Friday 16 September 2016

The Patient Safety Atlas

In March of 2016, in an effort to prevent healthcare associated infections (HAIs), the Centers for Disease and Prevention (CDC) issued a request for all healthcare providers and healthcare facilities to make three critical efforts to further this cause. The CDC also launched the online Patient Safety Atlas in an effort to control the rising threat of resistant bacterial infections.

The following guidelines are succinct and offer very clear advice:

1) Prevent infections related to surgery or placement of a catheter.
2) Prevent spread of bacteria from spreading between patients.
3) Improve antibiotic use.

There are six antibiotic resistant bacteria that are particularly dangerous and are considered urgent or serious threats by the CDC. They are:

  • MRSA (methicillin-resistant Staphylococcus aureus)
  • CRE (carbapenem-resistant Enterobacteriaceae)
  • ESBL-producing Enterobacteriaceae (extended-spectrum ß-lactamases)
  • VRE (vancomycin-resistant enterococci)
  • Multi-drug resistant Pseudomonas
  • Multi-drug resistant Acinetobacter

Infections caused by these organisms could lead to sepsis or even death. C. difficile infections are the most common HAI found in hospitals, and in many cases, lead to death. However, it is not antibiotic resistant like the others listed above.

Surgery and Catheters: The recommendation for preventing infections from catheters and after surgery include using catheters only when needed, following recommendations for safer surgery and catheter insertion and care, and removing catheters from patients as soon as they are no longer needed.

Patient Isolation: For preventing C.diffficile, it is recommended that healthcare providers are consistent and follow these actions for every patient without exception. When it is appropriate, patients should be isolated, and providers should know antibiotic resistance patterns in their facility and area.  In order to prevent dangerous bacteria from spreading, it is recommended that hand hygiene be improved and that gloves, gowns, and dedicated equipment be used for patients who have antibiotic resistant infections.

Antibiotic Use: Finally, to improve antibiotic use, it is recommended that cultures be obtained and antibiotics started promptly and reassessed 24 to 48 hours later, especially in cases of sepsis. Cultures should be used to reassess the need for antibiotics and to stop treatment as soon as they are no longer needed. Antibiotics should be used appropriately according to the type of infection and in the proper dosage, frequency, and duration.

The Patient Safety Atlas: A patient safety atlas (PSA) was created by the CDC and is a public portal that allows heathcare providers and the greater public to visualize and download data that is based on four years of surveillance (2011-2014) by 4,403 healthcare facilities. These include general acute care hospitals (n=3,676), long term acute care hospitals (n=506), and free-standing inpatient rehabilitation hospitals (n=221).

Source: Hardy Diagnostics

Posted by Dr. Tim Sandle

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