Infection Prevention and Epidemiology

Infection Prevention and Epidemiology / en Fri, 25 Apr 2025 17:23:04 -0500 Thu, 19 Dec 24 13:53:30 -0600 CDC announces first severe case of H5N1 bird flu /news/headline/2024-12-19-cdc-announces-first-severe-human-case-h5n1-bird-flu The Centers for Disease Control and Prevention Dec. 18 <a href="https://www.cdc.gov/media/releases/2024/m1218-h5n1-flu.html)" target="_blank">announced</a> that a patient in Louisiana was hospitalized with a severe case of H5N1 bird flu, the first known instance of severe infection in the U.S. The agency said the patient was exposed to sick and dead birds in backyard flocks and that an investigation is ongoing. It is the first case linked to backyard flock exposure, as most have been linked to daily dairy cows and poultry.&nbsp;There have been 61 reported human cases of H5N1 bird flu in the U.S. since April. The CDC said the immediate risk of bird flu to the public remains low.&nbsp; Thu, 19 Dec 2024 13:53:30 -0600 Infection Prevention and Epidemiology CDC report shows decreases in certain health care-associated infections in 2023 /news/headline/2024-11-06-cdc-report-shows-decreases-certain-health-care-associated-infections-2023 The Centers for Disease Control and Prevention Nov. 6 released its annual <a href="https://www.cdc.gov/healthcare-associated-infections/php/data/progress-report.html">progress report</a> on health care-associated infections, which showed continued decreases in hospitalizations last year. There was a 16% decrease in hospital-onset methicillin-resistant Staphylococcus aureus, or MRSA; a 15% decrease in central line-associated bloodstream infections, or CLABSI; a 13% decrease in hospital-onset Clostridioides difficile (C. difficile) infection; an 11% decrease in catheter-associated urinary tract infections; and a 5% decrease in ventilator-associated events. The declines align more closely with progress made prior to the COVID-19 pandemic in 2020, the CDC said.&nbsp; For inpatient rehabilitation facilities, there was a 14% decrease in hospital-onset C. difficile infection and an 8% increase in CAUTI in 2023, but no significant changes in CLABSI and hospital-onset MRSA standardized infection ratios compared with 2022. Among long-term care hospitals, there was a 13% decrease in hospital-onset C. difficile infections but no significant changes in 2023 SIRs compared with 2022.&nbsp; The report recommends facilities continue reinforcing prevention practices and review HAI surveillance data to identify areas for improvement. Wed, 06 Nov 2024 15:15:26 -0600 Infection Prevention and Epidemiology EVS Resource Tool Dashboard /project-firstline/evs-dashboard Thu, 11 Jul 2024 11:00:00 -0500 Infection Prevention and Epidemiology FDA grants enforcement discretion for use of conjunctival swabs to test for bird flu in humans /news/headline/2024-05-31-fda-grants-enforcement-discretion-use-conjunctival-swabs-test-bird-flu-humans The Food and Drug Administration last week <a href="https://www.cdc.gov/locs/2024/05-25-2024-Lab-Advisory-Enforcement_Discretion_Granted_Use_Conjunctival_Swabs_CDC_Human_Influenza_Virus_Real-Time_RT-PCR_Diagnostic_Panel_Influenza_A_H5_Subtyping_Kit.html">granted</a> enforcement discretion for the use of conjunctival swabs by laboratories as part of human testing for H5N1 bird flu, as two human cases only showed symptoms of conjunctivitis before confirmation. For patients that meet the Centers for Disease Control and Prevention's epidemiologic criteria and either clinical or public health response criteria for testing, local laboratories must submit the conjunctival swabs along with nasal swab samples to state laboratories. Conjunctival swabs must be collected and transported using the same media as the paired nasal swabs used with the current kit authorized by the CDC. &nbsp;&nbsp; &nbsp; Yesterday, a third confirmed human case of H5N1 bird flu — a second dairy farm worker in Michigan — was <a href="https://www.cdc.gov/media/releases/2024/p0530-h5-human-case-michigan.html">announced</a> by the CDC. The individual worked on a farm separate from where last week’s confirmed case was employed. Unlike the previous two cases where only conjunctivitis was reported, this individual also reported upper respiratory tract symptoms including cough without fever, making them the first human case of H5 bird flu in the U.S. to report more typical symptoms of acute respiratory illness associated with flu infection, including type A (H5N1) viruses. Fri, 31 May 2024 15:01:46 -0500 Infection Prevention and Epidemiology Mpox patients gain days of clarity, as Harborview Medical Center clinicians became adept at early identification /role-hospitals-harborview-medical-center-clinicians-became-adept-iding-mpox-uw-medicine-study-shows <div class="container"><div class="row"><div class="col-md-9"><div class="col-md-5"><img