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Health care facilities work to decrease infections

By Barbara Christiansen daily Herald - | Aug 23, 2015

Good communication can solve many difficulties — whether it be in families, government, education or elsewhere.

The same goes for health.

As a patient in a hospital acquires an infection, such as C. difficile or an antibiotic-resistant infection, that medical facility should strive to communicate with other hospitals or nursing homes to which that patient might be transferred.

The Mayo Clinic’s website indicates C. diff infections have increased, both in frequency and severity.

“Illness from C. difficile most commonly affects older adults in hospitals or in long-term care facilities and typically occurs after use of antibiotic medications,” says the website. “However, studies show increasing rates of C. difficile infection among people traditionally not considered high risk, such as younger and healthy individuals without a history of antibiotic use or exposure to health care facilities.

“Each year, more than a half million people get sick from C. difficile.”

Antibiotics are appropriately used to treat certain infections, but can be overused. A blog from Intermountain Healthcare details that issue.

“Overexposure to antibiotics causes bacteria to develop resistance because they naturally mutate to prevent being wiped out,” says an online article written by Edward Stenehjem. “It’s a survival mechanism.

“Unfortunately, it takes a long, long time to build new antibiotics to fight the new, more resistant bacteria. By the 1970s and 80s, scientists were engineering new antibiotics as a fix to the resistance problem.

“Some thought we were in the clear, and for a time, we were. But, after decades, these antibiotics also started to fail. Now we know that all antibiotics eventually fail.”

To minimize that reality, hospitals are working to have an effective stewardship of antibiotics, using them in the right amounts at the right time.

A report by the Centers for Disease Control estimates 619,000 cases of hospital-acquired infections could be eliminated in the next five years. The suggestion that would facilitate that is to have state health departments, hospitals and other facilities communicate with each other about patients with those infections.

Intermountain Healthcare is one medical group working to overcome the problem.

“Intermountain has been proactive with this,” said Fritz Kron, quality and patient safety director of Intermountain’s South Region. “We have a full-time pharmacist who provides that service.”

The pharmacist looks at antibiotics that are being prescribed. When a patient first receives antibiotics, it is usually a broad-spectrum version. At set intervals the patient and the prescription are reviewed, and changes may be recommended to the prescriber.

“We can adjust to a more specific and targeted level,” Kron said. “We really appreciate having this pharmacist who has a tremendous knowledge of antibiotics.

“We do what is best for the patient without prompting the emergence of resisting organisms.”

Narrowing down the type of antibiotic lessens the instance of overusing the drugs, which can lead to the development of antibiotic-resistant infection.

But it does not stop there.

“When patients transfer between facilities at Intermountain we have a longitudinal medical record,” Kron said. “If a patient is transferred the receiving hospital and sending hospital know that patient’s history. We are also actively engaged so that we can communicate this when a patient goes to a non-Intermountain facility.

“We always provide the most recent lab reports. There is a nurse-to-nurse conversation. We want to be sure the receiving facility quickly has the information. They can set up the same precautions.”

It sounds simple, but it can save lives.

“Antibiotic-resistant infections in health care settings are a growing threat in the U.S., killing tens of thousands of people each year,” said CDC Director Tom Frieden in a release. “New CDC modeling shows that we can dramatically reduce these infections if health care facilities, nursing homes and public health departments work together to improve antibiotic use and infection control so patients are protected.”


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