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Why Every Hospital Should Be A “No Fly Zone”
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Poster Abstracts / American Journal of Infection Control 40 (2012) e31-e176
environmental services and other healthcare providers recognized the critical role they play as individuals in the care and protection of the neonates in their unit. All staff were empowered to enforce infection prevention practices. Hospital-acquired infections decreased as a result of increased awareness and adherence to established infection control practices, including hand hygiene and strict precautions, as well as enhanced environmental cleaning.
Results: The gangrenous amputated limb was immediately transferred to Pathology and continuously refrigerated at 3-5 degrees C. On August 8 a sample of maggots was collected, placed in isopropyl alcohol, and sent to the New York State Department of Health's regional entomologist for identification. All were larvae of a blow fly in the genus Lucilia (order Diptera, family Calliphoridae) which is the most common cause of wound myiasis in North America. Most case reports, including this one, occur in late Spring or early Fall, in lower extremities of patients with PVD and/or CAD. The age of the larvae (45 hours) proved that exposure occurred at the university hospital. It was also determined that exposure most likely occurred when the patient's wife took him outside, 48 hours before maggots were discovered. Lesson Learned: Myiasis, although not life threatening, is a condition which must be prevented since it not only presents health implications, but aesthetic and cultural ones as well . Prevention requires effort on two fronts: minimize patient risk factors and reduce fly populations in the environment. There should be heightened awareness and zero tolerance for flies in the clinical setting. In this particular case, the main lesson learned was the importance of keeping wounds clean and covered at all times. The importance of replacing a dressing that is leaking, soiled or malodorous promptly, and ensuring that it is secure before allowing a patient outdoors was reinforced.
Presentation Number 9-132 Norovirus Outbreak in a Long Term Care Facility Presentation Number 9-131 Why Every Hospital Should Be A “No Fly Zone” Ann Marie Pettis RN, BSN, CIC, Director of Infection Prevention, University of Rochester Medical Center; Ms. Lynn Fine MPH, PhD, CIC, infection preventionist, URMC; Ms. Lynne Brown RN, BSN, M.B.A., infection preventionist, highland hospital; Ms. Melissa Z. Bronstein RN, MPA, CIC, Infection Preventionist, URMC; Ms. Richelle Pappalau R.N., Infection Preventionist, Rochester General Hospital; Mark Shelly MD, Highland Hospital; Paul Graman MD, URMC Issue: Myiasis is the term for the invasion of living tissue by fly larvae. This occurs when a gravid fly lays its eggs in an orifice or an uncovered wound. Noninvasive wound myiasis is one of the more common forms discussed, however reports of nosocomial wound myiasis are relatively rare. This may be explained by several facts; this is not a mandatorily reportable condition, it can be interpreted as a surrogate for medical negligence, and providers may not feel it is worthy of reporting. As a result, the true frequency of myiasis cannot accurately be estimated. A case of nosocomial wound myiasis in a 55 year old male with coronary artery disease (CAD) and peripheral vascular disease (PVD) that occurred in a 750 bed university tertiary hospital was investigated. Project: On August 3 Infection Prevention was alerted that maggots had been found when a patient's dressing was removed in the OR prior to performing a below the knee amputation. The surgery occurred in a 260 bed community teaching hospital, affiliated with the university hospital previously mentioned, where the patient had been transferred from the day before, after a one month stay. The case was clearly nosocomial but two things needed to be determined; where was the patient exposed and how?
Les Chock MS, SM (ASCP), CIC, CHEP, Regional Manager, Infection Control, Kaiser Permanente Medical Center Issue: An outbreak of gastrointestinal illness occurred in a Long Term Care Facility. Infection Control was notified and conducted and outbreak investigation to successfully control the outbreak. Project: Infection Control was notified about an outbreak of gastrointestinal illness in our Long Term Care Facility. Five patients with nausea and vomiting were initially reported. A Situation Management Team was formed that included Infection Control, Administration, Nursing, Security, Risk Management, Environmental Services and Dietary. The 13 step Outbreak Investigation
APIC 39th Annual Educational Conference & International Meeting j San Antonio, TX j June 4-6, 2012
Poster Abstracts / American Journal of Infection Control 40 (2012) e31-e176
environmental services and other healthcare providers recognized the critical role they play as individuals in the care and protection of the neonates in their unit. All staff were empowered to enforce infection prevention practices. Hospital-acquired infections decreased as a result of increased awareness and adherence to established infection control practices, including hand hygiene and strict precautions, as well as enhanced environmental cleaning.