src="/sites/default/files/2024-05/ths-uw-mpox-700x532.jpg" data-entity-uuid data-entity-type="file" alt="UW Medicine, Harborview Medical Center. stock image of hands covered in sores" width="700" height="532"></div>Though mpox cases are not life-threatening, recovery from the infectious disease caused by the monkeypox virus, it is still no picnic. Mpox can cause a painful rash, a fever and other flu-like symptoms. And once someone tests for it through a polymerase chain reaction (PCR) lab test, they must wait five or more days for results that confirm the infection. Those extra days come with uncertainty to the person experiencing uncomfortable symptoms and putting their life on hold; a little bit of clarity can make a big difference.Recent research findings, authored in part by UW Medicine, showed that during western Washington’s 2022 mpox outbreak, emergency response teams were highly accurate at identifying suspected mpox and providing same-day care. Clinicians at the King County Sexual Health Clinic at Harborview Medical correctly predicted and administered tecovirimat to 71% of 121 people who were later confirmed to have mpox. They also predicted with 99% accuracy which patients would be found mpox-negative via PCR test.“In cases where you might send off a swab to get tested and you don’t get the answer back for six days, that’s six days that someone is at home on pins and needles, worried and wondering: Can I see friends? Can I go to work? What if staying home means not getting a paycheck?” said study co-author&nbsp;Chase Cannon, M.D.,&nbsp;assistant professor in the Department of Medicine, Division of Allergy and Infectious Diseases at UW Medicine and medical&nbsp;director for the Public&nbsp;Health Seattle&nbsp;&amp; King County STD&nbsp;Clinic.Though Cannon noted that the World Health Organization’s stance is that only a PCR test can definitively confirm mpox, there is also value in a same-day provisional diagnosis.“It’s hugely helpful to tell someone upfront, ‘This really looks like mpox. We’ll send the swab for confirmation, but I’m fairly certain that’s what this is,’” he said. “We can start counseling patients and setting their expectations for what will happen, isolation recommendations, how to keep themselves and others safe.”The paper was published Feb. 29 in the journal Sexually Transmitted Diseases. Harborview Medical Center is owned by King County and managed by UW Medicine. <a href="https://newsroom.uw.edu/blog/clinicians-identifying-mpox">LEARN MORE&nbsp;</a></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/topics/innovation">Innovation, Research and Quality Improvement</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Thu, 02 May 2024 16:54:36 -0500 Infection Prevention and Epidemiology Administration releases strategy to protect against emerging global health threats /news/headline/2024-04-16-administration-releases-strategy-protect-against-emerging-global-health-threats The White House April 16 released a strategy to guide the federal government in protecting the nation from infectious disease threats by working with other nations and stakeholders. The Administration said the <a href="https://www.state.gov/united-states-global-health-security-partnerships/">Global Health Security Strategy </a>builds on progress made since 2019 and lessons from the COVID-19 pandemic to address goals in the <a href="https://www.whitehouse.gov/wp-content/uploads/2022/10/National-Biodefense-Strategy-and-Implementation-Plan-Final.pdf">2022 National Biodefense Strategy and Implementation Plan</a> and the Global Health Security and International Pandemic Prevention, Preparedness and Response Act of 2022. Tue, 16 Apr 2024 14:03:00 -0500 Infection Prevention and Epidemiology CDC recommends immunizing all infants under 8 months old against RSV /news/news/2023-08-04-cdc-recommends-immunizing-all-infants-under-8-months-old-against-rsv As proposed yesterday by its Advisory Committee on Immunization Practices, the Centers for Disease Control and Prevention <a href="https://www.cdc.gov/media/releases/2023/p-0803-new-tool-prevent-infant-hospitalization-.html">recommends</a> that starting this fall all infants under 8 months old receive one dose of the new long-acting monoclonal antibody nirsevimab to prevent respiratory syncytial virus, and that certain infants 8-19 months old at risk for severe disease receive one dose in their second RSV season. The Food and Drug Administration last month <a href="https://www.fda.gov/news-events/press-announcements/fda-approves-new-drug-prevent-rsv-babies-and-toddlers">approved</a>&nbsp;the product for use in these age groups. An estimated 58,000 to 80,000 U.S. children under age 5, mostly infants, are hospitalized each year due to RSV.