Going Back to Infection Prevention Basics
Miami Dade Corrections Infectious Disease Team
Miami-Dade County Safety
Imagine 2,000-plus new “patient” arrivals every week and an average daily in-house population of more than 6,000 culturally and socio-economically diverse patients living together unwillingly.
Then imagine that any number of these patients could have been in a foreign country within a few days of arrival.
Now determine how you will track down the origins of disease outbreaks and prevent new ones, particularly among employees who work in your facility every day.
That’s the challenge that Robert Marton and the Miami Dade Corrections Department face every day. Over the last 3.5 years, without additional budget, Marton’s Infectious Disease Group has reduced infections among corrections personnel from 40-50 per year to nearly zero, and saved approximately $90,000 in documented workers compensation claims in the process.
How did they do it?
In 2007, Marton asked permission to dig deeper into the root causes of the two-to-four workers compensation claims filed each month. Then, lacking specific infection control training, he joined APIC, taught himself the basics, and became an occupational safety and health manager turned germ-detective. He set a goal to reduce or eliminate unnecessary exposure for Miami Dade corrections personnel within one year.
Working cross-functionally, Robert and his team went back to the basics. “By starting with root cause analysis and investigation, necessary corrective action became much clearer,” said Marton.
A case in point: More than 15% of employee infections originally came from the laundry department. Reviewing infection prevention literature, Marton and his team learned that MRSA could be spread by air as well as through direct contact.
The Infectious Disease Group implemented a policy requiring all laundry workers, including supervisory staff, to use N95 masks and gloves, and the MRSA infection rate dropped to nearly zero.
Because of their documented successes, Marton and his team are now working with the CDC/NIOSH to create appropriate correctional facility infection control literature and training videos.
They also have partnered with a local university’s DNA forensic lab to identify origins of infection, giving students access to real-world scenarios and some “exotic” microorganisms. In return, Marton’s team gets research and analytic support from the university at no charge.
“We strive to improve infection control without having to spend a lot of additional funds. Once you understand the issues, you can break them down and prevent infections fairly cost-effectively,” says Marton.
His team is currently focused on reducing cross-contamination by color-coding cleaning equipment, and instituting more aggressive, proactive disinfection.