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INFECTION C ON TROL Taking Steps to Mitigate the Risk of Hospital-Acquired Infections Hospital-acquired infections are all-too- common. The U.S. Centers for Disease Control and Prevention estimates that one-in-25 hospitalized patients will contract an infection, and approximately 75,000 will die each year as a result. Even if an infection is not lethal, it can increase the length of a patient’s hospitalization, significantly increase costs and lead to substantially poorer overall outcomes. UCLA has been taking steps to mitigate these risks. “Many hospitalized patients are sicker than in years past. Perhaps they have undergone transplants or other treatments that suppress their immune system,” says Zachary Rubin, MD, an infectious disease specialist at UCLA Medical Center, Santa Monica. “Because they are sicker, they are undergoing more invasive procedures, providing more opportunities for infections to spread.” Complicating matters is the growing number of infections that are becoming resistant to antibiotics — so-called superbugs. “Years ago, these infections might have been considered an inconvenience,” says Daniel Uslan, MD, an infectious disease specialist at Ronald Reagan UCLA Medical Center. “Now they are potentially life-threatening. Taking measures to prevent them has become a paramount part of what we do in the hospital.” infections after an operation and Clostridium difficile (commonly referred to as C. difficile) — an infectious diarrhea spread by a bacteria that can be contracted from contaminated surfaces. “At UCLA, we have spent considerable time and effort developing a more holistic approach to infection prevention,” says Dr. Uslan. “To be effective, we need a multifaceted approach that involves all levels of care, all staff, and addresses the role of the physical environment.” For example, protocols have been implemented to reduce the risk of bloodstream infections from central venous catheters as well as surgical-site infections. Education initiatives are another key component. Steps have been taken to ensure cleanliness, including a systemwide hand-washing education program, standardization of the way rooms are cleaned and new levels of accountability. UCLA’s facilities are also among the first to use ultraviolet disinfection technology, and Dr. Uslan is currently heading a study to assess the value of installing antimicrobial copper fixtures in intensive care units. Patients also are offered baths with an antiseptic soap that kills bacteria on contact. These efforts have begun to pay off. While national rates of hospital-acquired C. difficile infections are on the rise, UCLA Health has reduced its rate over the last three years. “We have gone beyond the national guidelines in our efforts to reduce and ultimately eliminate preventable infections in both the hospital and ambulatory care settings,” says Dr. Rubin. “Because we see some of the most vulnerable patients, the urgency to address these issues is great, and we take that very seriously.” To view a video about reducing hospital-acquired infections, go to: reduceinfections Dr. Rubin explains that major medical procedures are inevitably associated with a certain infection risk. But research in the last two decades has found that rates for some types of infections can be pushed much lower. “Many infections can be eliminated by taking proactive steps,” he says. “That’s what we have done at UCLA.” The most common types of infections acquired in the healthcare setting include central line- associated bloodstream infections, catheter- associated urinary tract infections, surgical-site Vital Signs Winter 2015 Vol. 65 11