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Unit Based Champions Infection Prevention eBug Bytes


Unit Based Champions Infection Prevention eBug Bytes January 2012 CDC Clinical Reminder: Insulin Pens Must Never Be Used for More than One Person Insulin pens ... – PowerPoint PPT presentation

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Title: Unit Based Champions Infection Prevention eBug Bytes

Unit Based ChampionsInfection PreventioneBug
  • January 2012

CDC Clinical Reminder Insulin Pens Must Never
Be Used for More than One Person
  • Insulin pens containing multiple doses of insulin
    are meant for use on a single person only, and
    should never be used for more than one person,
    even when the needle is changed.
  • Insulin pens should be clearly labeled with the
    persons name or other identifying information to
    ensure that the correct pen is used only on the
    correct individual.
  • Hospitals and other facilities should review
    their policies and educate their staff regarding
    safe use of insulin pens and similar devices.
  • If reuse is identified, exposed persons should be
    promptly notified and offered appropriate
    follow-up including bloodborne pathogen testing.
  • These recommendations apply to any setting where
    insulin pens are used, including assisted living
    or residential care facilities, skilled nursing
    facilities, clinics, health fairs, shelters,
    detention facilities, senior centers, schools,
    and camps as well as licensed healthcare
    facilities. Use of insulin pens for more than one
    person, like other forms of syringe reuse imposes
    unacceptable risks and should be considered a
    'never event'.
  • References Sonoki K, Yoshinari M, Iwase M,
    Tashiro K, Iino K, Wakisaka M, Fujishima M.
    Regurgitation of blood into insulin cartridges in
    the pen-like injectors. Diabetes Care.


Pneumonia Most Common Infection After Heart
  • Researchers analyzed more than 5,100 patients in
    a heart surgery registry. Patients, average age
    64, were treated at nine U.S. academic medical
    centers and one Canadian center. The median time
    to major infection was 14 days after heart
    surgeries. Forty-three percent of all major
    infections occurred after hospital discharge. In
    this study, which excluded patients who were
    infected before surgery, researchers found 761
    infections 300 were classified as major
    infections (occurring in 6 percent of patients)
    and 461 were minor (in 8.1 percent of patients).
    Of the major infections
  • Pneumonia, infection of the lungs, occurred in
    2.4 percent of all patients.
  • C. difficile colitis, an intestinal infection,
    occurred in 1.0 percent.
  • Bloodstream infections occurred in 1.1 percent.
  • Deep-incision surgical site infections occurred
    in 0.5 percent.
  • Minor infections included urinary tract and
    superficial incision site infections.
  • References Presented at the American Heart
    Association's Scientific Sessions 2011

'Brain-Eating' amoeba kills second neti pot user
  • Louisiana state health officials are warning
    patients about potential dangers of using tap
    water in the sinus-irrigating neti pot after two
    patients died of Naegleria fowleri infection. N.
    fowleri is known as a "brain-eating" amoeba
    because it can enter a patient's nose, infect the
    brain, and cause primary amebic
    meningoencephalitis (PAM), a brain-tissue
    destroying condition. The first Louisiana
    patient died of neti pot-induced infection in
    June. An additional two patients died of N.
    fowleri infection in August after swimming in
    warm, fresh water.
  • Patients that irrigate their noses with a neti
    pot should use distilled, sterile, or previously
    boiled water
  • Symptoms of PAM include headache, fever, nausea,
    vomiting, and stiff neck, and may take one to
    seven days to start. Later symptoms include
    confusion, lack of attention to environment, loss
    of balance, seizures, hallucinations, and, in one
    to 12 days after infection, death.
  • Source MedPage Today - December 29, 2011

CDC reports two novel flu infections
  • The Centers for Disease Control and Prevention
    (CDC) have
  • identified two novel flu infections, including an
    H1N1 variant previously not reported in humans
    and a novel H3N2 variant identified in 11
    patients. The novel H1N1 virus is a
    triple-reassortant that has acquired the M gene
    of the 2009 H1N1 virus and has sickened an adult
    in Wisconsin who had occupational contact with
  • From August 17 to December 23, 2011, CDC received
    reports of 12 human infections with influenza A
    (H3N2)v viruses that have the matrix (M) gene
    from the influenza A (H1N1) virus (formerly
    called swine-origin influenza A H3N2 and
    pandemic influenza A H1N1 2009 viruses,
    respectively. The 12 cases occurred in five
    states (Indiana, Iowa, Maine, Pennsylvania, and
    West Virginia), and 11 were in children. Six of
    the 12 patients had no identified recent exposure
    to swine. Three of the 12 patients were
    hospitalized, and all have recovered fully.
  • A case in an adult male in Indiana with
    occupational exposure to swine was among the 12,
    and two children in West Virginia who regularly
    attended the same day care accounted for the
    latest cases. This report describes those cases
    and swine influenza virus (SIV) surveillance
    being conducted by the U.S. Department of
    Agriculture (USDA). MMWR December 23, 2011

