Infection Control Link Nurse Program: An interdisciplinary approach in targeting health care-acquired infection

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• 作者：Madhuri M. Sopirala ; MD ; MPH^a ; ^b ; ^{madhuri.sopirala@uchealth.com" class="auth_mail} ; Lisa Yahle-Dunbar ; RN ; CIC^b ; Justin Smyer ; MLS(ASCP)CM ; MPH^b ; Linda Wellington ; RN ; CIC^b ; Jeanne Dickman ; MT ; CIC^b ; Nancy Zikri ; PhD ; MPH^b ; Jennifer Martin ; RN ; MPH^b ; Pat Kulich ; RN ; CIC^b ; David Taylor ; PhD^b ; Hagop Mekhjian ; MD^c ; Mary Nash ; PhD^d ; Jerry Mansfield ; PhD^d ; Preeti Pancholi ; PhD^e ; Mary Howard ; RN^d ; Linda Chase ; PhD^d ; Susan Brown ; RN^d ; Kristopher Kipp ; RN^d ; Kristen Lefeld ; MHA^b ; Amber Myers ; MPH^b ; Xueliang Pan ; PhD^f ; Julie E. Mangino ; MD^a ; ^b
• 关键词：MRSA ; Multi-disciplinary ; Infection prevention ; Liaison ; Patient safety ; Nosocomial ; Hand hygiene ; Handwashing
• 刊名：American Journal of Infection Control
• 出版年：April, 2014
• 年：2014
• 卷：42
• 期：4
• 页码：353-359
• 全文大小：924 K

文摘

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Background

We describe a successful interdisciplinary liaison program that effectively reduced health care-acquired (HCA), methicillin-resistant Staphylococcus aureus (MRSA) in a university hospital setting.

Methods

Baseline was from January 2006 to March 2008, and intervention period was April 2008 to September 2009. Staff nurses were trained to be liaisons (link nurses) to infection prevention (IP) personnel with clearly defined goals assigned and with ongoing monthly education. HCA-MRSA incidence per 1,000 patient-days (PD) was compared between baseline and intervention period along with total and non-HCA-MRSA, HCA and non-HCA-MRSA bacteremia, and hand soap/sanitizer usage. Hand hygiene compliance was assessed.

Results

A reduction in MRSA rates was as follows in intervention period compared with baseline: HCA-MRSA decreased by 28% from 0.92 to 0.67 cases per 1,000 PD (incidence rate ratio, 0.72; 95% confidence interval: 0.62-0.83, P < .001), and HCA-MRSA bacteremia rate was reduced by 41% from 0.18 to 0.10 per 1,000 PD (incidence rate ratio, 0.59; 95% confidence interval: 0.42-0.84, P聽=聽.003). Total MRSA rate and MRSA bacteremia rate also showed significant reduction with nonsignificant reductions in overall non-HCA-MRSA and non-HCA-MRSA bacteremia. Hand soap/sanitizer usage and compliance with hand hygiene also increased significantly during IP.

Conclusion

Link nurse program effectively reduced HCA-MRSA. Goal-defined metrics with ongoing re-education for the nurses by IP personnel helped drive these results.