PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

To eliminate COVID-era bloodstream infections in heart, lung patients, Tampa Hospital had to innovate

Early recognition, a specially developed ECMO care bundle, and unit ownership drove rates to zero

2024-06-03
(Press-News.org) San Antonio, Texas – June 3, 2024 – Recognizing an unusual prevalence of bloodstream infections (BSI) that threatened extremely ill patients receiving Extracorporeal Membrane Oxygenation, or ECMO, Tampa General Hospital (TGH) infection preventionists started an intervention that eliminated these infections completely from their 18-bed Cardiothoracic Intensive Care Unit (CTICU).

At the APIC 2024 Annual Conference, presenters from the 1,000-bed, tertiary care, academic medical system  reported on how they reduced bloodstream infections in ECMO patients from a rate of 36% in October 2021 to a rate of 0% in April 2022. This rate was sustained for seven months. TGH  has continued to maintain low BSI rates in this population and are again on a 4-month streak of no infections.

At the time of the peak BSI rates, the unit was filled with critically ill COVID patients from surrounding regions who needed ECMO treatment and were transferred from other hospitals.

Led by a multidisciplinary team, TGH formed an ECMO task force to identify factors contributing to these infections. Among the things they identified was a lack of standardized infection prevention procedures around the care and maintenance of cannula sites and environmental factors.

ECMO involves insertion of large cannulas or tubes into the patient, often near the groin, so blood can be pumped out of the body, reoxygenated, and pumped back in. ECMO patients are prone to bleeding and require multiple dressing changes which can increase the chances of infection. Because ECMO is such a high-risk procedure for patients with severe heart and lung impairments, infections can lead to organ failure and death. It is believed that between 3 and 18% of ECMO patients get a bloodstream infection during treatment. 1

Starting from a pre-existing set of practices for prevention of central line-associated bloodstream infections (CLABSI), the TGH team added specific elements for ECMO to create an ECMO-specific cannula site care bundle. The ECMO line-related infection prevention bundle focused on standardizing use of antimicrobial dressings, aseptic techniques, cannula securement, daily antimicrobial patient bathing, and environmental factors like making sure cannulas did not touch the floor.

Mini Radhakrishnan, BSN, RN, CIC, is an Infection Preventionist at Tampa General Hospital and helped to identify the initial trend in the CTICU. She was part of the team that conducted weekly infection prevention rounds on the unit and tracked adherence to the bundle with an audit tool. In June 2022, just eight months later, there were zero ECMO-related BSIs.

“As there were no standardized procedures for ECMO infection prevention, we borrowed heavily from what we know about surveillance and CLABSI prevention and implemented procedures that would work,” said Radhakrishnan. “So much credit for our success goes to the CTICU team. When they identified the problem and saw how their actions could change outcomes for patients, that’s when the effort really took off.”

Unlike CLABSIs, BSIs that occur during ECMO procedures are not tracked by the National Healthcare Safety Network (NHSN) and can often be missed when doing routine infection surveillance.

“Because ECMO line-related infections aren’t specifically tracked through NHSN, it would be easy for infection prevention teams to overlook a potential problem," said Tania Bubb, PhD, RN, CIC, FAPIC, 2024 APIC president. “The TGH team is to be congratulated for not only identifying the infections in this population but also for proactively developing a set of ECMO infection prevention protocols that can be replicated by other institutions that utilize the procedure in their cardiothoracic units.”

The oral abstract, “Bundled Approach to Reduce Bloodstream infections in Patients Requiring use of Extracorporeal Membrane Oxygenation,” (QAPI 20) is being presented at 3:11 pm CT, June 3, at the APIC Annual Conference in San Antonio, Texas.

 

About APIC

Founded in 1972, the Association for Professionals in Infection Control and Epidemiology (APIC) is the leading association for infection preventionists and epidemiologists. With more than 15,000 members, APIC advances the science and practice of infection prevention and control. APIC carries out its mission through research, advocacy, and patient safety; education, credentialing, and certification; and fostering development of the infection prevention and control workforce of the future. Together with our members and partners, we are working toward a safer world through the prevention of infection. Join us and learn more at apic.org.

APIC’s Annual Conference, June 3-5, is one of the most comprehensive infection prevention conferences in the world, with programs led by experts from across the globe and attended by physicians, researchers, epidemiologists, educators, administrators, and medical technologists, with strategies that can be implemented immediately to improve prevention programs and make healthcare safer. Join the conversation on social media with the hashtag #APIC24.