Results: The gangrenous amputated limb was immediately transferred to Pathology and continuously refrigerated at 3-5 degrees C. On August 8 a sample of maggots was collected, placed in isopropyl alcohol, and sent to the New York State Department of Health's regional entomologist for identification. All were larvae of a blow fly in the genus Lucilia (order Diptera, family Calliphoridae) which is the most common cause of wound myiasis in North America. Most case reports, including this one, occur in late Spring or early Fall, in lower extremities of patients with PVD and/or CAD. The age of the larvae (45 hours) proved that exposure occurred at the university hospital. It was also determined that exposure most likely occurred when the patient's wife took him outside, 48 hours before maggots were discovered. Lesson Learned: Myiasis, although not life threatening, is a condition which must be prevented since it not only presents health implications, but aesthetic and cultural ones as well . Prevention requires effort on two fronts: minimize patient risk factors and reduce fly populations in the environment. There should be heightened awareness and zero tolerance for flies in the clinical setting. In this particular case, the main lesson learned was the importance of keeping wounds clean and covered at all times. The importance of replacing a dressing that is leaking, soiled or malodorous promptly, and ensuring that it is secure before allowing a patient outdoors was reinforced.
Presentation Number 9-132 Norovirus Outbreak in a Long Term Care Facility Presentation Number 9-131 Why Every Hospital Should Be A “No Fly Zone” Ann Marie Pettis RN, BSN, CIC, Director of Infection Prevention, University of Rochester Medical Center; Ms. Lynn Fine MPH, PhD, CIC, infection preventionist, URMC; Ms. Lynne Brown RN, BSN, M.B.A., infection preventionist, highland hospital; Ms. Melissa Z. Bronstein RN, MPA, CIC, Infection Preventionist, URMC; Ms. Richelle Pappalau R.N., Infection Preventionist, Rochester General Hospital; Mark Shelly MD, Highland Hospital; Paul Graman MD, URMC Issue: Myiasis is the term for the invasion of living tissue by fly larvae. This occurs when a gravid fly lays its eggs in an orifice or an uncovered wound. Noninvasive wound myiasis is one of the more common forms discussed, however reports of nosocomial wound myiasis are relatively rare. This may be explained by several facts; this is not a mandatorily reportable condition, it can be interpreted as a surrogate for medical negligence, and providers may not feel it is worthy of reporting. As a result, the true frequency of myiasis cannot accurately be estimated. A case of nosocomial wound myiasis in a 55 year old male with coronary artery disease (CAD) and peripheral vascular disease (PVD) that occurred in a 750 bed university tertiary hospital was investigated. Project: On August 3 Infection Prevention was alerted that maggots had been found when a patient's dressing was removed in the OR prior to performing a below the knee amputation. The surgery occurred in a 260 bed community teaching hospital, affiliated with the university hospital previously mentioned, where the patient had been transferred from the day before, after a one month stay. The case was clearly nosocomial but two things needed to be determined; where was the patient exposed and how?
Les Chock MS, SM (ASCP), CIC, CHEP, Regional Manager, Infection Control, Kaiser Permanente Medical Center Issue: An outbreak of gastrointestinal illness occurred in a Long Term Care Facility. Infection Control was notified and conducted and outbreak investigation to successfully control the outbreak. Project: Infection Control was notified about an outbreak of gastrointestinal illness in our Long Term Care Facility. Five patients with nausea and vomiting were initially reported. A Situation Management Team was formed that included Infection Control, Administration, Nursing, Security, Risk Management, Environmental Services and Dietary. The 13 step Outbreak Investigation
APIC 39th Annual Educational Conference & International Meeting j San Antonio, TX j June 4-6, 2012