosis in hospital settings involves environmental sampling, among other measures. The data yielded by sampling constitute an important means of risk assessment and provide a valid basis on which to plan remedial (cleansing and disinfection) and preventive (maintenance) interventions. This retrospective study had 2 objectives: (1) to evaluate the utility of biofilm sampling at distal sites and (2) to identify an efficient environmental sampling strategy.Methods: Samples of hot water and biofilm were collected between June 1999 and March 2008 from 41 hospitals in Italy's Piemonte region. We analyzed results of the samples (water and biofilm) taken from the same site and results of the water samples taken from the recirculation loop and water samples taken from the distal sites during the same sampling run.Results: Microbiological analysis was performed on 3910 pairs of samples (water/biofilm). In 81% of the pairs, the results were concordant; in 17% of the pairs, Legionella was isolated only from the water samples, and in only 2% of the pairs was Legionella isolated from the biofilm sample alone. Data from 299 sampling runs show that 79% (236) of results from the water samples taken from the recirculation loop and water samples taken from the distal sites during the same sampling run were concordant, and 21% (63) were discordant.Conclusions: Our findings suggest that hospitals could safely adopt a simpler (water sampling only without biofilm sampling) and more efficient (monitoring of the entire system through sampling of recirculation loop water) environmental sampling policy.

Significant impact of terminal room cleaning with bleach on reducing nosocomial Clostridium difficile

2010-02-02

Background: We were alerted to increased rates of Clostridium difficile-positive tests at all 3 hospitals in our health care system by MedMined Data Mining Surveillance Service, CareFusion (San Diego, CA). In response, an intervention of terminal room cleaning with dilute bleach was instituted to decrease the amount of C difficile environmental spore contamination from patients with C difficile infection (CDI).Methods: The intervention consisted of replacing quaternary ammonium compound as a room cleaning agent with dilute bleach to disinfect rooms of patients with CDI upon discharge. All surfaces, floor to ceiling were wiped with dilute bleach applied with towels to thoroughly wet the surfaces. Daily room cleaning remained unchanged. Patients remained on C difficile contact isolation precautions until discharge. To determine the effectiveness of this program, rates of nosocomial CDI for all 3 hospitals were determined using the MedMined Virtual Surveillance Interface for 10 months prior to and 2 years after the cleaning intervention. Statistical significance was determined using Poisson regression analysis.Results: There was a 48% reduction in the prevalence density of C difficile after the bleaching intervention (95% confidence interval: 36%-58%, P < .0001).Conclusion: The implementation of a thorough, all-surface terminal bleach cleaning program in the rooms of patients with CDI has made a sustained, significant impact on reducing the rate of nosocomial CDI in our health care system.

Inactivation of influenza A virus H1N1 by disinfection process

Eun Kyo Jeong, Jung Eun Bae, In Seop Kim — 2010-04-29

Background: Because any patient, health care worker, or visitor is capable of transmitting influenza to susceptible persons within hospitals, hospital-acquired influenza has been a clinical concern. Disinfection and cleaning of medical equipment, surgical instruments, and hospital environment are important measures to prevent transmission of influenza virus from hospitals to individuals. This study was conducted to evaluate the efficacy of disinfection processes, which can be easily operated at hospitals, in inactivating influenza A virus H1N1 (H1N1).Methods: The effects of 0.1 mol/L NaOH, 70% ethanol, 70% 1-propanol, solvent/detergent (S/D) using 0.3% tri (n-butyl)-phosphate and 1.0% Triton X-100, heat, and ethylene oxide (EO) treatments in inactivating H1N1 were determined. Inactivation of H1N1 was kinetically determined by the treatment of disinfectants to virus solution. Also, a surface test method, which involved drying an amount of virus on a surface and then applying the inactivation methods for 1 minute of contact time, was used to determine the virucidal activity.Results: H1N1 was completely inactivated to undetectable levels in 1 minute of 70% ethanol, 70% 1-propanol, and solvent/detergent treatments in the surface tests as well as in the suspension tests. H1N1 was completely inactivated in 1 minute of 0.1 mol/L NaOH treatment in the suspension tests and also effectively inactivated in the surface tests with the log reduction factor of 3.7. H1N1 was inactivated to undetectable levels within 5 minutes, 2.5 minutes, and 1 minute of heat treatment at 70, 80, and 90°C, respectively in the suspension tests. Also, H1N1 was completely inactivated by EO treatment in the surface tests.Conclusion: Common disinfectants, heat, and EO tested in this study were effective at inactivating H1N1. These results would be helpful in implementing effective disinfecting measures to prevent hospital-acquired infections.

Active surveillance testing and decontamination strategies in intensive care units to reduce methicillin-resistant Staphylococcus aureus infections

2010-03-02

Background: Active surveillance testing (AST) and decontamination strategies (DS) using a topical methicillin-resistant Staphylococcus aureus (MRSA) cleansing agent was introduced in July 2007 in a medical intensive care unit (MICU) and a surgical ICU (SICU) of a tertiary care hospital to reduce the incidence of MRSA infection.Methods: Data on ICU admissions between July 1, 2007, and June 30, 2008, was analyzed. All subjects, excluding known MRSA status, had an ICU length of stay (LOS) of more than 24 hours and nasal swabs performed on ICU admission, every 7 days during the ICU stay, and on discharge. MICU and SICU specimens were sent for culture and in-house real-time polymerase chain reaction, respectively. MRSA-colonized (MRSAc) patients were subjected to contact isolation precautions and DS for 5 days or until ICU discharge. Data recorded included demographics, LOS, and antibiotic use. Results were analyzed using SPSS. Control charts were used to determine special cause variation.Results: Of 653 eligible patients admitted to the ICU, 85 (13%) were determined to be MRSAc on ICU admission. A further 15% (52 of 351) were determined to be MRSAc during the ICU stay or at discharge. Thus, AST detected MRSA in at least 137 of the 653 patients (21.0%). In contrast, clinical cultures for MRSA were positive in only 12 patients (1.8%). Compared with noncolonized patients, MRSAc patients at any screening point had a longer pre-ICU LOS (P =.001), received more antibiotics (P = .004), and had a longer ICU LOS (P = .003). Compared with the preintervention period of July 2006 to June 2007, there was no significant reduction in mean MRSA infection incidence rate in both ICUs (3.8 to 3.0 per 1000 patient-days [P = .057] in the SICU and 1.4 to 1.7 per 1000 patient-days in the MICU) following intervention.Conclusions: In ICUs, AST detected 11 times more MRSA than clinical cultures. The lack of reduction in MRSA infection rates in the ICUs does not negate the roles of AST and DS, but does argue for better study design and outcome measures like MRSA transmission incidence, which perhaps would have demonstrated a true benefit of AST and DS.

Exposure of emergency medical responders to methicillin-resistant Staphylococcus aureus

Jonathan D. Sexton, Kelly A. Reynolds — 2010-04-09

Background: Methicillin-resistant Staphylococcus aureus (MRSA) infections result in 19,000 deaths a year in the United States. Epidemiologic studies have shown that community-acquired infections are increasing dramatically, and strains typical of community infections are increasingly detected in hospital populations. Emergency medical responders (EMR) are exposed to both community and hospital MRSA patients, which, combined with their communal lifestyles in fire stations, results in higher risk of exposure. This study determined the occurrence and frequency of MRSA and other bacterial indicators on environmental surfaces in fire stations, training sites, and offices of EMR.Methods: Handled sponges were used for collection of targeted bacteria from commonly contacted environmental surfaces at EMR facilities. Biochemical tests confirmed isolates as S aureus, and MRSA was confirmed by growth on selective and differential media. An initial set of 500 samples was collected at 9 fire-related facilities to identify areas of increased exposure. Subsequent studies targeted sites (n = 160) for repeat sampling that were MRSA positive.Results: S aureus was isolated from 10.6% (17/160) of the sampled sites. The couch and the classroom desks were the most contaminated at 20% (4/20 and 2/10, respectively). Of the S aureus isolated, 64.7% (11/17) were confirmed as MRSA.Conclusion: EMR have a high potential for exposure to MRSA, not only through patient and hospital contacts but also in the fire station environment. MRSA was isolated with the highest frequency on the couches and the class desks. Although the true health significance of these exposures is unknown, improved infection control practices, such as routine handwashing and surface disinfection, are warranted to reduce MRSA exposures.

Prevalence of preventive behaviors and associated factors during early phase of the H1N1 influenza epidemic

Joseph T.F. Lau, Sian Griffiths, Kai-chow Choi, Chunqing Lin — 2010-06-01

Background: The community plays an important role in controlling influenza A/H1N1. There is a dearth of data investigating adoption of preventive behaviors in the initial phase of the A/H1N1 pandemic.Methods: Three round of random, population-based, anonymous telephone survey were conducted in Hong Kong during the pre-community outbreak phase (May 7 to June 6, 2009) of the influenza A/H1N1 pandemic in Hong Kong (n = 999).Results: Respectively, 46.65%, 88.75%, and 21.5% washed hands more than 10 times/day, wore face masks when having influenza-like illness (ILI), and wore face masks regularly in public areas. Perceptions related to bodily damages, efficacy of frequent handwashing, nonavailability of effective vaccines, high chance of having a large scale local outbreak, and mental distress because of influenza A/H1N1 were associated with frequent handwashing (odds ratio [OR], 1.46 to 2.15). Perceived vaccine availability was associated with face mask use when having ILI (OR, 1.60). Perceived fatality, efficacy of wearing face masks, and mental distress because of influenza A/H1N1 were associated with face mask use in public areas (OR, 1.53 to 2.52).Conclusion: Preventive behaviors were prevalently adopted by the public and were associated with cognitive and affective factors. Prevention efforts should take public perceptions into account, and emerging infectious diseases provide good chances for promoting hygiene.

Reusable elastomeric air-purifying respirators: Physiologic impact on health care workers

2010-03-02

Background: Elastomeric air-purifying respirators offer the benefit of reusability, but their physiological impact on health care workers is unknown.Methods: Ten health care workers exercised at 2 health care-associated work rates wearing an elastomeric air-purifying respirator. Mixed inhalation/exhalation respirator dead space gases (oxygen, carbon dioxide) were sampled, and physiological parameters were monitored (heart rate, breathing rate, tidal volume, minute volume, oxygen saturation, transcutaneous carbon dioxide). Numerical rating scales were used to evaluate comfort and exertion.Results: Compared with controls (no respirator), significant decreases in the breathing rate at both work rates (P < .05) and increases in tidal volume at the lower work rate (P < .01) were noted with respirator use. Approximately half the subjects had transcutaneous carbon dioxide levels above the upper limit of normal after 1 hour of use. Although well tolerated, comfort was negatively impacted by elastomeric air-purifying respirators wear.Conclusion: Reusable elastomeric air-purifying respirators impose little additional physiological burden over the course of 1 hour at usual health care work rates. However, the potential for carbon dioxide retention in a significant proportion of users exists and requires further investigation.

Who is really caring for your environment of care? Developing standardized cleaning procedures and effective monitoring techniques

2010-05-03

Health care facilities have procedures for cleaning patient care environments, but there is often confusion about the division of labor when it comes to cleaning responsibilities. In addition, systems to monitor cleaning effectiveness are frequently suboptimal. In 2007, a multidisciplinary task force revised policies outlining staff responsibilities for cleaning in-patient nursing care units and chose a monitoring system using a specialized adenosine triphosphate bioluminescence test.

Effect of surfactants, temperature, and sonication on the virucidal activity of polyhexamethylene biguanide against the bacteriophage MS2

Federica Pinto, Jean-Yves Maillard, Stephen P. Denyer — 2009-12-14

Background: Virucidal compounds are essential in preventing the transmission of viral infection in the health care environment. Understanding their mechanisms of action is necessary to improve their efficacy. Inactivation of viruses is less documented than that of bacteria notably because different types of virus have diverse response to microbicides, making difficult to establish an inactivation pattern.Methods: The effect of viral aggregates on the virucidal activity of polyhexamethylene biguanide-based microbicide VANTOCIL™ TG (Arch Chemicals, Manchester, UK) against the bacteriophage MS2 was investigated by using in combination a standard suspension efficacy test under different conditions and dynamic light scattering measuring the presence and size of aggregates.Results: Temperature had a key role in increasing significantly the virucidal activity of VANTOCIL™ TG, reducing virus concentration by 4-log10 within 10minutes at 40°C. The high temperature was linked to a reduction of viral aggregates despite the exposure to the biguanide. In addition, the viral inactivation kinetic became significantly more linear at 30°C and 40°C. Such results were also observed with sonication during treatment, where a first-order kinetic was observed. However, the addition of surfactants, even though there was evidence of a decrease in viral clumps, did not enhance the virucidal activity of polyhexamethylene biguanide.Conclusion: The presence of viral aggregates was an important factor in the virucidal efficacy of the biguanide as demonstrated by the correlation among high temperature, decrease in aggregates, and increase in activity, although it is possible that high temperatures might also cause conformational changes of the viral capsid, increasing the sensitivity of virions to the microbicide.

Rural Indonesian health care workers' constructs of infection prevention and control knowledge

Brahmaputra Marjadi, Mary-Louise McLaws — 2010-03-15

Background: Understanding the constructs of knowledge behind clinical practices in low-resource rural health care settings with limited laboratory facilities and surveillance programs may help in designing resource-appropriate infection prevention and control education.Methods: Multiple qualitative methods of direct observations, individual and group focus discussions, and document analysis were used to examine health care workers' knowledge of infection prevention and control practices in intravenous therapy, antibiotic therapy, instrument reprocessing, and hand hygiene in 10 rural Indonesian health care facilities.Results: Awareness of health care-associated infections was low. Protocols were in the main based on verbal instructions handed down through the ranks of health care workers. The evidence-based knowledge gained across professional training was overridden by empiricism, nonscientific modifications, and organizational and societal cultures when resources were restricted or patients demanded inappropriate therapies. This phenomenon remained undetected by accreditation systems and clinical educators.Conclusion: Rural Indonesian health care workers would benefit from a formal introduction to evidence-based practice that would deconstruct individual protocols that include nonscientific knowledge. To achieve levels of acceptable patient safety, protocols would have to be both evidence-based and resource-appropriate.

Bacterial flora on cell phones of health care providers in a teaching institution

2010-04-05

We conducted a cross-sectional study involving culture of cell phones of 288 health care providers (HCP) during a 6-month period. One hundred nine (43.6%) HCP carried infective organisms on their cell phones. It is recommended that cell phones be cleaned regularly.

Outbreak of vancomycin-resistant enterococci in a tertiary hospital: The lack of effect of measures directed mainly by surveillance cultures and differences in response between Enterococcus faecium and Enterococcus faecalis

2009-12-14

To describe the effect of active surveillance to control vancomycin-resistant enterococci (VRE) after an outbreak, 549 surveillance rectal cultures were performed in 308 patients (35% positive). An educational intervention to prevent transmission was implemented. Infection and colonization by VR- Enterococcus faecalis decreased, but Enterococcus faecium persisted despite control measures. Infections by VR-E faecalis fell to zero in 2008. We observed difficulties in controlling colonization with measures directed mainly by surveillance cultures and differences between responses of E faecium and E faecalis.

Notifiable infectious disease reporting awareness among physicians and registered nurses in primary care and emergency department settings

Wayne Turnberg, William Daniell, Jeffrey Duchin — 2009-12-23

This study examined knowledge about notifiable infectious disease reporting among physicians and registered nurses (RNs) in primary care and emergency department settings in King County, Washington. In 2005, a total of 165 physicians and 170 RNs completed a questionnaire to assess knowledge, training and feedback regarding notifiable infectious disease reporting. Only 55% of the physicians and 63% of the RNs were aware of reporting procedures within their institution. Awareness was higher when employer-provided training had been provided. Our findings indicate that employer training can improve reporting knowledge.

Infection control nurse specialist education in Korea

Kyung Mi Kim, Jae Sim Jeong, Ho Ran Park — 2009-12-21

With the amendment of the Medical Service Act in 2003, the infection control nurse specialist system was launched as one of several specialties for nursing in Korea. Nurse specialists are certified through the national qualifying examination after graduating from a specialist nursing program with core and specialty courses at a graduate school approved by the Ministry of Health and Welfare. This article describes graduate preparation and certification for infection control nurse specialists in Korea.

