scholarly journals Impact of a Multidisciplinary Infection Prevention Initiative on Central Line and Urinary Catheter Utilization in a Long-term Acute Care Hospital

2018 ◽  
Vol 5 (7) ◽  
Author(s):  
Suganya Chandramohan ◽  
Bhagyashri Navalkele ◽  
Ammara Mushtaq ◽  
Amar Krishna ◽  
John Kacir ◽  
...  
Keyword(s):  
Acute Care ◽  
Infection Prevention ◽  
Urinary Catheter ◽  
Acute Care Hospital ◽  
Central Line ◽  
Care Hospital ◽  
Intervention Period ◽  
Infection Rates ◽  
Rebound Increase

Abstract Background Prolonged central line (CL) and urinary catheter (UC) use can increase risk of central line–associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI). Methods This interventional study conducted in a 76-bed long-term acute care hospital (LTACH) in Southeast Michigan was divided into 3 periods: pre-intervention (January 2015–June 2015), intervention (July–November 2015), and postintervention (December 2015–March 2017). During the intervention period, a multidisciplinary infection prevention team (MIPT) made weekly recommendations to remove unnecessary CL/UC or switch to alternate urinary/intravenous access. Device utilization ratios (DURs) and infection rates were compared between the study periods. Interrupted time series (ITS) and 0-inflated poisson (ZIP) regression were used to analyze DUR and CLABSI/CAUTI data, respectively. Results UC-DUR was 31% in the pre- and postintervention periods and 21% in the intervention period. CL-DUR decreased from 46% (pre-intervention) to 39% (intervention) to 37% (postintervention). The results of ITS analysis indicated nonsignificant decrease and increase in level/trend in DURs coinciding with our intervention. The CAUTI rate per catheter-days did not decrease during intervention (4.36) compared with pre- (2.49) and postintervention (1.93). The CLABSI rate per catheter-days decreased by 73% during intervention (0.39) compared with pre-intervention (1.45). Rates again quadrupled postintervention (1.58). ZIP analysis indicated a beneficial effect of intervention on infection rates without reaching statistical significance. Conclusions We demonstrated that a workable MIPT initiative focusing on removal of unnecessary CL and UC can be easily implemented in an LTACH requiring minimal time and resources. A rebound increase in UC-DURs to pre-intervention levels after intervention end indicates that continued vigilance is required to maintain performance.

scholarly journals 1186. Decreased Laboratory-Identified Clostridioides difficile Infections with Implementation of an Electronic Hand Hygiene Monitoring System in a Long-Term Acute Care Hospital Decreased Laboratory-Identified Clostridioides difficile Infections with Implementation of an Electronic Hand Hygiene Monitoring System in a Long-Term Acute Care Hospital

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S425-S425
Author(s):  
Maureen Banks ◽  
Andrew Phillips ◽  
Keith Chin ◽  
Lou Ann Bruno-Murtha
Keyword(s):  
Data Collection ◽  
Hand Hygiene ◽  
Monitoring System ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Intervention Period ◽  
Environmental Cleaning ◽  
Clostridioides Difficile

Abstract Background Hand hygiene (HH) is the cornerstone of infection prevention and improved compliance has been associated with reduced healthcare-associated infections (HAIs). However, traditional methods for HH data collection have limitations and may not accurately reflect true compliance. We sought to evaluate whether an electronic hand hygiene monitoring system (HHMS) can improve data collection, compliance, and reduce HAIs. Methods A HHMS was implemented as part of a pilot at a single facility in June 2018 for all healthcare workers (HCWs) who entered patient rooms. The system prompted HCWs to perform HH with an audible and visual reminder emitted from a badge if a HH event had not been registered within specific timeframes of entering or exiting a patient room. The system captured compliance with preferential handwashing (soap and water) for at least 15 seconds upon exit of Clostridioides difficile (C. difficile) designated rooms. All HH data were collected by the HHMS. Hand hygiene compliance and HAI data were compared for the pre-intervention (June 2017-May 2018) and intervention periods (July 2018-March 2019). No changes were made to environmental cleaning protocols or compliance monitoring, nor in antibiotic stewardship practices. Results HH compliance by direct observation in the pre-intervention period was 91% (1,612 observations). HH compliance with the HHMS during the intervention period was 97% (2,778,402 observations). The mean monthly HH opportunities recorded during the pre-intervention period was 134, while the HHMS captured 308,711, a greater than 2,300-fold increase. The incidence of healthcare facility-onset C. difficile infections (HO-CDI) pre-intervention was 9.60 per 10,000 patient-days (41 GDH+/Toxin+ laboratory-identified [labID] events/42,726 patient-days). With the HHMS, HO-CDI decreased 70% (P = 0.0003) to 2.89 per 10,000 patient-days (9 labID events/31,169 patient-days). No policy changes in environmental cleaning of high-touch surfaces were made or observed during the pilot. Conclusion The use of an HHMS facilitated more comprehensive HH data and improved compliance. The preliminary findings also support an association between more robust HH compliance data and a significant decrease in toxin-producing CDI. Disclosures All authors: No reported disclosures.