 

1. Kim, H.S., Park, S., Ko, H.H. et al. Different characteristics of bloodstream infection during venoarterial and venovenous extracorporeal membrane oxygenation in adult patients. Sci Rep 11, 9498 (2021). https://doi.org/10.1038/s41598-021-89108-4

 

# # #

END



ELSE PRESS RELEASES FROM THIS DATE:

New pathways for treating never-smoker lung cancer revealed

New pathways for treating never-smoker lung cancer revealed
2024-06-03
The primary cause of lung cancer is smoking. However, the incidence of lung cancer among never-smokers has been steadily increasing, especially among women. While approximately 80% of never-smoking lung cancer patients are prescribed targeted therapies that focus on mutations in proteins such as EGFR and ALK, the remaining patients often receive cytotoxic chemotherapy with high side effects and relatively low response rates, highlighting the urgent need for targeted therapies. Dr. Lee Cheolju's ...

Efficient CO2 conversion to fuels and chemicals using ionic liquid electrolyte

Efficient CO2 conversion to fuels and chemicals using ionic liquid electrolyte
2024-06-03
Converting CO2 into fuel and chemicals using electricity, also known as electrochemical conversion of CO2, is a promising way to reduce emissions. This process allows us to use carbon captured from industries and the atmosphere and turn it into resources that we usually get from fossil fuels. To advance ongoing research on efficient electrochemical conversion, scientists from Doshisha University have introduced a cost-effective method to produce valuable hydrocarbons from CO2. The study was made available online on 17 May 2024 and formally published in the journal Electrochimica Acta on 20 July 2024. The research team, led by Professor Takuya Goto and including Ms. Saya Nozaki from ...

Intoxication without alcohol: Auto-brewery syndrome

2024-06-03
How can someone have alcohol intoxication without consuming alcohol? Auto-brewery syndrome, a rare condition in which gut fungi create alcohol through fermentation, is described in a case study in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.231319. “Auto-brewery syndrome carries substantial social, legal, and medical consequences for patients and their loved ones,” writes Dr. Rahel Zewude, University of Toronto, with coauthors. “Our patient had several [emergency department] visits, was assessed by internists and psychiatrists, and was certified ...

HPV-based screening can help eliminate cervical cancer

2024-06-03
Implementing human papillomavirus (HPV)-based screening in British Columbia could eliminate cervical cancer in the province before 2040, according to a modelling study in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.231682. More than 90% of cervical cancer cases worldwide are caused by 9 types of high-risk HPV. The World Health Organization and the Canadian Partnership Against Cancer (CPAC) have both set targets to eliminate cervical cancer by 2040, defined as an annual rate of less than 4 per 100 000 women. The Pap test has been the primary screening ...

New biomarkers will enable personalised influenza vaccination schedule

2024-06-03
Berlin, Germany:  While influenza infection is a significant public health threat, causing serious illness in between three and five million people worldwide per year and leading to about up to 650,000 deaths, the effectiveness of influenza vaccines varies considerably between individuals depending on vaccine types and individual circumstances. A person’s ability to resist infection (host immunity) plays an important role in this. Now, researchers have developed a way of classifying host immunity in individuals, which may lead to the early identification of those who will not respond well to a regular vaccine schedule and therefore ...

Understanding how abnormal embryos self-correct may provide women with a better chance of IVF pregnancy

2024-06-03
Berlin, Germany:  Aneuploidy (the presence of an abnormal number of chromosomes) in embryos is a major cause of impaired embryo development, leading to conditions such as Down syndrome, as well as to pregnancy loss. The transfer of such embryos in women undergoing IVF is therefore usually avoided because of unfavourable pregnancy outcomes. But mosaic embryos, comprising both genetically normal and abnormal cells, can result in perfectly normal babies. Now, researchers have been able to understand how these mosaic ...

Metformin may be as safe as insulin during pregnancy, 11-year data shows

2024-06-02
BOSTON—Metformin is safe to use during pregnancy to manage diabetes, with no long-term adverse effects on the children born and their mothers for at least 11 years after childbirth, according to research presented Sunday at ENDO 2024, the Endocrine Society’s annual meeting in Boston, Mass. This is the first study to look at longer term effects of metformin use during pregnancy. “Metformin has been extensively used for managing raised blood glucose values in pregnancy for many decades now. It is the only blood glucose-lowering oral medication approved ...