Healthcare-associated Infections Studies Project: An American Journal of Infection Control and National Healthcare Safety Network Data Quality Collaboration

2010-05-12

The year 2010 will mark 2 important anniversaries in infection prevention. The National Healthcare Safety Network (NHSN) will celebrate its fifth year since merging several surveillance systems, including the National Nosocomial Infections Surveillance (NNIS) system, itself formed 40 years ago, and the Fifth Decennial International Conference on Healthcare-associated Infections that was held in March. In 1990, the third of these decennial conferences culminated in a supplement to the American Journal of Medicine. In that issue, Gaynes and colleagues outlined the achievements of the NNIS system as of then and proposed several challenges for the coming decade, including the need for validation studies, more ways of training infection preventionists (IPs) to assure data quality, and more rapid data exchange with participating hospitals. Since the Fourth Decennial Conference held in 2000, more than half of state legislatures have mandated some form of public reporting of health care-associated infections (HAI), and, currently, 21 have selected participation in NHSN as the mechanism for such reporting.

Potential bacterial cross-contamination using pillboxes in the hospital

2010-06-01

To the Editor: In most countries, hospital medications are stored in the pharmacy and globally delivered to medical units according to their specific needs. In contrast, the current trend in France is toward individual daily delivery for each patient. France's Desgenettes military teaching hospital is a pioneer in implementing a prescription system with individual daily dispensing. The procedure is as follows. According to the medical prescription, chemist's assistants use clean pillboxes to prepare the daily regimen for each patient using single-unit packaged medications. Pillboxes are delivered to the medical units, and the medicines are administered by caregivers without the patients coming in contact with the pillboxes. The pillboxes are returned to the pharmacy the next day.

APIC 2010 Abstracts

2010-06-01

Abstract Awards (denoted by∗)E8 Poster AbstractsE12

Abstract Awards

2010-06-01

Purpose: This award is given in the name of William A. Rutala, PhD, MPH, for the best abstract on the subject of disinfection, sterilization, or antisepsis. Selection Criteria: To be considered for this award, applicants must: 1) submit an abstract to the APIC Annual Educational Conference & International Meeting in the year the award is to be given; 2) have not received the award within the last 3 years; 3) submit a Format I abstract in the Antisepsis/Disinfection/Sterilization category, written in a clear, logical and concise manner which communicates the principal objectives, methodology, results and conclusions in a straightforward fashion; 4) submit research that is limited to the study and understanding of the principles and practices of disinfection, sterilization, and antisepsis; 5) submit an abstract that will reflect original research or (if not entirely new should supplement existing data), is conducted with appropriate data analysis, and is of major importance to the field of disinfection, sterilization, and antisepsis; 6) abstract is innovative, employs sound methodology, and represents a potentially significant, scientific contribution to the principles and practices of disinfection, sterilization and antisepsis; and 7) all abstract submitters who meet the above criteria during the abstract submission process will be considered for the “William A. Rutala Research Award.”

Abstracts and Posters Were Submitted in Two Different Formats

2010-06-01

This format is intended for abstracts involving scientific research, such as randomized clinical controlled trials, case-controlled studies, cohort, observational, descriptive studies, and/or experimental design. Abstracts should disclose primary findings and should not discuss works in progress with preliminary results.

A Process for Discontinuation of Contact Precautions

2010-06-01

Theresa Sieber, Project Coordinator; Kathleen McMullen, MPH, CIC, Infection Prevention Specialist, Barnes-Jewish Hospital, Saint Louis, MO; David K. Warren, MD, MPH, Hospital Epidemiologist, Washington University, Saint Louis, MO

An Overall Decrease in HAI MRSA Rates after Institution of an MRSA Screening Program in Critical Care

2010-06-01

Cathy S. Sanders, RN, BSN, CIC, Infection Prevention & Epidemiology Coordinator, Brookwood Medical Center, Birmingham, AL Background: Brookwood Medical Center, a 606-bed acute care facility in Birmingham, AL, instituted an MRSA screening program in one critical care unit in May, 2007. Three other critical care units were subsequently added to the active surveillance program. Since beginning the program, the facility has experienced MRSA HAI rates consistently below the prior mean rate for the facility.

Antibiotic Susceptibility Patterns for Community Acquired Methicillin- resistant Staphylococcus aureus Infections in a Veterans Administration Medical Center in Northwest Louisiana, 2005-2007

2010-06-01

G. Orlando Padilla, MD, Staff Physician; Ronald Washburn, MD, Chief, Infectious Disease; Vickie Moore, BS, CLS, MA, CIC, Infection Prevention Program Manager; Robert Penn, MD, Staff Physician; Steve Dauenhauer, PhD, Microbiology; Andrea Heckman, MLS-S (ASCP), MRSA Coordinator, Overton Brooks Veterans Administration Medical Center, Shreveport, LA

Comparison of Antimicrobial and Standard Privacy Curtains: Efficacy and Cost Analysis

2010-06-01

Georgeta Rinck, RN MPH, Infection Prevention and Control Nurse, Westchester Medical Center, Valhalla, NY Background: There is growing concern about transmission of microorganisms via privacy curtains, which are highly touched surfaces. Curtains with antimicrobial (AM) properties are now available to healthcare facilities. The purpose of this study is to assess AM activity of standard versus AM curtains and to compare direct and indirect costs associated with each.

The Influence of Feedback on the Prescribing of Antibiotics by Family Physicians for Respiratory Tract Infections

2010-06-01

Dick Zoutman, MD, FRCPC, Professor; Douglas Ford, MA, Research Associate, Queen's University, Kingston, ON, Canada Background: Antibiotics are over prescribed for respiratory tract infections and when antibiotics are indicated, first-line choices are underutilized. Research suggests feedback might improve prescribing practices.

Comparison of Inactivation Profiles of Surrogate Strains of Human Norovirus and Clostridium difficile Against Gaseous Ozone

2010-06-01

Geun Woo Park, PhD, Microbiologist; Jan Vinjé, PhD, Microbiologist, CDC, Atlanta, GA; Jaehong Kim, PhD, Professor; Min Cho, PhD, Professor, Georgia Institute of Technology, Atlanta, GA

Development of Fluorinated TiO2 Film and Evaluation of Its Potential Application to Control Human Norovirus on Environmental Surfaces

2010-06-01

Min Cho, PhD, Professor;Jaehong Kim, PhD, Professor, Georgia Institute of Technology, Atlanta, GA;Jan Vinjé, PhD, Microbiologist; Geun Woo Park, PhD, Microbiologist, CDC, Atlanta, GA

Elimination of Clostridium difficile Infections (CDI) by Illumination? Surface Disinfection by Ultraviolet Light Treatment

2010-06-01

Ann Marie Pettis, RN, BSN, CIC, Director of Infection Prevention, University of Rochester Medical Center, Rochester, NY Issue: CDI cases are increasingly common, and the clinical picture has become more severe. C. difficile spores can survive on environmental surfaces for months, posing a significant problem in room cleaning. Little is known about the role whole room disinfection plays in preventing CDI.

Elimination of Staphylococcus aureus Surgical Site Infections With a Common Susceptibility Pattern

2010-06-01

Kim Strelczyk, RN, MSN, ACNS-BC, CIC, Interim Manager, Salem Hospital, Salem, OR Issue: Surgical Site infections (SSI) are a significant cause of morbidity and mortality. During the spring of 2009, an increase of SSIs caused by methicillin sensitive strain of S. aureus (resistant only to Pen G) got the attention of the Infection Prevention Team (IPT) at our hospital. An investigation revealed 35 SSIs from January through August, in patients who had surgery in one of our facilities' Operating Rooms (ORs) housed in 3 different buildings.

Evaluation of a Programmatic Approach to Improving Patient Room Cleaning Outcomes

2010-06-01

Emily McCracken, MPH, Director Infection Prevention and QI, Hamot Health System, Erie, PA; Karen Martin, RN, BS, HPN, CIC, Director of Infection Control/Epidemiology and Environmental Services, Advocate Christ Medical Center, Oak Lawn, IL; Linda Homan, BSN, CIC, Clinical and Professional Services, Ecolab, Inc., St. Paul, MN

Persistence Factors in Handwashes

2010-06-01

Lawton A. Seal, Sr., PhD, Senior Scientific Advisor; Bert Slade, MD, Chief Medical Officer; Innes Cargill, PhD, Director, Clinical Affairs; Duncan Aust, PhD, Senior Vice President, Research and Development, Healthpoint, Ltd, Fort Worth, TX

Assessing Hospital Emergency Preparedness on Infectious Diseases in Japan

2010-06-01

Yoko Tsukamoto, PhD, Associate Professor, Health Sciences University of Hokkaido, Ishikari-gun, Japan; Yukari Matsuzawa, RN, MSN, RN, Kitami Red Cross Hospital, Kitami, Japan Background: As we have feared for some time, Pandemic influenza became reality in this past April and in response to that, all infection preventionists prepared for the event. However, due to the nature of the situation, all the medical facility became chaotic. The purpose of this study is to assess the emergency preparedness on infectious diseases at acute care hospitals and identify the issues to prepare better in the future.

Comparison of Filtration Efficiency of a N95 Filtering Facepiece Respirator and Surgical Mask Against Viral Aerosols

2010-06-01

Aaron Richardson, MS, Principal Research Scientist; Kent Hofacre, MS, Manager, Battelle Memorial Institute, Columbus, OH Background/Objective: The current 2009 H1N1 influenza pandemic has emphasized the need for more information regarding the collection efficiencies of N95 filtering facepiece respirators (FFRs) and surgical masks (SMs) for influenza virus. The objective of this study was to measure and compare the collection efficiencies of a commercially available N95 FFR and SM using challenge aerosols of sodium chloride (NaCl), A/PR/8/34 H1N1 influenza, and the Escherichia coli male-specific bacteriophage 2 (MS2).

Incident Management System Utilized for Pandemic Flu Response

2010-06-01

Linda J. Grupa, RN, MPH, Director, Infection Prevention and Control, Mayo Clinic, Rochester, MN Issue: In 2009, pandemic H1N1 challenged the Infection Prevention and Control [IPAC] unit of a large Midwestern hospital to conduct disease outbreak investigations and coordinate the diverse activities of the IPAC unit with the Hospital Incident Command System [HICS], institutional leadership and a team of infectious disease physicians.

Infection Prevention in a Large Community-wide Drive-thru Point of Dispensing (POD) for H1N1 Pandemic Influenza Immunization

2010-06-01

Ruth Carrico, PhD, RN, CIC, Assistant Professor, University of Louisville School of Public Health, Louisville, KY Issue: In response to the H1N1 2009 influenza pandemic, Louisville, Kentucky elected to utilize a unique community-based immunization process consisting of walk-up and drive-thru options where healthcare personnel administered both injectable and intranasal H1N1 influenza vaccine. Ensuring a single standard of care with respect to infection prevention for vaccine recipients as well as healthcare personnel was a priority and posed unique challenges in the drive-thru.

Novel Influenza A (H1N1) Outbreak Response: An Exercise in Health System Preparedness

2010-06-01

Jane A. Greenko, EMT-P, MPH, CIC, Epidemiologist; Donna Armellino, RN, PhD, CIC, Director; Mary Mahoney, RN, BSN, Bt Coordinator, North Shore-LIJ Health System, Syosset, NY; Mary Ann Haran, RN, BSN, Manager; Susan Nullet, RN, BSN, Nurse Epidemiologist, Long Island Jewish Medical Center, New Hyde Park, NY; Christine Ginocchio, PhD, Director, North Shore-LIJ Health System, Lake Success, NY; Joy Nagleberg, MD, Chief Physician, Schneider Children's Hospital, New Hyde Park, NY; Salvatore Pardo, MD, Associate Chairperson; Barbara Edwards, MD, Physician, Long Island Jewish Medical Center, New Hyde Park, NY

The Flu and You: Information to Keep you Forewarned and Forearmed

2010-06-01

Concepcion N. Moore, RN, MBA, CIC, Infection Preventionist, Manager; Janet Kerrigan, RN, BSN, Employee Health Manager; Kathryn V. Knak, MBA, CHEP, CHSP, Safety Officer; Kurt Weibel, PharmD, MS, Assistant Director, Pharmacy Services; Rebecca L. Landreth, RN; Cynthia S. Maschmeier, MT (ASCP) SM, Infection Preventionist; Sean E. Elliott, MD, FAAP, Medical Director; Sharon Larson, MT (ASCP), Medical Technologist; Donna M. Wolk, PhD, D (ABMM), Division Chief, University Medical Center, Tucson, AZ

A Collaborative Approach to Decreasing Knee Prosthesis (KPRO) SSI in a Total Joint Replacement Program

2010-06-01

Saungi McCalla, MSN, MPH, RN, CIC, Director of Infection Control; Carol Smullen, RNOC, Coordinator, Joint Replacement Program; Arthur Forni, MD, Section Chief, Infectious Diseases; Collen Fay, MD, Surgery/Orthopedics, White Plains Hospital Center, White Plains, NY

A Comparison of Performance of Two Computer Algorithms to Identify Surgical Site Infections (SSIs) Using Electronic Data

2010-06-01

Mandar Apte, MBBS, MsPH, Data Manager, School of Nursing, Columbia University, New York, NY; Timothy Landers, CNP, PhD, Assistant Professor, The Ohio State University College of Nursing, Columbus, OH; E. Yoko Furuya, MD, MS, Assistant Professor of Clinical Medicine, Columbia University, New York, NY; Sandra R. Hyman, RN, MPA, CIC, Epidemiology Research Nurse, New York – Presbyterian Hospital, New York, NY; Elaine Larson, RN, PhD, Professor of Pharmaceutical and Therapeutic Research, School of Nursing, Columbia University, New York, NY

A Novel Five-tier Approach to Reduce Central Line-associated Blood Stream Infections in an Academic Medical Center

2010-06-01

Andrea Flinchum, RN, BSN, CIC, Infection Control Manager; Cibina Harris, RN, CIC, Manager of Infection Control; Patricia Swiderski, RN, BSN, Infection Preventionist; Christopher Nelson, MD, Medical Director; Joseph Conigliaro, MD, MPH, Director; Phillip Chang, MD, UKCMC, Lexington, KY

A Successful Campaign: The Value of Teamwork in Implementing the Central Line Bundle on Six Medical Surgical Units and Interventional Radiology

2010-06-01

Gail I. Cook, RN, MS, Manager of Infection Prevention & Control; Winifred Caputo, BSN, CIC, Infection Control Practitioner; Marlene McLeod-Douse, MSN, MPA, Infection Preventionist, VANJHCS, East Orange, NJ

An Evidence-based Approach to Determining Hospital Suction Canister Change Protocols

2010-06-01

Keith S. Kaye, MD, MPH, Professor of Medicine, Corporate Director, Infection Prevention, Epidemiology and Antimicrobial Stewardship; Dror Marchaim, MD, Post Doctoral Fellow, Infectious Diseases, Detroit Medical Center & Wayne State University Health Center, Detroit, MI

Central Venous Catheter Microbial Colonization in Relation to Insertion and Care Practices in Some Egyptian Intensive Care Units

2010-06-01

Maha M. Fathy, Professor; Maha Hamdy, Associate Professor, Medical Microbiology and Immunology; Maha El-Touny, Professor, General Medicine; Noha Nagy, MSc, Medical Microbiology and Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt

Did You Bathe Your Patient Today? Common Sense Practice to Reducing Hospital-acquired Infections

2010-06-01

Susanne Stone, RN, BSN, IC Practitioner; Donna Chaffee, RN, IC Practitioner; Kenneth Rowin, MD; Marc Chasin, MD, Good Samaritan Hospital, Suffern, NY Issue: Many studies have shown that with the removal of prepackaged bath products and the re-introduction of basin baths, HAIs may dramatically increase. Basins are generally not sanitized prior to re-use, thus re-inoculating patients with the bacteria that they had washed off the previous day. These bacteria may include any number of infectious strains which may lead to, among others, UTI in hospitalized patients. UTIs are the most common HAI, accounting for 40% of 1 million cases annually. Eighty percent (80%) of these infections can be attributed to an indwelling urethral catheter (SHEA compendium, October 2008). The estimated cost of a CA-UTI ranges from $500-$3000, and is no longer a reimbursable diagnosis related group (DRG) for Medicare (HICPAC).

