While the rate of hospital-acquired infections has continued to rise in the rest of the country, Scott & White has managed to decrease its numbers significantly and provide a safer environment for its patients.
“Our approach is to have teams made up of physicians, nurses and other supportive disciplines that are involved in prevention,” said Glen Jett, Director of Infection Prevention and Control.
The teams create plans to improve practices and provide state-of-the-art care. These plans are implemented throughout the hospital.
“The teams remain active with ongoing monitoring even after the changes have been made,” Mr. Jett said.
Because of these plans, Scott & White has seen significant change in the area of ventilator-related infections.
“We’ve implemented procedures like keeping the head of the patient elevated to 35 to 45 degrees if they are on a ventilator,” Mr. Jett said. “It sounds simple, but it’s something that can sometimes fall through the cracks.”
Medical staff who work with these kinds of patients also provide routine oral care like brushing the patient’s teeth, keeping the mouth moist and rinsing around the ventilator’s tubing with antiseptic wash.
“All of these procedures decrease germs that pool in the mouth from sliding into the patient’s airway,” he said. “Studies show that’s a major cause of developing pneumonia. It’s significant to be able to monitor that.”
Another way patients on ventilators are protected from infection is by going through what is called a sedation holiday.
“Every day, we wean the patient off of the sedation medication for a period of time,” Mr. Jett said. “We can assess the patient’s progress and recognize if they are getting stronger.”
This process is important to preventing infection because it allows the patient to do things they would not be able to do under sedation, like coughing, taking deep breaths, or moving side to side.
“We also do a spontaneous breathing trial where we switch the machine to where they are initiating the breathing and the machine is just assisting,” he said. “This helps to determine if the person is getting closer to being off of the ventilator. This process has been really successful in the ICU.”
Because of the implementation of these simple procedures, the incidents of ventilator-related infections have decreased by over 50 percent in the last 18 to 24 months.
Mr. Jett said specific prevention techniques are important, but the most important way to protect patients from infections is hand hygiene.
“We promote a culture at Scott & White that everybody’s important,” he said. “It doesn’t matter if you’re a physician or a dietary aide, if you see me walk into a room and I don’t clean my hands or use the alcohol foam, then you should remind me. And the only acceptable response is thank you.”
This mindset is all to help reach the hospital’s goal of a zero infection rate.
“We don’t want any of our patients to contract an infection as a result of their hospital stay,” Mr. Jett said. “If you came in without an infection we want to leave without an infection.”