We’ve suggested before in this column that, in the search for a magic bullet for infection control, some things are being overlooked.

For example, there are probably more than 5,000 mobile medical devices rolling around in a typical 300 bed hospital every day.  These are the IV pumps, telemetry units, even wheel chairs and gurneys that are so commonplace they often don’t get the disinfection they need to protect patients.

It’s been well established that bacteria such as E.coli, MRSA, VRE and Strep live for months on dry surfaces. Now there is growing evidence of infection transmission via near-patient surfaces and equipment. This has prompted the Center for Disease Control to issue guidelines insuring that high-touch surfaces are thoroughly cleaned as part of regular room cleaning at discharge. In addition, the Center for Medicare & Medicaid Services has issued directives on how hospitals should get ready for on-site inspection of infection control practices (see ASC Infection Control Surveyor Worksheet).

This upends the notion that hand hygiene is the single best answer to containing hospital acquired infection (HAI). Even if hand washing compliance were 100 percent, which it clearly is not, it would be easily defeated because of unsterile medical equipment floating – or rolling – around the hospital.

And that doesn’t take into account the equipment hidden on the units for easy, on-demand access, which is known as hoarding. The problem is that when hospital equipment gets left in a room, it usually doesn’t get cleaned. Even when staff members suspect equipment hasn’t been cleaned, it’s often given a cursory wipe down as a precaution, which can re-contaminate the equipment if it has been adequately cleaned.

This is where a real-time location system (RTLS) comes into play.

  • First, RTLS eliminates hoarding by allowing staff to monitor the location of every piece of equipment in the hospital in real-time. This information is delivered via a floor plan screen graphic which is precise down to room level.
  • Secondly, a good RTLS system incorporates the means to determine if the equipment has been cleaned or not. This is often accomplished either through location configurations in our software, or turns of the dial on our proprietary Asset Status Tags.
  • Finally, RTLS facilitates the best practice of centralized equipment management, which means that appropriately-trained personnel are involved in the cleaning and maintenance of all mobile equipment.

Infections are the most common complication in hospital care. Hospital infections are also one of the nation’s top 10 causes of death. Hospital acquired infections already add about $45 billion a year to U.S. medical bills.

Under the Affordable Care Act, hospitals with infection rates exceeding national averages stand to lose one percent of their Medicare funding, starting in 2015.  With nearly 40 percent of U.S. hospitals now operating in the red, that reimbursement change can have huge ripple effects in terms of staffing, care delivery and even institutional survival.

Maybe it’s time to take a second look at what’s been overlooked in infection control. What do you think?

Jon Poshywak

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