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The Healthcare-associated training calendar: An innovative approach to infection control education
June 2005
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2003 was 400 PDD. Systematic typing of PRMOs would provide more detailed insight in the amount of spread of PRMOs and the effectiveness of this guideline. Abstract ID 51035 Tuesday, June 21
Measuring device days versus patient days for patients with urinary catheters A Kim1 C Kirchner1 D Fisman2 A Dhond 2 E Abrutyn2 1 2
Tenet Healthcare, Dallas, Texas Drexel University College of Medicine, Philadelphia, Pennsylvania
BACKGROUND: Device-related infection rates are useful measures and have been calculated using number of discharges (admissions) as denominator. Today, the preferred measure calculates rates with a denominator based on device days. This measure is thought to provide a more accurate portrayal of the burden of infection but the data require considerable effort to collect. The objective is to determine whether patient ‘‘hospital days’’ can serve as a surrogate for ‘‘device days.’’ We undertook a study to compare urinary catheter–related infection rates using each of these measures. METHODS: This large, nationwide healthcare system introduced systematic, computer-based data collection several years ago. Data over a 2.5-year period were reviewed to determine infection rates as a percentage of the population, and infection rates per 1000 urinary catheter days. Rates for hospitals of similar size and location were compared. RESULTS: The study included observations on 99,834 patients during 2002–2004. The infection rates per 1000 days over the entire period were 4.72 per 1000 patient days and 6.48 per 1000 device days. The correlation of infection rates per month using device days compared to patient days was 0.978 (p , 0.001) using Pearson’s and 0.987 (p , 0.001) using Spearman’s. This shows that the values are not independent. CONCLUSIONS: Rates calculated on the basis of patient discharges correlated highly with rates calculated using device days. The high correlation between these rates suggests that for some purposes rates based on discharges can serve as a surrogate for rates based on device days. Such a change would reduce the data-gathering burden on infection control practitioners. Abstract ID 51222 Monday, June 20
The Healthcare-associated training calendar: An innovative approach to infection control education J Lockhart Conway Human Development Center, Conway, Arkansas ISSUE: Teaching the principles of infection control to a large number of individuals from various educational backgrounds at a chronic care facility can be difficult. We developed an educational tool to assist the infection control director in this endeavor. PROJECT: A calendar featuring a monthly infection control topic is used to teach employees. A large calendar is displayed in the employee meeting room, where it was clearly visible to staff. Each calendar month features a
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osocomial disease/condition historically likely to be present in the facility during that timeframe. Identification numbers from the infection control manual matching the monthly topics are listed as a reference for employees. Lectures and demonstrations are also posted on the calendar, including the times and locations of presentations. Additional educational information, such as leaflets and audiovisual aids, are made available when appropriate. For example: October is pediculosis/head lice/scabies month. Many aspects of the monthly topic are presented, including residential cleaning practices, recognition of symptoms, handling of outerwear, prevention practices, and treatment. Other monthly topics include: influenza, methicillin-resistant Staphylococcus aureus (MRSA), aspiration pneumonia, and hand hygiene. RESULTS: Employee awareness of the infection control topics has improved, as evidenced by an increase in the volume of clients being brought to the infirmary for diagnosis and treatment of the ‘‘disease of the month.’’ In-service educational conferences are well attended; review of institutional policies and procedures have resulted in appropriate modification to those items. LESSONS LEARNED: The healthcare-associated training calendar is an efficient tool for educating employees at our chronic care facility. Raising awareness of employees to various diseases and infection control procedures should lead to better care of residents.
Abstract ID 51268 Tuesday, June 21
Unique challenges presented for remote/rural infection prevention program in a health service restructure MR Godsell South West Area Health Service, Bunbury, Australia BACKGROUND/PURPOSE: This health system was developed from the integration of five health services including 17 healthcare facilities with a combined 364 hospital beds (range 6–113). The unique challenges for this infection prevention program include the geographical size (23000 km2), population (135,450), number of locations, diversity of services, the short length of stay, innovative sustainability, and the standardization of data collection for healthcare-associated infection with an accurate baseline data for performance measure. The infection prevention program will support healthcare facilities, make an impact on high risk/target areas, raise awareness in the community, support clinical practice improvements, and develop effective surveillance systems. Program principles are to manage risk effectively, establish safe systems, and protect patients, healthcare workers, and visitors. An evidence-based approach will be used where possible. The program will be cost effective and customer focused. The program is strongly supported by the executive management. METHODS: An initial orientation and gap analysis questionnaire was completed by visiting all sites. This data, together with national and international program recommendations, was documented. An infection prevention program with risks identified (including action plan) was endorsed by the executive management group. RESULTS: Utilizing organizational systems, implementation began with communication networks established through e-mails to ‘‘infection prevention teams at all sites. An expert infection prevention panel is in progress. Policy standardization (with hyperlinks to Web pages) has been essential in hand hygiene, waste management, endoscopy, cleaning services, and staff immunization. As a resource, infection control manuals are at all sites, and directive outbreak management pack templates are available. The education plan focuses on a safe practice orientation package, self-directed learning packs, e-learning, and other learning opportunities. Standardization of surveillance systems, including multidrug-resistant organisms, is in process. Sentinel events, complaints data, and an incident monitoring and hazard alert are used to identify risk. CONCLUSION: Effective communication and education systems, with community ownership, strong leadership support, clear structural policies and procedures, and a focus on risk identification and quality management are key components of an ongoing successful program.
