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The Complexity Matters blog features the Thursday Complexity Post as well as other complexity inspired news items.

 

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ResistanceMap Tracks Rise in Superbugs

Posted By Susan Doherty, Wednesday, March 16, 2011
Updated: Thursday, June 6, 2013

From the Robert Wood Johnson Foundation -

The rapid rise in antibiotic resistance during the past decade can now be visualized using ResistanceMap, a new online tool that lets you see regions of the country where the problem is particularly severe. Drug resistance is the ability of bacteria like Methicillin-resistant Staphylococcus aureus (MRSA) to survive a treatment course with an antibiotic.

ResistanceMap was created by Extending the Cure, a research project supported by RWJF's Pioneer Portfolio. The maps show some dramatic trends, including how resistance to popular antibiotics like methicillin and ciprofloxacin has risen sharply between 2000 and 2009 among common microbes. For example, the tool shows that MRSA rates rose sharply in the United States over that period, eventually reaching levels of resistance at or greater than 60 percent in the South East Central region of the country.

Read more on the RWJF web site

Tags:  app  MRSA  stopMRSA 

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Unclean hospitals are a danger

Posted By Susan Doherty, Wednesday, January 19, 2011
Updated: Thursday, June 6, 2013
Originally in the NY Daily News by Betsy McCaughey, here are a couple excerpts from "After the gunfire: infections can kill: Unclean hospitals are a danger to patients nationwide"

According to her doctors, Rep. Gabrielle Giffords is breathing on her own and has been upgraded from critical to serious condition. Now, her major risk is infection, they report. Nationwide, an estimated 25% to 33% of patients in intensive care contract hospital infections.

Imagine surviving a gunshot, then having to fear a deadly germ lurking on your bedrail. Hospital infections kill an estimated 100,000 people in theU.S.each year, more than the combined death toll from highway fatalities, breast cancer and AIDS.

And also: 

When researchers at Chicago's Rush University Medical Center trained cleaners to drench surfaces, rather than spraying and quickly wiping, and to clean commonly overlooked objects, the spread of VRE to patients was reduced by two-thirds.

Robert Orenstein, an infectious disease expert at the Mayo Clinic, showed that cleaning frequently touched surfaces with a bleach-saturated wipe daily reduced the risk of the deadly infection Clostridium difficile by 33%.

Hospitals need to translate all this research into action. Converting to single rooms may not be feasible, but at the very least medical facilities should focus on thoroughly cleaning surfaces around a patient's bed and testing surfaces to be sure the cleaning is done. Hospitals did such testing routinely until the 1990s, when antibiotics replaced attention to hygiene.

Tags:  news  stopMRSA 

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Network Mapping at UHN

Posted By Susan Doherty, Thursday, November 18, 2010
Updated: Thursday, June 6, 2013
From the University Health Network website -

When most people hear the words "social network,” they think of the recent movie or one of the many websites that "bring people together.” But the General Surgery unit at TGH has put a twist on social networking, proving that it’s useful for more than just keeping track of friends in far-off places. Led by Nurse Manager Brenda Perkins-Meingast, the unit has been busy working on a new hand hygiene initiative with the Infection Prevention and Control (IPAC) department that maps the relationships between the people on her team.

Tags:  networks  stopMRSA 

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Inviting Everyone: A New Book from Plexus Institute

Posted By Susan Doherty, Thursday, August 12, 2010
Updated: Thursday, June 6, 2013
Plexus Institute announces the release of "Inviting Everyone: Healing Healthcare through Positive Deviance

This book tells the remarkable story of how a people-centered approach to organizational and social change, accompanied by sound scientific and technical expertise, yielded positive quality outcomes for ordinary citizens, health care institutions and their patients, and society in general. This work draws upon the collective wisdom and experience of infection control practitioners, doctors, public health authorities, nurses, social and organizational change practitioners, health care administrators, patients and front line workers. Additional benefits of use of the PD process to fight infection turned out to be improved workplace relationships, healthier and more resilient organizational cultures, and expanded networks of people in many fields and geographical locations who shared ideas, resources and the inspiration of their own contributions to saving lives.

