Oct. 16, 2019 – You may have heard the saying, “An ounce of prevention is worth a pound of cure.” The infection control team takes that old adage to heart! They dedicate themselves to preventing the spread of communicable diseases within the Hospital and to reducing the risks of health care-associated infections.
My visit began in Vice President of Operations Chris Abe’s office, which is down by the Sharp tunnel in the Nelson Pavilion. Interestingly, decades ago, this office was where patients would go to get X-rays, and the space in which we were sitting was once the waiting room. Before the presentation started, the team had unique and apropos gifts for me: a pocket-sized hand sanitizer and a tie with a MRSA (Methicillin-resistant Staphylococcus aureus) bacteria pattern!
A critical part of this team’s responsibilities is preparing for disease outbreaks. As part of a five-year grant, Rady Children’s is a designated Ebola assessment center, which means the team is ready to handle Ebola and any other highly infectious disease. The special infection disease unit has an activation plan and routinely practices simulations, which include wearing full protective gear and working on patient manikins to ensure processes are in place to safely care for all patients while also preventing exposures or transmissions.
Just as important as preparing for an outbreak is surveillance: collecting, analyzing and interpreting data about diseases. Rady Children’s works closely with the San Diego County health department to monitor what is going around in the community and follows infection trends within the Hospital in Epic. For example, this team built an interactive Epic dashboard that tracks rates of health care-associated infections, such as central line-associated bloodstream infections and catheter-associated urinary tract infections. Congrats to the team for achieving a significant decrease in CLABSI events this year!
If you’ve ever seen construction or repairs going on in clinical areas of the Hospital, you’ve probably noticed great care is taken to eliminate any exposure to dust, fumes or other contaminants. Any proposed construction requires an approved permit that outlines the type and scope of construction, as well as any risk factors. Those variables determine what actions must be taken to keep patients, families and staff safe. This includes providing special training to contractors and performing air sampling in areas with high-risk patient populations.
This group also proactively looks for infection concerns, rounding in different units almost every day, examining personal protective equipment, making sure signage is placed appropriately, inspecting patient rooms to identify possible risks and being available to educate medical staff.
The team also oversees the antimicrobial stewardship program, which seeks to improve patient outcomes, ensure cost-effective therapies and ensure the judicious use of antibiotics in an effort to reduce antimicrobial resistance. Detailed records of the type and frequency of use of various antimicrobials are maintained in Epic. The data can be used to track trends and emerging resistance patterns. Another useful tool creates a decision point for pharmacists, requiring them to evaluate whether continuing antimicrobial therapy is necessary or can be reduced. The Epic module has allowed for national reporting of antimicrobial utilization.
Next, I learned about the team’s Environment of Care Coordinator, Frank Rodriguez, who is responsible for leading emergency preparedness and tracking compliance with The Joint Commission. Frank makes regular rounds to verify units are in compliance, provides each unit with its TJC score and tracks opportunities for improvement. He also works closely with the County, participating in disaster planning to ensure Rady Children’s is ready for unforeseen emergencies, and manages emergency supplies such as decontamination and mass casualty tents.
This team does a lot behind the scenes to ensure Rady Children’s is ready for anything. It’s reassuring to know that this team is hard at work, providing a safe and secure environment for our families and allowing our clinical teams to deliver optimal care to our patients.