Infection Control Talk » General Infection Prevention Forums » New to Infection Prevention

[Kelly Pyrek]

What's the one question you have been wanting to ask other more seasoned infection preventionists but were too afraid or embarassed to ask? I'm hoping the veterans on this forum can help answer it!

[molesen]

Was I insane when I accepted this job? :-)

[lboris]

Has anyone heard of or implemented a "Chasing Zero" Program in their Institute and if so, how did you go about staff buy-in/enthusiasm towards the program?
Thanks,
Lisa

[Viralval]

"Chasing Zero:Winning the War on Health care Harm" with celebrity sponser Dennis Quaid featured through AARP

Or The Joint Commission "Chasing Zero" campaign see http://healthvie.com/wp-content/uplo...mic0210w28.pdf

Implementing the Joint Commission campaign is a continuous process based on SMART (Specific, Measurable, Attainable, Realistic, and Trackable) goals. We have a multidisciplinary hand hygiene team that has been meeting for two years to help drive our hand hygiene compliance rates up and our infection rates down. The hard part is revitalizing the team and thinking of new, inovative, fun ways to capture staff attention over what they percieve they are already doing. I would love to hear what others are doing with this campaign.

[washyourmits]

Moleson, I relate! Very funny.

[monica.tallman]

I think we all ask that same question, Moleson, at one time or another! ha

[KarenSC]

Hi y'all,
My burning question is when do you remove someone from precautions? For instance, if a resident is on C. diff precautions, I have read in the literature something about keeping precautions in place for 2 months after the antibiotics have stopped. That really would not be practical in the longterm care setting where I work. And for contact precautions relating to a wound; do you stop precautions when the wound ceases to drain, when the antibiotics are complete, or some other prescribed time after that?

[lmacdaid]

If you can get buy in to report your infections as raw numbers to leadership at all levels and on dashboard (performance) reports, that will be a step in the right direction. It is hard to visualize zero when you are reporting rates. I understand the value of rates and there will be many people who will argue the need to report rates. We report both. When you move away from the denominator and allow the numerator to bare and naked, it helps people to start putting a face on the harm of infections. Instead of a rate of 3.4, you say 5 people were harmed from a central line associated infection this month. You don't get to zero overnite. We have been working on it for years through heavy hitting goals. Each year, we set goals to cut infections by half. Each year there is doubt about meeting goals. Even if the goal is not met, we may still cut infections by 23% which is still success. We are not at zero but are closer than 2 years ago. Our small hospitals have attained zero in many cases and even they were doubters. They got there, but the hard part is staying there!!

[Viralval]

Originally Posted by KarenSC

Hi y'all,
My burning question is when do you remove someone from precautions? For instance, if a resident is on C. diff precautions, I have read in the literature something about keeping precautions in place for 2 months after the antibiotics have stopped. That really would not be practical in the longterm care setting where I work. And for contact precautions relating to a wound; do you stop precautions when the wound ceases to drain, when the antibiotics are complete, or some other prescribed time after that?

The CDC has a guideline called "Reducing the Transmission of Infections in Healthcare Settings". In this document they give a fairly thorough listing of pathogens/diseases, what type of precautions they should be placed in and when those precautions can be discontinued. For C.diff - the patient is placed in contact precautions and the precautions are continued as long as diarrhea is present. The grey area is when to stop precautions in the case of someone with irritable bowel syndrome, diverticulosis, or other chronic conditions where a person may have chronic loose stools. In those cases we work closely with the primary care physician to determine when the "diarrhea" has ended and the individual has returned to their baseline.

Hope this helps.

[KarenSC]

Thanks! That does help. The case you describe is exactly the problem I have right now. The resident has chronic diarrhea. He stopped for about a week. Of course, as soon as he started the diarrhea again, he was tested again, and he is positive again (no surprise there). This is the 4th time he has been tested since the summer. I will explore what is causing the diarrhea and how we can determine if he is back to his baseline.