Sabazco.qxp 13/11/07 11:55 Page 60
Infection Control
healthcare facilities, increased incidence has been experienced. The number APIC and SHEA jointly developed a position statement on ‘Legislative
one MDRO is methicillin-resistant Staphylococcus aureus (MRSA), but Mandates for the Use of Active Surveillance Cultures to Screen for MRSA
vancomycin-resistant Enterococci (VRE) and resistant Gram-negative bacilli and Vancomycin Resistant Enterococcus in the US.’
3
This was in response to
contribute to the bioburden on facilities. The literature and abstracts state legislatures introducing bills requiring active surveillance cultures of
presented at scientific meetings have addressed approaches used to prevent patients on admission to certain healthcare facilities.
their introduction into, or transmission within, the healthcare setting. These
have provided a forum to debate what is best practice. One of the most The Institute for Healthcare Improvement (IHI) has been a driving force for
controversial approaches has been surveillance for the presence of an MDRO the implementation in healthcare facilities of processes that have been
by culture on admission. The primary focus at this time for active surveillance shown to prevent infections. Healthcare organizations have signed on to
culturing is MRSA. However, some institutions have added one or more their ‘Saving 100,000 Lives’ campaign and ‘5 Million Lives’ campaign. The
MDRO to their agenda. infection prevention and control issues they have addressed are hand
hygiene, ventilator-associated pneumonia, central-line-associated
The infection prevention and control community has once again bacteremias and, recently, multidrug-resistant organisms.
6
collaborated and responded in many ways. CDC published ‘Management of
Multi-drug Resistant Organisms’ in October 2006
2
and released the
‘Guideline for Isolation Precautions’ in June 2007.
8
These guidelines provide
the infection prevention professional with approaches to prevent
US infection prevention and control
transmission of infectious agents in their organization.
programs need to acquire additional
APIC recognized that its members and consumers need resources to address
resources with the support of chief
and understand the many concerns surrounding MRSA, since MRSA is no
longer confined to the healthcare arena, but is often seen in the community.
executives in healthcare organizations.
In August 2006, APIC convened a conference on ‘Managing MRSA: A Call
to Action.’ This provided an opportunity to discuss approaches to
prevention and control, not only within healthcare facilities but also in the
community, as well as matters surrounding healthcare workers. This The Joint Commission, via its Infection Control Standard, continues to
require an effective infection prevention and control program within the
facilities seeking accreditation. The program proves its effectiveness through
annual assessments and ongoing measurement of outcomes.
7
The annual influenza vaccination
The annual influenza vaccination programs in the US are a recognized
programs in the US are a recognized patient and healthcare worker safety initiative. Many US healthcare
organizations require the influenza vaccine to be mandatory. For the most
patient and healthcare worker
part, this means that workers receive the vaccination or sign a declination.
safety initiative. This approach has led to improved vaccination rates and has also provided
a safer healthcare setting for both patients and workers.
In the US, consumers have established their right to access performance
conference identified a need to provide regional programs for infection data from the healthcare facility they are considering for their healthcare
prevention professionals and other leaders in healthcare on MRSA. This led needs. Healthcare organizations are responding by becoming more
to ‘MRSA Grand Rounds on the Elimination of MRSA Transmission,’ which transparent. The infection prevention and control community is supportive
was held in four US locations. An MRSA webinar series was also provided. of this transparency and eager to contribute, as long as the methods of
Volunteer member experts developed the ‘Guide to the Elimination of reporting are credible and provide accurate comparative data. Infection
MRSA Transmission in Hospital Settings’ to provide evidence-based practice prevention and control is a subject within healthcare that is being closely
guidance on prevention strategies.
4
The APIC Research Foundation funded monitored by the media and often provides subject matter on national
‘The Prevalence Study of MRSA in US Healthcare Facilities,’ which was news. US infection prevention and control programs need to acquire
conducted in October and November 2006. The study provided a snapshot additional resources with the support of chief executives in healthcare
of MRSA prevalence in the US. The data show that 46 out of every 1,000 organizations to accomplish not only the current requirements, but also
patients in the survey were either infected or colonized with MRSA. those on the horizon. ■
1. Shannon R, www.ramcampaign.org. Accessed August 8, 2007. 3. Weber SG, Huang SS, Oriola S, et al., Legislative mandates for the 4. www.apic.org. Accessed August 5, 2007.
2. Siegel JD, Rhinehart E, Jackson M, Ciarello L, Management of use of active surveillance cultures to screen for methicillin- 5. www.shea-online.org. Accessed August 5, 2007.
multidrug-resistant organisms in healthcare settings, 2006. resistant staphylococcus aureus and vancomycin-reistant 6. www.ihi.org/IHI/Programs/Campaign. Accessed August 5, 2007.
Available at: enterococci: position statement from the joint SHEA and APIC task 7. www.jointcommission.org. Accessed August 5, 2007.
www.cdc.gove/ncidod/dhqp/pdf/ar/mdroGuideline2006.pdf force. Available at www.shea-online.org. Accessed August 5, 8. www.cdc.gov. Accessed August 5, 2007.
Accessed August 4, 2007. 2007.
60 US INFECTIOUS DISEASE 2007
Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68