Hospital-Acquired Infections: Are Your Cancer Patients at Risk?
Hospital-acquired infections are a growing health risk. The COVID-19 pandemic has added another layer of risk. For cancer patients, this is a particular risk. as patients with cancer have a greater risk of severe COVID-19 a with the death rate increasing from 2.3% to 5.6%. The risk is even higher when cancer involves the lungs. More recent studies have shown a lower risk level, closer to that of the general population.
The transmission risk in a hospital setting, though, is present, although reduced by the separation of COVID-19 patients from others. What this highlights is the overall risk cancer patients experience from hospital-acquired infections. Preventing HAIs is a key goal of hospitals and clinics. Both inpatients and outpatients can be vulnerable to hospital-acquired infections (as can visitors and family members in some circumstances). Here are some best practices for preventing hospital-acquired infections.
Proper Selection and Use of PPE
Train all staff to correctly select and use personal protective equipment. The use of masks, gloves, gowns, etc ensures that infections do not transmit to, by, or from providers. For example, a face mask should be worn when there is potential contact with respiratory secretions, sprays of blood or body fluids, or when placing a catheter, injecting material into the spinal canal, or performing intrathecal chemotherapy.
PPE can both protect the patient, from bacteria or viruses a provider may be carrying without symptoms, and protect the provider.
Perform proper hand hygiene at all times. Alcohol-based hand rub is preferred for most situations over soap and water. Perform hand hygiene before touching the patient (even with gloves), before exiting the care area, after contact with blood, body fluids, or wound dressings, prior to performing an aseptic task, when moving from a contaminated-body site to a clean-body site, and after glove removal. Wash hands with soap and water after caring for patients with known or suspected Clostridium difficile or norovirus.
Require visitors to perform proper hand hygiene when entering or leaving patient rooms and place signs instructing them on the correct procedure.
Staff who have symptoms of respiratory infection should stay home. Any person who enters the facility with a potential respiratory infection must perform further hand hygiene, and cover the mouth and nose when sneezing. Providing a face mask is even better, and place patients with respiratory symptoms in exam rooms with closed doors. Do not allow visitors to enter patient care areas if they have respiratory infection symptoms.
During periods of increased activity, such as flu season, all patients should be pre-screened for respiratory symptoms when scheduling or confirming appointments, scheduled for a quiet time, and wear masks.
Reusable devices should be cleaned and disinfected properly, following FDA and manufacturers’ guidelines. EPA-registered disinfectant with an appropriate germicidal claim should be used.
The use of disposable devices when possible is demonstrated to control hospital-acquired infections. Hospital-acquired infections have actually been on the rise, and the correct use of disposables may reverse that trend. In particular, syringes must never be reused between patients, even if the needle is switched out. It’s also key not to reprocess single-use devices unless you have specific clearance to do so. Use single-use devices instead and properly disposed of after use. For inpatients, there has been some evidence that disposable items for patient care and comfort, such as TV remotes, can be helpful.
Best practices also include thorough cleaning of patient care areas, medication preparation areas, and bathrooms. Careful cleaning of bathrooms is particularly important if a patient appears to have a gastrointestinal infection and/or diarrhea.
Studies have shown that actively screening preoperative patients for MRSA (methicillin-resistant Staphylococcus aureus) reduces the number of MRSA infections. Surveillance also helps reduce carbapenem-resistant Enterobacteriaceae. By screening and treating infection prior to surgery, it prevents the spread of the bacteria.
Testing patients who come in with respiratory or gastrointestinal symptoms is also key to reducing spread; this includes testing for COVID-19, influenza, and other highly-contagious infections, such as Clostridium difficile.
Proper Food Handling
Food provided to inpatients and in canteens must be handled correctly and stored at the correct temperature. A point of concern is mini-fridges in patient rooms, which should be checked for correct temperature every shift. Encourage patients to eat their meals as soon as they arrive and remove uneaten food promptly.
Promptly remove linens soiled with blood or bodily fluids and ensure that they don’t come into contact with skin, mucous membranes, or other environments. Change linens regularly, always between patients, and laundered properly. Dispose of paper covers between patients.
Controlling antibiotic use helps reduce the development of resistance. Antibiotics slow the evolution of resistant bacteria and help control C. diff and similar infections. This also helps prevent surgical site and similar infections. It also helps keep antibiotics from becoming obsolete and thus slows the race to create new ways of dealing with bacteria as they become resistant.
Learn More About Hospital-Acquired Infections
Hospital-acquired infections are a particular concern for cancer patients, who tend to have suppressed immune systems from cancer or the treatment, and who may be spending extended time in hospital or making frequent outpatient visits. Hand hygiene prevents hospital-acquired infections and disposable instruments have significantly reduced cross-contamination. To find out about obp’s single-use devices and how they can help you control hospital-acquired infections, contact us today.