Eradicating Post-circumcision Staphylococcal Infection in the Well Baby Nursery

2010-06-01

Saungi McCalla, MSN, MPH, RN, CIC, Director of Infection Control; Joann Murphy, RN, Nurse Manager; Elizabeth Zimmermann, BSN, RN, Assistant Nurse Manager; Joan Carlin Halpern, MS, RNC, NNP, Director of Nursing, MCH; Jesus Jaile-Marti, MD, Section Chief, Neonatology, White Plains Hospital Center, White Plains, NY

Incidence of and Risk Factors for Nosocomial Bloodstream Infections in Pediatric Intensive Care in Vietnam

2010-06-01

Meklet Workneh, BA, School of Medicine, University of California San Francisco, San Francisco, CA; Ngai K. Le, MD, Pediatrics, National Hospital of Pediatrics, Hanoi, Viet Nam; Minh-Chi Tran, BA, School of Medicine, University of California San Francisco, San Francisco, CA; Thu H. Nguyen, MD; Lan Anh Le, BA; Huong V. Tran, MPH, National Hospital of Pediatrics, National Hospital of Pediatrics, Hanoi, Viet Nam; John Colin Partridge, MD, MPH, Pediatrics, University of California San Francisco, San Francisco, CA

Infection Prevention Initiative—Reduction of Surgical Site Infections With Antimicrobial Impregnated Gauze Dressings

2010-06-01

Laura A. Kehler, RN, BSN, MS, CIC, Infection Prevention Coordinator, Garden City Hospital, Garden City, MI Background/Objectives: Surgical site infections (SSIs) are the second most common type of adverse events occurring in hospitalized patients (Brennan. N Engl J Med. 1991:324:370-376). SSIs have been shown to increase mortality, readmission rate, length of stay, and cost for patients. (Kirkland, Infect Control Hosp Epidemiol.1999; 20: 725). While nationally the rate of SSIs averages between 2- 3% for clean cases, an estimated 40 -60 % are preventable. By reducing SSIs, hospitals could recognize an estimated savings of $25,546 per SSI in addition to improving patient outcomes (Stone. Am J Infect Control 2005; 33:501-9). Although the SSI rate at this hospital was well below the National Healthcare Safety Network (NHSN) benchmark, in this era of reduced provider payments, emphasis on patient safety, and improved patient outcome, it becomes paramount to reduce all infections in the hospital to the lowest possible numerator.

Maintained Low Rate of Catheter-related Bloodstream Infections (CRBSIs) After the Discontinuation of a Luer-access Device (LAD) at an Academic Medical Center

2010-06-01

Concepcion N. Moore, RN, MBA, CIC, Infection Preventionist, Manager; Rebecca Landreth, RN, Infection Preventionist; Cynthia Maschmeier, MT (ASCP) SM, Infection Preventionist; Kara Snyder, RN, MS, CCRN, CCNS, Clinical Nurse Specialist; Gail Priestley, RN, MSN, CCRN, Clinical Nurse Specialist; Angela Muzzy, RN, MSN, CCRN, Clinical Nurse Specialist; Sean Elliott, MD, FAAP, Chairman, Infection Prevention Committee, University Medical Center, Tucson, AZ

Maintaining a Zero Central Line-associated Blood Stream Infection Rate for 17 Months Across a Large and Diverse Adult Patient Population: What Gets the Credit?

2010-06-01

Timothy I. Royer, BA, BSN, CRNI, Nurse Manager / Vascular Access - Retired 2009, VA Puget Sound Health Care System, Tacoma, WA Issue: It is the objective of every health care facility to achieve and maintain a zero Central Line Associated Blood Stream Infection Rate (CLABSI). This facility achieved the goal by applying evidence based and critical thinking enhancements to the Central Line Bundle. An essential component of this is a dedicated IV Team. An important aspect of any improvement program is introducing innovations to improve care; however, the plan will not be as successful without staff education in outstanding care of the patient.

Prevention of Post-op Pneumonia Utilizing Pre-operative Oral Care

2010-06-01

Bonnie Colaianne, MSN, RN, Infection Preventionist, UPMC St. Margaret Hospital, Pittsburgh, PA Issue: Hospital associated infections (HAI) are often an avoidable consequence of a hospital stay. With an incidence of 10% to 20%, VAP is associated with increased morbidity and mortality of ventilated ICU patients, as well as an increased length of stay, increased resource use, and increased costs. Prevention is the most effective method of decreasing the incidence of VAP. Research has shown that aspiration around the endotracheal tube of oropharyngeal organisms and the subsequent development of infection is the most common mechanism of action in the development of VAP. Decreasing and/or removing the pathogenic microorganisms from the oral pharynx may decrease the incidence of infection. Chlorhexidine is an antimicrobial oral rinse that has shown positive results in the prevention of VAP. Since chlorhexidine products are effective in the prevention of VAP, the potential to prevent post operative pneumonias utilizing pre-operative oral care with a chlorhexidine product was hypothesized.

Range of Policies for Prevention of Catheter-associated Urinary Tract Infections in Intensive Care Units (ICUs)

2010-06-01

Sarah Jordan, MPH, Study Coordinator; Monika Pogorzelska, MPH, Study Manager; Elaine Larson, RN, PhD, FAAN, CIC, Associate Dean;Patricia W. Stone, PhD, MPH, FAAN, Associate Professor, School of Nursing, Columbia University, New York, NY

Reducing Ventilator-associated Pneumonia Using Team Approach

2010-06-01

Muhammad Yaseen, Infection Control Practitioner; Abdulhakeem Al Thaqafi, Director Infection Prevention and Control; Yasir Thashkandi, ICU Consultant; Medhat Lamfon, Infection Control Coordinator, King Abdulaziz Medical City for National Guards, Jeddah, Saudi Arabia

Reduction in Central Line-associated Bloodstream Infections

2010-06-01

Nancy McAlley, BSN, RN, CIC, Infection Control Coordinator, Blythedale Children's Hospital, Valhalla, NY Issue: Our acute pediatric rehabilitation hospital services patients with chronic and complicated health issues. Length of stay frequently is as long as 12 months. Some patients are on long term Total Parenteral Nutrition (TPN) therapy or have long term central lines for a variety of purposes. We experienced CLABSI rates of 8.0-12.7 in 2007 and 1st quarter 2008. We reviewed the cases and found no commonalities. We formed a task force to determine what changes were needed to decrease the incidence of infection.

Reduction in Central Line-related Bloodstream Infection (CLBSI) as a Result of Multiple Process Improvement Changes

2010-06-01

Renee L. Smith, MT(ASCP), Infection Control Coordinator; Kimberly Rivera, MT(ASCP), Supervisor, Infection Control; Lisa Snedeker, MT(ASCP); Jana Wolfgang, RN BS, Infection Control Coordinator; Lisa Rose, MT(ASCP); Haley Hardenstine, RN BS, Infection Control Coordinator; Pinnacle Health System, Harrisburg, PA

Reduction of Indwelling Urinary Catheter-associated Urinary Tract Infections (CAUTI) through System-wide Interventions

2010-06-01

Haley Hardenstine, RN, BS, Infection Control Coordinator; Kimberly Rivera, MT (ASCP), Infection Control Supervisor; Kimberly Fowler, MSN, RN, Clinical Nurse Specialist; Jana Wolfgang, RN, BS, Infection Control Coordinator, Pinnacle Health System, Harrisburg, PA

Reduction of Ventilator-associated Pneumonia Incidence in a 32-bed Combined Medical Surgical Intensive Care Unit After Adding Chlorhexidine Oral Care and Skin Cleansing to the Ventilator Bundle

2010-06-01

Vicki Keller, RN, BSN, PHN, CIC, Infection Prevention Manager, Northridge Hospital Medical Center, Northridge, CA Issue: Ventilator Associated Pneumonia (VAP) is a risk for any patient on a ventilator. During fiscal year 2008, our intensive care unit (ICU) had 11 VAPs with 4374 ventilator days, and a VAP rate of 2.51 per 1000 ventilator days. VAP continued to be an issue: in this 32 bed ICU, even after implementation of the ventilator bundle elements. The ventilator bundle consisted of 1) daily sedation vacation, 2) daily assessment for ventilator weaning, 3) head of the bed elevated to 30 degrees, 4) deep vein thrombosis (DVT) prophylaxis, and 5) stress bleeding prophylaxis. An oral care kit had also been implemented for use every four hours.

Targeting Zero: A Systematic Approach to Elimination of Catheter-related Bloodstream Infections in a Pediatric Healthcare System

2010-06-01

Donna Peace, RN, CPHQ, CIC, Infection Control Nurse, Children's Healthcare of Atlanta, Peachtree City, GA Targeting Zero: A Systematic Approach to Elimination of Catheter Related Blood Stream Infections (CR-BSI) in a Pediatric Healthcare System

Use of an Observational, Nationwide Inpatient Discharge Database to Document the Economic Benefits Associated With Innovative Antimicrobial Technology to Reduce the Risk of Surgical Site Infection (SSI)

2010-06-01

Charles E. Edmiston, Jr., PhD, MS, CIC, Professor of Surgery, Medical College of Wisconsin, Milwaukee, WI; Anuprita D. Patkar, PhD, Assoc. Director Outcomes Research, ETHICON, Inc, Somerville, NJ; Glenn Magee, MBA, Senior Researcher, Premier, Inc, Philadelphia, PA; Gary R. Seabrook, MD, FACS, Chief, Division of Vascular Surgery, Medical College of Wisconsin, Milwaukee, WI; Brian Vaughn, MPA, MBA, Global Director Health Economics & Reimbursement, ETHICON, Inc, Somerville, NJ

What Impact Does Chlorhexidine Gluconate Transparent IV Securement Dressing Have on Central Line-associated Bloodstream Infection (CLABSI) Rates?

2010-06-01

Patricia Gould, RN, Infection Prevention Coordinator; Antje Ouddaker, RN, ICU Coordinator, St. Joseph Mercy Health Center, Hot Springs, AR Background: The Central Line-Associated Bloodstream Infection (CLABSI) rate remained above the 50th percentile NHSN median in both ICU and medical/surgical inpatient units at St. Joseph's Mercy Health Center in Hot Springs, AR, despite implementation of evidence based guidelines and “bundle” practices. The CLABSI rate for the 25 bed ICU was 3.82 CLABSIs per 1,000 central line days for the 12 months prior to dressing trials (3 month trial was done using a silver alginate patch prior to this study) and the CLABSI rate for the inpatient medical/surgical units was 3.31 CLABSIs per 1,000 central line days for the 12 months prior to study.

Emergence of Methicillin- Resistant Staphylococcus aureus among Patients at a Tertiary Renal Medical Center

2010-06-01

Mel-Hatra I. Arakama, Doctor of Medicine, National Kidney and Transplant Institute, National Kidney and Transplant Institute, Quezon, Philippines Background: Methicillin-resistant Staphylococcus aureus infection is difficult to recognize. This study describes the clinical profile of patients with MRSA infections and the antibiotic resistance pattern.

Impact of a Measles Exposure in an Emergency Department

2010-06-01

Anna O'Donnell, RN, BSN, MSN Candidate, CIC, Infection Control Coordinator, Northwestern Memorial Hospital, Chicago, IL; Mary Alice Lavin, RN, MJ, CIC, Chief Nurse Epidemiologist, Rush University Medical Center, Chicago, IL; Laura Bardowski, BSN, MSN, Candidate, Infection Control Coordinator; Chris Silkaitis, BS, MT (ASCP), CIC, Infection Control Coordinator; Maureen Bolon, MD, MS, Medical Director, Infection Control and Prevention; Teresa Zembower, MD, MPH, Medical Director, Healthcare Epidemiology and Infection Control, Northwestern University, Chicago, IL

Impact of H1N1 on NJ Infection Preventionist Activities, or Swine, Surveys and Survival of the New Jersey Infection Preventionist 2009

2010-06-01

Amanda Hessels, RN, MSN, MPH, CIC, Infection Control Coordinator, Jersey Shore University Medical Center, Neptune, NJ; Gail H. Morchel, RN, BSN, COHN-s, CIC, Nurse Epidemiologist, Hackensack University Medical Center, Hackensack, NJ; Bridget Farrell, RN, CIC, CPHQ, Director IC & Employee Health Services, Cape May Regional Medical Center, Cape May Court House, NJ; Anne C. Maher, MS, M(ASCP), CIC, Infection Control Coordinator, Children's Specialized Hospital, New Brunswick, NJ; Nancy Szilagyi, LPN, CIC, Infection Control Coordinator, Capital Health, Trenton, NJ

The Canadian Containment Approach to Clostridium difficile

2010-06-01

Gayla D. Dionne, BScN, CIC, Infection Control & Occupational Health Coordinator, Shriners Hospitals for Children, Montreal, QC, Canada Issue: Since the spring of 2003 Quebec has witnessed increased morbidity and mortality related to a hyper virulent strain of Clostridium difficile. Guidelines were developed and a provincial committee was later formed to address the challenge of Clostridium difficile associated diarrhea (CDAD) and other nosocomial infections. The author of this abstract participated in both. Various guidelines have addressed the usual approaches of surveillance, antibiotic stewardship, isolation practices, hand hygiene and hospital environmental disinfection.

A Pilot Project to Determine Bacterial Contamination on Hospital Beds and Environmental Surfaces

2010-06-01

Jeanne H. Siegel, PhD, ARNP; Vivian Padro-Fajardo, PhD, ARNP, Assistant Professor; Denise Korniewicz, PhD, RN, Senior Associate Dean for Research and Professor, University of Miami, Coral Gables, FL

Assessment of Two Hydrogen Peroxide Technologies for Hospital Room Decontamination Following Patient Discharge

2010-06-01

Stephen A. Streed, MS, CIC, System Director of Epidemiology/Infection Control, Lee Memorial Health System, Fort Myers, FL; Joann Andrews, RN, BSN, CIC; Mary Lynn Medvecky, RN, BSN, Infection Preventionist, Lee Memorial Hospital, Fort Myers, FL; Frances Cioffi, BS, MTASCP, Manager, Clinical Microbiology Laboratory, Cape Coral Hospital, Cape Coral, FL

Operating Room Environmental Surveillance: Do You See What I See?

2010-06-01

Nancy Hutchinson, RN, MSN, CIC, Nurse Epidemiologist; Mary Lou Sorter, RN, CIC, Senior Infection Control Practitioner; Michael Cloughessy, MS, BSEH, REHS, CIC, Infection Control Practitioner; Beverly Connelly, MD, Director, Infection Control, Cincinnati Children's Hospital Medical Center, Cincinnati, OH

Patient Ready Rooms: A Surveillance Method for Improving Cleaning Quality

2010-06-01

Brucella melitensis Exposure of Healthcare Workers (HCWS) in the Clinical Laboratory of a Large Acute Care Hospital

2010-06-01

Michele A. Carra, BS, ASCP, MT, Infection Control Surveillance and Database Coordinator; Ravi K. Vemuri, MD, Infectious Disease Physician; Janet M. Tippett, BSc, MSc, CLS(NCA), CIC, FIMBS, Director, IC/Epid; Jeffrey Brock, Pharm D, Infectious Disease Pharmacist; Carrie Parker, BSN, Manager of EHS; Daniel H. Gervich, MD, Medical Director, IC/Epid, Mercy Medical Center, Des Moines, IA

Exploring Influenza Vaccination as a Condition of Employment: One Hospital's Journey

2010-06-01

Diana Scheide, BA RN CIC, Infection Prevention and Control, Memorial Hospital, York, PA Issue: Seasonal Influenza is responsible for 200,000 hospitalizations and 36,000 deaths every year. Flu vaccines are safe and effective. Unvaccinated Healthcare workers (HCW) spread influenza by shedding virus on their patients 24-48 hours before signs and symptoms start. 70% of HCWs continue to work when they are sick. National Quality Forum lists immunization of as one practice that should be universally used to reduce risk of harm to patients. Annual influenza immunization of HCWs to prevent patient harm is widely recommended by national infection control agencies. HCW vaccination rates in our hospital mirrored national average of 42-54%.

Indeterminate and Positivity Rates of a Commercially Available Enzyme-linked Immunospot (ELISPOT) Blood Test in At-risk Groups for Tuberculosis Infection

2010-06-01

Janet Matsubara, MS, MT (ASCP), Laboratory Manager, Oxford Diagnostic Laboratories, Marlborough, MA Background/Objective: Use of the tuberculin skin test (TST) for tuberculosis (TB) screening in at-risk individuals or groups is changing as health care facilities and university settings adopt blood tests as a screening tool for TB. Blood tests offer several advantages over the TST including increased sensitivity and specificity. The objective of this study was to determine the indeterminate and positivity rates of a commercially available ELISPOT blood test on a national sample of health care workers, immigrants, patients and international students attending U.S. universities.

