In recent times, significant physical, social, psychological and economic burdens are causing infections to increase awareness of the government and the public about the importance of their prevention. This increased attention reflects the current tendency for every hospital employee to be held responsible for their own duties in controlling infection and is also a reflection of the desire for health-related infections to be considered as a possible medical mistake that could be avoided.

Croatia has in the process of aligning its legislation with the European brought into force the Ordinance on Conditions and Methods for Measures to Prevent and Combat Hospital Infections (NN 85/12), and in March 2013, the National Program for the Control of Infections Related to Health Care. These are major steps for national health care, but much remains to be done to make this area a serious threat to public health.

Pharmamed has recognized this global burden and, in line with its mission, wants to have a positive impact by implementing products in its portfolio that reduce the possibility of hospital acquired infections (HAI). We would like to highlight some of the hospital-acquired infections and which products from our portfolio can influence on their prevention.

VAP - ventilator acquired pneumonia

There is many clinical evidence of how important prevention is, and we can also point to a large number of sources. We will outline a table that systematically demonstrates ways of preventing VAP in patients who need to be intubated and which can serve as a guideline for VAP prevention.

One of the steps before intubation is to check the possibility for using non-invasive mechanical ventilation. Pharmamed has a whole product line dedicated to non-invasive ventilation in your portfolio, so it would be best to refer you to our product catalog where you can choose this specific group of products.

After the intubation itself several instructions are mentioned such as: the use of humidifiers, closed suction, use of a chlorhexidine oral rinse solution.

One of our largest suppliers  has a large number of products that can affect VAP prevention. Long-term cooperation is ensured by product quality and continuous development, which Pharmamed as a company primarily requires when selecting suppliers. To get a better picture of products that can be used in VAP prevention, please refer to our web catalogue. We suggest that you choose Intersurgical as a supplier and review the product list.

Izvor: Ventilator-Associated Pneumonia: Diagnosis, Treatment, and Prevention,Steven M. Koenig and Jonathon D. TruwitClin Microbiol Rev. 2006 Oct; 19(4): 637–657., doi: 10.1128/CMR.00051-05

Central venous catheter related infections

These infections are still one of the leading causes of nosocomial infections, especially in intensive care units. Pharmamed also has a significant number of quality products in this area that can affect prevention.

One of the major prevention steps is good preparation and disinfection of the skin before setting up a catheter. A great novelty in our portfolio is an applicator with povidone iodine that was developed according to our requirements listening to the needs of healthcare professionals. An essential fact when introducing the umbilical catheter is that iodine tincture can not be used, but povidone iodine can be used which makes this applicator applicable to the smallest patients.

In the area of skin disinfection we offer disinfectant wipes containing alcohol and 0.5% chlorhexidine. These wipes are extremely popular with our users for their size and practical packaging.The CDC guidelines require the use of single chamber invasive pressure gauges and the use of a sealed wash system. Pharmamed and in this segment offers a wide choice for different needs.When using a catheter with needleless connector it is recommended to use one with a split septum and it is also recommended avoiding the use of catheter with needleless connector having a mechanical valve. In order to comply with such guidelines, our CVC supplier has replaced the needleless connector on its catheters, and they now contain a needleless connector without a mechanical valve.

Surgical site infections

Infections of the surgical site due to the frequency of hospital infections take the third place after urinary infections and pneumonia. It is estimated that about 2-5% of patients develop a surgical site infection after a non abdominal surgery and 20% of patients after abdominal surgery.

One of the guidelines before surgery, during surgery and after surgery includes maintaining the patient's normothermia through a  device that blows hot air into the surface under the patient, called a blanket. Pharmamed has recognized the importance of this kind of infection prevention and dedicated a part of its portfolio to normothermia and other devices for warming and cooling of the patient.

A great novelty in this part of the portfolio are the pediatric blankets used below the patient. For more information, be sure to review the patient's heating / cooling product group in our web catalogue.

In order to reduce the risk of infection during the disinfection of the surgical site, Pharmamed offers the already above mentioned applicator, which eliminates the possibility of infection because there is no contact between the healthcare worker and the patient, but the skin is exclusively in contact with the sterile applicator.

