Healing facility Water: Is it a Source for Nosocomial Infections .


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Hospital Water: Is it a Source for Nosocomial Infections?. Copyright 2002, Robert Garcia, BS, MMT(ASCP), CIC. Causative Agent. Reservoir. Susceptible host. Portal of exit. Portal of entry. Mode of Transmission. The Chain of Infection. Components of the Infectious Disease Process.
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Healing facility Water: Is it a Source for Nosocomial Infections? Copyright 2002, Robert Garcia, BS, MMT(ASCP), CIC

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Causative Agent Reservoir Susceptible host Portal of leave Portal of section Mode of Transmission The Chain of Infection. Segments of the Infectious Disease Process.

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Water as a Reservoir of Nosocomial Pathogens Organisms, for example, Pseudomonas aeruginosa, Serratia marcescens, and Acinetobacter calcoaceticus can recreate in moderately immaculate water May be available in drinking water that has satisfactory breaking points of security (<1 coliform bacterium/100 mL)

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P. aeruginosa Infections because of Hospital Water Sources >12 reports showing transmission and advancement of disease from sullied healing center water Trautmann M, Michalsky T, et al. Tap water colonization with Pseudomonas aeruginosa in a surgical emergency unit connection to Pseudomonas contaminations of ICU patients. Taint Control Hosp Epidemiol 2001;22:49-62.

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Burn Infections Tap water has been refered to as the hotspot for genuine injury and sepsis Kolmos HJ, Thuesen B, et al. Episode of disease in a blaze unit because of Pseudomonas aeruginosa beginning from tainted tubing utilized for water system of patients.

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Infections from Hospital Sinks Many reports have recognized the nearness of gram-negative microorganisms in clinic sinks Organisms may get by for >250 days on sink surfaces Simor AE, Ramage L, et al. Sub-atomic and epidemiologic investigation of multiresistant Serratia marcescens contaminations in a spinal rope harm recovery unit. Contaminate Control Hosp Epidemiol 1988;9:20-27.

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Tip of the Iceberg More than 40 references of water as a wellspring of nosocomial diseases Anaissie et al evaluate that >1,400 passings happen every year because of waterborne nosocomial pneumonia because of P.aeruginosa alone Anaissie EJ, Penzak SR, Dignani C. The doctor\'s facility water supply as a wellspring of nosocomial diseases. An arrangement for activity. Curve Intern Med 2002;162:1483-92.

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"… In such settings, clinic water may have sullied ecological surfaces (eg, sinks, depletes, and whirlpool showers), medicinal gear (eg, by washing tube nourish sacks, endoscopes, respiratory hardware, and so forth., with faucet water), or human services suppliers, driving at last to patient presentation." - Anaissie EJ, et al. The healing center water supply as a wellspring of nosocomial contaminations. An arrangement for activity. Curve Intern Med 2002;162:1483-92.

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How are Patients Exposed to Hospital Water? Handwashing (cross-pollution) Bedpans Enteral feedings Respiratory hardware Drinking Showering Bed washing

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Basin Bath Drawbacks High utilization of assets Negative effect on nursing and patients Damaging impacts on the skin Contamination dangers with bowls & water Real financial aspects of bowls

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Why Should Hospitals Care? The majority of your patients skin is at hazard Cost of skin breakdown in U.S.: $13 Billion Nosocomial pollution may prompt nosocomial disease Cost of nosocomial contamination: $5.9 Billion JCAHO Patient Safety Quality Indicators Patient "gauge" for their nature of care Source: Stone P. et al, Outcomes of ICU Working Conditions, Nov 2001

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Nursing Shortage versus Persistent Outcomes JCAHO Expert Panel Report "Lacking staffing not just antagonistically impacts social insurance quality and patient security, it additionally bargains the wellbeing of medical caretakers themselves" Source: Joint Commission on Accreditation of Healthcare Organizations, August 2002

