Back in January, our newsletter’s MediaWatch section included a story on the dangers of scrubs as fashion statement.

This past weekend, the CBC’s Sunday Edition ran their coverage of this story:

We all know hospitals are dangerous places, literally crawling with dangerous bugs. In fact, around 8,000 Canadians a year die of infections caused by microbes such as C.Difficile which pollute hospital emergency wards, treatment rooms and patients’ rooms. But what can happen when all those hospital bugs begin turning up in coffee shops, on public transit, or even grocery stores carried by hospital personnel wearing their green scrubs, their uniforms, outside the hospital?

Listen to their coverage (in hour 2) here.

New strains of MRSA (Methicillin-resistant staphylococcus aureus), of VRE (Vancomycin-resistant enterococci), C. difficile, even TB are becoming drug-resistant.  Some are now classified as XDR:  extensively drug-resistant.  Many of these “superbugs” spread fastest in what should be the most hygienic and safe of environments — hospitals.

Hospital-acquired infections (HAI) are a growing fear in the public’s mind, litigation is on the rise, and millions are spent on new cleaning protocols alone.  The average cost of hospital care for patients who acquired infections is over $180,000 (US) compared with $31,000 (US) for regular acute patients.  A single class action suit in Canada (against Ontario’s St. Joseph Brant hospital) totaled $50M, and since 2005 the UK’s National Health Service (NHS) has paid £12 million to people claiming compensation involving superbugs.  Financial news sources in the US are predicting this as just the beginning of a wave of superbug-related litigation.

Yet one of the most effective strategies in combatting hospital-acquired infections (HAI) is simple contact management — tracing and understanding interactions:  between patients and staff, patients and equipment, staff and equipment.  Hospitals currently lack the means to track the spread of these outbreaks within their walls, and unable to isolate where contamination occurred and how it is spreading, time and resources are spent starting from scratch every time.

Keeping track of who touched what and what went where, done manually, can quickly add to, not alleviate the burden on overworked professionals.  However, data gathered through RFID happens automatically (no extra steps for hospital personnel); is accurate; and is available in real-time.

That’s why Infonaut Inc has created a precise RFID and GIS-based infectious disease risk-management tool, called Hospital Watch Live (HWL).

“We are very excited to be working on this project and about the potential it brings to the healthcare industry,” said Niall Wallace, CEO, Infonaut. “This innovative health IT product will help health stakeholders control the spread of infectious diseases such as C. difficile. In the future, we hope that hospitals, long-term care facilities and other health facilities will be able to use this system to help manage and reduce the impact of future number of disease outbreaks.”

When a “Patient Zero” is identified in Hospital Watch Live, GIS mapping technology combines with RFID locators to support immediate risk assessment, containment and outbreak mitigation.  RFID tag technology enables hospitals to literally see who and what infected patients have interacted with, where they have been, and which equipment has been in close proximity to them – all turned into actionable information.  An analytical extension determines potential commonalities and high-risk contacts. Profiles are dynamically generated: as people and assets interact with each other, associated risk levels change to reflect new inputs.

“We recognize the importance of supporting the development of this unique system that could help staff manage the spread of infectious diseases at SAH [Sault Area Hospital] while creating a value-added product for use throughout the healthcare sector,” said David Orazietti, MPP for Sault Ste Marie.

A Beta implementation of Hospital Watch Live will launch within the next month at the Sault Area Hospital (SAH), a provincial leader in C. difficile management.

“The Sault Area Hospital is pleased to collaborate on this innovative solution with Infonaut,” said Marc Bouchard, Chief Information and Privacy Officer, Sault Area Hospital. “The project will see the development of what should be an interesting tool that could assist our ongoing efforts in infection control and prevention.”

The next phase of development on the HWL solution includes installation and simulated use in George Brown College (GBC)’s Controlled Applied Learning Environment (CALE), Simulated Practice Centre (SPC).  George Brown’s $1.2 million advanced facility incorporates an electronic health records system, video camera broadcast system, and complex simulation mannequins.  Nursing students will use the system as part of the infection control curriculum, and other faculty and students will be involved in the testing and development of system components.

This relationship gives Infonaut a strategic advantage, as testing on hyper-real simulations that give hospitals and healthcare organizations added confidence in the robustness of Infonaut’s technology.  Robert Luke, Director of Research and Innovation at GBC said of Infonaut’s technology: “This is the kind of applied research the country needs — innovation meeting real needs.”

To learn more about this product, or the rest of the Infonaut Live suite, please contact Sandra Linklater, Director of Business Development at slinklater[at]infonaut[dot]ca or 705-987-3816.

Only 7 percent of hospitals meet Leapfrog medication error prevention (CPOE) standards and few hospitals are  meeting mortality standards, according to the 2008 Leapfrog Hospital Survey, released Wednesday.

…

Other highlights of the 2008 hospital survey include:

• Low percentages of reporting hospitals are meeting volume and risk-adjusted mortality standards or adhering to nationally endorsed process measures for eight high-risk procedures, where following nationally endorsed and evidence-based guidelines is known to save lives:
  • 43 percent for heart bypass surgery;
  • 35 percent for heart angioplasty;
  • 32 percent for high-risk deliveries;
  • 23 percent for pancreatic resections;
  • 16 percent for bariatric surgery;
  • 15 percent for esophagectomy;
  • 7 percent for aortic valve replacement; and
  • 5 percent for aortic abdominal aneurysm repair.
• Sixty-five percent of participating hospitals do not have all recommended policies in place to prevent common hospital-acquired infections (HAIs).

