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Intensive care unit (ICU) staffs across the country are working diligently to implement strategies, procedures and technologies in order to successfully lower incidence rates of HAIs. As ICUs are the most common sites for infectious outbreaks, they are faced with taking the lead role in fighting both community-acquired and hospital-related infections, like MRSA (methicillin-resistant Staphylococcus aureus). Most often, infection prevention specialists advise hospitals to undergo deep cleans and emphasize staff education and compliance on evidenced-based guidelines to reduce infection rates. However, without a two-pronged strategy of enforcing strict hygiene control measures and using technology to augment, HAIs will never be eliminated. Helping Hands Guidelines developed by the CDC and infection control organizations recommend that health care workers use an alcohol-based antiseptic to routinely clean their hands and basic hand washing with soap and water, as antiseptic cleaning agents used in conjunction with diligent hand washing can assist in combating bacteria. Hospitals also should have systems in place to support a bundle of interventions, including standard hand and facility hygiene precautions, active surveillance measures, contact barrier tools, and an emphasis on culture change using briefings on patient care units, leadership involvement and other strategies like the latest in medical device technologies. Beyond strict hygiene standards, hospitals must start looking to innovations in medical devices to protect patients. This is especially important for patients with invasive devices such as central venous catheters (CVC) and ventilators since they are at greater risk for developing HAIs, both because of the invasive devices and the severity of their underlying illnesses. In fact, of the 1.7 million total infections reported by the CDC, about 250,000 are catheter-related bloodstream infections (CRBSIs), which are the second leading cause of death associated with HAIs, second only to pneumonia. CRBSIs develop when bacteria enter the bloodstream through the channel created by the CVC. CRBSIs result in longer patient recovery times, a higher chance of long-term complications or death and increased hospital costs for treating these highly preventable infections. For these reasons, along with the upcoming Oct. 1, 2008 CMS (Centers for Medicare & Medicaid Services) reimbursement policy change for 8 hospital-acquired conditions, hospitals are working harder than ever to find the perfect combination of attack strategies. The rule states that Medicare will no longer pay for hospital care necessary for a condition, including CRBSIs, acquired by a patient during a hospital stay that could have been reasonably prevented by following evidence based guidelines. Furthermore, the comment period for an additional nine hospital-acquired conditions that would take effect in October 2009 closed in early June. Augmenting Hygiene Standards Implementing hygiene standards is never a guaranteed control measure, but in combination with the use of advanced medical device technologies where human error and non-compliance are mitigated, hospitals can see lower infection rates. Such advanced devices include catheters, urinary tract catheters, wound dressings and chest tubes, many of which are coated with powerful antibiotics or antiseptics that prevent infections. The specific example of catheters is ideal for demonstrating how devices are vital keys in the battle against infection. Advanced catheters impregnated with antibiotics like minocycline and rifampin can be very effective tools to combat these infections. The antibiotic coverage on both the external and internal surfaces of the catheter helps reduce the rate of bacterial colonization, which minimizes the chances of bacteria entering a patient’s bloodstream. These two antibiotics work synergistically to provide broad-spectrum activity against most leading organisms causing CRBSIs. By pairing the most effective process control measures with leading-edge technology, the healthcare industry can significantly reduce unnecessary treatment costs, lower infection occurrence and save lives. Healthcare staff must comply with stringent practice standards and those responsible for procurement should choose medical devices that can help in the battle against infections. These measures will not only promote a culture of excellence, but it will also emphasize teamwork within each institution to the promise of reducing infections to the goal of zero. Thomas Cherry, RN, BSN, is clinical product manager of the critical care division of Cook Inc., a medical device manufacturer that makes antimicrobial catheters. www.HealthNewsDigest.com Top of Page 
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