Guidelines for Preventing Opportunistic Infections Among Hematopoietic Stem Cell Transplant Recipients

Opinion: Stick To Infection Prevention Rules To Guard Residents, Workers, Bottom Line

Long-term care facilities need to pay attention to the latest research on cleaning and disinfection in order to prevent residents from being infected with multidrug-resistant organisms (MDROs) as well as common viruses. And if they do, the payoffs can go beyond good health, a recent article states.

Even though nursing homes are more familiar with viruses such as COVID-19 and the flu, studies still show that only about half of high-touch surfaces (in hospitals) are cleaned properly, according to an article in April 19 article in Infection Control Today. This can increase health care-associated infections (HAIs) that affect hospitals and long-term care facilities.

Not only can infections be a threat to people living at the facilities as well as workers. Infections can affect the bottom line of a nursing home. The Centers for Medicare & Medicaid Services Hospital-Acquired Condition (HAC) Reduction Program, which penalizes poor infection control measures against HAIs, was reinstated in 2022. Getting a fine for poor infection prevention and infection control practices can actually cost healthcare facilities extra money.

The author of the April 19 article highlighted three studies that showed adhering to cleaning standards reduced vancomycin-resistant enterococci, Methicillin-resistant Staphylococcus aureus and Clostridioides difficile infections by about half. Total compliance wasn't needed to get those results, the author pointed out. "Improvements that boosted compliance rates to approximately 80% or better were enough to make a difference," the author wrote.

"However, fast, meaningful improvement must also be paired with effective communication with the public and staff to ease their concerns. Health system leaders should clarify to marketing and public relations teams that infection prevention standards are a priority message for 2024," the author added.

Consumers may care more about cleanliness after the pandemic. A study released last year found that 1 of every 2 Americans has concerns about getting sick when going into a hospital. Of those polled, more than 75% said a clean space is a factor when choosing a hospital or medical facility.

Antibiotic-resistant Hospital Infections Well Above Pre-COVID-19 Levels

Hospital-acquired antimicrobial-resistant infections remain at least 12% above pre-pandemic levels, according to a new study from data at 120 U.S. Hospitals. 

Researchers analyzed trends in the incidence of AMR infections in adults across three periods: January 2018 to December 2019 (pre-pandemic); March 2020 to February 2022 (during); and March 2022 to December 2022 (after). 

During the pandemic, hospital-onset resistant infections jumped 32%, and they remained 13% higher than pre-COVID-19 levels as of December 2022, researchers found. 

Two more findings: 

Hospital-acquired infections resistant to carbapenems — considered the antibiotics of last resort for severe infections — increased most. They remain at least 35% higher than pre-pandemic levels.

Hospitals with the highest levels of surges of severe COVID-19 patients saw the greatest increases in hospital-acquired antimicrobial resistant infections, "with incidence increasing in a stepwise fashion," researchers said. Hospitals with the highest bed capacity (500 beds) also had more than double the odds of these infections relative to smaller hospitals. 

"While overall antimicrobial resistance levels appear to have almost returned to pre-pandemic levels, the persistence of high rates of hospital-acquired AMR infections in U.S. Healthcare facilities is concerning," Christina Yek, MD, of the National Institute of Allergy and Infectious Diseasea and lead study author, said in a news release. "More action is needed to protect people, especially from difficult-to-treat hospital-acquired gram-negative infections that remain concerningly high."

Several Austin Area Hospitals Received A And B Grades. Here's Which Ones Got A C

Ascension Seton Medical Center earned an A in the Leapfrog Group's new safety rankings.

Patient satisfaction scores at hospitals nationwide are improving for the first time since the pandemic, according to the spring 2024 safety survey from the Leapfrog Group, a nonprofit that has been offering analyses of hospitals' safety records for 12 years. Infection rates at hospitals also have steadily improved since the pandemic.

The safety survey assigns a letter grade to each hospital based on data from a hospital survey the nonprofit conducts and from Centers for Medicare & Medicaid Services information.

The grades consider infection control, staffing levels, leadership structures, use of medication bar codes, computerized physician orders, hand hygiene, doctor and nurse communications, staff responsiveness and discharge information.

The Austin metro area ranked 17th with 53.3% of its hospitals making an A grade. The Allentown, Pennsylvania, area was No. 1.

The bad news: the Austin area now has four hospitals receiving a C grade: Dell Seton Medical Center, Baylor Scott & White Medical Center Lakeway, Baylor Scott & White Medical Center Pflugerville and Baylor Scott & White Medical Center Round Rock.

More rankings: Which three Austin hospitals made Fortune magazine's national Top 100 list?

No Austin-area hospitals received a D or F.

Baylor Scott & White Health noted that its Round Rock hospital received five out of five stars on performance from CMS. "We are committed to providing safe, high-quality care, and we closely and continuously measure our performance across a variety of objective systems and metrics considered strong indicators of patient safety," the hospital system said in a statement.

Dell Seton Medical Center at the University of Texas said it recognizes the value of the Leapfrog survey and will take the feedback seriously. "We are committed to continuously improving our quality programs and safety protocols, including ongoing robust monitoring of patient quality and safety indicators, reducing hospital acquired conditions and employing enhanced technology solutions," the hospital said in a statement.

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These received A grades:

Austin: Ascension Seton Medical Center, Ascension Seton Northwest Medical Center and St. David's North Austin Medical Center

Cedar Park: Cedar Park Regional Medical Center.

Kyle: Ascension Seton Hays Medical Center

Round Rock: Ascension Seton Williamson Medical Center

Georgetown: St. David's Georgetown Hospital

San Marcos: Christus Santa Rosa Hospital San Marcos

These received B grades:

Austin: St. David's Medical Center and St. David's South Austin Medical Center

Marble Falls: Baylor Scott & White Medical Center

Round Rock: St. David's Round Rock Medical Center

These received C grades:

Austin: Dell Seton Medical Center at the University of Texas

Lakeway: Baylor Scott & White Medical Center Lakeway

Pflugerville: Baylor Scott & White Medical Center Pflugerville

Round Rock: Baylor Scott & White Medical Center Round Rock

Don't see your hospital on the list? The Leapfrog Group doesn't rank free-standing pediatric hospitals such as Dell Children's or Texas Children's Hospital. It also doesn't rank specialty hospitals or those with multiple categories of information missing. There were no rankings for Ascension Seton Southwest Medical Center or Baylor Scott & White Medical Center Austin.

This article originally appeared on Austin American-Statesman: Many Austin area hospitals receive A and B grades. Which ones got a C?

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