&nbsp; “RSV is the leading cause of hospitalizations for infants and older babies at higher risk and today we have taken an important step to make this life saving product available,” said CDC director Mandy Cohen, M.D. &nbsp; Fri, 04 Aug 2023 16:09:33 -0500 Infection Prevention and Epidemiology Essentials for Teaching Infection Control /education-events/essentials-teaching-infection-control Essentials for Teaching Infection Control&nbsp; Thursday, August 31, 2023&nbsp; 1 – 1:45 p.m. Eastern; noon – 12:45 p.m. Central; 10 - 10:45 a.m. Pacific &nbsp;&nbsp; <div class="webreplay"> .webreplay{ border: solid 2px #777; padding: 15px 5px; margin: 0 0 10px 15px; } @media (min-width:360px){ .webreplay{ min-width: 290px; float: right; } } <h2>On-demand Webinar</h2> MktoForms2.loadForm("//sponsors.aha.org", "710-ZLL-651", 3439); </div> Join the AHA Project Firstline and League for Innovation in the Community College team as we showcase newly released video resources for clinicians and instructors to teach various infection prevention and control topics such as: hand hygiene, personal protective equipment, and ventilation standards. This session will also highlight an accompanying instructor manual designed to assist teaching these topics in both the health care setting and classroom.  Project Firstline is a national collaborative led by the U.S. Centers for Disease Control and Prevention (CDC) to provide infection control training and education to frontline health care workers and public health personnel. AHA is proud to partner with Project Firstline, as supported through Cooperative Agreement CDC-RFA-CK20-2003. CDC is an agency within the Department of Health and Human Services (HHS). The contents of this presentation do not necessarily represent the policies of the CDC or HHS and should not be considered an endorsement by the Federal Government.&nbsp; Speakers:&nbsp; Benjamin D. Galvan, MLS (ASCP), CIC, CPH&nbsp; Director, Infection Prevention &nbsp; HCA Florida South Tampa Hospital&nbsp; Rhonna Krouse-Adams, MS &nbsp; Associate Professor, Health Science Department &nbsp; College of Western Idaho&nbsp; Wed, 26 Jul 2023 08:58:51 -0500 Infection Prevention and Epidemiology What Is a CLABSI and How to Prevent It /advancing-health-podcast/2023-07-26-what-clabsi-and-how-prevent-it In the health care field one of the scariest types of infections is called CLABSI, or Central Line-associated Bloodstream Infection. In this episode, Nishant Prasad, M.D., attending physician and program director of infectious diseases at NewYork-Presbyterian Queens, shares how they re-approached CLABSI prevention by deeply examining structure and process, and how their work got them to zero CLABSIs in the last year. <div><a href="https://soundcloud.com/advancinghealth" target="_blank" title="Advancing Health">Advancing Health</a> · <a href="https://soundcloud.com/advancinghealth/what-is-a-clabsi-and-how-to-prevent-them" target="_blank" title="What is a CLABSI and How to Prevent It">What is a CLABSI and How to Prevent It</a></div> <hr /> <details class="transcript"><summary> <h2 title="Click here to open/close the transcript.">View Transcript &nbsp;</h2> </summary> 00;00;01;01 - 00;00;41;29 Tom Haederle Many of us do a root cause analysis when an adverse event such as the health care associated infection - or HAO - occurs, and we apply interventions to prevent future HAIs from occurring. But what if the interventions still don't work? Today's guest, an attending physician of infectious disease at a Flushing Queens hospital, is here to share how his organization flipped the order of performance improvement tools to achieve desired outcomes. 00;00;42;02 - 00;01;12;19 Tom Haederle Welcome to Advancing Health, a podcast from the �� Association. I'm Tom Haederle with AHA Communications. The AHA’s Healthcare Associated Infection Antimicrobial Resistance Project is a funded partnership with the Centers for Disease Control and Prevention. Through the project, the AHA has been listening to the field share its challenges and successes with infection prevention and control. NewYork-Presbyterian Queens in Flushing recently celebrated having no CLABSI’s in more than one year. 00;01;12;22 - 00;01;29;20 Tom Haederle Dr. Nishant Prasad, attending physician and program director of Infectious Diseases, shares how they re approached CLABSI prevention by deeply examining structure and process. He's in conversation with Marie Cleary-Fishman, AHA's vice president of Clinical Quality. 00;01;29;23 - 00;01;50;19 Marie Cleary-Fishman Well, Dr. Prasad, thank you so much for being here today. We really appreciate the time and effort you're putting into this, and we're really interested in learning more about your CLABSI work at your hospital at the NewYork-Presbyterian Queens in Flushing I understand. Could you tell us what that acronym stands for? 00;01;50;22 - 00;02;17;00 Dr. Nishant Prasad Sure. And again, thank you for having me. So a little bit of explanation. Like you said, is a central line associated bloodstream infection. So those invasive catheters that we put into patients to give them medications at the hospital can sometimes be associated with infections that get into the blood from those catheters. So that's what a CLABSI would be considered, when one of those infections occurs. 