Pulmonary Tuberculosis Exposure Investigation: When the Source Is a Health Care Worker Working at Two Affiliated Hospitals

2010-06-01

Robin Haag, RN, BC, MA, Director, Coney Island Hospital, Brooklyn, NY; Mary O'Keefe, RN, MPH, CIC, Director, Maimonides Medical Center, Brooklyn, NY; Ellen Graffeo, RPA-C, Physician Assistant, Coney Island Hospital, Brooklyn, NY

Strategies to Improve Seasonal Influenza Vaccination among HCWs

2010-06-01

Jennifer Madigan, MPH, CIC, Infection Preventionist; Janice Rey, MT(ASCP), CIC, Manager, Infection Prevention and IV Team; Michelle Flood, RN, MSN, CIC, Infection Control Practitioner; Debi Hopfner, RN, BSN, CIC, Infection Control Practitioner; Nicole Bryan-Nomides, MT(ASCP), MS, CIC, Infection Preventionist; Rebecca Herman, BA, Infection Prevention Assistant; Andrew Vosburgh, MD, Medical Director Occupational Health; Mohamad Fakih, MD, Medical Director Infection Prevention, St. John Hospital and Medical Center, Detroit, MI

The Successful Implementation of Mandatory Seasonal Influenza Vaccination for Health Care Workers at an Academic Medical Center

2010-06-01

Bridget A. Gaughan, RN, MS, Infection Control Practitioner, Loyola University Medical Center, Maywood, IL Issue: Influenza immunization is the most effective means for preventing influenza. The importance of minimizing the transmission of influenza in healthcare settings can not be understated. Influenza immunization rates amongst health care workers (HCWs) is estimated to be 40%. The CDC has set a national goal for flu vaccination of 60%. Through use of evidence based voluntary approaches we achieved a 73% flu vaccination rate amongst HCWs in 2008-9 influenza season. Though well above the National average, it still meant that 1 in 4 HCWs were not immunized. For the 2009-10 season we set our goal to have 100% of HCWs vaccinated.

Two-step Tuberculosis Contact Investigation using QuantiFERON-TB Gold

2010-06-01

Masaki Tanabe, MD, Department of Infection Control and Prevention; Yoshiko Matsushima, MT, Department of Central Laboratory; Midori Fukuda, RN, Department of Infection Control and Prevention, Mie University Hospital, Tsu, Japan

Bacteremia Associated With Hemodialysis Catheters in the Outpatient Chronic Hemodialysis Unit

2010-06-01

Paula Morris, RN, Infection Control, Provena St. Mary's Hospital, Kankakee, IL Issue: During the reporting period of January 2008 to December 2008, the incidence of primary bacteremia associated with hemodialysis catheters was reported at a rate of 3.5 per 1000 dialysis catheter days (29 infections). This rate was increased as when compared to previous year of 2007_rate was 1.5 per 1000 dialysis catheter days (16 infections). The cases of bacteremia were reviewed and found to be consistent with Staphylococcus suggesting skin as a source of bacteremia.

100% Universal Admission Screening for Methicillin-resistant Staphylococcus aureus (MRSA) Plus Eradication Therapy With Mupirocin Plus Chlorhexidine Decreased Healthcare-associated Infections due to MRSA in a Tertiary Care Hospital

2010-06-01

Mary Cochran, RN, BSN, MS, CIC, Manager, Infection Control, Pitt County Memorial Hospital, Greenville, NC Background: Healthcare-associated infections (HAI) due to MRSA continue to be a major challenge for hospitals in the US. Strategies to decrease HAI-associated MRSA include hand hygiene, isolation of known and high-risk patients for carriage, selective screening and eradication, and universal surveillance plus eradication. A Quality Board initiative to eradicate HAI-associated infections due to MRSA was initiated in 2007.

A Comprehensive, Ongoing Program to Eliminate Central Line-associated Bloodstream Infections in Two Intensive Care Units

2010-06-01

Rachel Zastrow, RN, BSN, Patient Safety Liaison; Marla Husch, RPH, BS, Project Consultant; Sallie Rivera, RN, MSN, CIC, Infection Control Preventionist; Patricia Grisco, RN, BSN; Susan Innes, RN, 3ICU; Kristyn Shields, RN, BSN, CCRN, 2ICU, Central DuPage Hospital, Winfield, IL; William Foster, MA Economics, Project Consultant, University of Illinois, Chicago, Chicago, IL

A Descriptive Evaluation of Infection Control at HIV Centers Within Drug-resistant TB Hospitals in South Africa

2010-06-01

Kara Franz, MPH, MSN, PNP, Nurse Practitioner; Carrie Tudor, MPH, RN, Doctoral Student, Johns Hopkins University, Baltimore, MD; Matsie Mphalele, MPH, Scientist, Medical Research Council, Pretoria, South Africa; Susan Dorman, MD, Associate Professor, Johns Hopkins University, Baltimore, MD; Martie van der Walt, PhD, Scientist and Director, Medical Research Council, Pretoria, South Africa; Jason E. Farley, PhD, MPH, CRNP, Assistant Professor, Johns Hopkins University, Baltimore, MD

A Multi-faceted Approach Results in Sustained Improvement in Hand Hygiene Practices at a Community Hospital

2010-06-01

Brenda Grant, RN, MPH, CIC, CHES, IP, Stamford Hospital, Stamford, CT Issue:. Hospital-acquired infections (HAIs) are the most common complication of hospitalized patients, with approximately 5-10 percent of patients developing an infection during their hospitalization. It is estimated that at least 20 percent of these infections are preventable. There is substantial evidence that hand antisepsis reduces the incidence of HAIs, however unacceptably low hand hygiene compliance contributes to the transmission of microbial agents responsible for HAIs. Nationally, there is a focus on reducing HAIs. Consumers and other organizations are targeting a goal of zero tolerance for HAIs.

A Novel Approach to the Challenges of MDRO Management in a Long-term Acute Care (LTAC) Hospital Setting

2010-06-01

Vivian Almario, APRN, Infection Preventionist, Hospital for Special Care, New Britain, CT Issue: LTACs provide acute level care to multiply complicated patients over a prolonged period of time that can last weeks, months or years. The ongoing challenge is to develop a system for infection control and prevention that provides a safe environment for all while providing quality of life for patients, especially those who are there for longer stays of care.

Automated collection of hand hygiene data shows statistical relationship which can alert health care facility when rates fall below acceptable level

2010-06-01

Carl Mooney, PHD, B Sc, Doctor, Lecturer, Flinders University, Adelaide, Australia; Patricia Roberts, RN, Graduate Certificate in Nursing Science (IC), Clinical Practice Consultant, Infection Control, Repatriation General Hospital, Adelaide, Australia; Philip C. Cheney, B. Ec Cert Stud, rL Solutions - Software for Safer HealthCare, Toronto, ON, Canada

Characteristics of Hospitals Participating in Patient Safety Collaboratives and Implementation of Infection Prevention and Control Practices

2010-06-01

Helen Halpin, ScM, PhD, Professor of Health Policy; Megan Vanneman, MPH, Graduate Student Researcher, UC Berkeley, Berkeley, CA Background: Collaborative efforts have been associated with improvements in patient safety process measures and infection rates. This paper examines which hospital characteristics are linked to participation in patient safety collaboratives, and whether or not participation is linked to infection control practices. A particular focus is on hospitals participating in the Bay Area Patient Safety Collaborative (BEACON), CA Healthcare-Associated Infection Prevention Initiative (CHAIPI) and the Southern CA Patient Safety Collaborative (SCPSC).

Hospital Adoption of Automated Surveillance Technology and the Implementation of Infection Prevention and Control Programs

2010-06-01

Helen Halpin, ScM, PhD, Professor of Health Policy; Wayne Enanoria, PhD, Director, Epidemiology Preparedness & Informatics; University of California, Berkeley, Berkeley, CA Background: This purpose of this research is to analyze the relationship between hospital use of automated surveillance technology and implementation of formal written evidence based infection control practices. Our hypothesis is that hospitals that use automated surveillance technology will have made more progress implementing their infection control programs than hospitals that rely on manual surveillance.

Does Tdap (Tetanus, diphtheria acellular pertussis) Vaccine Compliance Increase with “Mandatory” Healthcare Worker (HCW) Influenza Immunization (FluImm) Program?

2010-06-01

Wendi Gornick, MS, CIC, Infection Prevention & Epidemiology Manager; Jasjit Singh, MD, Medical Director of Infection Control; Nimfa Santos, RN, Associate Health Manager, CHOC Children's Hospital, Orange, CA

Education for Population-based Infection Control & Environmental Safety (PICES): How Are We Preparing the Next Generation of IPs?

2010-06-01

Ida Androwich, PhD, RN, FAAN, Professor; Diana Hackbarth, RN, PhD, Professor, Loyola University Chicago, Maywood, IL Issue: The need for nurses to meet the challenges of emerging infections, environmental hazards and the threat of bioterrorism has never been greater. Today's health care system demands that professional nurses assume leadership for patient safety and infection prevention, and broaden their scope of practice beyond the hospital to be community and population focused. Prevention, early detection, surveillance and treatment modalities must be designed, implemented, and evaluated at the system level. Specialized education at the masters level is key to providing nurses with the required knowledge and skills to effect change now and in the health care system of the future.

Evaluation of a New Flexible Mounting Dispenser to Improve Point of Care Product Access in an Acute Care Hospital and the Resulting Effect on Hand Hygiene Compliance Rates

2010-06-01

Dede Ouren, RN, CIC, Infection Control Manager; Stephanie Tismer, RN, BSN, Infection Control Practitioner, Regions Hospital, St. Paul, MN Background/Objective: One of many reasons for non-compliance with accepted hand hygiene practice is the lack of readily accessible hand hygiene stations. In this study, the effect of a new point -of-care (POC) dispenser on hand hygiene compliance (HHC) was evaluated. The dispenser is designed to be readily mounted and removed from either horizontal or vertical mounting surfaces.

Facilitators and Barriers in Implementing the Centers for Medicare and Medicaid Services Policy of Nonpayment for Preventable Complications

2010-06-01

Timothy Hoff, PhD, Associate Professor, University at Albany, SUNY, Albany, NY; Christine Hartmann, PhD, Research Health Scientist and Assistant Professor, Bedford VA Medical Center; Boston University School of Public Health, Bedford, MA; Maya Dutta-Linn, MPH, Project Manager, Harvard Pilgrim Health Care Institute, Boston, MA; Peter Wroe, BA, Research Assistant, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA; Jennifer Palmer, MS, Research Assistant, Bedford VA Medical Center, Bedford, MA; Christina Soerensen, BA, Graduate Assistant, University at Albany, SUNY, Albany, NY; Grace Lee, MD, MPH, Assistant Professor of Population Medicine & Assistant Medical Director of Infection Control, Harvard Pilgrim Health Care Institute and Harvard Medical School, Children's Hospital Boston, Boston, MA

Clinical Decision Support Technology Streamlines Documentation of Infection Control Interventions for Timely Removal of Foley and Central Venous Catheters

2010-06-01

Alex Chavez, MT, CIC, Infection Control Practitioner, Memorial Hospital Miramar, Miramar, FL Issue: Foley catheter-related urinary tract infections (UTIs) account for 40% of U.S. hospital-acquired infections. Patients with central venous catheters are vulnerable to catheter-associated bloodstream infections (CABIs); 250,000-500,000 CABIs occur annually. Preventing these infections is a main focus for infection preventionists (IPs), but documenting interventions and tracking their impact are challenging.

Host Genetic Polymorphisms in Couples Discordant for Human Immunodeficiency VirusType 1 Infection in Accra, Ghana

2010-06-01

Yvonne Affram, BEd. (Science), MPhil Microbiology, Department of Microbiology, University of Ghana Medical School, Accra, Ghana Background: Some individuals remain HIV-1 seronegative despite multiple sexual exposures to the virus. The mechanisms underlying this resistance remain unclear and several genetic factors have been implicated, among which are the homozygosity for mutations in CCR5 gene (CCR5 Delta 32) and CCR2 gene (CCR2 64I).

Impact of Enhanced Isolation Precautions for Influenza Beyond Nationally Established Recommendations

2010-06-01

Laura Bardowski, RN, BSN, MSN Candidate; Cara Coomer, RN, BSN, Infection Control Coordinator, Northwestern Memorial Hospital, Chicago, IL; Mary Alice Lavin, RN, MJ, CIC, Chief Nurse Epidemiologist, Rush University Medical Center, Chicago, IL; Pradeep Sama, MBA, Manager, Clinical Analytics; Maureen Bolon, MD, MS, Medical Director, Infection Control and Prevention, Northwestern Memorial Hospital, Chicago, IL; Teresa Zembower, MD, MPH, Medical Director, Healthcare Epidemiology and Infection Control, Northwestern University, Chicago, IL

Improving Hand Hygiene Compliance: A Multidisciplinary Approach

2010-06-01

Tracie Harris, MT(ASCP), CIC, Infection Control Practitioner, Children's National Medical Center, Washington, DC; Laura de Nobel, RN, JD; Andrea Colevas, MSN, RN; Nalini Singh, MD, MPH; Roberta DeBiasi, MD; Xianoyan Song, PhD

Leveraging Executive Support; Assuring Management Accountability for Infection Prevention Outcomes

2010-06-01

Linda R. Greene, RN, MPS, CIC, Infection Control and Prevention, Rochester General Hospital, Rochester, NY Issue: In order to reduce Health Care-Acquired Infections (HAIs) and to support a culture of zero tolerance for adverse events, it is essential to maximize the potential for successful implementation of best practices. Central to this effort is the importance of setting clear, measurable goals and a committed leadership. Executive support is essential to an effective program; however, managing patient outcomes may not always be a top priority for leaders. They may view patient outcomes as a clinical rather than management function.

Mandatory LTC Infection Surveillance Reporting to a State Agency: Lessons Learned

2010-06-01

Steven Schweon, RN, MPH, MSN, CIC, HEM, Infection Preventionist; Kathleen Morrell, RN, BSN, NHA, Nursing Home Administrator, Pleasant Valley Manor Nursing Home, Stroudsburg, PA

Medicare's Policy of Nonpayment for Catheter-associated Urinary Tract Infections

2010-06-01

Jennifer A. Palmer, M.S., Research Assistant, Bedford VA Medical Center, Bedford, MA; Christine W. Hartmann, PhD, Research Health Scientist and Assistant Professor, Bedford VA Medical Center; Boston University School of Public Health, Bedford, MA; Timothy Hoff, PhD, Associate Professor, University at Albany, SUNY, Albany, NY; Maya Dutta-Linn, MPH, Project: Manager; Peter Wroe, BA, Research Assistant; Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, MA; Grace Lee, MD, MPH, Assistant Professor of Population Medicine & Assistant Medical Director of Infection Control, Harvard Pilgrim Health Care Institute and Harvard Medical School, Children's Hospital Boston, Boston, MA

MRSA Prevention Partnership

2010-06-01

Suzanne H. Fritz, RN, BSN, CIC, Infection Preventionist; Theresa Haley, BS MT(ASCP), MPC MRSA Prevention Coordinator, Lebanon VA Medical Center, Lebanon, PA; Ericka L. Kalp, MPH, CIC, Manager of Infection Control, The Chambersburg Hospital, Chambersburg, PA; Diana Scheide, BA RN CIC, Manager of Infection Prevention, Memorial Hospital of York, York, PA; Marla Konas, RN, Infection Control Coordinator, Lancaster Regional Medical Center, Lancaster, PA

Multi-disciplinary Approach to Clostridium difficile Infection (CDI) Appears Effective

2010-06-01

Karen Maceno, BS, RN, Manager, Infection Prevention and Control; Leia Skol, PharmD, Infectious Diseases Pharmacist; Dale Lieu, MD, CIC, Chairman, Infection Prevention and Control, Kaiser Permanente, San Diego, CA

Optimizing Infection Prevention (IP) Process and Management of Pandemic (H1N1) 2009 Influenza in a Pediatric Oncology Unit in Guatemala City

2010-06-01

Mario A. Melgar, MD, ID consultant; Rosa Elvira de Leon, RN; Mariana Jerónimo, RN; Marilin Ramirez, RN, Preventionist; Edwin J. Asturias, MD, ID consultant; Federico Antillón-Klussmann, MD, PhD, Medical Director, Unidad Nacional de Oncología Pediátrica, Guatemala; Don Guimera, RN, International Epidemiology Coordinator; Miguela Caniza, MD, Infectious Diseases Program Director - International Outreach, St. Jude Children's Research Hospital, Memphis, TN

Patient Education: Making a Better Health Care Consumer

2010-06-01

Mary C. Wilson, RN, BSN, CNOR, Clinical Nurse Preceptor/Educator; Dianne DeAngelis, RN, ICP, CIC, Nurse Clinician, Infection Control; Susan Hardway, RN, Clinical Nurse Preceptor/Educator, West Virginia University Hospitals, Morgantown, WV

Post Exposure Prophylaxis in a Pandemic: A Prescription for National Disease Specific Definitions

2010-06-01

Elizabeth Monsees, RN, BSN, CIC, Infection Control Practitioner; Yolanda Ballam, BS, CIC, Infection Control Practitioner; Deborah Rivera, RN, COHN, Occupational Health Nurse Supervisor, Children's Mercy Hospitals and Clinics, Kansas City, MO

Project: Clean Sweep Reducing Healthcare-associated Infections, Employee Absenteeism, Healthcare Cost and Hospital Readmissions in a Long Term Care Facility

2010-06-01

Janice M. Schandel, BSN, Director of Nursing; Kimberly S. Thomas, ADN, Infection Control Coordinator, Mountainview Specialty Care Center, Greensburg, PA Issue: The reemergence of the H1N1 virus, and the continued concern of a seasonal influenza on the high risk resident population, prompted a close review of the current practices focusing on hand hygiene and environmental cleaning/disinfection in our long term care facility. The facility has 137 beds with a variety of acuity levels. Two thirds of the beds are dedicated for skilled and sub acute nursing services. The resident services offered include acute and chronic ventilator management, advanced wound care, post surgical care, as well as comprehensive rehabilitation.