Up for the Challenge: Eliminating Peripherally Inserted Central Catheter Infections in a Complex Patient Population

2014 ◽  
Vol 19 (3) ◽  
pp. 159-164 ◽  
Author(s):  
Holly D. Tavianini ◽  
Vera Deacon ◽  
Judylee Negrete ◽  
Sharon Salapka
Keyword(s):  
Acute Care ◽  
Dwell Time ◽  
Blood Stream Infection ◽  
Improve Patient Safety ◽  
Acute Care Hospital ◽  
Blood Stream ◽  
Central Line ◽  
Care Hospital ◽  
Evaluation Phase

Abstract Background: In response to Medicare reimbursement changes related to central line-associated blood stream infection (CLABSI) effective January 2011, a long-term acute care hospital implemented quality improvement measures to reduce these health care-associated infections. Improvements included alcohol-impregnated port protectors, chlorhexidine gluconate barrier dressings, and didactic/hands on training for care and maintenance. During 2010 the peripherally inserted central line (PICC) team at a neighboring Magnet hospital was asked to partner and develop strategies to further decrease CLABSI. Methods: The PICC team evaluated the effects of an antimicrobial PICC device in an effort to further reduce the incidence of CLABSI. Upon initiation of the evaluation phase, a database was created to track infection/thrombus rate, insertion-related complications, dwell time, diagnosis, tip location, infusate, vein used, and catheter size. Data collection and reporting was managed by the PICC team. Results: Across a 2-year period (July 2011–July 2013), 100 devices were inserted with a total of 1,705 line days without any reported CLABSI. The majority of patients received a 4.5F single lumen device (59%). Dwell time ranged from 1 to 57 days with an average of 17 days. To date, no CLABSIs related to this device have been reported at the long-term acute care hospital. Conclusions: Based on 100 insertions yielding no infections this new product appears to improve patient safety and quality of care. Relative to these results sole use of this product has become their institutional standard for long-term intravenous needs.

scholarly journals Intestinal microbiome disruption in patients in a long-term acute care hospital: A case for development of microbiome disruption indices to improve infection prevention

2016 ◽  
Vol 44 (7) ◽  
pp. 830-836 ◽  
Author(s):  
Alison Laufer Halpin ◽  
Tom J.B. de Man ◽  
Colleen S. Kraft ◽  
K. Allison Perry ◽  
Austin W. Chan ◽  
...  
Keyword(s):  
Acute Care ◽  
Infection Prevention ◽  
Acute Care Hospital ◽  
Intestinal Microbiome ◽  
Care Hospital

Prevention of Bloodstream Infections by Use of Daily Chlorhexidine Baths for Patients at a Long-Term Acute Care Hospital

2009 ◽  
Vol 30 (11) ◽  
pp. 1031-1035 ◽  
Author(s):  
L. Silvia Munoz-Price ◽  
Bala Hota ◽  
Alexander Stemer ◽  
Robert A. Weinstein
Keyword(s):  
Experimental Study ◽  
Acute Care ◽  
Acute Care Hospital ◽  
Bloodstream Infections ◽  
Ventilator Associated Pneumonia ◽  
Care Hospital ◽  
Intervention Period ◽  
Chicago Area ◽  
Quasi Experimental

Objective.To evaluate the effect of bathing patients with 2% chlorhexidine on the rates of central vascular catheter (CVC)–associated bloodstream infection (BSI) at a long-term acute care hospital (LTACH).Design.Quasi-experimental study.Setting.A 70-bed LTACH in the greater Chicago area.Patients.All consecutive patients admitted to the LTACH during the period from February 2006 to February 2008.Methods.For patients at the LTACH, daily 2% chlorhexidine baths were instituted during the period from September 2006 until May 2007 (ie, the intervention period). A preintervention period (in which patients were given daily soap-and-water baths) and a postintervention period (in which patients were given daily nonmedicated baths and weekly 2% chlorhexidine baths) were also observed. The rates of CVC-associated BSI and ventilator-associated pneumonia were analyzed for the intervention period and for the pre- and postintervention periods.Results.The rates of CVC-associated BSI were 9.5, 3.8, and 6.4 cases per 1,000 CVC-days during the preintervention, intervention, and postintervention periods, respectively. By the end of the intervention period, there was a net reduction of 99% in the CVC-associated BSI rate. No changes were seen in the rates of ventilator-associated pneumonia during the preintervention and intervention periods.Conclusion.Daily chlorhexidine baths appeared to be an effective intervention to reduce rates of CVC-associated BSI in an LTACH.

Education and Consistent Infection Prevention Practices Prevail: An Outbreak of CRE in a Long Term Acute Care Hospital

2019 ◽  
Vol 47 (6) ◽  
pp. S10
Author(s):  
Alicia Pucci ◽  
Chelsea Foo ◽  
Kelsey OYong ◽  
Merle Baron ◽  
Amber Griffin ◽  
...  
Keyword(s):  
Acute Care ◽  
Infection Prevention ◽  
Acute Care Hospital ◽  
Care Hospital

Healthcare-acquired infection rates in a long-term acute care hospital: A 3-year study

2005 ◽  
Vol 33 (5) ◽  
pp. e182
Author(s):  
C. Stamilio ◽  
J. Shuey ◽  
M. Waters ◽  
P. Hnatuck ◽  
L. Tkatch
Keyword(s):  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Infection Rates

scholarly journals Investigation of a Group A Streptococcal Outbreak Among Residents of a Long-term Acute Care Hospital

2011 ◽  
Vol 52 (8) ◽  
pp. 988-994 ◽  
Author(s):  
M. Deutscher ◽  
S. Schillie ◽  
C. Gould ◽  
J. Baumbach ◽  
M. Mueller ◽  
...  
Keyword(s):  
Acute Care ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Group A
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