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Damage to the Skin Soaps can strip the corrosive mantle, raise the pH and trade off the epidermis Washcloths present grinding since they are unforgiving and unpleasant Drying cleanser and harsh washcloths are delicate skin\'s most exceedingly bad adversary Sources: Friers, S.A. Ostomy, Wound Management June 2001 Bryant R. A. Ostomy, Wound Management June 2001 Wysocki A. Intense and Chronic Wounds 2 nd Edition 2000

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Whose Skin Are We Talking About? Your Patient Majority are elderly Most have pruritic skin condition Epidermis and dermis are more slender Skin has diminished hindrance work Reduced skin flexibility Poor epidermal turnover Lowered sebum creation Loss of subcutaneous fat and muscle Source: Thomas MD, D., Clinical Journal of Medicine, Cleveland

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Pressure Ulcers 1.6 million cases for every year in intense care Varied settings: therapeutic wards surgery and working rooms escalated mind units restoration focuses long haul and home care

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Prevalence of Pressure Ulcers Reported rates to be somewhere around 3% and 11% Two vast studies: 9.2% (148 healing centers) 1 7% (116 doctor\'s facilities) 2 1. Meehan M. Multisite weight ulcer pervasiveness study. Decubitus 1990;3:4-14. 2. Whittington K, Patrick M, Roberts JL. A national investigation of weight ulcer commonness and rate in intense care healing centers. J Wound Ostomy Continence Nurs 2000;27:209-15.

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Cost Impact: Hospitals Unadjusted mean expenses: With Pressure ulcers - $37,288 Without weight ulcers - $13,924 Adjusted for affirmation indicators and nosocomial diseases: With weight ulcers - $29,048 Without weight ulcers - $13,819 Allman RM, Goode PS, Burst N, et al. Weight ulcers, healing facility intricacies, and sickness seriousness: Impact on clinic expenses and length of remain. Adv Wd Care 1999;12:23-30.

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Basinborne Contamination Study Hospital staff don\'t see bowl shower water as essentially debased 100% of the specimens in the study were sure for bacterial development, 60.8% were gram negative The bacterial number in bowl water was so high it was like the bacterial tally in the pee from patients with UTI\'s Employees, wearing sullied gloves utilized amid the system, were seen to touch numerous ecological surfaces. Bowl water may serve as a repository of anti-infection safe creatures Source: Shannon R et al., Patient Bath Water as a Source of Nosocomial Microbiological Contamination: A mediation Study utilizing Chlorhexidine. J Healthcare Safety Infect Control, 1999;3:180-84.

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Basinless Bathing Removes the danger of bowl defilement Removes the danger of waterborne pollution 8 washcloths to decrease exchange of life forms Mild chemical keeps up skin\'s normal hindrance Single-utilize diminishes natural/cross sullying No water spills lessen slips & fall potential Better Science and Patient Safety

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$6.84 per shower What\'s the Real Cost of Basin Bathing? Vitality, Water & Sewer $.10 Nursing $5.11 Laundry Processing $.98 Materials $.65 Source: Total Delivered Cost Analysis Database from U.S. clinics 1997 - 2002, Sage showcasing information on document.

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Solid Economics $5.11 Nursing Time $6.84 add up to $3.68 add up to $1.83 Nursing Time $1.73 $1.90 $.98 Laundry &Linens Basinless Bath $1.10 to $1.90 $1.10 $.10 Water,Sewer,Energy $.65 Materials Basin Bath Cost Basinless Cost Source: Total Delivered Cost information investigation of U.S.hospitals 1997-2002

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Time is on Your Side Original Price $5.50 New Concept $5.00 $4.00 $3.00 $2.00 $1.00 High Distribution Margins H o s p i t a l p r i c e One or Two Product Choices $3.75 Manufacturing Efficiencies The Cost of Basinless Bathing GPO Contracts $2.25 $2.05 Multiple Product Choices $1.90 $1.10

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