Two medication classes reduced cardiovascular and liver events in people with type 2 diabetes

2024-06-02
BOSTON—GLP-1 receptor agonists (GLP-1s) and SGLT-2 inhibitors lower the risk of major cardiovascular events like heart attacks and severe liver complications compared to other diabetes treatments, according to data being presented Sunday at ENDO 2024, the Endocrine Society’s annual meeting in Boston, Mass. “Before this study, there was limited information about how these specific diabetes medications work in patients with both type 2 diabetes and metabolic dysfunction-associated steatotic liver disease (MASLD),” said Alexander Kutz, M.D., M.P.H., M.Sc., a research fellow in the Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, at Brigham ...

Neoadjuvant Immunotherapy for early stage melanoma shows positive results

Neoadjuvant Immunotherapy for early stage melanoma shows positive results
2024-06-02
Immunotherapy before surgery for patients with metastatic melanoma appears to be especially successful. Fifty-nine percent of patients responds so well to this therapy that adjuvant treatment is no longer needed, according to the results of the NADINA study that were published today. The NADINA study, led by researchers from the Netherlands Cancer Institute, was named one of the eleven clinical studies with the biggest impact on health care in 2024 by Nature Medicine. The study now proves that this was not an empty claim, as shown by the results presented by medical oncologist and research leader Christian Blank today during ASCO 2024, the international congress ...

CDC reports its decade-long efforts in standardizing vitamin D tests

2024-06-02
BOSTON—Vitamin D tests certified by the U.S. Centers for Disease Control and Prevention (CDC) Clinical Standardization Programs (CSP) are well calibrated overall, according to a new study presented Sunday at ENDO 2024, the Endocrine Society’s annual meeting in Boston, Mass. However, the researchers found some inaccuracies among the assays studied. The blood tests show an “appropriate” level of analytical accuracy, said the study’s lead researcher, Otoe Sugahara, manager of the CDC Vitamin D Standardization-Certification Program (VDSCP) in Atlanta, Ga. Analytical accuracy is the test’s ability to correctly analyze vitamin D in this ...

LAST 30 PRESS RELEASES:

QUT scientists create material to turn waste heat into clean power

Major new report sets out how to tackle the ‘profound and lasting impact’ of COVID-19 on cardiovascular health

Cosmic crime scene: White dwarf found devouring Pluto-like icy world

Major report tackles Covid’s cardiovascular crisis head-on

A third of licensed GPs in England not working in NHS general practice

ChatGPT “thought on the fly” when put through Ancient Greek maths puzzle

Engineers uncover why tiny particles form clusters in turbulent air

GLP-1RA drugs dramatically reduce death and cardiovascular risk in psoriasis patients

Psoriasis linked to increased risk of vision-threatening eye disease, study finds

Reprogramming obesity: New drug from Italian biotech aims to treat the underlying causes of obesity

Type 2 diabetes may accelerate development of multiple chronic diseases, particularly in the early stages, UK Biobank study suggests

Resistance training may improve nerve health, slow aging process, study shows

Common and inexpensive medicine halves the risk of recurrence in patients with colorectal cancer

SwRI-built instruments to monitor, provide advanced warning of space weather events

Breakthrough advances sodium-based battery design

New targeted radiation therapy shows near-complete response in rare sarcoma patients

Does physical frailty contribute to dementia?

Soccer headers and brain health: Study finds changes within folds of the brain

Decoding plants’ language of light

UNC Greensboro study finds ticks carrying Lyme disease moving into western NC

New implant restores blood pressure balance after spinal cord injury

New York City's medical specialist advantage may be an illusion, new NYU Tandon research shows

Could a local anesthetic that doesn’t impair motor function be within reach?

1 in 8 Italian cetacean strandings show evidence of fishery interactions, with bottlenose and striped dolphins most commonly affected, according to analysis across four decades of data and more than 5

In the wild, chimpanzees likely ingest the equivalent of several alcoholic drinks every day

Warming of 2°C intensifies Arctic carbon sink but weakens Alpine sink, study finds

Bronze and Iron Age cultures in the Middle East were committed to wine production

Indian adolescents are mostly starting their periods at an earlier age than 25 years ago

Temporary medical centers in Gaza known as "Medical Points" (MPs) treat an average of 117 people daily with only about 7 staff per MP

Rates of alcohol-induced deaths among the general population nearly doubled from 1999 to 2024

[Press-News.org] To eliminate COVID-era bloodstream infections in heart, lung patients, Tampa Hospital had to innovate
Early recognition, a specially developed ECMO care bundle, and unit ownership drove rates to zero