APIC 2019: New research released during day 2 of the conference

June 13, 2019

This week, nearly 5,000 healthcare professionals focused on infection prevention will gather in Philadelphia, PA for the 46th Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC). Here’s a look at some of the research released on the second day.

A hidden truth: Hospital faucets are often home to slime and biofilm

Hand hygiene is a critical component of infection prevention in hospitals, but the unintended consequences include water splashing out of a sink to spread contaminants from dirty faucets according to new research.

Researchers at the University of Michigan Health System assessed eight different designs across four intensive care units to determine how dirty sinks and faucets really are. They found that a shallow depth of the sink bowl enabled potentially contaminated water to splash onto patient care items, healthcare worker hands, and into patient care spaces – at times at a distance of more than four feet from the sink itself.

“The inside of faucets where you can’t clean were much dirtier than expected,” said study author Kristen VanderElzen, MPH, CIC. “Potentially hazardous germs in and around sinks present a quandary for infection preventionists, since having accessible sinks for hand washing is so integral to everything we promote. Acting on the information we found, we have undertaken a comprehensive faucet replacement program across our hospital.”

To identify the grime level of the sinks, the researchers used adenosine triphosphate (ATP) monitoring to measure the cleanliness. Visible biofilm was associated with higher ATP readings, and cultures tested over the course of the study grew Pseudomonas aeruginosa, mold, and other environmental organisms. The research team also found aerators on sinks where they had previously been removed, pointing to an overall inconsistency of equipment protocols across the facility. Included in the design improvement program were sink guards, which were shown to limit splash significantly.

New female external catheter technology reduces CAUTI by 50 percent

Hospital-wide introduction of new female external catheter technology halved the number of catheter-associated urinary tract infections (CAUTIs) according to new research. After identifying a slow climb in the number of CAUTIs from 2016 to the first quarter of 2018, infection preventionists (IPs) at NYC Health + Hospitals/Coney Island introduced the hospital’s healthcare providers to new female external catheter technology – an alternative and non-invasive method of managing incontinent patients.

“The leading risk factor for CAUTI development is prolonged use of indwelling Foley catheters,” said study author Briana Episcopia, BS, RN, CIC. “The female external catheter gave doctors and nurses an alternative that eliminated the need for an indwelling catheter, ultimately eliminating some patients’ risk of developing this type of infection.”

Utilizing data from the Center for Disease Control and Prevention’s National Healthcare Safety Network (NHSN), researchers compared inpatient infections, Foley utilization, and the standardized infection ratio (SIR) pre- and post-implementation (October 2017 to September 2018). Highlights included:

·   A hospital-wide reduction of inpatient CAUTIs by 51.7 percent

·   Reduction of the Foley utilization rate from 15.7 to 10.7, which resulted in a decline in the number of Foley days for the hospital