Taking a new approach to HAIs in the COVID-19 Era

The pandemic has forced hospitals to rethink how they can protect the safety of patients and staff. Periods of change and disruption lead to different—and often better—ways of doing things. Reversing the COVID-19 induced increase in healthcare-associated infections (HAIs) is a perfect case in point. Modern Healthcare Custom Media hosted a panel of healthcare professionals to discuss new and better solutions to mitigate HAI risk, reduce PPE use and improve efficiency during times of constrained resources. To access the full webinar, visit: www.modernhealthcare.com/NewApproachtoHAIsWebinar.

1 Diversion of resources to COVID-19 has led to an increase in healthcare-associated infections (HAIs).

With reports that 75% of infection prevention resources are being devoted to COVID-19, hospitals are experiencing a strain on prevention efforts amidst a rise in HAIs. Methicillin-resistant Staphylococcus aureus (MRSA) and methicillinsusceptible Staphylococcus aureus (MSSA) are major contributors to HAIs, including CAUTI, VAP, BSI, respiratory illness and secondary bacterial infections associated with viral infections.

2 High impact infection prevention programs can be implemented with little or no additional financial capital, leveraging existing resources.

Clinically proven programs currently exist to help reduce MRSA bacteremia up to 96% and save up to $1.4 million in one year. By implementing MRSA and MSSA colonization risk mitigation programs, hospitals are making immediate, material improvements within their facilities. Fewer patients are colonized, fewer are becoming infected, and fewer are in isolation. Hospitals are also benefiting from the programs by reducing contact precautions over 40%, helping to alleviate PPE shortages.

3 The nose is increasingly understood as a reservoir for acquisition and transmission of pathogens.

In a time when much attention is paid to wearing masks and washing hands, there is a greater understanding that the nose is a critical source of pathogen acquisition and transmission. About 80% of MRSA infections can be traced back to the DNA of bacteria in the patient’s own nose. Touching the nose, which occurs 100 times per day on average for an individual, can spread germs from nose to hands with further risk of self-infection or transmission to others. This role of the nose as a bacteria reservoir can be of critical concern when patients are immunocompromised, and/or have portals of entry for these opportunistic bacteria such as surgical wounds, IV and urinary catheters. These pathogens can cause serious infections, with significant morbidity and increased risk of death.

4 Most MRSA colonized patients can remain undetected. Nurses enter the room of an undetected MRSA colonized patient 143,000 times per year in a typical 200 bed hospital.

Even with active surveillance, approximately 65% of all MRSA colonized patients in a hospital and nearly all MSSA colonized patents are undetected. The resulting colonization pressure caused by prevalence of MRSA or MSSA is directly associated with an increased risk of HAIs. Hospitals implementing colonization risk mitigation programs utilize universal decolonization to achieve demonstrated outcomes such as optimal reduction of MRSA. This universal decolonization approach lowers colonization pressure and is an effective replacement of the more typical screen and isolate/treat protocols that miss a majority of colonized MRSA and all MSSA patients.

5 Nasal colonization risk mitigation should be a priority.

While it’s important to follow proper masking and hand-washing protocols, colonization risk mitigation is a costeffective approach to help reduce the spread of bacteria including MRSA and MSSA. By decolonizing harmful bacteria from the nose through a well-designed, proven colonization risk mitigation program, healthcare professionals help protect patients from self-infection or transmitting pathogens to others. Providing better care at lower costs, these programs are helping reduce risk of HAIs and are a vital healthcare response to the challenges in the COVID-19 era and beyond.