| Five Steps to Effective Infection Control
| |
| | management are critical for successful
|
| in Long Term Care
| |
| | outcome. In some cases, the timely
|
| Joseph J. Tomaino, M.S., R.N.
| |
| | diagnosis of infection initiation of
|
| Probably no other category of illness has
| |
| | antibiotic therapy can make the
|
| such major implications or
| |
| | difference between life and death.
|
| unpredictability of outcome for a health
| |
| | Ineffective management can result in
|
| care provider than infection and septic
| |
| | extended periods of illness. Cost issues
|
| shock. A "simple" urinary tract infection
| |
| | regarding antibiotic therapy can be
|
| can evolve into urosepsis and a resource
| |
| | complicated. A tradition step approach to
|
| intensive course of therapy in critical
| |
| | antibiotics, starting with standard and
|
| care. Urosepsis alone is the major cause
| |
| | less expensive ones and then advancing to
|
| of death of adults over 65.
| |
| | newer, more expensive ones if they don't
|
| It is for this reason that prevention of
| |
| | work may seem cost effective. But if
|
| this complication must be one of the
| |
| | going to the newer "big guns" earlier may
|
| health care provider's highest
| |
| | result in shorter period of illness and
|
| priorities. Being vigilant to preventive
| |
| | need for critical care. On the other
|
| measures is imperative. Something as
| |
| | hand, if you jump to the "Big Guns" and
|
| simple as handwashing is critical to the
| |
| | they don't work, where do you go next?
|
| spread of infection. But so often, this
| |
| | These steps should be followed in the
|
| simple approach is neglected.
| |
| | continuing care setting to ensure that
|
| As the health care provider tracks and
| |
| | infections are controlled:
|
| trends lengths of stay and tries to
| |
| | 1. Monitor new admissions as well as
|
| identify variances which result in a
| |
| | existing patients for evidence of
|
| longer stay than anticipated, infection
| |
| | infections; if an infection is
|
| should always be considered. When looking
| |
| | identified, determine if it is community
|
| at infections, it is important to
| |
| | acquired (prior to admission to your
|
| differentiate between community acquired
| |
| | program) or nosocomial
|
| and nosocomial infections. For example,
| |
| | 2. Begin a line listing of each infection
|
| when looking at pneumonia in a subacute
| |
| | so it can be tracked from start to
|
| setting, it is important to differentiate
| |
| | finish, including the organism causing
|
| between an increase in pneumonia in the
| |
| | the infection, the sensitivity report,
|
| general population during the flu season,
| |
| | the treatment used, and the date of
|
| and infections which may be acquired in
| |
| | resolution
|
| the facility due to care related issues.
| |
| | 3. Identify patterns of infections that
|
| The way to differentiate the two is line
| |
| | may indicate they may be spread by the
|
| listing of infections. For each patient
| |
| | facility or staff; such patterns may
|
| with an infection, list the site of
| |
| | include several patients on a unit having
|
| infection, the organism, sensitivity
| |
| | the same source organism with the same
|
| report, date of admission and date of
| |
| | antibiotic sensitivity report indicating
|
| symptoms onset. Then categorize together
| |
| | they shared the same source, or a
|
| all of the patients with the same site
| |
| | geographical distribution pattern of an
|
| and organisms, then drop off the
| |
| | infection that may indicate the spread by
|
| infections which occurred within 48 hours
| |
| | poor hand-washing
|
| of admission (not enough time for
| |
| | 4. Follow state and local health
|
| incubation of a nosocomial infection).
| |
| | department requirements regarding
|
| Then take the patients with the same site
| |
| | reporting of infections
|
| and organism and look at the sensitivity
| |
| | 5. Educate staff with information gained
|
| reports. If the sensitivity to
| |
| | through above steps as to how they can
|
| antibiotics is variable, it is unlikely
| |
| | prevent the spread of infections in your
|
| that the infections came from a single
| |
| | particular setting
|
| source. If on the other hand, the
| |
| | Following these steps will help ensure
|
| sensitivities are identical, it is
| |
| | that your patients and staff are
|
| unlikely that they were randomly acquired
| |
| | protected from unnecessary infections,
|
| community infections.
| |
| | and that you will enjoy higher success
|
| Once sepsis occurs, aggressive
| |
| | with your clinical outcomes.
|
| monitoring, antibiotic therapy, and fluid
| |
| |
|