Preventing Healthcare-Associated Infections: Q&A With Wava Truscott of Kimberly-Clark Health Care
Kimberly-Clark Health Care.
Q: Who is most vulnerable to contracting a healthcare-associated infection and why?
Wava Truscott, PhD, MBA: All patients entering any healthcare environment are vulnerable to infections, due to injury and/or a compromised immune system. Their normal barriers to infection are focused on healing injuries, preventing invasion of foreign bodies, or have become less effective due to malnutrition, natural aging or diseases like diabetes. According to the Centers for Disease Control and Prevention, approximately 1.7 million hospital patients contract an HAI each year in the United States. That means that 1 in 20 individuals walking into a facility seeking help for a medical concern become infected while they are there.
Q: What are the different ways in which an infection, more specifically an HAI, can be transferred?
WT: Staff, sick patients, visitors and contaminated objects are primary sources for transferring infections. Microorganisms are deposited on surfaces within aerosol droplets from coughing, sneezing and contaminated humidifiers, or by touch transfer from contaminated hands, clothing and instruments. These contaminated surfaces and objects can subsequently play a role in the transfer of pathogens onto other surfaces, the hands of healthcare providers and the hands of patients.
Q: What are some preventative measures that can be taken to reduce the risk of HAI exposure?
WT: Proper use of personal protective equipment, thorough hand hygiene by patients, residents and staff, comprehensive environmental cleaning, meticulous instrument sterilization practices and frequent disinfection of potentially contaminated surfaces all significantly reduce the risk of patients acquiring an infection. To expand:
• According to the CDC, the most important factor for infection prevention within the hospital setting is hand hygiene. Hand hygiene policies should include mandatory use of an alcohol-based rub or soap and water by staff and visitors before and after any contact with patients or potentially contaminated surfaces.
• Easy access to PPE, including gloves, masks and gowns, makes compliance with appropriate protection much more likely. Policies need to be posted reminding staff and visitors of appropriate PPE to be worn depending on the patient’s level of vulnerability and possible infectious status.
• Proper surface disinfection begins with choosing an Environmental Protection Agency-approved disinfecting agent. For example, sodium hypochlorite at the appropriate concentration and pH is commonly chosen to address Clostridium difficile concerns. However, especially in the case of C. difficile contamination, the EPA first requires cleaning to remove feces and other organic substance that could physically or chemically interfere with the effectiveness of the disinfectant. Following are important considerations:
- Research has shown that the act of cleaning can actually contribute to transmission of organisms if one is not cognizant of the critical nature of such a seemingly easy task. For example, use of the old open bucket "dip-and-squeeze" method can leave pathogens alive and infectious, floating in the cleaning solution. Each dip of the contaminated rag increases the number of microorganisms in the bucket, and can be spread to each subsequent surface and room. A closed-bucket wiper dispensing system solves this problem easily by eliminating the need to re-dip wipers, preventing associated cross-contamination.
- If the disinfectant is applied inadequately or inappropriately, there is the potential for not killing the pathogens. For example, few institutions understand that many disinfectants are rendered inadequate if a cotton rag or paper wipe is used to spread the disinfectant, due to the pathogen-killing molecules actually binding to cotton and paper fibers. This decreases the effectiveness of the disinfectant due to its decreased concentration. For example, Schultz (2009) demonstrated over 75 percent loss of chlorine concentration in a hypochlorite disinfectant when it was in contact with paper wipes for just 10 minutes. Compatible wipes, usually composed of polypropylene, are critical for ensuring appropriate concentration of the disinfectant is consistently delivered to the target surface. In situations where cleaner-disinfectant combination solutions can be used, the importance of a closed container system that dispenses compatible non-binding wipes are similarly essential.
- Healthcare facilities need to be especially mindful of "high-touch areas," which include frequently visited locations and points of contact such as television buttons, light switches and door handles, making certain that they are routinely disinfected.
Q: What can healthcare professionals and patients do to educate themselves further about HAI prevention?
WT: Healthcare professionals should continually update themselves on developments and compliance requirements related to HAI prevention. Clinicians and Environmental Services supervisors should provide regular education programs for employees, as well as comprehensive offerings for staff as turnover occurs or untrained, temporary employees are utilized.
• Continuous education around infection prevention practices is vital to ensuring excellent patient care. Kimberly-Clark Health Care has a number of complimentary accredited educational webinars specifically for ASCs archived at https://www.excellentiagroup.com/complimentary-webinar, and additional complimentary online courses available at http://en.haiwatch.com/ClinicalEducation.aspx.
• The Heart of Healthcare campaign, created by Kimberly-Clark Professional* and the Association for the Healthcare Environment, features educational materials for Environmental Services professionals on HAI prevention including a toolkit that supervisors can use to demonstrate the importance of infection prevention within the healthcare setting and to provide key steps employees can take to reduce these risks. Because routine and thorough surface disinfection is a critical and mandatory facet of infection control, the professionals in Environmental Services play a key role in prevention efforts within healthcare facilities.
• The Kimberly-Clark* HAI Patient Education Program includes in-depth information on infection prevention for patients and their families through a dedicated patient education website, toolkit and support of community events. Additionally, Kimberly-Clark* provides HAI prevention resources and training to clinicians and healthcare organizations through the website HAI Watch.
• Healthcare professionals and patients who have worked to reduce HAIs in the healthcare setting are now being recognized by the annual HAI WATCHDOG* Awards. The program, sponsored by Kimberly-Clark Health Care, recognizes these efforts and awards educational grants to those working to prevent HAIs in their facilities and also provides a forum for healthcare providers to share infection prevention best practices.
Learn more about Kimberly-Clark Health Care.
Related Articles on Infection Control:
8 Tools and Resources for Boosting Patient Satisfaction
Large Metro Hospitals "Breeding Ground" for Superbugs
White Paper Highlights Role of Environment Hygiene in Patient Safety
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