Full article:  Most hospitals fall short on safety measures, Leapfrog survey shows

Thousands of patients undergoing treatment or surgery at Scottish hospitals are to be screened for MRSA, Nicola Sturgeon, the Health Secretary, said yesterday.

The national screening programme, which follows pilot programmes by three Scottish health boards, will take place over the next 12 months and will focus on the elderly and people admitted for kidney disease, skin problems and vascular surgery, a group deemed to be most at risk. The only patients not to be screened will be psychiatric, obstetric and paediatric patients.

Ms Sturgeon made the announcement as official figures showed a drop in the number of cases of Clostridium difficile and MRSA in Scottish hospitals.

Full Article: Scottish hospitals to screen patients for superbugs

The definition of an “outbreak” was recently called into question, when a number of patients at St. Joseph’s Healthcare acquired c.difficile — but in a pattern which didn’t exactly match reporting guidelines.

This caused confusion within the hospital over whether to declare an outbreak situation, as well as highlighting the delay between an identified rise in infections, and when the public finds out about it.

Eventually, all outbreaks get reported in each hospital’s monthly filing on a public website set up by the Health Ministry. But it could be a month before the public hears about it, Baker acknowledges. Hundreds of patients and visitors could pass through a hospital in that time.

…

One definition says an outbreak occurs when three or more new cases appear within seven days in one ward. It is also an outbreak when six or more cases occur within 30 days in a single ward or unit.

But at St. Joe’s, the current C. diff outbreak was not confined to one ward. Cases were spread through the hospital.  Chief of staff Dr. David Higgins says that made it difficult to establish whether St. Joe’s was in outbreak or simply faced a seasonal rise in C. diff.

“That’s why we agonized over this for several days,” says Higgins.

Full article: What makes it an oubreak?

Five seniors with C. difficile have died at St. Joseph’s Hospital in the last month.

That is nearly one in three of those who got the bacterial infection that causes severe diarrhea.
…
C. diff is one of three outbreaks St. Joseph’s Healthcare is currently battling.

Another senior died during the first week of March from invasive Group A streptococcus, which was spreading on the geriatric psychiatry unit at the Centre for Mountain Health Services.

Three wards remain closed to visitors at the downtown hospital as St. Joseph’s tries to contain the Norwalk virus.

Full Article:  Three St. Joe’s patients die of C. diff since April 1

>>April 7th 2009

Feel safe in hospital?  You’re not.

“This trend toward green products is not without risk,” says Richard Marchand, a microbiologist and member of a government committee that monitors hygiene and safety standards in Quebec’s hospitals. He says that, since the industry escapes regulation, some products are diluted by the manufacturer and, once delivered to hospitals, diluted again by infection-control staff eager to save money – just as cheap beauty salons do with hair shampoo.”

>>April 2nd 2009

Hospitals cautioned against ‘green’ cleaners

“The flood of new “green” cleaning products and disinfectants being used by Canadian hospitals are often ineffective in combatting infections that sicken thousands of patients a year, experts warn.”

4 newborns dead from hospital-acquired infection in N China

>>Mar 21

Four newborns died and two others were still receiving medical treatment after contracting infections in a hospital in north China’s Tianjin Municipality, local health official said Saturday.

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An initial investigation showed the deaths were caused by hospital-acquired infection of enterobacter cloacae, a clinically significant Gram-negative bacterium.

One of the two newborns receiving medical treatment did not survive.  Five hospital staff were fired over the deaths of the five newborns.

>>Mar 30

Five staff of China hospital dismissed over newborn children deaths

Wang Xin, president of Jixian County Maternal and Child Care Service Center in northern Tianjin Municipality, and Wang Lianjiang, the center’s vice president, were removed from their posts, the Jixian County government said.

…

Three other staff in charge of newborn care service at the center were also dismissed from their posts.

The county government has decided to compensate each family of the dead newborn children with 180,000 yuan (26,354 U.S.dollars).

Environmental cleaning intervention reduces transmission of multidrug-resistant organisms in ICUs

A rigorous environmental cleaning intervention can reduce the transmission of methicillin-resistant Staphylococcus aureus (MRSA) and other multidrug-resistant organisms in hospital intensive care units (ICUs), according to a new study released today at the annual meeting of the Society for Healthcare Epidemiology of America (SHEA). Researchers found that following an enhanced cleaning protocol reduced the spread of MRSA to patients exposed to rooms in which the prior occupant had been colonized or infected.

Canadian Medical Association Journal (CMAJ) has published “Hospital infection control strategies for antibiotic-resistant organisms”:

Identified risk factors include:

…increasing age of patient and severity of disease, increasing length of hospital stay, admission to an intensive care unit and proximity to patients carrying an antimicrobial-resistant organism. Use of broad-spectrum antibiotics and/or prolonged use of antibiotics are also risk factors.

Full Article:  “Hospital infection control strategies for antibiotic-resistant organisms”