00;02;17;02 - 00;02;28;22 Marie Cleary-Fishman Thank you for sharing that. And then let's talk a little bit about your focus in 2017 and why you decided to focus on CLABSI. What was your driving force for that? 00;02;28;24 - 00;03;13;23 Dr. Nishant Prasad Yeah, so it actually started well before 2017 because we identified times of events of concern. Prior to that, I would say before 2017, we had set the processes in place to try to address our concern, but we didn't have our initial process as well structured as it should have been. And it's really 2016-ish that we figured out how we should approach our concerns with potential associated bloodstream infections at our hospital. 00;03;13;25 - 00;03;22;00 Dr. Nishant Prasad And once we started utilizing that process is when we really started to see the positive effects. 00;03;22;03 - 00;03;41;19 Marie Cleary-Fishman So just to summarize that a little bit, so would you say that what really made this more successful this time around was that you identified those processes, maybe looking at structure and process to really get to the outcome you were looking for. Was that sort of the crux of the difference for this effort? 00;03;41;22 - 00;03;49;24 Dr. Nishant Prasad Yes, You restated it very, very, very appropriately. I actually don't have anything to add to that. 00;03;49;26 - 00;04;16;17 Marie Cleary-Fishman You've got lots to add. But yeah, so my question, having been in quality for a very, very long time at this point in my life, you know, we know that so many interventions have been around and we've tried those. What performance improvement tools? PDSA Cycles? What kinds of things did you focus on this time and what made that different this time around than the previous times you may have tried? 00;04;16;19 - 00;04;45;25 Dr. Nishant Prasad Right. So that's a wonderful question because it's really the big change that we made. You know, we were all taught as part of, you know, addressing health care quality initiatives that you have to do, you know, an investigation and a root cause analysis. Right. And then you got to talk to the people where that, you know, that event occurred and and try to figure out what could we have done to prevent that occurrence. 00;04;45;28 - 00;05;07;05 Dr. Nishant Prasad That's what we were all taught. The change that we made and that's what we initially did before 2016. And unfortunately for us, it felt like we were spinning our wheels. Because we were coming up with interventions that didn't seem to be having the effect that we were hoping for and that we were not reducing our CLABSI rate. 00;05;07;07 - 00;05;14;16 Dr. Nishant Prasad So we took the tack of, and I'm sure this has been done before, is we copied the airline industry. 00;05;14;18 - 00;05;15;00 Marie Cleary-Fishman Okay. 00;05;15;02 - 00;05;46;22 Dr. Nishant Prasad We called in our experts. So we put together a very diverse team to focus and address the problem, of course, led by infection control and infectious diseases, because we know we're the sort of the stewards of infection control and health care associated infections at any hospital. And then we added to that everybody that takes part in the lifecycle of a central line. 00;05;46;24 - 00;06;20;20 Dr. Nishant Prasad So interventional radiology, the intravenous access team, right? The nurses on the floor to maintain the catheters, supply is right acquisition for a purchasing right What kind of supply should we purchasing for these catheters and their maintenance, right? The interns in the intensive care unit - all of these people were brought to the table and we had a committee formed and it was a sizable committee at the time and we discussed how to approach the problem. 00;06;20;23 - 00;06;55;14 Dr. Nishant Prasad And one of the things I remember, one of the one of the attendings speaking at that time is: we need to centralize our expertise. So one of the issues that we identified was that when we were doing the sort of the old teaching of having an RCA with the people who were caring for the patient, where the event occurred; you were asking the people who had the event what they think went wrong, where they're not necessarily subject matter experts in that occurrence. 00;06;55;17 - 00;07;15;00 Dr. Nishant Prasad So what we needed to do is reverse that. We needed to do our own evaluation before the root cause analysis. And that's what we started doing. So I felt infectious diseases, infection control and the other teams that were involved with those would do an incredibly detailed analysis of every single event. 