Reducing the Threat of Clostridium diffcile by implementing a Clostridium difficile Bundle

2010-06-01

Frances P. Abraham, Dr.PH, RN, Infection Control Coordinator; Patricia A. Byers, RM, M(ASCP), CIC, Infection Preventionist/MRSA Coordinator; Debra A. Lewis, RN, MSN, Infection Control Manager; Carol Steans, BS, MA, RN, BSN, Infection Preventionist; Andrea Munoz-Rodriguez, RN, Infection Control Nurse; Anthony Quarles, Eval Graduate, EMS Supervisor, Michael E. DeBakey VA Medical Center, Houston, TX

Reduction in Hospital-acquired MRSA and VRE Infections Through Active Surveillance Cultures

2010-06-01

Cynthia Maschmeier, MT(ASCP), SM, Senior Epidemiologist; Concepcion Moore, RN, MBA, CIC, Senior Epidemiologist; Rebecca Landreth, RN, Infection Preventionist; Donna Wolk, MHA, PhD, D(ABMM), Director Microbiology; Wanda Petty, MT(ASCP), SM, Technical Specialist, University Medical Center, Tucson, AZ

Reduction of Low Transverse Cesarean Section-associated Surgical Site Infections

2010-06-01

May M. S. Riley, RN, MSN, CIC, CCRN, ACNP, Clinical Epidemiologist, MPH/PhD student; David Pegues, MD, Hospital Epidemiologist; Deborah Suda, RN, MSN, OB L&D Unit Director; Khalil Tabsh, MD, OB Surgeon; Udaykumar Devaskar, MD, Neonatologist, UCLA Medical Center, Los Angeles, CA

Reduction of Surgical Site Infections Following Pancreatectomy Procedure

2010-06-01

May M. S. Riley, RN, MSN, CIC, CCRN, ACNP, Clinical Epidemiologist; David Pegues, MD, Hospital Epidemiologist; Howard Reber, MD; Joe Hines, MD, Surgeon; Barbara Clerkin, RN, MPH, Nurse Coordinator, UCLA Medical Center, Los Angeles, CA

Rural Healthcare—Proactive Role of Campaigning for Influenza Prevention

2010-06-01

Ronda Sweet, RN, MSN, Staff Growth & Development Educator; Debra Meek, Human Resource Specialist, Employee Health, Rush Memorial Hospital, Rushville, IN Issue: Even though influenza vaccines were available at no cost, only 40% of employees chose to receive them each year.

Situation Analysis of Nosocomial TB Transmission Prevention among Hospitals in Thailand

2010-06-01

Akeau Unahalekhaka, Ph.D.(Epidemiology), Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand Background/Objective: M. tuberculosis can transmit and cause problems in hospitalized patients and hospital personnel. The objective of this study was to determine activities in prevention of nosocomial TB transmission conducted by Thai hospitals including their problems and their needs.

The Connector or Not the Connector: Reduction of Blood Culture Contamination

2010-06-01

Rebecca Landreth, RN, Infection Preventionist; Connie Moore, RN, MBA, CIC, Senior Epidemiologist; Cynthia Maschmeier, MT, ASCP, SM, Senior Epidemiologist, Infection Preventionist, University Medical Center, Tucson, AZ

The Importance of Piloting Changes: Our Surprise That More is Less—Staff Rejection of Additional Visual Clues for Use of Contact Precautions

2010-06-01

Herminia Pua, RN, BSN, CIC, ICP, Loyola University Medical Center, Maywood, IL Background: Health care worker (HCW) compliance with use of personal protective equipment (PPE) in settings where contact precautions are required is suboptimal. One reason is skirting the use of PPE in entering the patient's room for an encounter where contact might not be required such as to ask a question. The Pittsburg Regional Health Initiative borrowed ideas from the “factory floor” and experimented with the use of additional visual clues such as taping lines on the floor and posting signage with arrows. These unequivocal visual clues outline where HCWs may enter the room without PPE, defining that they must gown if they pass the line. We tested a similar system at our 573 bed tertiary care university hospital.

The Use of Coaches to Enhance the Infection Prevention Program at a Large Teaching Hospital

2010-06-01

Audrey Adams, RN, MPH, BSN, CIC, Infection Control Director; Sheron Wilson, RN, MPH, CIC, Infection Control Nurse; Rodolfo Simons, Jr., CIC, Infection Control Analyst, Montefiore Medical Center, Bronx, NY

Use of a Room Placement Algorithm for Safe Placement of Patients With MRSA and/or VRE Colonization in a Long-term Acute Care (LTAC) Hospital Setting

2010-06-01

Vivian Almario, MSN, APRN, Infection Preventionist, Hospital for Special Care, New Britain, CT Issue: Our LTAC has seen a steady increase in the number of admissions for drug resistant organism colonized or infected patients over the past ten years. Our facility has few private rooms and our patient population is complicated with multiple medical co-morbidities. Our ongoing challenge is how to assign safe room placement in our environment for these patients.

Witness to the 21st Century Infection Preventionist (IP) Pioneer Spirit: Establishing a Sister Chapter Partnership in Kenya

2010-06-01

Candace K. Auel, RN, BSN, Infection Prevention, Grant Regional Health Center, Lancaster, WI; Karen Allen, RN, BSN, Infection Prevention, Hospice Care, Madison, WI; Melody Bahr, RN, BSN, Infection Prevention, Homeward Bound, Lancaster, WI; Barb Gordon, BS, Infection Prevention, UW Hospital, Madison, WI; Anna Hutchings, RN, BSN, Infection Prevention, Fort Atkinson Healthcare, Fort Atkinson, WI; Maria Leary, RN, BSN, Infection Prevention, Upland HIlls Health, Dodgeville, WI; Nancy Moskal, RN, BSN, Infection Prevention, Stoughton Hospital, Stoughton, WI; Rose Ngugi, RN, Infection Prevention, Nairobi Hospital, Nairobi, Kenya; Melanie Reppen, RN, CIC, Infection Prevention, St. Mary's Hospital, Madison, WI; Sally Rosemeyer, RN, BSN, Infection Prevention, Boscobel Health, Boscobel, WI; Ellen Willett, RN, BSN, Infection Prevention, UW Clinics, Madison, WI; Linda McKinley, RN, BSN, Infection Prevention, Madison VA Hospital, Madison, WI

A Failure Mode Effect Analysis (FMEA) Approach Significantly Decreased SSI in Cardiac Surgery

2010-06-01

Lynn S. Fine, PhD, MPH, CIC, Infection Preventionist; Anna E. Lambert, RN MS CCRN, Associate Director of Cardiovascular & Thoracic Nursing; Paul S. Graman, MD, Professor of Medicine, University of Rochester Medical Center, Rochester, NY

A Guideline for Prioritization of Investigation of Possible Healthcare-related Disease Transmission—New York State

2010-06-01

Ernest J. Clement, RN, MSN, CIC, Infection Prevention and Control Unit Manager, Bureau of Healthcare Associated Infections; Elena M. Rizzo, MA, Hepatitis Surveillance Coordinator, Bureau of Communicable Disease Control; Rachel L. Stricof, MPH, CIC, Director of HAI Reporting, Bureau of Healthcare Associated Infections; Barbara J. Wallace, MD, MSPH, Division of Chronic Disease and Injury Prevention; Geraldine S. Johnson, MS, Office of Science and Public Health; Perry F. Smith, MD, Division of Epidemiology; Joshua K. Schaffzin, MD, PhD, Bureau of Healthcare Associated Infections, New York State Department of Health, Albany, NY

A Multidisciplinary Approach to Vancomyocin-resistant Enterococcus Outbreak Management

2010-06-01

Natalie Joy Goertz, Registered Nurse, Infection Control; Janice Qubty, BScN, Manager of Medicine, Victoria Campus; Elaine Mayo, Registered Practical Nurse, P.S.A. T.S.A. Infrastructure Admin; Marg Kooy, BScN, Coordinator of Medicine and Respirology; Barbara Watson, BScN, MScN, Educator; Tara Vyn, BScN, MScN, Infection Control, London Health Sciences Centre, London, ON, Canada

An Outbreak of Community Acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA) in a Pediatric Hospital Burn Unit

2010-06-01

Barbara Roman, BS, MT(ASCP), CIC, Epidemiology Specialist, Nationwide Children's Hospital, Columbus, OH Issue: Transmission of CA-MRSA within hospitals is being reported with an increased frequency. These infections usually present as minor skin and soft tissue infections, but more invasive disease has also been described. The CDC's Management of Multidrug-Resistant Organisms in Healthcare Settings, 2006 states that the identification of an MDRO from even one patient in a special unit with a highly vulnerable patient population (e.g. burn unit) can call for decisions to intensify Multidrug Resistant Organism (MDRO) control activities. In December, 2009 five burn patients developed significant MRSA infections within the course of one week which prompted an immediate outbreak investigation.

Bed Bug Infestation on a Maternity Unit in a Tertiary Care Center

2010-06-01

Adebisi Adeyeye, RN, MPH, CIC, Infection Control Nurse; Audrey Adams, RN, MPH, CIC, Infection Control Director; Lucille Herring, RN, MSN, CIC, Infection Control Nurse; Brian P. Currie, MPH, MD, VP, Director of Medical Research, Montefiore Medical Center, Bronx, NY

Control of Recurrent Outbreaks of Multidrug-resistant Acinetobacter baumannii Attributed to Removal of Alcohol Sources from the ICU Environment in a United Arab Emirates Hospital

2010-06-01

Manju Mathew, RN, CIC, Infection Control Department, Tawam Hospital, Al Ain, United Arab Emirates Issue: Recurrent outbreaks of multidrug resistant (MDR) Acinetobacter baumannii (A. baumannii) in the ICU of a United Arab Emirates tertiary care teaching hospital in 2008-2009 posed a serious challenge for the IP team. It was evident that routine Infection control interventions were not effective, requiring more aggressive measures.

First Outbreak of Methicillin-resistant Staphylococcus aureus USA300 Among Japanese Healthcare Workers and Hospitalized Patients

2010-06-01

Miki Nagao, MD, PhD, Yoshitsugu Iinuma, MD, PhD, Associate Professor, Department of Infection Control and Prevention, Kyoto University Hospital, Kyoto, Japan; Masahiro Suzuki, PhD, Laboratory of Bacteriology, Aichi Prefectural Institute of Public Health, Nagoya, Japan; Junko Igawa, RN; Shunji Takakura, MD, PhD; Satoshi Ichiyama, MD, PhD, Professor, Department of Infection Control and Prevention, Kyoto University Hospital, Kyoto, Japan

Going Batty: Investigation of Bat Infestation in a Tertiary Hospital

2010-06-01

Amy M. Dziewior, RN, BSN, Infection Preventionist; Kathie Wilkerson, RN, CIC, Infection Control Practitioner; Lorrie Ingram, RN, BSN, Infection Preventionist; Thomas Talbot, MD, MPH, Chief Hospital Epidemiologist & Assistant Professor of Medicine and Preventive Medicine; Titus L. Daniels, MD, MPH, Associate Hospital Epidemiologist & Assistant Professor, Vanderbilt University Medical Center, Nashville, TN

Hepatitis B Virus Exposure in an Inpatient Hemodialysis Unit Due to Delayed Recognition of Reactivation in a Kidney Transplant Patient

2010-06-01

Sandra R. Myrick, BS, MT(ASCP), Coordinator, Infection Control; Sandra Reiner, RN, BSN, Infection Control and Prevention Coordinator, Northwestern Memorial Hospital, Chicago, IL; Mary Alice Lavin, RN, MJ, CIC, Chief Nurse Epidemiologist, RUSH University Medical Center, Chicago, IL; Cybele Ghossein, MD, Associate Professor of Medicine and Director, Inpatient Dialysis Unit; Walter Aguilar, RN, CNN, Clinical Coordinator, Inpatient Dialysis Unit; Robin Oakley, RN, BSN, Nurse Manager, CCU and Inpatient Dialysis Unit; Cynthia Barnard, MBA, MSJS, CPHO, Director, Quality Strategies; William Schlueter, MD, Director, Outpatient Dialysis Unit; Teresa Zembower, MD, MPH, Healthcare Epidemiologist; Northwestern Memorial Hospital, Chicago, IL

Identification and Control of an Outbreak of Vancomycin-resistant Enterococcus faecium in Hematology/Oncology Patients at a Comprehensive Cancer Center

2010-06-01

Kay Sams, RN, BSN, CIC, Infection Preventionist; Stacy Martin, RN, BSN, CIC, Infection Preventionist Supervisor; John N. Greene, MD, FACP, Chief of Infectious Diseases & Hospital Epidemiologist; Ana Paula Velez, MD, Division of Infectious Diseases & International Medicine; Rod Quilitz, PharmD, BCOP, Clinical Pharmacist Infectious Disease; H. Lee Moffitt Cancer Center, Tampa, FL

Invasive Group A Streptococcal Infection in Adult Long Term Care—New York, 2009

2010-06-01

Monica J. Quinn, RN, MS, CIC, Infection Control Coordinator; Ann Sullivan-Frohm, BS, Public Health Epidemiologist; Patricia S. Many, RN, MS, Public Health Epidemiologist; Amy E. Burns, MS, Public Health Epidemiologist; Christina M. Hidalgo, MPH, Public Health Epidemiologist; Brenda E. Naizby, RN, Public Health Epidemiologist; Joshua K. Schaffzin, MD, PhD, Medical Director of Healthcare Epidemiology & Infection Control Program, Bureau of Healthcare Associated Infections, New York State Department of Health, Albany, NY

Investigation of a Parainfluenza Outbreak in a Bone Marrow Transplant (BMT) Unit

2010-06-01

Jo-Anne Janigan, BScN, Infection Prevention and Control, The Ottawa Hospital, Ottawa, ON, Canada; Josee Shymanski, BScN, Infection Prevention and Control, Montfort Hospital, Ottawa, ON, Canada; Suzanne Madore, BScN, Clinical Manager 5WST; Lothar Huebsch, MD, Director of Blood and Marrow Program, The Ottawa Hospital, Ottawa, ON, Canada; Timothy Karnouchow, PhD, Head, Division of Virology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada; Kathy Suh, MD, Associate Director of Infection Prevention and Control; Virginia Roth, MD, Director of Infection Prevention and Control; The Ottawa Hospital, Ottawa, ON, Canada

Investigation of an Outbreak of Carbapenem-resistant Acinetobacter baumannii in the Medical Intensive Care Unit and Efficacy of Infection Control Measures

2010-06-01

Hyang Mi Mun, MT, MPH; Hye Ran Choi, RN, MPH; Min Kyung Han, RN, MSN, CIC; Sun Hee Kwak, RN, BSN; Min Jee Hong, RN, BSN; Young Ju Lim, RN, MSN, Department of Infection Control, Asan medical center, Seoul, Korea, Republic of; Mi Na Kim, MD, PhD, Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea, Republic of; Jae Sim Jeong, RN, CIC, PhD, Department of Clinical Nursing, University of Ulsan College of Medicine, Seoul, Korea, Republic of; Oh-Hyun Cho, MD, Division of infectious Diseases, Asan medical center, Seoul, Korea, Republic of; Jun Hee Woo, MD, PhD, Department of Infection Control and Division of infectious Diseases, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Republic of Korea

Legionella - Every Infection Preventionist's Dream—Or Is It?