Blood-bourne infections – needle stick injuries

According to the Ordinance on the manner of implementing protection measures to prevent the occurrence of injuries to sharp objects (NN 84/13 and 17/17), each employer is obliged to abolish the unnecessary use of harsh objects. Accordingly it is recommended to use needleless connector instead of needles. Pharmamed has recognized the ways to protect healthcare professionals against infections and it is one of our objectives to continue to raise awareness about the importance of using needlelss connectors versus needles. Our offer of needleless connectors includes different flow rates to better tailor the patient's needs.

Sources

  1. F. Vrijens, F. Hulstaert, S. Van de Sande, S. Devriese, I. Morales, Y. Parmentier, Hospital-acquired, laboratory-confirmed bloodstream infections: linking national surveillance data to clinical and financial hospital data to estimate increased length of stay and healthcare costs, Journal of Hospital Infection, Volume 75, Issue 3, 2010, Pages 158-162, ISSN 0195-6701, http://dx.doi.org/10.1016/j.jhin.2009.12.006.

  2. Yokoe DS, Anderson DJ, Berenholtz SM, et al. A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2014 Updates. Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America. 2014;35(8):967-977. doi:10.1086/677216.

  3. Eggimann, Philippe & Pittet, Didier. (2002). Infection control in ICU. Chest. 120. 2059-93. 10.1378/chest.120.6.2059.

  4. Vandijck DM, Racco M, Horn K. Central catheter-related infections. Crit Care Nurse. 2007 Aug;27(4):14; author reply 14. PubMed PMID: 17671241.

  5. Jarvis WR. The Lowbury Lecture. The United States Approach to Strategies in the Battle Against Healthcare-Associated Infections, 2006: Transitioning from Benchmarking to Zero Tolerance and Clinician Accountability. Journal of Hospital Infection. 2007;65(Suppl 2):3–9

  6. Yokoe DS, Mermel LA, Anderson DJ, Arias KM, Burstin H, Calfee DP, Coffin SE,Dubberke ER, Fraser V, Gerding DN, Griffin FA, Gross P, Kaye KS, Klompas M, Lo E, Marschall J, Nicolle L, Pegues DA, Perl TM, Podgorny K, Saint S, Salgado CD, Weinstein RA, Wise R, Classen D. A compendium of strategies to prevent healthcare-associated infections in acute care hospitals. Infect Control Hosp Epidemiol. 2008 Oct;29 Suppl 1:S12-21. doi: 10.1086/591060. PubMed PMID:18840084.

  7. Prim.dr.sc. Vesna Tripković, Infekcije kirurškog mjesta; https://www.yumpu.com/xx/document/view/38073524/tripkovic-infekcije-kirurskog-mjestapdf

  8. Berríos-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, Reinke CE, Morgan S, Solomkin JS, Mazuski JE, Dellinger EP, Itani KMF, Berbari EF, Segreti J, Parvizi J, Blanchard J, Allen G, Kluytmans JAJW, Donlan R, Schecter WP, for the Healthcare Infection Control Practices Advisory Committee. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg.2017;152(8):784–791. doi:10.1001/jamasurg.2017.0904

  9. Guidelines for the Prevention of Intravascular Catheter-Related Infections (2011); https://www.cdc.gov/infectioncontrol/guidelines/bsi/index.html

  10. Ventilator-Associated Pneumonia: Diagnosis, Treatment, and Prevention,Steven M. Koenig and Jonathon D. TruwitClin Microbiol Rev. 2006 Oct; 19(4): 637–657., doi:  10.1128/CMR.00051-05

  11. dr. sc. Mirjana Huić, dr. med., Carmen H. Kostrenčić, mag. pharm., Služba za razvoj, istraživanje i zdravstvene tehnologije, Agencija za kvalitetu i akreditaciju u zdravstvu i socijalnoj skrbi; Utjecaj upotrebe kirurških konaca obloženih triklosanom na infekciju kirurškog mjesta (engl. Impact of triclosancoated sutures on surgical site infection): Procjena zdravstvene tehnologije (engl. HTA), Broj 09/2014.

  12. Pravilnik o načinu provođenja mjera zaštite radi sprječavanja nastanka ozljeda oštrim predmetima (NN 84/13 i 17/17)

  13. Pravilnik o uvjetima i načinu obavljanja mjera za sprečavanje i suzbijanje bolničkih infekcija (NN 85/12)

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