As I type this article for the TSICP newsletter, I am reflecting on how blessed I am to be back in the world of infection prevention! After a year and a half spent as the Director of Nursing at a skilled-nursing facility, today was my first day back in the full-time world of hospital infection prevention. While I am thrilled to be back in the area where I’ve spent most of the last 13 years, I am also somewhat apprehensive. After all, I know some new things have popped up in the time I was away. So I decided to do a quick literature search just to see what I’ve been missing…
Possibly the biggest story today is the septicemic plague-related death of a 16 year-old Colorado boy on June 8, four days after he developed flu-like symptoms. Officials failed to accurately identify his illness since he presented with what officials thought was the common flu and did not exhibit the telltale sign of plague swollen lymph nodes. Officials are now warning mourners who attended the young man’s memorial service on his family’s land to immediately see their doctor if they develop a high fever since they may have been exposed to the infected fleas that bit the young man.
Another story causing a great deal of concern in the infection prevention community is Middle Eastern Respiratory Syndrome (MERS). The virus seems to be circulating throughout the Arabian Peninsula where the majority of cases (>85%) have been reported. While community transmission has not been documented, clusters of cases have been reported in healthcare facilities which may support the theory human to human transmission can occur in the right circumstances. While animal to human transmission is not well understood, camels are thought to be a major reservoir host for this virus. Though the risk to the U.S. is considered low, it is important to note the case fatality rate from MERS is reported to be as high as 30-40%.
Of course, the outbreak of CRE infections at UCLA Medical Center made the entire infection prevention community sit up and take notice. The culprit was once again found to be those pesky scopes…in this case, duodenoscopes. Though the scopes were cleaned and processed according to both “FDA and manufacturer guidelines”, something was obviously missed during the processing of these devices. No doubt, this incident will spur regulatory agencies such as CMS and The Joint Commission to continue to focus (as they should!) on high-level disinfection and facilities’ policies and processes surrounding it.
Though a few new concerns and issues popped up in the infection prevention world while I was gone, I’m sure many of the same things I grappled with before as an IP, I will grapple with again such as transparency in reporting, overuse of antibiotics, poor hand hygiene and influenza vaccine compliance and convincing the C-suite to invest in technology, equipment and tools that assist the bedside nurse with efforts to prevent healthcare-associated infections. The IP’s “to do” list is always full, but I am grateful to be back in the position to tackle this type of “to do” list!
Renae Yates, BSN, RN, CIC