Microbial Communities on Skin Affect Humans'
Attractiveness to Mosquitoes
  • The microbes on your skin determine how
    attractive you are to mosquitoes, which may have
    important implications for malaria transmission
    and prevention. Without bacteria, human sweat is
    odorless to the human nose, so the microbial
    communities on the skin play a key role in
    producing each individual's specific body odor.
  • The researchers conducted their experiments with
    the Anopheles gambiae sensu stricto mosquito,
    which plays an important role in malaria
    transmission. They found that individuals with a
    higher abundance but lower diversity of bacteria
    on their skin were more attractive to this
    particular mosquito. They speculate individuals
    with more diverse skin microbiota may host a
    selective group of bacteria that emits compounds
    to interfere with the normal attraction of
    mosquitoes to their human hosts, making these
    individuals less attractive, and therefore lower
    risk to contracting malaria. This finding may
    lead to the development of personalized methods
    for malaria prevention.
  • Reference Verhulst NO, Qiu YT, Beijleveld H,
    Maliepaard C, Knights D, et al. (2011)
    Composition of Human Skin Microbiota Affects
    Attractiveness to Malaria Mosquitoes. PLoS ONE
    6(12) e28991. doi10.1371/journal.pone.0028991

Over-reliance on gloves leads to poor worker
hand hygiene
Stone and his colleagues observed more than 7,000
patient contacts in 56 ICUs and geriatric care
units in 15 hospitals. They found that proper
hand hygiene compliance rates were
disappointingly low, at 47.7 a statistic,
experts contend, that contributes to the costs
associated with healthcare-associated
infections.Proper hand hygiene protocol
includes changing gloves and washing one's hands.
Hands can be contaminated by back spray when
gloves are removed after contact with bodily
fluid, researchers said. Some germs can get
through latex gloves, investigators note. Stone
and his team suggested that more studies are
needed to determine behavioral reasons behind
poor hand hygiene habits.The study, The Dirty
Hand in the Latex Glove A Study of Hand-Hygiene
Compliance When Gloves Are Worn, was published
in the December issue of Infection Control and
Hospital Epidemiology. From the January 2012
Issue of McKnight's Long Term Care News
Temporary central venous catheter utilization
patterns in a large tertiary care center
  • Intravenous literature Tejedor, S., Tong, D.,
    Stein, J., Payne, C., Dressler, D., Xue, W. and
    Steinberg, J.P. (2012) Temporary central venous
    catheter utilization patterns in a large tertiary
    care center tracking the idle central venous
    catheter. Infection Control Hospital
    Epidemiology. 33(1), p.50-7.
  • AbstractObjectives Although central venous
    catheter (CVC) dwell time is a major risk factor
    for catheter-related bloodstream infections
    (CR-BSIs), few studies reveal how often CVCs are
    retained when not needed (idle). We describe
    use patterns for temporary CVCs, including
    peripherally inserted central catheters (PICCs),
    on non-ICU wards.
  • Design A retrospective observational study.
  • Setting A 579-bed acute care, academic tertiary
    care facility.
  • See next slide for results and conclusions

Temporary central venous catheter utilization
patterns in a large tertiary care center
  • Methods A retrospective observational study of a
    random sample of patients on hospital wards who
    have a temporary, nonimplanted CVC, with a focus
    on on daily ward CVC justification. A uniform
    definition of idle CVC-days was used.
  • Results We analyzed 89 patients with 146 CVCs
    (56 of which were PICCs) of 1,433 ward
    CVC-days, 361 (25.2) were idle. At least 1 idle
    day was observed for 63 of patients. Patients
    had a mean of 4.1 idle days and a mean of 3.4
    days with both a CVC and a peripheral intravenous
    catheter (PIV). After adjusting for ward length
    of stay, mean CVC dwell time was 14.4 days for
    patients with PICCs versus 9.0 days for patients
    with non-PICC temporary CVCs (other CVCs
    Formula see text). Patients with a PICC had
    5.4 days in which they also had a PIV, compared
    with 10 days in other CVC patients (Formula see
    text). Patients with PICCs had more days in
    which the only justification for the CVC was
    intravenous administration of antimicrobial
    agents (8.5 vs 1.6 days Formula see text).
  • Conclusions Significant proportions of ward
    CVC-days were unjustified. Reducing idle
    CVC-days and facilitating the appropriate use of
    PIVs may reduce CVC-days and CR-BSI risk.

Legionnaires' Disease Outbreak Linked to
Hospital's Decorative Fountain
  • Environmental testing within the hospital
    detected notable amounts of Legionella in samples
    collected from the water wall decorative
    fountain located in the hospitals main lobby.
  • The investigation revealed that all eight
    patients had spent time in the main lobby where
    the fountain is located. This, along with the
    proximity of each patients onset of illness and
    the degree of Legionella contamination in the
    fountain strongly support the conclusion that the
    decorative fountain was the source of the
    outbreak. Hospital officials quickly shut down
    the fountain when it was first suspected as a
    source, and notified staff and approximately
    4,000 potentially exposed patients and visitors.
    Prior to the investigation, the decorative
    fountain underwent routine cleaning and
    maintenance. Since this investigation, many
    healthcare facilities in Wisconsin shut down or
    removed decorative fountains in their facilities,
    while others enhanced their regular testing
    protocols to reduce the risk of Legionnaires
    disease, the researchers report.
  • Reference Haupt TE, et al. An outbreak of
    Legionnaires disease associated with a decorative
    water wall fountain in a hospital. Infection
    Control and Hospital Epidemiology. 332. February
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