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Top 10 Infection Control Challenges

Cheryl Clark, for HealthLeaders Media, June 27, 2011

3. Surveillance Practice for MRSA and Other Infections
Hospitals are debating whether to swab every patient upon admission for Methicillin-Resistant Staphylococcus aureus, or just every patient admitted to the intensive care unit, or just certain patient populations such as those undergoing dialysis or those in pediatric settings.

Or perhaps they should avoid such practice altogether, except for patients scheduled for higher risk invasive cardiac, neuro or joint replacement surgeries, the practice in place at Virginia Commonwealth University Medical Center's Infectious Disease Chairman Michael Edmond, MD, has in place at his hospital. 

"Even if your active surveillance was 100% effective, and you were able to reduce your infections from methicillin-resistant Staphylococcus aureus to zero, that program is not going to have much effect on other organisms. We'll never be able to culture our way out of this problem because there [are] always new bugs that are evolving."

Once certain patients are discovered to be carriers of infections such as MRSA, the decision must be made whether to decolonize those patients with antibiotics, an activity that could increase the emergence of resistant bacterial strains.

"I think we've all made our decisions on this, and chosen the populations we will target," said Sharon Jacobs, manager of infection prevention and control for St. Clair Hospital in Pittsburgh. "Of course, we need to re-assess periodically but that's part of the ever-changing infection prevention environment."

4. Collaboration with Community Organizations
Many infection control officials surveyed for this list indicated the need for hospitals to engage with their competing and neighboring hospitals and nursing homes in ways once thought impractical or impossible. 

In communities, towns, and cities where these facilities share patients, one institution's infection control lapse or outbreak can translate to a nightmare, and significant expense, for other facilities in the region that care for those same patients.

Deb Burdsall, RN, an infection preventionist at Lutheran Home in Palatine, IL said educating long-term care providers on correct practices and working with nursing homes in the community as well as hospitals to her are top priorities.

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