2010-06-01

Kristine Chafin, BA, MBA, RN, CIC, Infection Preventionist, North Central Baptist Hospital, San Antonio, TX Issue: Legionella is everywhere in the environment and can sometimes be fatal. Legionella is transmitted through inhalation of mist, aerosols or fine spray into the lungs or aspiration while drinking, swallowing or choking. It is not spread from person to person. CDC's definition of hospital acquired legionella pneumonia is pneumonia in a patient who has been in the hospital ten straight days or more then develops legionnaire's disease. Sources of legionella can be potable water systems, spray misters, decorative fountains, cooling tower drift, irrigation systems, respiratory therapy equipment, whirlpools, therapy pools and spas. Legionella thrive in water temperatures of 65-124 degrees. Texas law requires that the hospital's hot water not be hotter than 110 degrees - the ideal temperature for legionella growth. The threat of legionella grows as construction occurs due to the disruption of soil and water. North Central Baptist Hospital (NCBH) was built in 1991 as a multi-service acute care hospital. In 2005, the hospital grew from 125 beds to 268 beds with the construction of the new hospital building.

Nosocomial Listeriosis Associated With Tuna Fish Salad

2010-06-01

Sandra Hardy, RN, MA, Infection Prevention and Control Practitioner; Regina Toomey Buueno, MS, FACHE, DHCFA, Senior Director of Food & Nutrition Services; Kenneth Inglima, MS, Manager, Clinical Microbiology and Immunology; Angela Anderson, AHCFA, Assistant Director/ Patient Services; Chris Lord, Director of Operations; Michael Phillips, MD, MPH, Hospital Epidemiologist/Director Infection Prevention & Control, NYU Langone Medical Center, New York, NY

Preventing Methicillin-resistant Staphylococcus aureus (MRSA) Transmission—A Private Room Helps but Is Not the Solution

2010-06-01

Obaida A. Merheb, MS, CIC, Infection Control Practitioner, Children's National Medical Center, Washington, DC Issue: The Neonatal Intensive Care Unit (NICU) in our institution is a 54-bed level IIIC unit. It is a newly constructed area featuring 46 private rooms and two shared bays. The unit was opened in May 2009. In late July 2009, an increase in nosocomial acquisition of methicillin-resistant Staphylococcus aureus (MRSA) was noted (Figure 1).

Successful Eradication of a Vancomycin-resistant Enterococcus Outbreak in a Neonatal Intensive Care Unit—When Order Counts in Hand Hygiene

2010-06-01

Alexander Tomich, MSN, RN, Infection Control Practicioner II; Jorge Parada, MD MPH, Medical Director Infection Prevention and Control; Paul Schreckenberger, PhD, Director of Clinical Microbiology Lab; Violeta Rekasius, MT ASCP, Technical Specialist; Julie Venci, MD, Resident; Patricia Hester-Lund, BSN RN, Assistant Manager Neonatal Intensive Care Unit; Tricia Thomson, MD, Pediatric Fellow; Kathleen McKinley, BS, Research Assistant III; Malliswari Challapalli, MD, Associate Professor Pediatric Infectious Diesase; Loyola University Medical Center, Maywood, IL

The Impact of Infection Control Interventions to Prevent Norwalk Virus Outbreaks on Inpatient Psychiatric Units

2010-06-01

Larry Colbert, BA, MA, CIC, Associate Director of Infection Conrol; Susan Marchione, BS, CIC, Senior Associate Director of Infection Conrol; Keith Krasinski, MD, Professor, Pediatrics Chair, Infection Control, Hospital Epidemiologist, Bellevue Medical Center, New York City, NY

Change in Clostridium difficile Testing Methodology: Impact on Hospital Costs and Infection Control Activity

2010-06-01

Christopher Harrison, MPH; Candace Friedman, MPH-CIC, Director; Benrong Chen, MS, PhD, Statistician, Infection Control & Epidemiology; Bill Lebar, PhD, Clinical Microbiology; Carol Chenoweth, MD, MPH, Hospital Epidemiologist, Infection Control & Epidemiology, University of Michigan, Ann Arbor, MI

Clostridium difficile testing by Polymerase Chain Reaction: Change to Benefit All

2010-06-01

Jean Watson, MT(ASCP), MPH, CIC, Infection Control Practitioner; Mary Diamond, RN, BSN, Infection Control Practioner, Advocate Christ Hospital and Medical Center, Oak Lawn, IL

Coaching the Change: 2% Chlorhexidine gluconate (CHG) and 70% Isopropyl Alcohol

2010-06-01

Elizabeth DiPersia, RN, MS, CIC, Infection Preventionist; Kara Colopinto, BSN, RN, CNOR, ONC, Perioperative Patient Safety Specialist, New York Presbyterian Weill Cornell Medical Center, New York, NY

Financial Implications of Methicillin-resistant Staphylococcus aureus Screening in Hospitals

2010-06-01

Christopher S. Hollenbeak, PhD, Associate Professor, Penn State College of Medicine, Hershey, PA Background/Objectives: Patients are increasingly being admitted to hospitals colonized with Methicillin-resistant Staphylococcus aureus (MRSA). Many hospitals are evaluating methods to screen patients for MRSA upon admission. We sought to evaluate the economic implications of MRSA screening using different culture and polymerase chain reaction (PCR) methods.

Hospital Costs Associated With Surgical Site Infections in General and Vascular Surgery Patients

2010-06-01

Christopher S. S. Hollenbeak, PHD, Associate Professor; Melissa Boltz, MD, Resident; Gail Ortenzi, RN, Research Nurse; Peter Dillon, MD, MS, Professor and Chair, Penn State College of Medicine, Hershey, PA

Process Improvement Project Utilizing Antimicrobial Dressings With the Goal of Reducing the Surgical Site Infection Rate

2010-06-01

Victoria E. Milliken, BS MT(ASCP), CIC, Infection Preventionist, Unity Health Center, Shawnee, OK Background/Objectives: At this 114 licensed-bed acute care rural hospital located in Central Oklahoma, the core purpose is to positively impact human life through exceptional healthcare. This goal reflects the zero Surgical Site Infection (SSI) benchmark of the National Healthcare Safety Network. The Deficit Reduction Act of 2005 provided a monetary incentive for zero benchmarking. Approximately 6450 admissions and 5700 surgical procedures are performed each year. Surveillance is performed on all SCIP Core measures as well as other surgical procedures.

The Improper Placement of the Chlorhexidine Gluconate Sponge Dressing for Use on Central Venous Devices

2010-06-01

Cynthia A. Kohan, MT(ASCP), MS, CIC, Infection Preventionist; John M. Boyce, MD, Hospital Epidemiologist, Section Chief of Infectious Diseases, Hospital of St. Raphael, New Haven, CT

Use of an Antimicrobial Luer Activated Device on Peripherally Inserted Central Venous Catheters (PICCs) to Reduce Central Line-associated Bloodstream Infection Rates

2010-06-01

Andre Schotte, RN, PhD, Vascular Access IV Team Leader, Riverside County Regional Medical Center, Moreno Valley, CA Issue: Central line-associated bloodstream infections (CLABSIs) are associated with increased morbidity and mortality, thus hospitals are implementing interventions to reduce these preventable complications. In its 2002 Guidelines for the Prevention of Intravascular Catheter Related Infections, the Centers for Disease Control and Prevention recommends the use of an antimicrobial central venous catheter if, after implementing a comprehensive strategy to reduce the rate of CLABSI, the CLABSI rate remains above the institution's goal. Over a three year period, a 377 bed county regional medical center implemented specific strategies to reduce its CLABSI rate, including the addition of a dedicated PICC Team; the Institute for Hospital Improvement (IHI) central line bundle, a chlorhexidine impregnated protective disc and a clear, positive displacement, swabable connector. These interventions are associated with decreasing the Adult ICU PICC CLABSI rate from 15.0% to 0.29%.

Use of an Organoleptic Panel to Evaluate Environmental Sporicide Aesthetics

2010-06-01

Jeanne Medvick, MT (ASCP), MBA, Manager, Clinical Affairs; Daniel Klein, MA, Senior Manager, Microbiology and Clinical Affairs; Amy Suiter, MS, Associate Scientist; Jerry Newman, PhD, Senior Director, Product Development, STERIS Corporation, Saint Louis, MO

Assessment of a Mandatory Reporting System on Compliance With Evidence-based Practices for Prevention of Central Line-associated Bloodstream Infections

2010-06-01

Sharon M. Bradley, RN CIC, Risk Management, ECRI Institute, Plymouth Meeting, PA Issue: Pennsylvania's Act 52 of 2007 included the requirement that training programs be provided for hospitals on healthcare associated infection (HAI) prevention. Analysis of central line associated bloodstream infection (CLABSI) reports identified the rate of compliance with evidence based practices and CLABSI infection rates reported through the National Healthcare Safety Network (NHSN).

Mandatory Reporting of Hip Replacement Procedures: Validating Accuracy, New York State 2008

2010-06-01

Peggy Ann Hazamy, RN, BSN, CIC, Research Scientist-HAI Reporting Program, New York State Department of Health, Buffalo, NY; Carole VanAntwerpen, RN, BSN, CIC, Program Manager - HAI Reporting Program; Boldt Tserenpuntsag, DrPH, Data Analyst - HAI Reporting Program; Valerie Haley, MS, Data Manager- HAI Reporting Program, New York State Department of Health, Albany, NY; Diana Doughty, RN, MBS, CPHQ, Research Scientist-HAI Reporting Program, New York State Department of Health, Syracuse, NY; Marie Tsivitis, MPH, CIC, Research Scientist-HAI Reporting Program, New York State Department of Health, Central Islip, NY; Kathleen A. Gase, MPH, CIC, Research Scientist-HAI Reporting Program, New York State Department of Health, New York, NY; Rachel L. Stricof, MPH, CIC, Bureau Director, New York State Department of Health, Albany, NY

New York State Hospital-acquired Infection Reporting System: Neonatal Intensive Care (NICU) Central Line Infection Rates, New York State Rate

2010-06-01

Diana Doughty, RN, MBA, CIC, CPHQ, Hospital Acquired Infections Program, New York State DOH, Syracuse, NY Background: In 2005, a law was signed requiring New York State (NYS) hospitals to report select healthcare-associated infections (HAIs) in order to assess and compare the incidence of HAIs in the state. The legislation called for the initial monitoring of central line-associated bloodstream infections (CLABSI) in Level II/III NICUs and Level III NICUs where the use of central lines is a standard practice.

A Multi-disciplinary Approach to Improving Environmental Hygiene In a Pediatric System

2010-06-01

Donna Peace, RN, CPHQ, CIC, Infection Control Practitioner, Children's Healthcare of Atlanta, Atlanta, GA Issue: Environmental surfaces have a documented 30-40% association with healthcare acquired infections. Organisms are highly resilient on surfaces. Environmental Services (EVS) is a key stake holder in preventing healthcare acquired infections. Quality Improvement processes are devoted to reducing turn around time, as focus on disinfection and decreasing environmental bio-burden has increased. Bundles are an accepted method of decreasing variation, improving care and patient outcomes. Can applying the “bundle” concept to environmental hygiene have the same effect on improving patient safety?

A Multi-faceted Hand Hygiene Performance Improvement Initiatitve Improved Hand Hygiene Compliance and Potentially Decreased Methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile

2010-06-01

Stephanie Mayoryk, RN, BSN, CIC, Infection Control Practitioner; Karen Mackie, RN MA CIC, ICP, Infection Control Practitioner, Greater Baltimore Medical Center; Baltimore, MD Issue: A one-day point prevalence study occurred in early 2007 among nursing units to ascertain Hand Hygiene compliance. Observation data collected by non-Infection Preventionist's demonstrated 26.7% compliance among departments surveyed. Hand hygiene performance was inferior to prior data reports. A multi-disciplinary team was established to drive change.

Adaptation of World Health Organization Hand Hygiene Method for a Large United States Healthcare System

2010-06-01

Connie Steed, MSN, RN, CIC, Director of Infection Prevention & Control; Susan Boeker, BSN, RN, CIC, Infection Preventionist; J. William Kelly, MD, Hospital Epidemiologist, Greenville Hospital System, Greenville, SC; Paul Alper, BA, Business Development Director, Deb Worldwide Healthcare Inc, Wynnewood, PA; Kristen Hauck, MSN, RN, Patient Safety Coordinator; Karen Hudson, BSN, RN; Patricia Combs, BSN, RN, RN - Quality Monitoring, Greenville Hospital System, Greenville, SC; Elaine Larson, RN, PhD, FAAN, CIC, Professor of Pharmaceutical and Therapeutic Research, Associate Dean for Research, Columbia University, New York, NY

Can Automated Surveillance Software Assist With Cohorting Patients with Multidrug-resistant Organisms?

2010-06-01

Tania Ciolko, BA, CIC, Infection Control Practitioner; Barbara Fry-Arrighy, BS, MBA, CIC, Director, Infection Control; Parimala Sarvareddi, BS, MT (ASCP); Margaret McAllister, AS, Infection Preventionist, Hahnemann University Hospital, Philadelphia, PA

Comprehensive Auality Improvement Program in Magnet Facility ICU Significantly Reduces Ventilator-associated Pneumonia (VAP) Incidence

2010-06-01

Kara Heck, BSN RN-BC, ICU/TU Clinical Nurse Educator, Holland Hospital, Holland, MI Issue: Ventilator-acquired pneumonia (VAP) is a serious hospital-acquired infection associated with increased patient length of stay, morbidity and mortality, and expenditures. National health prevention initiatives are underway to prevent the development of VAP, such as the Keystone Intensive Care Unit (ICU) program. The Keystone ICU program has a toolkit which assists facilities in implementing a “Plan, Do, Study, Act” (PDSA) quality improvement (QI) intervention to improve outcomes in mechanically-ventilated patients.

Developing a Process to Reduce Risk of Intravascular Catheter-related Infections and Complications in the Non-intensive Care Units

2010-06-01

Karen Jones, RN, BSN, Project Coordinator, Infection Prevention and Control; Janice Rey, BSMT (ASCP), CIC, Manager, Infection Prevention & Control and IV Therapy; Dorine Berriel-Cass, BSN, MA, Director, Quality Management and Infection Prevention and Control, St John Hospital and Medical Center, Grosse Pointe Woods, MI; Ann Hendrich, RN, MSN, FAAN, VP, Clinical Excellence Operations, Ascension Health, St. Louis, MO; Louis Saravolatz, MD, Chief and Program Director, Internal Medicine; Mohamad Fakih, MD, MPH, Medical Director, Infection Prevention and Control, St. John Hospital and Medical Center, Grosse Pointe Woods, MI

Does an Automated Infection Surveillance System Benefit a Hospital With Limited Information System Resources?

2010-06-01

Parimala Savareddi, BS, MT(ASCP); Barbara Fry-Arrighy, BS, MBA, CIC, Director, Infection Control; Tania Ciolko, BA, CIC, Infection Control Practitioner; Margaret McAllister, AS, Infection Preventionist, Hahnemann University Hospital, Philadelphia, PA

Effects of Applying Excessive Suction Pressure to a Ventilated Porcine Lung Model

2010-06-01

Doug Pursley, M. Ed, RRT, Program Director—Respiratory Care, Ozarks Technical Community College, Springfield, MO Background/Objectives: Endotracheal suctioning is a common practice performed on patients receiving mechanical ventilation. However, suctioning is not a benign procedure and clinicians should be aware of the potential hazards including hypoxemia, atelectasis, trauma, bleeding, and possible infection. The objective of this study was to determine the effect of suction pressure on the end expiratory lung volume (EELV) of ventilated pig lungs when failing to occlude the suction tubing while setting the pressure.

