This week, nearly 5,000 healthcare professionals focused on infection prevention are gathered in Philadelphia, PA for the 46th Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC). Some of the research that will be presented at the conference:
Interdisciplinary approach to antimicrobial stewardship decreases broad spectrum antibiotic usage
The microbiology lab at Einstein Medical Center Montgomery in Pennsylvania, in collaboration with the antimicrobial stewardship team, implemented a new protocol to treat sepsis patients. Rapid BCID polymerase chain reaction (PCR) tests were administered to identify the bacteria making the patient sick, and pharmacists made recommendations on how to manage or readjust the previously prescribed antibiotic regimen.
Data collected for four months before and after implementation showed that the new BCID PCR test protocol resulted in providers adjusting patients’ antibiotic treatment a full 25 hours sooner on average, decreasing patients’ time on broad spectrum antibiotics. Pharmacists’ recommendations were developed using an algorithm that determines the best course of treatment for the type of bacteria indicated by the BCID PCR test results. By optimizing antibiotic use, Montgomery Hospital observed a length of stay reduction of 1.45 days per patient, which resulted in a cost avoidance of $322,508 over four months.
Every penny counts: Reducing infections improves care, cuts costs
Looking to decrease healthcare-associated infection (HAI) rates across their healthcare system, Infection Control Practitioners in Syracuse, New York identified chlorhexidine gluconate (CHG) bathing as a means of reducing infection rates. After conducting thorough staff training, hospital-wide use of CHG bathing for every patient was implemented, leading to significant results: a 65 percent reduction in central line-associated bloodstream infection (CLABSI), a 30 percent reduction in catheter-associated urinary tract infection (CAUTI), a 100 percent reduction in Methicillin Resistant Staphylococcus Aureus bacteremia (MRSA), and a 28 percent reduction in Clostridioides difficile (C. diff).
Estimated total cost savings fell just shy of $515,000 between April 2017 and March 2018. A task force compiled the total cost of HAIs based on a number of factors, including direct costs per infection as shown in literature reviews and the Centers for Medicare & Medicaid Hospital Acquired Condition Reduction Program penalty. While the estimated cost impact of HAI reduction during the intervention period amounted to $514,739, CHG bathing costs totaled only $40,114.
In addition to bathing the patients, staff implemented Agency for Healthcare Research and Quality (AHRQ) recommendations to clean patient devices with CHG during the process, including cleaning external catheters six inches down from the patient, as well as lumens of central lines. Educating staff about the CHG bathing was key to ensuring compliance. To alleviate concerns about potential skin side effects using this bathing method, the team incorporated a skincare bundle, including lotions, in the process.
