Acinetobacter outbreak in LTAC Hospital

BrnEyedGirl, BSN, MSN, RN, APRN · Mar 16, 2009

Do you mean Acinetobacter? I'm not an expert in micro, but we see this in trauma pts and often in farming accidents, especially those who don't get treatment immediately. I thought it was a common gram neg bacteria that lived in soil,.....I'll have to do some research.

Magsulfate, BSN, RN · Mar 16, 2009

I guess I did spell it wrong! lol thanks..

ErraticThinker · Mar 16, 2009

strict contact precautions, if the nurse taking care of that patient goes into another room he/she should use reverse precautions with good hand hygiene. also see what policies your institution has in place for it. it spreads quickly so might need to start checking other patients for it as well. acinetobactor is found everywhere, but there are resistant strains of it that are pretty nasty.

Home Health Columnist / Guide · Mar 16, 2009

from the cdc

overview of drug-resistant acinetobacter infections in healthcare settings

released: september 24, 2004

what is acinetobacter?

acinetobacter (ass in ée toe back ter) is a group of bacteria commonly found in soil and water. it can also be found on the skin of healthy people, especially healthcare personnel. while there are many types or “species” of acinetobacter and all can cause human disease, acinetobacter baumannii accounts for about 80% of reported infections.

outbreaks of acinetobacter infections typically occur in intensive care units and healthcare settings housing very ill patients. acinetobacter infections rarely occur outside of healthcare settings.

what are the symptoms of acinetobacter infection?

acinetobacter causes a variety of diseases, ranging from pneumonia to serious blood or wound infections and the symptoms vary depending on the disease. typical symptoms of pneumonia could include fever, chills, or cough. acinetobacter may also “colonize” or live in a patient without causing infection or symptoms, especially in tracheostomy sites or open wounds.

how do people get acinetobacter infection?

acinetobacter poses very little risk to healthy people. however, people who have weakened immune systems, chronic lung disease, or diabetes may be more susceptible to infections with acinetobacter.hospitalized patients, especially very ill patients on a ventilator, those with a prolonged hospital stay, or those who have open wounds, are also at greater risk for acinetobacter infection. acinetobactercan be spread to susceptible persons by person-to-person contact, contact with contaminated surfaces, or exposure in the environment.

how is acinetobacter infection treated?

acinetobacter is often resistant to many commonly prescribed antibiotics. decisions on treatment of infections with acinetobacter should be made on a case-by-case basis by a healthcare provider. acinetobacter infection typically occurs in very ill patients and can either cause or contribute to death in these patients.

what should i do to prevent the spread of acinetobacter infection to others?

acinetobacter can live on the skin and may survive in the environment for several days. careful attention to infection control procedures such as hand hygiene and environmental cleaning can reduce the risk of transmission. for more information on infection control practices and hand hygiene, see hand hygiene in healthcare settings and guideline for isolation precautions in hospitals.

*********

expect this infection to beadded to list of "never events" that insurance companies will not pay for; therefore forcing healthcare facilites to eat the cost. good bye raises.... "ounce prevention worth a pound of cure.".....what i tell my staff.

i know there are soaps that can be used for handwshing then uv black light passed over to show amount particloes not removed....

check out http://www.globright.com/handwashing.html

Straydandelion · Mar 16, 2009

Your hospital may have to resort to written warning for not following hospital policy on infection control and making sure they have the latest available tools to help the workers follow these policies. I would also look at ancillary department procedure i.e. housekeeping, dietary etc.Would appreciate an update on curtailing the spread of it for curiousity sake.

Aneroo, LPN · Mar 16, 2009

Expect this infection to beadded to list of "NEVER EVENTS" that insurance companies will not pay for; therefore forcing healthcare facilites to eat the cost. GOOD BYE RAISES.... "Ounce prevention worth a pound of cure.".....what I tell my staff.
I know there are soaps that can be used for handwshing then UV black light passed over to show amount particloes not removed....
Check out http://www.globright.com/handwashing.html

We use something similar in the schools to show kids about the important of handwashing. When all else fails, I use the old cheap standby- glitter mixed with lotion. Only put it on a few hands, and by the end of the day check out where the glitter is- hair/nose/doorknobs/books/phones....

I agree with the last poster as well. If it is continuing to spread and staff is not listening to instructions (that should be common sense and is one of the first things learned in class), I'd resort to written displinary action.

cruisin_woodward · Mar 16, 2009

Unfortunately this is a very common problem in a lot of ICUs. We have resorted to throwing everything out in the room after patient's leave, in order to prevent the spread. AACN had an article about it in the Critical Care Nurse Journal, but I think that NRSKaren summed it up pretty well...

Here is what we do:

When we have a pt with AB or suspected AB, we put them in a room for contact isolation. EVERYONE entering the room must wear a gown and gloves. Strict hand washing. The visitors must be educated. Anything brought into the room, stays in the room, disposable stethoscopes etc. Things that can not stay in the room, must be wiped clean with alcohol based wipes. When the pt is transported, the transporters wear gowns and gloves. After the patient leaves, the room is deep cleaned, including walls, floors, curtains, windows etc. Housekeeping must be educated. All supplies in drawers etc, are thrown out. This is very costly, so we have really decreased the amount of supplies that we keep in the rooms.

Once AB hits an ICU, you will see more and more incidents of it. It is not unusual for us to have 1 to 2 cases of it on every ICU (we have 5 of them). Some area hospitals have even resulted in dedicated one unit strictly to AB patients so that it is contained. THE BIGGEST CULPRIT IS POOR HAND HYGIENE! Be your patient's advocate. Educate physicians. How many of them do you see enter and leave rooms with out washing their hands. Stop them. Embarrass them in front of their residents if you have to. You are the pt advocate!

Home Health Columnist / Guide · Mar 17, 2009

Like the glitter in the hand lotion idea....

allnurses Guide · Mar 17, 2009

I've seen it in a few different ICUs - almost universally fatal in critically ill patients. Spreads like wildfire - we have one corner of a unit dedicated to those patients. STRICT isolation. I do not agree that capital equipment can be wiped with alcohol-based wipes though.. our head of infection control was very specific that we had to use the strong bleach-based hospital wipes. Rooms are now doused with hydrogen peroxide mist to decontaminate as well.

Acinetobacter in ICU.pdf

Magsulfate, BSN, RN · Mar 17, 2009

I feel like I need to post one more time. My post count was 666 above. Freaky.

Thanks everyone for the replies. I just don't know what management is going to do about this. We'll see in the next day or so.