aseptic – Eideard

New research shows that well-child doctor appointments for annual exams and vaccinations are associated with an increased risk of flu-like illnesses in children and family members within two weeks of the visit. This risk translates to more than 700,000 potentially avoidable illnesses each year, costing more than $490 million annually…

“Well child visits are critically important. However, our results demonstrate that healthcare professionals should devote more attention to reducing the risk of spreading infections in waiting rooms and clinics. Infection control guidelines currently exist. To increase patient safety in outpatient settings, more attention should be paid to these guidelines by healthcare professionals, patients, and their families,” said Phil Polgreen, MD, MPH, lead author of the study.

Researchers from the University of Iowa used data from the Agency for Healthcare Research and Quality’s (AHRQ) Medical Expenditure Panel Survey to examine the healthcare trends of 84,595 families collected from 1996-2008. Included in the analysis were demographic, office-based, emergency room, and outpatient cases records.

After controlling for factors, such as the presence of other children, insurance, and demographics, the authors found that well-child visits for children younger than six years old increased the probability of a flu-like illness in these children or their families during the subsequent two weeks by 3.2 percentage points.

This incremental risk could amount to more than 700,000 avoidable cases of flu-like illness each year and $492 million in direct and indirect costs, based on established estimates for outpatient influenza.

In a commentary accompanying the study, Lisa Saiman, MD, notes, “The true cost of flu-like illnesses are much higher since only a fraction result in ambulatory visits and many more cases are likely to result in missed work or school days. Furthermore, these flu-like illness visits are associated with inappropriate antimicrobial use.”

The authors stress the importance of infection prevention and control in ambulatory settings, suggesting pediatric clinics follow recommended guidelines that include improving environmental cleaning, cough etiquette, and hand hygiene compliance.

“Even with interventions, such as the restricted use of communal toys or separate sick and well-child waiting areas, if hand-hygiene compliance is poor, and potentially infectious patients are not wearing masks, preventable infections will continue to occur,” said Polgreen.

And every one of the kind of locations cited is managed by folks who know better. Think about that. Reflect on how a simple reordering of priorities may save a great deal of sick time, expense or worry for parents.

A new study of hand hygiene in hospitals found that wearing latex gloves makes health care workers less likely to clean their hands before and after treating patients. The finding is concerning, researchers say, because germs can travel through latex gloves, and because they’re often worn when doctors work with bodily fluids and the sickest, most infectious patients. Taking off latex gloves can also cause a “back spray” effect, in which fluids and germs are snapped back onto the wearer’s hands.

As a result, doctors and nurses who don’t wash up after using latex gloves can spread infections through contaminated hands, said Dr. Sheldon Stone, lead author of the study…

“If you’re a patient, you assume that if someone is wearing gloves they’re being careful and protecting you from infection,” he said. “But in fact, their hands could be very dirty…”

The researchers found that the overall hand-washing rate — regardless of whether gloves were worn — was just 47.7 percent, similar to compliance rates for hand hygiene in American hospitals, which average about 40 percent. But when gloves were used, the latest study found, hand washing in the 15 hospitals that were part of the research went down even further, to about 41 percent…

The study found that health care workers wore gloves in roughly a quarter of all contacts with patients, and in 60 percent of those cases did not clean their hands either before or after treating the patient…

It was unclear why doctors, nurses and other hospital workers were less likely to wash or disinfect their hands before and after donning gloves. But Dr. Stone and his colleagues speculated that they might be influenced by a widespread misconception that gloves are impermeable to pathogens. While gloves do lower the rate of hand contamination, germs can still get through. Dr. Stone said he and his colleagues wanted to dispel the myth and get across to hospital workers the idea of “The Dirty Hand in the Latex Glove.”

“We want health care workers to avoid it,” he said. “It’s gross. And it’s not just a British phenomenon. I’m sure if you went all over you would find it.”

Eeoough!