Improving implementation of infection control guidelines to reduce nosocomial infection rates: pioneering the report card

被引:16
|
作者
Yinnon, A. M. [1 ,2 ]
Wiener-Well, Y. [2 ]
Jerassy, Z. [2 ]
Dor, M. [3 ]
Freund, R. [3 ]
Mazouz, B. [2 ]
Lupyan, T. [4 ]
Shapira, S. [5 ]
Attias, D. [6 ]
Assous, M. V. [6 ]
Kopuit, P. [2 ]
Block, C. [4 ]
Raveh, D. [2 ]
Freier-Dror, Y. [7 ]
Moses, A. E. [4 ]
Benenson, S. [4 ]
机构
[1] Hebrew Univ Jerusalem, Div Internal Med, Shaare Zedek Med Ctr, Hadassah Med Sch, IL-91031 Jerusalem, Israel
[2] Hebrew Univ Jerusalem, Infect Dis Unit, Shaare Zedek Med Ctr, Hadassah Med Sch, IL-91031 Jerusalem, Israel
[3] Israeli Minist Hlth, Jerusalem, Israel
[4] Hebrew Univ Jerusalem, Hadassah Med Sch, Dept Clin Microbiol & Infect Dis, IL-91031 Jerusalem, Israel
[5] Hebrew Univ Jerusalem, Dept Surg, Hadassah Mt Scopus Med Ctr, IL-91031 Jerusalem, Israel
[6] Hebrew Univ Jerusalem, Clin Microbiol Lab, Shaare Zedek Med Ctr, Hadassah Med Sch, IL-91031 Jerusalem, Israel
[7] Mashav Appl Res, Jerusalem, Israel
关键词
Checklist; Infection control; Nosocomial infections; SURGICAL-SITE INFECTION; ANTIBIOTIC USE; ADVISORY-COMMITTEE; RECOMMENDATIONS; MORTALITY; SURVEILLANCE; PREVENTION; HOSPITALIZATION; CHECKLISTS; PERSONNEL;
D O I
10.1016/j.jhin.2012.04.011
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: Two detailed checklists were developed, based on published infection control guidelines, for daily use by infection control practitioners in departments and operating rooms. Aim: To assess the impact of the checklists on nosocomial infection rates in three hospitals over the course of one year. Methods: The checklists included 20 subheadings (+150 items). Project nurses conducted rounds in the study (but not control) departments; during each round, the nurses selected 15-20 items for observation, marked the checklists according to appropriateness of observed behaviour and provided on-the-spot corrective education. Rates of adherence to the checklist, antibiotic use, number of obtained and positive cultures, and positive staff hand and patient environment cultures were reported monthly as a report card to relevant personnel and administrators. The rate of nosocomial infections was determined in the first and last months. Results: The baseline nosocomial infection rate was similar in the study and control departments: 37/345 (11%) and 26/270 (10%) respectively. In the last month, the rate in the study department decreased to 16/383 (4%) (P < 0.01); in the control it decreased insignificantly to 21/248 (8%) (not significant). No significant trends were detected in the number of obtained cultures, positive cultures, or antibiotic use. Adherence to guidelines ranged from 75% to 94% between the hospitals (P < 0.001): the overall rate increased from 80% to 91% (P < 0.01). Conclusions: The use of checklists during the conduct of infection control rounds, combined with monthly reports, was associated with a significant decrease in nosocomial infections in study departments. (C) 2012 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:169 / 176
页数:8
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