Rigorous, ongoing work
Northwell has also slashed infection rates with Clostridium difficile (C. diff), bacteria that's on the rise across the country, partly because of overuse of antibiotics. The Healthcare Association of New York State recently recognized Northwell's campaign for appropriate antibiotic use with its 2018 Pinnacle Award for Quality and Patient Safety.
A C. diff infection causes diarrhea and colon inflammation and can be shockingly aggressive, said Bruce Farber, MD, chief of infectious disease at North Shore University Hospital. A few years ago, he and his team struggled to save a man who was admitted with the infection. The 50-year-old had been generally healthy, but developed C. diff after his physician gave him antibiotics for an upper respiratory infection.
"I'll never forget it," Dr. Farber said. "He had to have his colon removed to save his life. He survived, but at what a price."
Dr. Farber has been part of the push to bring down hospital-acquired C. diff infection through moves such as putting more emphasis on isolating infected patients, and by cleaning rooms approach to rooms even more rigorously before a new patient is brought in.
The efforts paid off. Northwell has cut the C. diff infection rate by 56 percent since 2011. Plans are also underway to roll out PurpleSun, the new ultraviolet light-based cleaning technology that kills C. diff and fully disinfects surfaces in 90 seconds. Northwell has invested in PurpleSun, which is expected to hit the market early next year.
More infection control strategies are under development. One of Dr. Armellino's priorities is a set of care bundles that target the rate of bloodstream infection with methicillin-resistant Staphylococcus aureus (MRSA), another nasty microbe that can grow quickly and become life-threatening. One measure will provide a daily antiseptic bath to anyone who has a central line, in case skin is colonized with MRSA. Patients at higher risk, like those who are receiving hemodialysis through a central line, may get the daily bath plus an antibiotic nasal ointment, because many people carry MRSA in their nose.
Infection rates are moving in the right direction, said Dr. Armellino, but the fight won't be over any time soon. Organisms are constantly evolving, with some becoming more virulent or resistant to antibiotics. "We have to be on our toes and we have to be creative," she said. "It's tough to get to zero, but that's our aim."