Hand Hygiene Measurement: Analysis of the Methodology

2010-06-01

Diane M. Hopkins-Broyles, RN, MSN, CIC, Manager Interventional Epidemiology, Infection Prevention; Angela Recktenwald, MPH, Clinical Epidemiologist; Marilyn Jones, BSN, MPH, CIC, Director Interventional Epidemiology; Keith F. Woeltje, MD, MPH, Medical Director for Infection Prevention and Epidemiology Consortium, BJC HealthCare, Saint Louis, MO

Improving the Process of Supplying Central Supply Instruments to the OR by Applying Lean

2010-06-01

Kathi Mullaney, BSN, MPH, CIC, Senior Associate Director; Jacqueline Dawson, BA, MS, Senior Associate Director; Gregory Atwater, BA, MS, Associate Executive Director, Metropolitan Hospital Center, New York City, NY

Patient and Environmental Service Employee Satisfaction and Tolerance of Using Germicidal Bleach Wipes for Patient Room Cleaning to Reduce Transmission of Clostridium Difficile Infection

2010-06-01

Kimberly Aronhalt, BSN, RN, Infection Preventionist, Mayo Clinic, Rochester, MN Issue: Attempts to control Clostridium difficile infection (CDI) have focused on patient and environmental factors. Because C. difficile spores can persist in the environment for many months and are resistant to the usual cleaning and disinfection measures, more healthcare institutions are using bleach products which are sporicidal. There may be patient and employee concerns about the appearance of residue left on surfaces, odors, and respiratory tract irritation. One aim of this quality improvement project was to assess patient and Environmental Service employee (ESE) satisfaction and tolerance of daily and terminal patient room cleaning using germicidal bleach wipes.

Reducing Surgical Post-operative Infections Through a Multidisciplinary Team Approach

2010-06-01

Sandra R. Hyman, RN, MPA, CIC, Epidemiology Research Nurse; Paul Bernstein, BSN, CIC, Nurse Epidemiolgist; Soon-Hye Shim, BSN, CNOR, Perioperative Team Leader; Maria Messina, RN, Nurse Epidemiologist; Jeshua Villamor, RN, CNOR, Perioperative Staff Nurse, New York-Presbyterian Hospital, New York, NY; Peter Angevine, MD, MPH, Assistant Professor; Sander Connolly, MD, Associate Professor; Yoko Furuya, MD, MS, Assistant Professor Clinical Medicine, Columbia University Medical Center, New York, NY; Margaret Katz, BSN, Perioperative Staff Nurse, New York-Presbyterian Hospital, New York, NY; Lisa Saiman, MD, MPH, Professor of Pediatrics; Brian Scully, MD, Associate Professor, Columbia University Medical Center, New York, NY

Squeaky Clean Hands Result from Child/Family Directed Care

2010-06-01

Barbara J. Simmonds, RN, BS, CIC, Director, Miami Children's Hospital, Miami, FL Issue: Patient-directed care was the guiding philosophy in our commitment to achieve the critical patient safety goal of hand hygiene. IHI states that in spite of well-established hand hygiene standards, procedures are only followed by health care staff approximately 50% of the time, facilitating the transmission of health-care-associated pathogens to patients. This presentation will demonstrate one organization's journey to bring the first line of defense to life with involvement of children and families to direct care. This multi-pronged approach could easily be replicated in other settings.

Surgical Site Infection Prevention Initiative: Patient Attitude and Compliance

2010-06-01

Faith Skeete, RN, Infection Prevention and Control, New York University Langone Medical Center, New York, NY; Nancy Berger, RN; Kandy Kraemer, RN, Perioperative Services; Louise Comeau, DNP, Acute Surgical Services, New York University Hospital for Joint Disease, New York, NY; Michael Phillips, MD, Hospital Epidemiologist, New York University Langone Medical Center, New York, NY; Janet Haas, DNSc, Director, Infection Prevention and Control, Westchester Medical Center, Valhalla, NY; Steven Bock, RN, Infection Prevention and Control, New York University Langone Medical Center, New York, NY; Joseph Bosco, MD, Department of Orhtopedics; Andrew Rosenberg, MD, Department of Anesthesia, New York University Hospital for Joint Disease, New York, NY; Sandra Hardy, RN, Infection Prevention and Control, New York University Langone Medical Center, New York, NY

Use of Trained Student Volunteers to Assess Adherence to Hand Hygiene Guidelines by Healthcare Workers

2010-06-01

Susan Boeker, BSN, RN, CIC, Infection Preventionist; J. William Kelly, MD, Hospital Epidemiologist; Connie Steed, MSN, RN, CIC, Director of Infection Prevention & Control, Greenville Hospital System, Greenville, SC

Using a Multidisciplinary Team to Prevent HAIs in the NICU

2010-06-01

Michelle T. Flood, RN, MSN, CIC, Infection Preventionist; Kim McCullen, RN, MSN, BC-CNNP; Amy Rathje, RN, MSN, BC-CNNP, Nurse Practioner; Cheryl Vorpagel, RNC-NIC, BSN, NICU staff nurse; Renato S. Casabar, MD, Neonatologist, St John Hospital and Medical Center, Detroit, MI

Using Lean/Six Sigma Quality Improvement Methodologies to Reduce Central Line-associated Bloodstream Infections (CLABSI) in a Pediatric Hospital

2010-06-01

Tina Adams, RN, Infection Preventionist; Mauri Williams, RN, MBA, MHA, Manager; Vickie Brown, RN, MPH, CIC, Associate Director; Heidi Troxler, RN, BSN, CNII; Susan Wood, RN, BSN; Ashley Tate, RN, BSN, CNP; Jennifer McElroy, RN, BSN, Nurse Manager; David Weber, MD, MPH, Medical Director; William Rutala, PhD, MPH, Director, UNC Health Care, Chapel Hill, NC

Utilizing LEAN Concepts and Kaizen Methods to Standardize Processes and Decrease Surgical Site Infection Following Coronary Artery Bypass Grafting Surgery

2010-06-01

Janet Curtin, BSMT(ASCP), CIC, IP, Riverside Methodist Hospital, Columbus, OH Issue: Postoperative mediastinitis is a horrendous complication of median sternotomy associated with Coronary Artery Bypass Grafting (CABG). Annually, there are 469,000 open heart surgeries performed in the United States. SSI is linked with increased patient morbidity, mortality, extended length of stay, re-admission, re-operation, and increased cost. During the period of July 2008 through December of 2008, our CABG SSI rates were above the 50th percentile when compared to the NHSN data summary report.

Special Populations (Infections in the Immunocompromised Host, Pediatrics) NICU Journey to Zero Central Line-associated Bloodstream Infections: Incremental Interventions Lead to Sustainable Outcomes

2010-06-01

Beth Rhoton, RN, BSN, MS, CIC, Infection Preventionist; David J. Annibale, MD, Director, Division of Neonatology; W. Michael Southgate, MD, Director, Pediatric Residency Program; Cassandra Salgado, MD, MS, Hospital Epidemiologist; Katherine E. Chase, RN, MSN, Manager, Neonatal Intensive Care Unit; Wanda E. Beardsley, RN, BSN, Infection Preventionist; Tracey L. Driggers, BSN, RNC-NIC, Cllinical Nurse III, Medical University of South Carolina Medical Center, Charleston, SC

Amazon Parrot With Mycobacteria tuberculosis Complex

2010-06-01

Kathleen T. Darling, MS, CIC, MT, M(ASCP), Infection Prevention Coordinator, Texas A&M University Veterinary Medical Teaching Hospital, College Station, TX; Patricia Gray, DVM, MS, Resident; Sharman Hoppes, DVM, ABVP-avian, Assistant Clinical Professor, Texas A&M University Zoological Service, College Station, TX

Armed and Ready for Change: Validation of Using Alcoholic Chlorhexidine Gluconate for Blood Donor Services

2010-06-01

Connie Mollo, MPH, MT(ASCP) SBB, Quality Assurance Director, Central California Blood Center, Fresno, CA Issue: Our 5 centers supply blood/blood products to 31 hospitals in Central California. We collect between 5,000-6,000 pints of blood per month to meet community needs. The main risk of transfusion-related infectious disease is from bacterial sepsis. Risk has been partially controlled through phlebotomy practices and improved materials for transfusion product collection and storage. Historically blood donor arm preparation consisted of a multistep process using povidone iodine (PI), taking 2 minutes to complete. Staining of donor's skin, clothes and arm pads from PI is problematic. Validation of alternate method of skin preparation was pursued.

Emergency Preparedness in the Ambulatory Care Setting: Lessons Learned: From H1N1

2010-06-01

Pamela Halstuk, RN, CIC, Infection Control Practitioner; Joan Coatar, RN, MA, MBA, Assistant Vice President; Michael P. Ross, BS, Industrial Hygienist; John Franke, CIH, PhD, Industrial Hygieinist; Ari Robicsek, MD, Hospital Epidemiologist, Senior Director of Research Informatics; Marc-Oliver Wright, MT(ASCP), MS, CIC, Corporate Director of Infection Control, NorthShore University HealthSystem, Evanston, IL

Evolution of an Infection Prevention Program in a Network of Ambulatory Care Settings

2010-06-01

Pamela Halstuk, RN, CIC, Infection Control Practitioner; Joan Coatar, RN, MA, MBA, Assistant Vice President; Ari Robicsek, MD, Hospital Epidemiologist, Senior Director Research Informatics; Marc-Oliver Wright, MT(ASCP), MS, CIC, Corporate Director of Infection Control, NorthShore University HealthSystem, Evanston, IL

Steps to Development of a Sustainable Resident Immunization Program in Long-term Care

2010-06-01

Sharon M. Bradley, RN CIC, Risk Management, ECRI Institute, Plymouth Meeting, PA Issue: Despite the 2005 Centers for Medicare and Medicaid Services requirement to offer influenza and pneumococcal vaccines to all long-term care facility (LTCF) residents, immunization programs often fall short of providing comprehensive policies and procedures to ensure that recommended vaccines are delivered to all eligible residents. Improving the delivery of currently available vaccines decreases the exacerbation of underlying disease, hospitalizations and deaths from pneumonia and influenza in the over 65 age group. Only 59% to 66% of institutionalized adults in the United States are immunized each year against influenza and 42%to 49% for pneumococcal disease. Healthcare workers self-report a low 45% acceptance of influenza immunizations

Improving Accuracy of Electronic Outpatient Influenza Surveillance With Staff Training Following a Vaccine Miscoding Event

2010-06-01

Maria C. Rangel, MD, PhD, Epidemiologist, Department of Veterans Affairs, Palo Alto, CA Issue: The accuracy of electronic surveillance for influenza-like illness (ILI) is important for early outbreak detection and implementation of control measurements, especially during an influenza pandemic. In October 2009, outpatient encounters for seasonal influenza immunization were found incorrectly coded with the influenza infection ICD-9 code during a routine chart review. Additional coding errors were noted in early December when the H1N1 vaccine became widely available at this facility. Suspicion of widespread coding errors that could affect our ability to monitor influenza prompted a retrospective evaluation of all outpatient encounters with an ICD-9 for influenza at this medical facility.

Increasing Cleaning Practice and Morale in Multi-role Personal Support Workers

2010-06-01

Natalie Joy Goertz, BScN, Infection Control; Janice Qubty, BScN, Manager of Medicine, Victoria Campus; Elaine Mayo, Registered Practical Nurse, P.S.A. T.S.A. Infrastructure Admin; Marg Kooy, BScN, Coordinator of Medicine and Respirology; Barbara Watson, BScN, MScN, Educator; Tara Vyn, BScN, MScN, Infection Control, London Health Sciences Centre, London, ON, Canada

Meeting National Patient Safety Goals 7 and 13: A Model for Healthcare-associated Infection Prevention Education

2010-06-01

Katie Wickman, MS, RN, Infection Preventionist; Teresa Chou, MPH, CIC, Manager, Epidemiology and Infection Control; James Kerridge, MA, RN, Infection Preventionist; Mandavi Kulkarni, MD, Infectious Disease Physician; James Malow, MD, FIDSA, Chairman Internal Medicine and Infection Control Committee, Advocate Illinois Masonic Medical Center, Chicago, IL

Search and Destroy

2010-06-01

Theresa Haley, BSMT (ASCP), MRSA Prevention Coordinator; Suzanne Fritz, RN BSN CIC, Infection Preventionist, Lebanon VAMC, Lebanon, PA Issue: Demystifying what is “clean” or “not clean” in a patient care area.

Which PPE is right for you?

2010-06-01

Lorie Lerner, RN, BSN, MSN, CIC, CNS, Dir, JC, Director, Infection Control, Emergency Management, Children's Hospital Medical Center of Akron, Akron, OH Issue: Staff does not know how to appropriately apply and remove PPE.

A Conceptual Model for Developing an Evidence-based Program to Indentify and Manage the Patient at Risk for Clostridium difficile Infection

2010-06-01

Georgine Kruedelbach, RN, BSN, CIC, Infection Preventionist; Carol Lawrence, MS, BSN, RNC-OB, Nursing Practice Specialist; Annette Forlenza, RN, BSN, CCRN, ICU Director; Frances Cioffi, BS, MTASCP, Manager Clinical Microbiology Lab, Cape Coral Hospital, Cape Coral, FL; Stephen Streed, MS, CIC; System Director of Infection Control, Health Park Hospital, Fort Myers, FL

A Prospective Study of the Outcome of Incident Nasal Colonization With MRSA

2010-06-01

Maureen Bunch, RN, MSN, MDRO Coordinator; Karen Guerin, RN, MS, Director Infection Control; Mary Bessesen, MD; Chief of Infectious Diseases, VA Eastern Colorado Health Care System, Denver, CO

Description of a Hospital Based Aggregate Reporting System Developed During the 2009 H1N1 Influenza Pandemic: Importance of Partnering Among Public Health Nurses and Infection Preventionists

2010-06-01

Sharon Sakamoto, RN, MSN/MPH, CNS, Public Health Nurse; Ramon Guevara, PhD, MPH; Dawn Terashita, MD, MPH, Medical Epidemiologist; Laurene Mascola, MD, MPH; David E. Dassey, MD, MPH, Deputy Chief, ACDC, Department of Public Health, County of Los Angeles, Los Angeles, CA

Development of Electronic Capture of Central Venous Catheter (CVC) Characteristics and Use

2010-06-01

Janet Haas, DNSc, RN, CIC, Director of Infection Prevention & Control; Robert Smith, Senior System Analyst , Senior System Analyst; Thomas Sullivan, Medical Data Analyst , Director of Infection Prevention & Control; Moira Quinn, RN, BS, Nurse Epidemiologist; Marisa Montecalvo, MD, Hospital Epidemiologist; Westchester Medical Center, Valhalla, NY

H1N1 Influenza Coding Errors Resulting in Widespread Influenza-like-Illness Alerts in Veterans Affairs Medical Facilities

2010-06-01

Cynthia A. Lucero, MD, Epidemiologist; Maria Rangel, MD, PhD; Patricia Schirmer, MD, Medical Epidemiologists, Department of Veterans Affairs - Office of Public Health Surveillance and Research, Palo Alto, CA; Jackie McFarlin, RN, MPH, MS, Infection Preventionist, Dallas VA Medical Center, Dallas, TX; Gina Oda, MS, CIC, Associate Director; Mark Holodniy, MD, CIC, FACP; Director, Department of Veterans Affairs - Office of Public Health Surveillance and Research, Palo Alto, CA

Hail to Electronics! Electronic Surveillance Systems (ESS) and 34% UTI Reduction

2010-06-01

Deborah Mulligan, MSN, RN, PHN, CIC, Infection Prevention Manager, Mission Hospital Regional Center, Mission Viejo, CA Issue: For years our hospital focused primarily on preventing infections in critical care patients and the problem “belonged” to the Infection Prevention Department. Despite intense effort, our critical care CAUTI rates remained above national benchmarks in 2005. Critical care unit-based teams had been formed but were unsuccessful at reducing rates, interest was lack-luster, data feedback was only quarterly and data was obtained through considerable effort. Infection issuess on non-critical care units were given little attention unless caused by an epidemiologically significant organism, and UTI data were unknown.