00;07;15;03 - 00;07;16;01 Marie Cleary-Fishman Okay. Interesting. 00;07;16;08 - 00;07;41;07 Dr. Nishant Prasad So just like the airline industry does when there's a catastrophe on a plane, right? They will investigate with experts to figure out what happened. And sometimes they can even focus their investigation to the point where they can identify a single component, right? You've heard about those results of those investigations. We tried to get that level of granularity with our investigations and then we would have the RCA. 00;07;41;09 - 00;07;49;21 Marie Cleary-Fishman So you would actually look at the data and do that analysis prior to sitting down in the room with those at the frontline. Correct. Interesting. 00;07;49;21 - 00;08;15;10 Dr. Nishant Prasad And sometimes, the other thing we did is we greatly accelerated the initiation of that review process. As we would be monitoring - for example - when it comes to CLABSIs, we would be monitoring blood culture, positivity, these daily. And as soon as a blood culture turned up positive and it had the potential to be called a CLABSI we would start that review process to see, okay, is it truly a CLABSI? 00;08;15;10 - 00;08;36;05 Dr. Nishant Prasad If it is, what can we do and look at to see why was this a CLABSI? And once you do that deep investigation, sometimes even I would go and see the patient myself after talking to the primary team and say, Hey, listen, this might be a CLABSI, Do you mind if I see your patient and take a look and see what's going on and talk with the staff they've been caring for them? 00;08;36;05 - 00;08;58;04 Dr. Nishant Prasad They're always happy to accept our help in those regards. And when we go to the RCA, we're just adding to that incredibly detailed investigation because most of the time we actually had a pretty good idea of why the CLABSI had already occurred, and we're just adding more pieces to that puzzle with that RCA. 00;08;58;06 - 00;09;22;13 Marie Cleary-Fishman That's great. I really appreciate that and I think that's new, thinking or just kind of reordering things and really thinking about what's the best way to get at this. One thing in your case study, I just wanted to ask about, you mentioned including the palliative care team and and so that's not always a member of the team that we think about for central line infections. 00;09;22;13 - 00;09;28;21 Marie Cleary-Fishman Can you just briefly describe what palliative care was doing there and why you brought them in? 00;09;28;24 - 00;09;59;05 Dr. Nishant Prasad Yeah. So in that initial group of participating services that we put together to address this issue, we did not include palliative care in the beginning, but as a result of those incredibly detailed analysis, it turned out we identified cases where their input would have been very appropriate earlier on in the lifecycle of the central line. And so we chose to incorporate them into that group. 00;09;59;05 - 00;10;27;10 Dr. Nishant Prasad And as part of those, our RCA results, we decided that they would be an integral part and they were very helpful in addressing urgent palliative care issues, right? I know even right now, palliative care physicians and consultants are being employed as early as even the emergency room. It's great. You know, that was the new thing, right? So back then, getting them involved earlier was the recommendation. 00;10;27;10 - 00;10;43;08 Dr. Nishant Prasad But we as the committee could make that official recommendation to the department and the administration saying, hey, we need to get palliative care involved earlier on these patients, because quite frankly, a lot of patients that have central lines may benefit from earlier interventions from palliative care. 00;10;43;15 - 00;11;12;07 Marie Cleary-Fishman Right. That's great. I love that. It's including all of those across the care continuum. So it sounds like you've really built a lot of trust, a lot of credibility within your organization on that infection control prevention resources, the folks that you have in your organization. And if you were going to summarize the lessons learned, what are those things that in your experience that you've really learned? 00;11;12;07 - 00;11;21;20 Marie Cleary-Fishman I think you've identified a few things, but if you can also talk about those things that have really reinforced that trust and credibility of the team as lessons learned. 00;11;21;22 - 00;11;56;05 Dr. Nishant Prasad Thank you for that, because that's a perfect question. The real emphasis on our process is centralizing your expertise. And that's where you have to have people who understand infections and central lines, part of the analysis of every single CLABSI. See, because once you've got experts with that level of understanding, evaluating those events, they can really drill down to the why. 00;11;56;07 - 00;12;30;01 Dr. Nishant Prasad Why did that CLABSUI occur? And once they've identified that, then identifying effective interventions becomes much more easy and then you can implement your plan, do study, act cycles, because deciding what to do is incredibly time consuming and expensive, right? Some of these things do cost, you know, $0. You know, switching from one type of catheter to another type of catheter is a substantial cost, especially when the when the when the new catheter costs more money than the old catheter. 