Long-Term Acute Care Hospitals (LTACHs) are facilities serving only patients with serious medical conditions who need at least 25 days of ICU-level care. They evolved from the TB sanitoriums and other specialized treatment facilities of the past, and have experienced significant growth over the past decade. In today’s post, we’ll explore the purpose of these new medical facilities, as well as the implications for infection control when serving these high-risk populations.
As we age, our bodies go through changes that can make us more susceptible to disease, injury, and infection. Individuals who experience the greatest number of health issues as they age may find that a nursing home or assisted living facility provides the best medical support. Unfortunately, that then places those individuals in a subset of our aging population who are at greatest risk for infection. Today's post will explore how age and infection risk are related.
The infection control landscape is difficult to navigate without an understanding of the key terms used by experts in the field. Some of these terms have found their way into every-day language, but often without the technical nuances that can make a big difference in a health care setting. Today we will start to demystify the terminology of infection control, starting with four "anti" terms.
Terminal cleaning is a thorough, deep-cleaning of a patient room between occupants. Its purpose is to rid the room of infectious agents and provide the new occupant a sanitary space for recovery and healing. Terminal cleaning protocols vary by hospital, but the CDC, or Centers for Disease Control and Prevention, has recommendations for environmental cleaning, including terminal cleaning. This advice includes the staff involved in monitoring and evaluating cleaning, the training of environmental staff, and the analysis of data collected through regular assessments.
As concerns over hospital-acquired infections have grown over the past decades, innovative technologies have been invented to aid in the reduction of germs in the patient room, what specialists call the "bioburden". Since numerous studies have proven that patients are infected as a result of a contaminated environment (and not just contaminated individuals) these technologies have emphasized testing the surfaces in the room for proof of effective cleaning. Only recently has bacteria-killing technology emerged that supplements the cleaning done by environmental staff. This post will outline the 4 innovative technologies that assist a hospital in ensuring a clean, sanitary room for each patient.
When we enter a hospital room as a patient, we are seeing the room at its cleanest. The room has just been scrubbed down during what is called "terminal cleaning," the rigorous cleaning that takes place after one patient is moved in preparation for the next patient to move in. However rigorous this cleaning procedure (and studies indicate that up to 60% of hospital rooms are not cleaned properly), there will be residual contamination by infectious pathogens. In a dynamic process of contamination and recontamination, after cleaning and through cross-transmission, germs stick around and continue to make patients sicker.
Surface disinfection has become the new normal. Today's post takes the concept of a high school geometry proof to connect contaminated environments to infected patients. Although this research is in healthcare settings the concept applies to all surfaces in all environments. Rest assured, you’re not crazy for questioning the last time the shopping cart handle, mass transit grab rail, or door push plate you just touched was wiped down.
Included in recent news about COVID-19, hospital isolation rooms have made headlines. Retrofitting of regular hospital units and emergency construction of public spaces to increase capacity for treating highly contagious patients are just some of the areas utilizing innovative technologies. But isolation rooms are not just for protecting the uninfected - they also create a clean environment for the patient whose immune system may be compromised. What goes into designing and building an isolation room? What can we learn from the best practices in these rooms to apply to our lives as the world starts to exists extreme self-isolation?
With a few words, a family's life is forever changed: "It's cancer." For any patient, these words bring anxiety and fear. When that patient is a child, however, no words can express the emotions that send shock waves through a family, friends, and community. Today's post begins a three-part story of one such young patient, a little boy named Jack. (Best of all, Jack's story has a happy ending.) During Childhood Cancer Awareness Month join us as we see the challenges of pediatric cancer treatment and infection control through the eyes of a boy and his mother.
Germ theory, the idea that infection is caused by microscopic organisms unseen to the naked eye, is only a few hundred years old. This theory focuses on three main components.
- The reservoir: The person, animal, or surface that carries the infection.
- The mode of transmission: Via direct contact, a droplet of liquid, airborne, a vector (such as an insect), or a vehicle (food or surface)
- The susceptible host: A person and his/her ports of entry (nose, mouth, incision, medical device, wound)
But the paths from the reservoir to the susceptible host seem infinite. To narrow down the steps needed to prove this relationship between contaminated rooms and infected patients, researchers have proposed routes of transmission that could account for a relationship. Here are two proposals, both of which demonstrate the critical role played by surfaces in the transmission of pathogens.