June 7, 2002

According to the U.S. Centers for Disease Control and Prevention, nearly 2 million patients in the United States contract an infection while hospitalized — infections they did not have before admission. Because these infections are often resistant to antibiotics, some can be particularly difficult to treat. To address this issue, the MGH is instituting several programs to give clinicians the resources they need to stop the spread of these infections.

Starting in June, the Clinical Applications Suite (CAS) patient information system has a new onscreen icon — denoted by a red letter "P "— that will identify a "precautions" status. David C. Hooper, MD, chief of the MGH Infection Control Unit, explains that precautions status alerts clinicians to follow contact precautions to prevent the transmission of infections. The two most prevalent hospital-acquired or nosocomial infections are methicillin-resistant Staphylcoccus aureus (MRSA) — often called a staph infection — and vancomycin-resistant enterococci (VRE). These bacteria usually are resistant to many common antibiotics.

When a clinician sees the red "P" icon on the computer screen, he or she can select the icon to view a menu detailing the contact precautions requirements and guidelines. Some of the precautions guidelines include wearing gloves to enter the patient's room, wearing a gown while in contact with the patient or nearby environment, cleaning hands with a disinfectant and ensuring the patient is in a private room. The menu also provides information to help identify circumstances when a patient may no longer need to be on precautions status.

"Our goal is to improve the quality of our patient care by preventing these infections from starting in the first place," says Hooper. "The precautions flag on the CAS system is one way to help prevent the transmission of these infections to other patients and to make sure that the most up-to-date information is available to assess a patient's need for precautions."

Another hospitalwide program that has been in place for several years but will be re-introduced this summer is the MGH Hand Hygiene program. According to many studies, when health care workers consistently disinfect their hands before and after patient care encounters, nosocomial infections can be significantly reduced or prevented. Using alcohol-based antiseptic hand gel — products such as Cal Stat, which is used at the MGH — can be more effective, more convenient and better tolerated by sensitive skin than using soap and water to remove bacteria from hands.

"Hospitals across the country, including the MGH, are increasing their efforts to fight off nosocomial infections," says Hooper. "We currently are instituting these programs and providing educational resources to help caregivers prevent these infections from ever occurring, which is better for patients and ultimately can reduce the length of stay in the hospital."

For more information about the precautions status or the Hand Hygiene program, call the Infection Control Unit at (617) 726-2036.