E69
2003 was 400 PDD. Systematic typing of PRMOs would provide more detailed insight in the amount of spread of PRMOs and the effectiveness of this guideline. Abstract ID 51035 Tuesday, June 21
Measuring device days versus patient days for patients with urinary catheters A Kim1 C Kirchner1 D Fisman2 A Dhond 2 E Abrutyn2 1 2
Tenet Healthcare, Dallas, Texas Drexel University College of Medicine, Philadelphia, Pennsylvania
BACKGROUND: Device-related infection rates are useful measures and have been calculated using number of discharges (admissions) as denominator. Today, the preferred measure calculates rates with a denominator based on device days. This measure is thought to provide a more accurate portrayal of the burden of infection but the data require considerable effort to collect. The objective is to determine whether patient ‘‘hospital days’’ can serve as a surrogate for ‘‘device days.’’ We undertook a study to compare urinary catheter–related infection rates using each of these measures. METHODS: This large, nationwide healthcare system introduced systematic, computer-based data collection several years ago. Data over a 2.5-year period were reviewed to determine infection rates as a percentage of the population, and infection rates per 1000 urinary catheter days. Rates for hospitals of similar size and location were compared. RESULTS: The study included observations on 99,834 patients during 2002–2004. The infection rates per 1000 days over the entire period were 4.72 per 1000 patient days and 6.48 per 1000 device days. The correlation of infection rates per month using device days compared to patient days was 0.978 (p , 0.001) using Pearson’s and 0.987 (p , 0.001) using Spearman’s. This shows that the values are not independent. CONCLUSIONS: Rates calculated on the basis of patient discharges correlated highly with rates calculated using device days. The high correlation between these rates suggests that for some purposes rates based on discharges can serve as a surrogate for rates based on device days. Such a change would reduce the data-gathering burden on infection control practitioners. Abstract ID 51222 Monday, June 20
The Healthcare-associated training calendar: An innovative approach to infection control education J Lockhart Conway Human Development Center, Conway, Arkansas ISSUE: Teaching the principles of infection control to a large number of individuals from various educational backgrounds at a chronic care facility can be difficult. We developed an educational tool to assist the infection control director in this endeavor. PROJECT: A calendar featuring a monthly infection control topic is used to teach employees. A large calendar is displayed in the employee meeting room, where it was clearly visible to staff. Each calendar month features a
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Vol. 33 No. 5
osocomial disease/condition historically likely to be present in the facility during that timeframe. Identification numbers from the infection control manual matching the monthly topics are listed as a reference for employees. Lectures and demonstrations are also posted on the calendar, including the times and locations of presentations. Additional educational information, such as leaflets and audiovisual aids, are made available when appropriate. For example: October is pediculosis/head lice/scabies month. Many aspects of the monthly topic are presented, including residential cleaning practices, recognition of symptoms, handling of outerwear, prevention practices, and treatment. Other monthly topics include: influenza, methicillin-resistant Staphylococcus aureus (MRSA), aspiration pneumonia, and hand hygiene. RESULTS: Employee awareness of the infection control topics has improved, as evidenced by an increase in the volume of clients being brought to the infirmary for diagnosis and treatment of the ‘‘disease of the month.’’ In-service educational conferences are well attended; review of institutional policies and procedures have resulted in appropriate modification to those items. LESSONS LEARNED: The healthcare-associated training calendar is an efficient tool for educating employees at our chronic care facility. Raising awareness of employees to various diseases and infection control procedures should lead to better care of residents.
Abstract ID 51268 Tuesday, June 21
Unique challenges presented for remote/rural infection prevention program in a health service restructure MR Godsell South West Area Health Service, Bunbury, Australia BACKGROUND/PURPOSE: This health system was developed from the integration of five health services including 17 healthcare facilities with a combined 364 hospital beds (range 6–113). The unique challenges for this infection prevention program include the geographical size (23000 km2), population (135,450), number of locations, diversity of services, the short length of stay, innovative sustainability, and the standardization of data collection for healthcare-associated infection with an accurate baseline data for performance measure. The infection prevention program will support healthcare facilities, make an impact on high risk/target areas, raise awareness in the community, support clinical practice improvements, and develop effective surveillance systems. Program principles are to manage risk effectively, establish safe systems, and protect patients, healthcare workers, and visitors. An evidence-based approach will be used where possible. The program will be cost effective and customer focused. The program is strongly supported by the executive management. METHODS: An initial orientation and gap analysis questionnaire was completed by visiting all sites. This data, together with national and international program recommendations, was documented. An infection prevention program with risks identified (including action plan) was endorsed by the executive management group. RESULTS: Utilizing organizational systems, implementation began with communication networks established through e-mails to ‘‘infection prevention teams at all sites. An expert infection prevention panel is in progress. Policy standardization (with hyperlinks to Web pages) has been essential in hand hygiene, waste management, endoscopy, cleaning services, and staff immunization. As a resource, infection control manuals are at all sites, and directive outbreak management pack templates are available. The education plan focuses on a safe practice orientation package, self-directed learning packs, e-learning, and other learning opportunities. Standardization of surveillance systems, including multidrug-resistant organisms, is in process. Sentinel events, complaints data, and an incident monitoring and hazard alert are used to identify risk. CONCLUSION: Effective communication and education systems, with community ownership, strong leadership support, clear structural policies and procedures, and a focus on risk identification and quality management are key components of an ongoing successful program.