Joint Commission's new standard signals greater focus on antibiotic-resistant bacteria

The Joint Commission adopted a new antimicrobial stewardship standard that goes into effect Jan 1. The standard, MM.09.01.01, is the result of an interdisciplinary effort and falls under its Medication Management chapter. However, it touches on the broader challenge of reducing antibiotic-resistant bacteria in health care facilities.

At a White House meeting in 2015, the Joint Commission states that it met with “more than 150 major health care organizations, food companies, retailers and animal health organizations at the forum to express commitment for implementing changes over the next five years to slow the emergence of antibiotic-resistant bacteria, detect resistant strains, preserve the efficacy of existing antibiotics and prevent the spread of resistant infections.”

The Joint Commission’s efforts in infection control are not limited to ensuring that antibiotics are not needlessly prescribed. It also urges organizations to eliminate multidrug-resistant organisms in the physical environment. For instance, the Joint Commission and the American Society for Healthcare Engineering (ASHE) run a co-branded project to address some of the most commonly cited standards in health care facilities. The first standard they addressed, EC.02.05.01, discusses proper utility system management, including the role these systems play in the proliferation of airborne contaminants if not maintained correctly.

Recommendations from ASHE include:

• The HVAC system should be properly sized and installed.
• The system should be capable of handling the cool­ing and heating loads within the building.
• The building should be positively pressurized with respect to the outdoors to prevent the uncontrolled infiltration of moisture and airborne contaminants into the building.
• A preventive maintenance program should be implemented that provides regular inspections of HVAC compo­nents and prompt response to faulty equipment.
• All moisture leaks should be repaired immediately.
• Moisture should not be allowed to accumulate within wall cavities.
• The Environmental Protection Agency recommends that water-damaged items should be discarded or dried within 24 to 48 hours to prevent mold growth.

As antibiotic-resistant infections become harder to fight, it’s important that the health care community address this battle on every front available. The Centers for Disease Control and Prevention has identified three overarching strategies to prevent antibiotic-resistant infections: focusing on preventing infections from catheters and after surgery; preventing bacteria from spreading; and improving overall antibiotic use. Each core strategy contains additional recommendations that health care facility professionals may find helpful.