Tags:  plexus  positive deviance  stopMRSA 

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iScrub app from University of Iowa

Posted By Susan Doherty, Thursday, August 5, 2010
Updated: Thursday, June 6, 2013
iScrub Lite is an iPhone/iPad application for healthcare professionals who wish to monitor hand-hygiene compliance without the time-consuming and error-prone use of clipboards and transcription. Use iScrub Lite to record observations annotated with time, location and job role. Transferring data from iScrub Lite is as easy as clicking "Email Observations.” iScrub Lite was developed by the University of Iowa, Computational Epidemiology Research Department. 

Tags:  app  stopMRSA 

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Poor Infection Control at Surgical Centers

Posted By Susan Doherty, Wednesday, June 9, 2010
Updated: Thursday, June 6, 2013
A new CDC study finds 68 percent of centers had at least one lapse in infection control and 18 percent had lapses in in three or more out of five infection-control categories. In 2007, more than 6 million surgical procedures were performed in such centers.

Tags:  research  stopMRSA 

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Protecting Patients from Hospital Acquired Infections

Posted By Susan Doherty, Tuesday, June 8, 2010
Updated: Thursday, June 6, 2013
From the Not on My Watch Prevention Campaign web site:

"As part of an ongoing commitment to quality care and infection prevention, nationwide doctors and hospitals are partnering with Kimberly-Clark to deliver continuing education programs on healthcare-associated infection (HAI) prevention to staff and management. As simple as education sounds, busy doctors and nurses on the front lines of delivering care can find it difficult to find the time to take advantage of scheduled programs within their hospitals.

The HAI Education Program is part of a national infection awareness campaign for healthcare professionals called "Not on My Watch” and will provide the facility with a toolkit that contains informational flyers, patient safety tips and posters.

The "Not on My Watch” campaign provides accredited continuing education (CE) programs based on best practices and guidelines as well as research available on reducing the incidence of healthcare-associated infections.”

Tags:  news  stopMRSA 

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An Elegant Solution

Posted By Susan Doherty, Thursday, May 27, 2010
Updated: Thursday, June 6, 2013
From JONA, Volume 40, Number 4, pp 150-153, "Positive Deviance: An Elegant Solution to a Complex Problem” by Curt Lindberg and Thomas R. Clancy. Statistics from the partnership hospitals using the innovative PD intervention documented dramatic declines in MRSA infection rates.

Article attached below.

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Tags:  positive deviance  stopMRSA 

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No Blame versus Accountability

Posted By Susan Doherty, Wednesday, May 26, 2010
Updated: Thursday, June 6, 2013
From the New England Journal of Medicine "Balancing ‘No Blame’ with Accountability in Patient Safety” by Robert M. Wachter, M.D. and Peter J. Pronovost, M.D., Ph.D.

"Most errors are committed by good, hardworking people trying to do the right thing. Therefore, the traditional focus on identifying who is at fault is a distraction. It is far more productive to identify error-prone situations and settings and to implement systems that prevent caregivers from committing errors, catch errors before they cause harm, or mitigate harm from errors that do reach patients.”

Complete article attached below.

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Tags:  news  pronovost  stopMRSA 

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Hospital Acquired Infections on the Increase

Posted By Susan Doherty, Tuesday, April 20, 2010
Updated: Thursday, June 6, 2013
From the April 14, 2010 article by Candy Lashkari

"Despite being reported over a decade ago, little has been done in America to reduce hospital born infections as per a Health and Human Services department quality report for 2009 to Congress. Hospital acquired infections seem to be on the increase according to the report when compared with statistics available for 2007. The situation is being seen as critical by many health care experts.”


Plexus Institute’s Lisa Kimball comments, "In 2006 in an effort spearheaded by Plexus Institute, six Beta Site hospitals, CDC, Positive Deviance Initiative, and Delmarva Foundation came together to pioneer the first use of Positive Deviance (PD) to reduce the transmission of MRSA (methicillin-resistant staphylococcus aureus) in healthcare organizations. The article, published by the Association for Professionals in Infection Control, presents the work of these hospitals, the results they achieved which include dramatic sustained reductions, a primer on PD, and suggestions for employing PD to prevent MRSA.” See Staff-Driven Cultural Transformation Diminishes MRSA attached.

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Tags:  MRSA  stopMRSA 

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