Methods of Measuring compliance With Transmission-based isolation Precautions: Comparison of Paper-based and Electronic Data Collection

2010-06-01

Melissa Marine, BS, Research Coordinator; Mei Chou, MS, Programmer Analyst; Bevin Cohen, MPH, Program Coordinator, CIRAR; Rohit Chaudhry, MS, Sr Systems Analyst; Elaine Larson, RN, PhD, CIC, Professor of Pharmaceutical and Therapeutic Research in the Faculty of Nursing and Professor of Epid, Columbia University, New York, NY; Maryam Behta, PharmD, Director, Quality Research & Technology Utilization, NewYork-Presbyterian Hospital, New York, NY; Timothy Landers, PhD, CNP, Assistant Professor, The Ohio State University, Columbus, OH; Barbara Ross, RN, BSN, CIC, Infection Preventionist, New York-Presbyterian Hospital, New York, NY

Streamlining Ventilator-Associated Pneumonia Surveillance Methods

2010-06-01

Ellen W. Trovillion, RN, BSN, CIC, Infection Prevention Consultant; Joshua Doherty, BS, Medical Informatics Analyst, BJC HealthCare, Saint Louis, MO; Kathleen McMullen, MPH, CIC, Infection Prevention Specialist, Barnes-Jewish Hospital, Saint Louis, MO; Jeanne Zack, RN, PhD, CIC, Infection Prevention Manager, Missouri Baptist Medical Center, Saint Louis, MO; Margaret Dubowski, RN, BS, Infection Prevention Specialist, Barnes-Jewish St. Peters Hospital, St. Peters, MO; Pamela Mattox, RN, CIC, Infection Prevention Specialist, Christian Hospital, Saint Louis, MO; Diane Hopkins-Broyles, RN, MSN, CIC, Manager, Infection Prevention, BJC HealthCare, Saint Louis, MO; Keith F. Woeltje, MD, PhD; Medical Director, Infection Prevention & Hospital Epidemiology Consortium, BJC HealthCare & Washington University in St. Louis, Saint Louis, MO

Surveillance Cultures for Multi-Drug Resistant Gram Negative Bacilli from Patients Admitted from Long-Term Care Facilities

2010-06-01

Melanie A. Gavin, BS, M (ASCP), Infection Control Practitioner, Washington Adventist Hospital, Takoma Park, MD; Ronald N. Master, MS, Director, Hospital Microbiology, Quest Diagnostics Nichols Institute, Chantilly, VA; Margaret J. White, MT (ASCP), CIC, MSEd, Infection Control Manager; Randall P. Wagner, MD, Chairman and Medical Director, Critical Care Medicine; Norton A. Nelson, MD; Chairman, Department of Medicine, Washington Adventist Hospital, Takoma Park, MD

Survey to Determine Compliance With Center for Disease Control (CDC) Recommendations for Vacccination among Pregnant Women

2010-06-01

Christine Kettunen, PhD, MSN, RN, CIC, Director of Nursing; Katie McIntyre, RN, Staff Nurse; Linda Nappi, RN, Public Health Nurse, Ashtabula County Health Department, Jefferson, OH; Cindy Callahan, RN; Infection Control Nurse; Ashtabula County Medical Center, Ashtabula, OH

Use of Active Surveillance Cultures to Determine Methicillin-resistant Staphylococcus aureus (MRSA) colonization and the Effect on MRSA Clinical Culture Rates in an Intensive Care Unit.

2010-06-01

Diane Salisbury, RN, MSN, CIC, Director; Wanda Mullins, RN, BSN, CIC, IC Practitioner; Sherri Rhodes, RN, BSN, CIC, Infection Control Preventionist; Gary Bollin, MD; Medical Director Infection Control, Akron General Medical Center, Akron, OH

Use of the Electronic Health Record (EHR) to Optimize Communication of Isolation Practices

2010-06-01

Maria L. Caserta, RN, BSN, CIC, Infection Control Practitioner; Joan Vinski, MSN, RN, CIC, Infection Control Practitioner; Cynthia Fatica, RN, BSN, CIC, IP, Infection Control Practitioner; Persis Sosiak, RN, MPH, Department Coordinator; Terri Durr, RN, BA, Clinical Analyst; Marlene Oblak, RN, Manager Nursing Infomatics; William Morris, MD, Hospital Medicine; Steven M. Gordon, MD, Hospital Epidemiologist; Tom Fraser, MD ; Medical Director Infection Prevention, Cleveland Clinic, Cleveland, OH

Using Electronic Surveillance to Facilitate Implementation of a Process Improvement Program for Catheter Associated Urinary Tract Infections (CAUTI) Prevention

2010-06-01

Jean-Hervey Saade, RN, Infection Control Practitioner; Kaiser Permanente, Fontana, CA Issue: CAUTI represent our most common HAI. Each CAUTI costs an additional $7,400 in extended length of stay (LOS) of 5 days compared to patients within the same diagnosis related group (DRG).

Microbial Contamination and the Sterilization/Disinfection of Surgical Guides Used in the Placement of Endosteal Implants

2010-06-01

Peter N. Smith, DDS, MSD, Graduate Resident, Indiana University School of Dentistry, Indianapolis, IN; Charles Palenik, DDS, MS, PhD, MBA, Director of Infection Control; Steven B. Blanchard, DDS, Director of Graduate Periodontics, IN University School of Dentistry/Oral Biology, Indianapolis, IN

Efficacy of Hand Hygiene Products Against Pandemic H1N1 Influenza

2010-06-01

Sarah Edmonds, MS, Clinical Scientist, GOJO Industries, Inc, Akron, OH; Volha Dzyakanava, PhD, Manager of Virology Laboratory, BioScience Laboratories, Bozeman, MT; David Macinga, PhD, Prinicipal Microbiology Scientist, GOJO Industries, Inc, Akron, OH

Comparison of Fluorescent Marker Systems to Two Quantitative Methods of Assessing Discharge Cleaning Practices

2010-06-01

Nancy L. Havill, BS/MT (ASCP), Epidemiology Laboratory Technologist; Heather Havill, College Intern, Providence College, RI; Elise Mangione, College Intern, Villanova, PA; Diane G. Dumigan, BSN, RN, CIC, Infection Preventionist; John M. Boyce, MD, Section Chief of Infectious Disease and Hospital Epidemiologist, Hospital of Saint Raphael, New Haven, CT

Cupriavidus pauculus Bloodstream Infection in ECMO Patients Related to Inadequate Disinfection

2010-06-01

Christy M. Wisdom, RN, BSN, Infection Control Practitioner; Toni K. Beavers, BSMT (ASCP) SM, Technical Chief of Microbiology; Michele Honeycutt, RN, BSN, CIC, Infection Control Practitioner; Laura Cantrell, BSMT (ASCP), Medical Technologist, Arkansas Childrens Hospital, Little Rock, AR; Stephanie H. Stovall, MD, Division of Infectious Diseases, Arkansas Childrens Hospital and University Of Arkansas for Medical Sciences, Little Rock, AR; John J. LiPuma, MD, Director, Burkholderia cepacia Research Laboratory & Repository, University of Michigan Medical School, Ann Arbor, MI; Wes Ware, BS, RRT-NPS, ECMO Specialist; Craig Gilliam, BSMT, CIC, Director of Infection Prevention, Arkansas Childrens Hospital, Little Rock, AR

Preventing Catheter-associated Urinary Tract Infection in U.S. Hospitals: 2005 to 2009

2010-06-01

Russell N. Olmsted, MPH, CIC, Epidemiologist, Saint Joseph Mercy Health System, Ann Arbor, MI; Sarah L. Krein, PhD, RN, VA Ann Arbor Healthcare System, Ann Arbor, MI; Christine P. Kowalski, MPH, Research Health Science Specialist, Ann Arbor VAMC, Ann Arbor, MI; Sanjay Saint, MD, MPH, Professor of Internal Medicine, University of Michigan Health System, Ann Arbor, MI

Pediatric Surgical Site Infection Risk Factors for Craniotomy Procedures

2010-06-01

Jeanne Yegge, RN, BSN, MPH, CIC, Infection Prevention Intervention Consultant, BJC HealthCare, St. Louis, MO; Louise Jadwisiak, RN, BSN, Infection Prevention Specialist, St. Louis Childrens Hospital, St. Louis, MO; Patti Kieffer, RN, BSN, CIC, Infection Prevention Specialist, St. Louis Children's Hospital, St. Louis, MO; Alexis Elward, MD, MPH, Associate Professor Pediatric Infectious Diseases, Washington University, St. Louis, MO; Angela Recktenwald, MPH, Clinical Epidemiologist, BJC HealthCare, St. Louis, MO; Diane Hopkins-Broyles, RN, MSN, CIC, Interventional Epidemiology Manager, BJC HealthCare, St. Louis, MO; Melinda Hohrein, BA, Senior Data Technician, BJC HealthCare, St. Louis, MO; Keith F. Woeltje, MD, PhD, Medical Director Infection Prevention; BJC HealthCare, St. Louis, MO

New Interventions in Addition to the Central Line Bundle which are Associated With a Sustained Reduction of Central Line-associated Bloodstream Infections

2010-06-01

Victor Lange, BS, BA, MS, MSPH, Corporate Director of Infection Control, Vista Healthcare, Rancho Cucamonga, CA Issue: Central line associated bloodstream infections (CLABSIs) are a preventable cause of poor patient outcomes. The aim of this study was to systematically review successful programs implemented at six different facilities to reduce CLABSIs.

Significant Reduction in the Rate of Surgical Site Infection (SSI) Post C-section (CS)

2010-06-01

Sophie Labrecque, RN, MSc, Nurse Epidemiologist; James Smith, MD, Chief of Perinatology; Kerry Terminello, BSN, MS, Nurse Manager L&D/Maternity/WBN; Janet Haas, DNSc, RN, CIC, Director Infection Control; Marisa Montecalvo, MD, Hospital Epidemiologist, Infection Control, Westchester Medical Center, Valhalla, NY

Rapid Identification and Mitigation of an Outbreak of Extensively Drug Resistant Acinetobacter baumannii (XDR-Ab)

2010-06-01

Elizabeth R. Wallace, MPH, CIC, Infection Preventionist; Kim S. Strelczyk, RN, MSN, ACNS-BC, CIC, Director of Infection Prevention; Lisa K. Kenner, RN, MSN, CIC, Infection Preventionist; Zakir Hussain A. Shaikh, MD, MPH, FIDSA, CPE, CMSL, Hospital Epidemiologist and Medical Director of Infection Prevention, Methodist Dallas Medical Center, Dallas, TX

Pseudo-outbreak of Ochrobactrum anthropi in Post-operative Tissue: Cultures

2010-06-01

Nan Starr, BS, MT(ASCP), ICP, Advocate Good Samaritan Hospital, Downers Grove, IL Issue: Ochrobactrum anthropi is a gram negative rod. It is an infrequent cause of infection in humans with competent immune systems. While doing surveillance for class I surgical site infections in a suburban level 1 trauma center, O. anthropi was found to be present in operative cultures from eight patients during March and April of 2009. No O. anthropi had been isolated at this hospital during the previous year.

Outbreak of Hepatitis C in an Outpatient Alternative Medicine Clinic

2010-06-01

Roger Sanderson, RN, MA, BSN, Epidemiologist, Florida Department of Health, Tampa, FL; David Atrubin, MPH; Adlin Santiago, RN, Epidemiologist, Hillsborough County Health Department, Tampa, FL; Gail Scilabro, BS MT (ASCP), Serology Supervisor, Florida Department of Health, Tampa, FL; Debbie Daniels, RN, Epidemiologist, Hillsborough County Health Department, Tampa, FL

An Outbreak of Carbapenem-resistant Klebsiella pneumoniae Infections Associated With Endoscopic Retrograde Cholangiopancreatography (ERCP) Procedures at a Hospital

2010-06-01

Roger Sanderson, MA, BSN, Regional Epidemiologist, Florida Department of Health, Tampa, FL; Leona Braithwaite, MPH, County Epidemiologist, Florida Department of Health, Sebring, FL; Lauren Ball, DO, MPH, Medical Epidemiologist; Patricia Ragan, PhD, MPH, Administrator of Florida Epidemic Intelligence Service Fellowship Program; Leah Eisenstein, MPH, Surveillance Epidemiologist; Florida Department of Health, Tallahassee, FL

Comparison of Respiratory Specimens for the Detection of Mycobacterium tuberculosis

2010-06-01

Christina Silkaitis, BS, MT (ASCP), CIC, Infection Control Coordinator, Northwestern Memorial Hospital, Chicago, IL; Laura Bardowski, RN, BSN, Infection Control Coordinator, Northwestern Memorial Hospital, Chicago, IL; Cari Coomer, RN, Infection Control Coordinator, Northwestern Memorial Hospital, Chicago, IL; Kathy Trakas, MT (ASCP), Application Specialist, BD Diagnostics, Sparks, MD; Teresa Zembower, MD, MPH, Medical Director, Healthcare Epidemiologist, Infection Control and Prevention, Northwestern University, Chicago, IL

Impact of the Ventilator Bundle on Ventilator-associated Pneumonia (VAP) Rates in Intensive Care Units (ICU)

2010-06-01

Monika Pogorzelska, MPH, Doctoral Student, Columbia University, New York, NY; E. Yoko Furuya, MD, MS, Assistant Professor of Clinical Medicine, Columbia University Division of Infectious Diseases, New York, NY; Andrew Dick, PhD, Senior Health Economist, Rand Corporation, Pittsburgh, PA; Eli N. Perencevich, MD, MS, Associate Professor, University of Maryland School of Medicine, Baltimore, MD; Donald Goldmann, MD, Professor, Harvard Medical School, Harvard School of Public Health, Boston, MA; Patricia W. Stone, PhD, FAAN, Professor, Columbia University, New York, NY

Improved Detection of Staphylococcus aureus Colonization Using a Modified Nasal Wash Technique

2010-06-01

Timothy F. Landers, CNP, PhD, Assistant Professor; Thomas E. Wittum, PhD, Professor; Kurt B. Stevenson, MD, MPH, Associate Professor; Randall E. Harris, MD, PhD, Professor, The Ohio State University, Columbus, OH

HHS/CDC Action Plan to Prevent Healthcare-associated Infections: How Are We Preparing the Next Generation of Nurses?

2010-06-01

Diana Hackbarth, PhD, RN, FAAN, Professor, Loyola University Chicago, Chicago, IL; Jason Farley, PhD, MPH, CRNP; Assistant Professor, Johns Hopkins University, Baltimore, MD Background: The Health & Human Services/Centers for Disease Control Action Plan to prevent healthcare associated infections (HAIs) is an evidence-based document which serves as a blueprint for changing current practice and educating future health professionals in infection prevention.

The Effect of Increased Body Mass Index on the Risk of Surgical Site Infection

2010-06-01

Helen M. Miller-McDermott, RN, BS, MPH, CIC, CPH, Infection Preventionist, Hospital of University of Pennsylvania, Philadelphia, PA; Longjian Liu, MD, PhD, Associate Professor of Epidemiology and Public Health, Drexel University School of Public Health, Philadelphia, PA; Neil Fishman, MD, Director, Department of Healthcare Epidemiology and Infection Control, Hospital of University of Pennsylvania, Philadelphia, PA

Post-operative Pneumonia in the US

2010-06-01

Walter T. Linde-Zwirble, OHP, VP Research, ZD Associates LLC, Perkasie, PA; Jonathan D. Bloom, MD, Associate Director of Medical Affairs; Roger S. Mecca, MD, VP Medical Affairs; Douglas M. Hansell, MD, MPH, Chief Medical Officer & VP, Covidien, Boulder, CO

Detection of H1N1 on Hands and Household Surfaces of Infected Individuals

2010-06-01

Bevin Cohen, MPH, Columbia University School of Nursing, New York, NY; Dhritiman V. Mukherjee, PhD, Project Coordinator, Columbia University School of Nursing, New York, NY; Mary Ellen Bovino, RN, CEN, Manager, Urgent Care, Health Services at Columbia, Columbia University, New York, NY; Susan Whittier, PhD, D(ABMM), Associate Director, Clinical Microbiology Service, Columbia University Medical Center, New York, NY; Elaine L. Larson, RN, PhD, FAAN, CIC, Professor of Pharmaceutical and Therapeutic Research, Columbia University School of Nursing, New York, NY

To Gown or Not to Gown? What is the Answer to this Question?

2010-06-01

Shawn Mueller, MSN, RN, CIC, Manager; Silvera Ford, RN BSN, Infection Preventionist, The University of Kansas Hospital, Kansas City, KS Background/Objective: After experiencing an outbreak of Community Associated Methicillin-resistant Staphylococcus aureus (MRSA) in 2005, the Burnett Burn Center at the University of Kansas Hospital implemented Contact Precautions for all burn patients during their hospital stay. The risk for infection is high in patients with greater than 30% total body surface area burn injury. The wounds of the burn patient provide ample opportunity for Multidrug Resistant Organisms (MDRO) colonization, infection and transmission. The most effective infection control precautions for burn patients have not been established and remain controversial for routine care. A consensus on how to prevent transmission of infection to and from burn patients has not been reached and there is a lack of research on infection control precautions in the burn setting. It was hypothesized that placing patients in Contact Precautions throughout their hospital stay would decrease the transmission of MDRO, specifically MRSA and Vancomycin-resistant Enterococcus (VRE).

Author Index - 2010 Abstracts

2010-06-01

Abraham, F, 8-081 Adams, A, 8-091

Future APIC Annual Conference Dates and Locations

2010-06-01

Annual Conference 2011 Baltimore, MD

2010-06-01

Editorial Board

2010-06-01

APIC Masthead

2010-06-01

Information for Readers

2010-06-01