3 Hospital-Acquired Infection Tips for Health-System Pharmacists

Patients may view a hospital as a safe, sterilized place, but pharmacists should make sure to inform them about the risk for hospital-acquired infections.

Patients may view a hospital as a safe, sterilized place, but pharmacists should make sure to inform them about the risk for hospital-acquired infections (HAI).

Linda Spooner, PharmD, RPh, BCPS, FASHP, professor of pharmacy practice at MCPHS University, told Pharmacy Times about the following 3 HAI-related tips for health-system pharmacists:

1. Formalize your antimicrobial stewardship program.

The Joint Commission, which accredits and certifies nearly 21,000 health care organizations and programs in the county, has proposed that health systems should have antimicrobial stewardship programs based on evidence-based guidelines.

This proposal calls for education of all hospital staff on antimicrobial ordering, dispensing, and administration; monitoring about antimicrobial resistance; and antimicrobial stewardship practices. It also emphasizes patient education on the appropriate use of antimicrobial medications. A team of pharmacists, infectious disease physicians, and infection preventionists will be needed to tackle these stewardship programs.

Dr. Spooner noted that most health systems have viewed antimicrobial stewardship as a concern since 2000, when the CDC released recommendations on what providers and patients can do to protect antibiotics like vancomycin from being overused.

“But now that it’s going to be a Joint Commission mandate, it really makes it necessary to more formalize [antimicrobial stewardship programs],” Dr. Spooner said.

Her own institution has formalized its antimicrobial stewardship program over the past year through an antimicrobial stewardship committee with bylaws and specific processes. However, this may be a more difficult project for smaller institutions that only have a clinical generalist or don’t have a clinical pharmacist on staff.

2. Teach patients how to stay out of the hospital.

“One big thing that I always teach my patients is to try not to go to the hospital in the first place,” Dr. Spooner said.

She teaches her students that they can educate patients about ways to prevent being admitted. For instance, they can make sure that their patients are taking their medications properly and not missing doses. As another example, pharmacists can remind patients with congestive heart failure to keep track of their weight and to limit their salt intake.

Pharmacists can also encourage good hand hygiene among patients. They can remind patients to wash their hands before they eat, to not touch their face unless they washed their hands, and to carry hand sanitizer with them.

3. If patients do get admitted, teach them to look out for themselves.

“Be your own advocate,” Dr. Spooner tells her patients.

If patients see health care professionals walk into their room and they don’t wash their hands before or after examining them, they shouldn’t be afraid to say something about it. Dr. Spooner assures her patients that providers won’t be upset if they’re gently reminded about hand hygiene.

Another behavior that can be problematic is residents or practitioners who walk around carrying cups of coffee, water, or soda, because that introduces an infection risk.

“I’ll tell patients, ‘If you see somebody doing that or you see something that just doesn’t look right to you, say something,’” she said. “No one is going to call you a complainer.”

Patients should also be careful about picking up an infectious disease from their roommate or by simply walking around the hospital with their physical or occupational therapist.

Once patients are discharged, pharmacists can ensure that they look out for themselves as they enter the world immunocompromised. For example, at the grocery store, a shopping cart handle can have more bacteria on it than a toilet seat, so patients should use a sanitizer as a basic infection precaution.

“Whether you’re inpatient or outpatient, recognizing [good hygiene] is so important,” Dr. Spooner said.