How to Reduce Hospital Acquired Infections in Your Facility

Multiple C. difficile outbreaks throughout 2011 made headlines and caught the attention of consumer watchdogs. One investigation led by the consumer reports program CBC Marketplace looked into the unsanitary conditions at a number of hospitals as a major cause of the outbreak.

CBC Marketplace visited 11 hospitals in early 2012 with hidden cameras. The team applied a glow gel to handrails, doors, and other high touch areas, and returned 24 hours later to test if the surfaces had been cleaned by observing whether the glow gel had been removed. The glow gel is invisible without black light and can only be removed by a combination of friction and cleaning chemicals.

Glow gel was applied to high-touch surfaces throughout the hospital. View the CBC Marketplace video.

When the cameras returned a day later, it was discovered that many of the surfaces had been left untouched by the cleaning team. These high touch surfaces could act as a harbour for bacteria and spread the infection to anyone who pressed an elevator button or used a washroom.

Hospital Acquired Infections are currently the second most common adverse event affecting health care facilities. Hospital Acquired Infections including C. difficile, MRSA, and E. coli are common in the United States, with over 2 million cases reported each year and over 100,000 deaths annually.

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5 More Reasons to Use a Low Hospital Bed

With patient safety concerns at an all-time high, it may be time to think about using low hospital beds in your facility. We’ve already shared 5 Reasons to Use a Low Hospital Bed, but here are 5 more: 

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Who Pays for Patient Falls?

As of October 2008, the Centers for Medicare and Medicaid Services (CMS) will no longer pay for patient falls. The CMS ruled that hospitals and health care providers will no longer be reimbursed for preventable Hospital Acquired Conditions (HAC), which means that the CMS will not pay to treat conditions that were not present upon the patient’s admission.  CMS includes “Patient Falls” as one of 10 Hospital‐Acquired Conditions that is high cost, high volume, or both, and can reasonably be prevented through the application of Evidence Based Guidelines.

As a result, it is now the hospital’s responsibility to pay for resulting patient injuries, or required treatments, from a fall in a hospital setting.

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5 Reasons to Use a Low Hospital Bed

When it's time to purchase new hospital beds for your facility, consider a low hospital bed. Specifically designed with patient safety and comfort in mind and recommended by leading health care groups, low hospital beds can be a valuable component of your hospital's fall prevention strategies.

Here are 5 reasons why your facility should use low hospital beds:

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Understanding Bed-Exit Alarms

Most hospital bed falls occur when a patient enters or exits the bed without staff assistance. Many fall risk patients forget to use the nurse call button and overestimate their physical abilities, which can lead to a fall or trip out of bed. Maintaining constant patient supervision to eliminate this unassisted movement can prove to be a costly effort for hospitals, as the cost of around the clock sitters adds up.

To combat the high cost of patient sitters, bed-exit alarms were introduced to detect bed activity and to minimize the number of bed exits without staff assistance. Instead of using a sitter to observe patient movement, the bed-exit alarm was designed to alert the nurses’ station to bed exit activity based on a change in patient positioning. A nurse’s response to the alarm would enable her to reposition, or assist the patient out of bed, which would minimize the possibility of a fall.

A nurse using a bed-exit alarm

The use of a bed-exit alarm is recommended for use with patients with stability issues, on medication, with cognitive impairment, or with any patient identified as a fall risk. Bed-exit alarms can help prevent falls by alerting nurses to bed exit behaviour that is attributed to patient falls, and is recommended as an integral component of a hospital’s patient fall prevention program.

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Patient Falls from Hospital Beds

Patient falls continue to be a serious problem for hospitals. Although hospitals have implemented strategies to reduce and prevent falls, patient falls still make up the largest single category of reported hospital incidents.¹

Patient falls are more common in the elderly, as patients over the age of 65 are 9 times more likely to experience hospital falls than any other age category.² As the United States population continues to age, the number of senior patient falls is expected to rise 78.8% from 2010, without accounting for immigration or extended life expectancies.³ As a result, hospitals should anticipate the growing at-risk population for falls and continue to redefine patient fall prevention strategies.

Among seniors, falls are the leading cause of death due to injury. Falls are the most common cause of nonfatal injuries, and can result in fractures, sprains, or concussions.⁴ Serious head injuries can occur as a result of patient falls, including a subdural hematoma (the bleeding of the brain), which is three times more likely to occur in senior falls.¹ A subdural hematoma can lead to further complications including severe brain herniation, which can be fatal.⁵

Though a low-velocity fall can sound non-threatening to the average person, serious complications are more prone to occur in older patients and can trigger repeat fall events and injuries.¹ Prevention measures should be put in place in order to minimize risk factors and minimize patient injury as a result of falls.

