1. 1 © 2010 TMIT NQF-Endorsed ® Safe Practices for Better Healthcare Student Projects Safe Practice 24 Multidrug-Resistant Organism Prevention

2. 2 © 2010 TMIT NQF Safe Practices: Brought to you by The Quality Choir

3. 3 © 2010 TMIT Culture SP 1 2010 NQF Report

4. 4 © 2010 TMIT Overview Key Points:  Part I – Background:  Definition of what we’re trying to prevent: Multidrug- Resistant Organisms (MDROs)  Why should you care about MDROs?  Part II – Barriers:  What impedes prevention of MDROs in the healthcare setting?  Part III – Strategies:  How can students contribute to stopping the spread of MDROs on a variety of levels?  Part IV – Resources:  Tools for further education

5. 5 © 2010 TMIT The Objective Multidrug-Resistant Organism Prevention Prevent healthcare-associated multidrug- resistant organism (MDRO) infections, including methicillin-resistant Staphylococcus aureus (S. aureus) (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile infections (CDIs).

6. 6 © 2010 TMIT Background Safe Practice 24 Multidrug-Resistant Organism Prevention

7. 7 © 2010 TMIT Background As health professions students, it is paramount that we be aware of these infections and how to prevent their spread in order to save patient lives. Unnecessary patient morbidity and mortality Why do we care? Approximately 100,000 deaths per year Millions of dollars in treatment for preventable disease What is the extent of the damage? Patient to patient via caregivers Improper room sanitation How are they allowed to spread?

8. 8 © 2010 TMIT The Problem © Dr. John Sinnott  Increasing incidence  High mortality  High associated cost

9. 9 © 2010 TMIT The Problem  Increasingly common sequelae of antibiotic therapy incidence  Toxin-mediated intestinal wall infection that can lead to toxic megacolon – frequently fatal  High mortality/cost

10. 10 © 2010 TMIT Barriers to Solutions Safe Practice 24 Multidrug-Resistant Organism Prevention

11. 11 © 2010 TMIT Barriers 1) Lack of understanding of the sequelae and prevention of MDROs amongst health professions students and hospital staff What hinders us as health professions students from preventing MDRO infections? © Joint Commission

12. 12 © 2010 TMIT Barriers 2) Existence of hospital hierarchy creating a lack of power/fear amongst health professions students to engage in and advocate for MDRO prevention What hinders us as health professions students from preventing MDRO infections? © Joint Commission

13. 13 © 2010 TMIT Strategies: Health Professions Students’ Implementation of Solutions Safe Practice 24 Multidrug-Resistant Organism Prevention

14. 14 © 2010 TMIT Strategies 1) Gelling in and out of patient rooms/following posted infection control guidelines 2) Remembering that gel doesn’t kill C. diff. spores – wash your hands! 3) Ask if your patient has ever been diagnosed with MRSA, and if so, tell your attending 4) Clean equipment, especially stethoscopes, with alcohol swabs between patients Remember that anything that touches a patient should be cleaned! A great reason to avoid wearing ties – patient safety has its perks for you too! 5) Alternatively, use patient-specific disposable equipment, such as disposable blood pressure cuffs

15. 15 © 2010 TMIT Strategies Perform a risk assessment of spread of hospital-acquired infections Perform a risk assessment of spread of hospital-acquired infections Organize hand-washing campaigns! Study MDRO-related issues in health professions students Spread NQF modules or create your own!

16. 16 © 2010 TMIT Strategies “We must remember that one determined person can make a significant difference, and that a small group of determined people can change the course of history.” -Sonia Johnson http://www.ihi.org/IHI/Programs/IHIOpenSchool/CheckABoxSaveALife.htm Get involved with, or start a chapter of, “Check a Box. Save a Life,” Atul Gawande’s effort to empower health professions students to decrease surgical infections.

17. 17 © 2010 TMIT Strategies Educate patients colonized with MRSA and their families about healthcare-associated infections and infection prevention strategies Thorough patient handout about living with MRSA WebMD link for MRSA patients CDC MRSA patient information website

18. 18 © 2010 TMIT Resources Safe Practice 24 Multidrug-Resistant Organism Prevention

19. 19 © 2010 TMIT Additional Resources 1. Great interactive resource for MDRO information and beyond: Antibiotic Stewardship. IHI Improvement Map. Cambridge (MA): Institute for Healthcare Improvement (IHI); 2009. http://www.ihi.org/imap/tool/#Process=584d97d9-d698-478f-8a10- ee60362d7462 2. Management of Multidrug-Resistant Organisms in Health Care Settings, 2006. Siegel JD, Rhinehart E, Jackson M, et al. Am J Infect Control 2007 Dec;35(10 Suppl 2):S165-93. http://www.cdc.gov/ncidod/dhqp/pdf/ar/MDROGuideline2006.pdf 3.Discussion of the systemic barriers to MDRO prevention: Are You Infected? Denham CR. J Patient Saf 2009 Sep;5(3):188=96. http://www.safetyleaders.org/QuickStart/SP24/resources/QuickStart_Articl e_SP24_A.pdf Feel free to explore the rest of this module’s website as well!