Infection Control Today

APR 2019

ICT delivers to infection preventionists & their colleagues in the operating room, sterile processing/central sterile, environmental services & materials management, timely & relevant news, trends & information impacting the profession & the industry

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6 ICT April 2019 editor's letter EDITORIAL EDITOR IN CHIEF Kelly M. Pyrek S ALE S/MARK E TING GROUP PUBLISHER William Mulderry PUBLISHER John Currid SUBSCRIPTION CUSTOMER SERVICE 800-581-1811 PRODUC TION ART DIRECTOR Robert Rys AD PRODUCTION MANAGER Bonnie Streit DIRECTOR PUBLICATIONS Joseph Chackola HUMAN RESOURCES DIRECTOR Donna Layton INFORMA E XHIBITIONS LLC 2020 N. Central Ave., Ste. 400 Phoenix, AZ 85004 Phone: 480-867-7943 Web: Prevent MRSA Infection After Hospital Discharge Kelly M. Pyrek Editor in Chief I wanted to bring to your attention a new study that indicates hospital patients who have methicillin-resistant Staphylococcus aureus (MRSA) can be protected from future infections with a standard bathing regimen at home or in a nursing home after hospital discharge. University of California, Irvine researchers found that adults with MRSA who used topical over-the-counter antiseptic soap for showering or bathing, as well as a prescription mouthwash and a nasal ointment experienced a 30 percent reduction in subsequent MRSA infections and hospitalizations. "These results show that we can help protect thousands of patients who have MRSA from serious infections after they leave the hospital," reports Susan Huang, MD, MPH, the study's lead author and professor in the Division of Infectious Diseases, UCI School of Medicine. "Currently, patients who have MRSA somewhere on their body have a 1 in 4 risk of developing a serious infection in the year after discharge, and 1 in 10 will develop a new MRSA infection. Nearly all of these infections will require re-hospitalization. We have found a way to help prevent them." The clinical trial, called Project CLEAR (Changing Lives by Eradicating Antibiotic Resistance), involved 2,121 adults who were assigned randomly into two groups: the education-only group and the education plus decolonization group. The education-only group received education about MRSA and information about cleaning and laundering to prevent MRSA in the home. The education plus decolonization group received the same education, but also were given a fi ve-day decolonization treatment regimen to remove MRSA. This decolonization treatment regimen included regular bathing or showering with over-the-counter chlorhexidine soap, rinsing with prescription chlorhexidine mouthwash, and treating the nose with prescription mupirocin ointment. This group used the decolonization regimen twice a month for six months after hospital discharge. Patients in the education plus decolonization group were protected from infections and repeat hospitalizations as compared to the education-only group. The education plus decolonization group had a 30 percent reduction in repeat MRSA infection and 17 percent fewer infections from any type of germ as compared to the education-only group. Patients who did not miss any doses experienced 44 percent fewer MRSA infections and 40 percent fewer infections from all germs. What's more, researchers from the William S. Middleton Memorial Veterans Hospital and the University of Wisconsin School of Medicine and Public Health have created a new toolkit. Chlor- hexidine Bathing Treatments: A Toolkit to Guide Implementation contains a comprehensive set of modifi able resources that provide step-by-step guidance to roll out CHG bathing treatments at your organization. This toolkit was developed based on two implementation studies: Implementation of Chlorhexidine Bathing to Reduce HAIs (the ICARE study), funded by the Agency for Healthcare Research and Quality and Human-factors Engineering to Prevent Resistant Organisms (the HERO study) funded by the Veterans Health Administration. Both studies evaluated implementation of CHG bathing treatments in multiple non-ICU acute care settings using a human factors model called the Systems Engineering Initiative for Patient Safety (SEIPS). The toolkit contains the scientifi c rationale behind CHG bathing treatments, tools to assess organizational readiness, instructions for imple- menting CHG bathing treatments, and steps for monitoring and obtaining feedback. There is also a cost consideration calculator, monitoring and feedback templates, and educational materials for staff. The toolkit is customizable, which allows you to easily adapt the content for use in your organization. The CHG bathing toolkit was designed specifi cally for infection prevention profes- sionals, nursing and other allied health professionals, and researchers interested in general implementation science. It is available at: Until next month, bust those bugs! References: Huang S, et al. Decolonization to Reduce Post-discharge Infection Risk among MRSA Carriers. New England Journal of Medicine. Feb. 14, 2019. Musuuza J, et al. Chlorhexidine Bathing Treatments: A Toolkit to Guide Implementation. Veterans Health Administration (VHA) National Center for Patient Safety, Patient Safety Center of Inquiry and the University of Wisconsin (UW) – Madison Department of Medicine and the UW Health Innovation Program. 2018.

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