Welcome to the   UCLA Infection Prevention Website

Clinical Epidemiology and Infection Prevention

Hand Hygiene Peer to Peer Phrase Contest:

Over 600 entries for the peer to peer reminder about hand hygiene contest were submitted!  The contest closed October 14th at midnight and due to the overwhelming number of submissions, the judges need extra time to review the entries and narrow it down for voting.

Finalists will be announced in January 2015 and voting will begin.

Thank you to everyone who submitted and are committed to proper hand hygiene!

 

The UCLA Clinical Epidemiology and Infection Prevention department’s (CEIP) primary responsibility is to prevent healthcare associated infections (HAIs).  CEIP performs risk-based, targeted surveillance for HAI using CDC definitions. Data generated by CEIP is used by the UCLA Health to drive quality improvement.  CEIP promotes a culture of safety by assisting direct care providers with translating evidence into practice.

CEIP serves patients, staff and visitors across the UCLA Health, which includes: Ronald Reagan UCLA Medical Center, Resnick Neuropsychiatric Hospital, UCLA Medical Center, Santa Monica and licensed outpatient clinics. 

CEIP can be reached via email at:  ceip@mednet.ucla.edu

Contact Precautions changes happened system-wide on July 1!

Contact Precautions (gloves/gowns) will no longer be required for MRSA and VRE infected or colonized patients as of July 1, 2014.  For more information on why the hospital chose to change policy, please read this letter. On July 1, 2014 visitors are no longer required to follow contact or contact/Spore Precautions. 
Major HS IC 002 Policy Changes:

 

Healthcare Worker

Visitor

Contact Precautions for MRSA/VRE

 

 

 

 

Contact Precautions for other pathogens such as resistant Gram negative bacteria, certain URI pathogens x (on room entry)  
Contact/spore Precautions for C.difficile x (on room entry)  
Droplet and Airborne Precautions x (on room entry) x (on room entry)
Practice Standard Precautions x x
Wash hands with alcohol rub or soap/water x x

 

 

 

Education on the Changes to Contact Precautions:

Nursing Huddle message - Download the pdf here

Health Care Workers Frequently Asked Questions - Download the printable posters here

Frequently Asked Questions about the Changes to Contact Precautions: 

Why are we making this change?
• Studies have not shown added benefit of gloves/gowns over hand washing for preventing transmission of MRSA and VRE.
• There can be consequences to Contact Precautions, including poorer quality of care and healthcare workers spending less time with patients. Contact Precautions should only be used when necessary.
• Studies have shown the benefit of additional efforts, including daily chlorhexidine gluconate (CHG) bathing, in reducing healthcare-associated infections.

How can I can keep my patients, visitors and myself safe?
• Wash your hands 100% of the time, including on room entry and after leaving the room.
• Wash hands with alcohol hand rub (rub until dry) or the provided soap and water frequently (wash for 15 seconds).
• Alcohol hand rub should be used preferentially except for C. difficile or when your hands are visibly soiled.

What if my patient has a draining wound, diarrhea or URI symptoms?
Practicing Standard Precautions is very important and will not change with the HS IC 002 policy change. Standard Precautions assumes that all blood and body fluids may be infectious.
Assess the patient’s symptoms and decide what type of personal protective equipment you need (gloves,
gowns, mask, eye protection).

Will other bacteria/viruses require Contact Precautions for healthcare workers?
Many bacteria/viruses will require Contact Precautions such as resistant Gram negatives and Parainfluenza. Please refer to the HS IC 002 policy for more information.

When should healthcare workers put on PPE for Contact, Contact/spore, Droplet and Airborne precautions?
The new recommendation is to put on PPE (gloves, gown or masks) upon room entry.

Why do visitors no longer need to follow Contact and Contact/spore Precautions?
Unlike healthcare workers, visitors are less likely to spread organisms/infection from patient to patient.

When should visitors wear gloves or gown?
If they are performing direct patient care, such as helping change a wound, diaper, etc.

Do I still need to screen certain high-risk patients for MRSA?
Yes, MRSA screening for high-risk patients is a California law. But, if a patient has a positive MRSA screen, he or she will no longer need Contact Precautions.

How do I clear my patient from MRSA and VRE precautions?
Clearance of MRSA and VRE precautions will no longer be necessary.

What additional measures will prevent infection in our patients?
Patients >2mo old (except post-partum women after vaginal birth, NICU, Resnick patients ) will be offered daily CHG bath treatment. Select rooms are cleaned with UV light (Xenex) upon discharge.

Who do I contact if I have additional questions about the policy change?
Talk to your nurse unit leadership. You can also call Infection Prevention RRUCLA 4-0187 or SMUCLA 9-8537

 

 

 

Reducing catheter associated blood stream infections (CLABSI)

Reducing the risk of CLABSI is a key focus of CEIP.  UCLA’s CLABSI Task Force has tackled CLABSIs head-on by using a multidisciplinary approach to implement the following:

  • CHG bathing for all ICU patients plus acute care patients with central lines
  • Comprehensive resident and fellow central line insertion training for programs including surgery, medicine, anesthesia, emergency medicine, family medicine, pediatrics, obstetrics & gynecology
  • Ethanol lock therapy
  • Support for direct care provider campaigns such as “Scrub the Hub”
  • Continuous evaluation of new products for line insertion, maintenance and access

Reducing catheter associated urinary tract infections (CAUTI)

CAUTI is an up and coming area for CEIP.  CEIP collaborates with nursing units to reduce the risk of CAUTI and improve patient outcomes.  CEIP is currently involved in the “On the CUSP:  Stop CAUTI” UHC Collaborative, which aims to both improve the unit-based culture of safety and reduce CAUTI rates.  Interventions aimed at insertion and removal of indwelling urinary catheters are on the horizon for CEIP.

Reducing Ventilator associated pneumonia (VAP)

CEIP has worked closely with critical care physician and nursing leadership to implement the VAP bundle.  CEIP (including Antibiotic Stewardship) has been an integral part of creating prevention, diagnosis, and treatment guidelines for physicians, and co-authors order sets for VAP prevention.  CEIP collaborates with physician teams and respiratory therapy regarding utilization of sensitive diagnostic tools and new technology.

Prevention of Surgical Site Infections (SSI)

CEIP performs SSI surveillance and is actively involved in sterile processing and disinfection efforts across UCLA Health.  CEIP is implementing CHG bathing for pre-op patients plus a specific S. aureus decolonization protocol using CHG + intranasal mupirocin.

Prevention of Clostridium difficile Infection (CDI)

A number of important strategies are being implemented to decrease the burden of CDI at UCLA.  Antibiotic Stewardship, led by Dan Uslan, MD, has achieved recent success in curbing antibiotic utilization.  Dr. Uslan is also looking at PPI utilization and its impact on healthcare-associated CDI.  CEIP has partnered with Environmental Services to bring UV disinfection to UCLA.  UV-C disinfection is now being used each shift for C.difficile discharges.