UAB Synopsis, Vol. 24, No. 32, September 5, 2005
New and continuing residents need to keep infection control issues in mind. Use Standard Precautions — avoidance and personal protective equipment, such as gloves — to prevent contact between your skin and mucous membranes and the blood, body fluids, tissues, mucous membranes, and non-intact skin of all patients.
Report any exposure to blood, body fluids, mucous membranes, and non-intact skin at UAB immediately to Employee Health (934-3675, Jefferson Tower, first floor, Monday-Friday, 8 am to 4 pm) or to the Rapid Response Team (934-3411, all other times). It provides risk assessment, counseling, baseline serologic testing, and immunization/chemoprophylaxis as necessary.
Make sure you are immune to hepatitis B. If your antibody titer was not checked 1 to 2 months after the third dose of vaccine, have it checked now in Employee Health.
Have a high index of suspicion for tuberculosis when you encounter a patient with cough of more than 2 weeks duration, hemoptysis, fever, night sweats, anorexia, or weight loss. Most patients with tuberculosis are undiagnosed on admission. The chest radiograph may show apical infiltrates, cavitary pneumonia, or nodular opacities. Admit potential cases directly to Airborne Isolation rooms.
Always put on an N95 respirator (mask) before entering AFB Isolation. Residents must get a tuberculin skin test yearly at Employee Health.
The burden of nosocomial infectious disease due to multidrug-resistant bacteria is increasing; common problems include methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus faecium (VRE). To prevent the spread of these pathogens, as well as gram-negative bacilli and Clostridium difficile, from patient to patient, wash your hands or disinfect them with alcohol between each and every patient contact — this is critical in the ICUs.
Patients with colonization or disease due to MRSA, VRE, or another antibiotic-resistant bacteria are cared for using Contact Precautions — put on gloves and a gown when you enter these rooms; take them off and wash your hands when you exit. Preventing hospital-acquired infections gets your patients home faster with less complicated stays.
Address any infection control questions to Alan Stamm, MD, chairman of the UAB Health System Infection Control Committee (934-9638 or astamm@uab.edu) or one of the infection control practitioners (934-5324).