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Safe Patient Handling: Taking Care of Our Nurses

Day-to-day patient care can take a lot out of nurses. From bathing to weighing to repositioning patients sometimes multiple times throughout the day, patient transfers can add up. With the average weight of the United States adult population climbing to almost 180 pounds, it’s not hard to believe that nurses lift an upwards of 1.8 tons, or the equivalent of a mid-sized SUV, in an eight hour shift.^{1 2}

As a result of repetitive manual patient lifting at extreme weights, back injuries are the number one reported injury in healthcare. The primary cause of back injury is overexertion from lifting, pushing, or pulling, especially when moving heavy equipment or transferring patients. What’s thought of as routine tasks for nurses, such as transferring a patient from a bed to a chair or repositioning a patient, are actually considered high risk patient handling tasks according to the Occupational Health and Safety Agency (OSHA). It’s no wonder overexertion is 4.5 times more commonly cited in nursing injuries than in any other job category.¹

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The Impact of Baby Boomers on Healthcare

The next generation of senior citizens is posed to live longer and be larger than any previous generation. Starting in 2011, the first members of the baby boomer generation turned 65 years old, joining the existing population of 40.2 million seniors living in the United States. By 2030, the baby boomer generation is expected to contribute over 80 million seniors to the American population.¹

Given increased life expectancy rates, there could be an upwards of 120 million Americans aged 65+ by 2030.

Much like the baby boom forced public schools in the 1950s to increase their capacity due to demand, there will be a similar effect on the healthcare system in the years to come. Unlike public schools, however, the demand for healthcare will never stop and will actually increase as more seniors are living longer and with more chronic conditions.

Today’s seniors are said to already use hospital services at 4.5 times the rate of the younger population, which indicates that inpatient care will rise exponentially in the next 20 years as the senior boomers grow in numbers.²

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The Risk Factors Associated with Patient Falls

Patient falls are one of the most frequent and costly hospital acquired conditions in the United States. Beyond the fall itself, hospitals are concerned about adverse events and injuries caused by a patient falling out of bed. These risks and injuries can include bruising, fractures, dislocations, brain injuries, a decline in overall health, and in some instances, death.¹

Patient falls can be one of the most challenging hospital incidents for healthcare providers to approach because of the varying risk factors and circumstances that contribute to each fall.

Who is at Risk for a Fall?

The National Center for Patient Safety has identified a number of physiological and internal risk factors that contribute to a patient’s risk of hospital falls including:²

1. Age
2. Chronic Disease
3. Visual Impairment
4. A Previous Fall
5.  Medication
6. 
   

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Alarm Fatigue: Hazards and Prevention

A typical 15-bed hospital unit experiences 942 high-priority monitoring alarms each day.¹ That’s almost 63 alarms per bed each day, or 40 alarms that nurses are required to tend to each hour. With such a high volume of alarms sounding off regularly, it can be easy for staff to lose a crisis alarm in the mix of continuous beeping.

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Desensitization, missed alarms, or delayed responses to alarms are common symptoms of alarm fatigue. What’s startling is that approximately 90% of hospital alarms are said to go unanswered by staff.² It can be next to impossible for nurses to respond every 90 seconds to a sounding alarm since almost everything in a patient’s room is hooked up to a monitor. Everything from high-priority cardiac alerts, to restless movement, to interference can signal an alarm at the nurses’ station. Studies have indicated that approximately 95% of alarms are alerting staff to non-actionable events, which translates roughly to only 50 cases of alarms requiring actual nurse intervention each day on a typical 15-bed unit.³

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Nurses: Are You Using Social Media?

Social media is a great tool for nurses to collaborate with other nurses and healthcare professionals. Facebook, Twitter, and LinkedIn are great resources for nurses because they are peer-to-peer networks that thrive on social communication and act as a virtual community.

Today, 8 out of 10 nurses in America are on social media. Right now nurses are on Facebook connecting with their friends online or Tweeting about their day, but there is untapped potential in using social media professionally.

What is the untapped potential in using social media to interact with other nurses?

There are over 19.3 million nurses worldwide, and many are already online. What could be better or easier than reaching out to such a vast number of nurses than through social media? In the past, nurses have relied on conferences to meet and interact with nurses from the rest of the country and around the world, but now social media can transform networking for nurses and bring it to the computer screen.

Here are some great tips for nurses to get started using Facebook, Twitter, and any other social media sites professionally:

1. Share your thoughts and ideas and follow other nurses online to build your own nursing community
2. Interact with healthcare companies and hospitals to find out about news, trends , and current issues in healthcare
3. Think outside of the box and create a Twitter “network” about a topic that is important to you
4. 
   

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