Get Smart About Antibiotics and Infection Control
By the TravelNursing.com team
Deadly infection outbreaks have been all over the news in recent weeks, creating more national attention about the importance of infection control. Here are some of the latest news updates, awareness campaigns and scientific findings to keep nurses in the know:
Get Smart About Antibiotics Week, Nov. 17-23
Throughout this week, the Centers for Disease Control and Prevention (CDC), the Association for Professionals in Infection Control and Epidemiology (APIC), and a number of local, state and federal health care organizations are partnering to raise awareness of antibiotic resistance and the importance of appropriate antibiotic prescribing and use.
The CDC reports that each year in the United States, at least 2 million people become infected with bacteria that are resistant to antibiotics and at least 23,000 people die as a direct result. Many additional people will die from other conditions that were complicated by an antibiotic-resistant infection.
The Get Smart About Antibiotics campaign covers the ABCs of antibiotic resistance. It encourages patients to:
• Ask if antibiotics are appropriate;
• Understand that antibiotics only kill Bacteria and won’t work against viruses; and,
• Complete the course of their antibiotics--even if they feel better before finishing them.
Nurses can download the ABC’s of Antibiotics poster from APIC for patient education and reference.
Ebola claims the life of a physician; new PPE protocols made available.
Martin Salia, a 44-year-old surgeon who had been infected by Ebola while working at hospitals in his native Sierra Leone, died on Nov. 17, just a few days after being admitted to the Nebraska Medical Center. While other Ebola patients had been successfully treated at the facility, doctors say that by the time Salia was admitted, he was too sick to overcome the virus. Meanwhile, two Texas nurses who had contracted the virus from a patient who died of the disease in October have recovered. And as of Friday, Nov. 14, the last of the 177 people who had come in contact with the two nurses or the patient when they might have been infectious are no longer being monitored for signs of the disease.
The CDC has provided enhanced training and protocols for using personal protective equipment to keep health care professionals safe from Ebola. Keep up with the latest Ebola news and download the new PPE training video here.
Studies find more infection control lapses occur late in health care worker shifts.
Two recent studies have shown that health care workers are better about following infection control protocols and antibiotic recommendations earlier in their shift. The first, a JAMA Internal Medicine study, showed that physicians are more likely to prescribe unnecessary antibiotics later in their workday, perhaps succumbing to what psychologists call “decision fatigue.”
A related study, conducted by the American Psychological Association, showed that nurses and other health care workers are more likely to skimp on hand-washing as their shift progresses. Researchers at the University of Pennsylvania found that hand-washing compliance rates dropped by nearly 9 percentage points from the beginning to the end of a typical 12-hour shift, and the compliance issue was magnified by more intense workloads. Researchers suggest that mental fatigue makes it harder to follow the rules.
While most nurses can’t change the length of their shifts, they can be more aware of this “end-of-shift fatigue” phenomenon and strive to “finish well” every time they go to work.
Bacterial or viral? Point-of-care tests may reduce unnecessary antibiotics.
When physicians test for a bacterial infection at the point of care, they prescribe fewer antibiotics, according to a review published in The Cochrane Library. Many patients who go to the doctor with an acute respiratory infection have a cold or other viral infection, but physicians may prescribe antibiotics because they cannot tell definitively whether the infection is viral or bacterial. This unnecessary prescription contributes to antibiotic resistance.
Researchers examined evidence from trials using a point-of-care kit that tests a drop of patient blood and can indicate if a bacterial infection is present. Among the 1,685 patients who took this test, 631 were prescribed antibiotics (37 percent), compared to 785 of the 1,599 patients (49 percent) who did not take the test.
"These results suggest that antibiotic use in patients with acute respiratory infections could be reduced by carrying out biomarker tests in addition to routine examinations," said Rune Aabenhus, the lead researcher.
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