00;12;30;04 - 00;12;42;29 Dr. Nishant Prasad But having a good reason for why you're doing that is predicated on understanding that that switch, that intervention is very likely to have the desired effect. 00;12;43;01 - 00;12;59;17 Marie Cleary-Fishman And then also, as you mentioned, that I would imagine the role of leadership in your C-suite and maybe even the board plays a role in that trust and credibility from the front line all the way through. Can you just talk a little bit about the leadership support that you've had for this? 00;12;59;19 - 00;13;28;11 Dr. Nishant Prasad Oh, yeah. The support was incredible from our leadership in that once we were able to really tell them and define the problem, right, and then say, you know what, this we think is an intervention that's going to be helpful. They were incredibly supportive and I think they were more willing to support us because we had such detailed analysis. 00;13;28;13 - 00;13;50;15 Dr. Nishant Prasad It's not that we were saying, oh, it seems like or it looks like now we can actually point to individual cases and say, okay, this is what our analysis showed. This is what happened on that case. We think if we implement this process, it's going to make it better. And most of the time we had already done, you know, like a cheap you know, PDSA cycle just to see if it had a desired effect. 00;13;50;15 - 00;14;12;17 Dr. Nishant Prasad So we had an idea that, okay, now we need to request more resources or, you know, ask for more staffing or something like that to, to get the full, you know, protocol implemented throughout the hospital. And of course, they were always involved when we had to change workflows because sometimes the intervention required that kind of a workflow change. 00;14;12;20 - 00;14;30;10 Marie Cleary-Fishman Yeah, I think that's so important. I mean, if we go back to that fundamental and I say it over and over again, but structure, process and outcome, if you don't look at the workflow as part of that, then it's unlikely that structure alone is going to get you to the outcome you're looking at or looking for. So that's really important. 00;14;30;12 - 00;14;53;19 Marie Cleary-Fishman The timeframe that you worked on this covered the COVID 19 pandemic and you know, that had such an impact on our workforce, our supply chain, and on our organizational priorities, where we really had to shift how we were doing things, what we were doing. How did that impact this effort? Did it help? Did some of the change come out of that or what? 00;14;53;21 - 00;14;56;07 Marie Cleary-Fishman Can you talk a little bit about that experience? 00;14;56;10 - 00;15;12;04 Dr. Nishant Prasad Yeah. So the kind of good news for us is that most of our effective initiatives had already been implemented prior to the pandemic, sort of coming to New York City. And as you know, you know, Queens was hit pretty hard. 00;15;12;10 - 00;15;12;29 Marie Cleary-Fishman That's right. 00;15;12;29 - 00;15;35;20 Dr. Nishant Prasad So the good news is, is we were able to maintain pretty much all of our best practices throughout the pandemic. We didn't really suffer for it in any real way. Because one of the things that we identified even before the pandemic was these interventions are not sort of a fad diet, to put it that way. You can't start them and do them for a little bit until the problem is solved, 00;15;35;20 - 00;15;48;08 Dr. Nishant Prasad then stop. Yeah, sure, you have to switch and change and maintain. And so I like to say, you know, kind of the price of of good, good work is eternal vigilance in the world of infection control. 00;15;48;11 - 00;16;17;28 Marie Cleary-Fishman I love that. And that that was exactly the last place I wanted to go in really was to talk about sustainability. Yes. So you've touched on that a little bit. But any other lessons learned or issues around sustainability? Have you made any changes? Are you still maintaining the, you know, the work on your own beforehand, looking at the data and then moving to the RCA committee or what kinds of things can you tell me about sustainability? 00;16;18;00 - 00;16;25;19 Dr. Nishant Prasad Yeah, So in sustainability for us, you know, knock on wood, we haven't had a CLABSI seeing a little bit over a year now. 00;16;25;19 - 00;16;28;06 Marie Cleary-Fishman It's great, which is incredible. 