Procedure speeds up contact precautions
Procedure speeds up contact precautions
Standard infection control procedures dictate that when hospital patients test positive for difficult-to-treat and/or resistant organisms, the first order of business is to get them placed on contact precautions — the faster, the better.
At Cary Medical Center in Caribou, ME, Darlene Higgins, CPHQ, and Patty Carson, infection control officer, have come up with a way to expedite the reporting of lab test results to caregivers. A new reporting procedure now gets patients placed on contact precautions in a more timely fashion — and benefits patients, hospital staff, and payers in the process.
The problem is a common one
Previous practices at Cary mirrored those in many hospitals. Bacteriology lab test results were sent directly from the lab to the unit where the patient resided, printed off the computer, and put in a basket along with a multitude of other reports, according to Carson. "There was nothing on the report to indicate it might need special attention," she says, and as a result, "these reports were often overlooked or misplaced."
This system failed in at least one instance. "We had one case where we had a patient [who tested positive for] methicillin-resistant staph aureus," says Higgins. "Four days elapsed before our infection control officer got the word," she says, "and, by that time, a number of staff had come into contact with that patient."
Add a line and place on alert values list
Now, Cary Medical Center patients having methicillin-resistant staphylococcus aureus, vancomycin-resistant enterococcus, positive clostridium difficile or positive respiratory syncytial virus have a new line added at the end of their bacteriology reports.
It states: "Patient must be immediately placed on contact precautions." Additionally, these four lab results are now placed on the "alert values list," bringing them to the immediate attention of the nurse or caregiver whenever they occur.
"We added the line to the bottom of the [bacteriology] report to help call attention to the results more quickly," says Higgins. Perhaps, more importantly, placing positive lab results for these conditions on the alert values list "tells technicians that they have to pick up the phone and notify someone immediately," she says, as opposed to merely transmitting a routine report to the unit where the affected patient resides.
New procedures meet JCAHO requirement
These new procedures instituted by Cary Medical Center are part of this institution’s compliance with requirements of the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, for the implementation of methods to reduce the risk of nosocomial infections, says Higgins.
The importance of these methods is heightened in today’s hospital environment where, she says, "We’re now paying the price for the overuse and/or inappropriate use of antibiotics in the past."
Expediting contact precautions benefits staff and other patients because difficult-to-treat and/or resistant organisms are more quickly confined to the infected patient. The infected patient benefits because the physician is alerted to assess current antibiotic therapy and change it as needed. Meanwhile, patients, caregivers, and payers alike enjoy the health and economic benefits of reduced length of stays.
[For more information, contact Dorothy Higgins at Cary Medical Center, 163 Van Buren Road, Caribou, ME 04736. Telephone: (207) 498-1114.
To access more information about this and other innovations in health care, point your browser to www.best4health.org, the site of The Best Practice Network, an organization devoted to promoting information-sharing and experience exchange among nurses, physicians, and other health care professionals. For more information on The Best Practice Network, e-mail [email protected] or call (800) 899-2226.]
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