Lewis & Clark

Infection Control

- Is it time to update your Policy & Procedure?

Methicillin-Resistent Staphylococcus Aureus (“MRSA”) has historically been associated with hospitals and long-term care institutions. However, evidence has shown this infection has moved into the community and is known as the community-acquired Methicillin-Resistent Staphyloccus Aureus (“CA-MRSA”). CA-MRSA has emerged as a common cause of skin and soft tissue infection (“SSTI”) in the United States, and has rapidly increased in clinical settings outside the hospital.

The bacteria is being spread among people of competitive sport teams, daycare centers, correctional facilities, and military recruits. Given the concern related to the spread of MRSA in non-hospital settings, it is now time to focus on office based physicians, ambulatory care centers, diagnostic centers as well as other outpatient settings. As hospitals usually have an infection control officer to educate and monitor infection, non-hospital settings operate under a more modest scale. With this being said, physicians and their staff are going to be faced with updating their policy and procedures to become more proactive about infection control and prevention.

Molecular differences are present between the hospital-acquired and community-acquired MRSA, making it essential to recognize/identify symptoms early for appropriate treatment. Whereas hospital-acquired MRSA is less likely to respond to antibiotic therapy, community-acquired MRSA strains are more susceptible to antibiotics. According to the CDC, 12 million outpatient visits reported last year in the United States were MRSA skin infections.

With the rising rate of MRSA throughout all of our healthcare facilities, office based physicians need to protect themselves , as well as their staff, to eliminate further infection and take proper prevention. Listed below are a few infection control basics:

How Is Infection Spread?
Infections are spread by exposure to germs by either contact or droplets. Contact involves both direct and indirect contact. An example of direct contact would be touching an open wound with unprotected hands. While indirect contact would involve transferring the infection /germs by sharing a drink or eating from the same utensils. The spread of infection through droplets simply means the germs are being transferred through the air by a cough or sneeze.

How Are Infections Treated?
A viral infection may not require actual treatment. Viruses are usually fought off by a person’s immune system and are treated with supportive measures such as Tylenol and increased fluids for hydration. Bacterial infections are treated with antibiotics. These medications can be given orally, by injection, or by intravenous therapy.

What Is Resistant Bacteria?
Resistant bacteria is a microorganism that has the ability to withstand any effects of an antibiotic, which in turn allows the microbes to proliferate. Unfortunately, increased infection transmission and inappropriate antibiotic use have contributed to bacteria antibiotic resistance.

What Can Be Done To Completely Prevent And/Or Reduce The Possibility Of The Spread Of Infection?
Simply put, good hand washing techniques can impact the spread of infection. Statistics show that 30 to 50 percent of all infections could be prevented if everyone practiced proper hand washing techniques. Something as simple and inexpensive as soap and water can help reduce not only your infection rate, but the financial ramifications involved when treating an infection.

From a patient safety perspective, it is time to update our infection control program and remain focused on our options for prevention and treatment as we address the challenge our out-patient environment faces. Following are suggestions of Office-Based Practice Infection Control:

• Does your practice have written policy/procedures and an updated infection control plan?
• Is compliance with infection control standards recognized as patient safety, and part of the employee annual educational requirement that is demonstrated in their daily performance?
• Do you have a designated person/team overseeing infection control and keeping current with research, training, education, and trends?
• Is your staff/office in compliance with reporting certain infections to the State?
• Does your staff recognize that infection control falls outside the actual clinical boundaries, to include the use of disinfectants throughout the facility/office?
• Is there a protocol/pathway for your staff to screen or identify high risk patients?

If you would like further assistance with updating your policy and procedures manual, please contact Susan Bugg, BSN, CLNC [J.M. Woodworth RRG, Inc.] at 678-781-2425.