00;16;28;10 - 00;16;44;14 Dr. Nishant Prasad It is still just as painstaking of a process because there are many, many potential CLABSIs and that review for each one of those is still done in exactly the same way that we did it when we were having concerns. 00;16;44;14 - 00;16;45;17 Marie Cleary-Fishman That's really great. 00;16;45;17 - 00;16;56;08 Dr. Nishant Prasad Yeah, you can't let off the gas. It's just not feasible to to stop doing what you know works. Quite frankly its common sense. 00;16;56;10 - 00;17;19;22 Marie Cleary-Fishman All of that. That's great. I mean, I think this is so important as we think about this whole process and the learnings that you've had, the best practice items that have come out of this. But, you know, we really are looking at how do we reinforce and sustain that trust with our patients. And every CLABSI belongs to someone's loved one and we really want to prevent those things. 00;17;19;24 - 00;17;42;01 Marie Cleary-Fishman Really driving to zero is what we all want right? So really love to hear that. I'd like to just ask you if there's any other ideas or suggestions that you'd like to share that I did not touch on today. Anything you would like to share, because this is a great opportunity for you to share your success and your best practices with everybody else in the field. 00;17;42;01 - 00;17;55;16 Marie Cleary-Fishman So now we get to best sustainability to spread, and that's really what we at the AHA like to try to facilitate across our members. So any last pieces of information you'd like to share? 00;17;55;19 - 00;18;17;25 Dr. Nishant Prasad Yeah, thank you for that. You know, I'd really like to just emphasize the couple of key points that I made. Number one, centralize your expertise, get people who know the subject materials, right? I'm not an interventional radiologist. I don't know how to place a central line. Last time I did that was when I was a resident and that was over a decade ago. 00;18;17;27 - 00;18;49;23 Dr. Nishant Prasad Right? So you really have to get those kinds of physicians and staff members involved in the evaluation of every single event. When there is an event that occurs that's related to their division, their input must be part of that RCA. And the evaluation should be done before the RCA. So again, just to reiterate, centralize your expertise and do a very, very detailed analysis because you really have to figure out that why as close as you can get to it. 00;18;49;23 - 00;19;10;05 Dr. Nishant Prasad You know, I know many things in medicine are many times ambiguous and you can't really, really know for sure what exactly happened that may have caused something, but you want to get as close as you possibly can, because then you'll make decisions for the interventions with much more clarity and you're more likely to have interventions that are effective. 00;19;10;07 - 00;19;20;03 Dr. Nishant Prasad So somebody just sort of taking our interventions and applying them to their facility may not be as effective because quite frankly, their problems may be different. 00;19;20;06 - 00;19;40;23 Marie Cleary-Fishman Very well said. Well, thank you, doctor. We really appreciate your insight, your ideas that have been innovative and really have driven to your success and really all of that sustainability and spread that we're sharing with others. So thank you so much for helping us to improve and to tell everybody about that journey. 00;19;41;00 - 00;19;42;17 Dr. Nishant Prasad Thank you for having me. 00;19;42;20 - 00;20;15;19 Tom Haederle This publication is part of a program of the Health Research and Educational Trust, supported by the Centers for Disease Control and Prevention - CDC - of the U.S. Department of Health and Human Services - HHS - under CDC/HHS as part of a financial assistance award totaling $75,000 with 100% funded by CDC/HHS. The contents are those of the authors and do not necessarily represent the official views of nor an endorsement by CDC, HHS, or the U.S. government. </details> Wed, 26 Jul 2023 08:00:00 -0500 Infection Prevention and Epidemiology AHA podcast: Getting to Near Zero with Infection Prevention /news/headline/2023-06-21-aha-podcast-getting-near-zero-infection-prevention Waleed Javaid, M.D., director of infection prevention and control at Mount Sinai Health System in New York, shares successful strategies for eliminating healthcare-associated infections. <a href="/advancing-health-podcast/2023-06-21-getting-near-zero-infection-prevention" target="_blank">LISTEN NOW</a> <div><a href="https://soundcloud.com/advancinghealth" target="_blank" title="Advancing Health">Advancing Health</a> · <a href="https://soundcloud.com/advancinghealth/infection-prevention-is-everyones-job" target="_blank" title="Getting to Near Zero With Infection Prevention">Getting to Near Zero With Infection Prevention</a></div> Wed, 21 Jun 2023 14:44:36 -0500 Infection Prevention and Epidemiology