Staphylococcus aureus bacteraemia as a quality indicator for hospital infection control
| Autor: | Paul D R Johnson, Barrie C. Mayall, M Lindsay Grayson, Rhea Martin, Claire Dendle, Elizabeth A Grabsch, Donna R. M. Cameron |
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| Rok vydání: | 2009 |
| Předmět: |
Methicillin-Resistant Staphylococcus aureus
medicine.medical_specialty Cross Infection Infection Control Staphylococcus aureus Victoria business.industry Outcome measures Psychological intervention Staphylococcus aureus bacteraemia Bacteremia General Medicine Drug resistance Staphylococcal Infections medicine.disease Health care Emergency medicine medicine Infection control Humans business Intensive care medicine Initial rate Quality Indicators Health Care |
| Zdroj: | The Medical journal of Australia. 191(7) |
| ISSN: | 0025-729X |
| Popis: | Objective: To evaluate the practicality and effectiveness of a new program that made health care-associated Staphylococcus aureus bacteraemia (SAB) a quality indicator at Austin Health. Design and setting: Roll-out of the program over 9 months and review over 27 months from January 2006. Every episode of SAB at Austin Health was promptly reviewed, and classified as community- or health care-associated and as inpatient- or non-inpatient-related. Feedback was provided to treating clinicians for every SAB episode considered potentially preventable, and education-based interventions were introduced where appropriate. Main outcome measure: Episodes of SAB associated with health care at Austin Health per 1000 separations (hospital discharges) per month. Results: We identified 131 episodes of health care-associated SAB, of which 90 (68.7%) were caused by methicillin-susceptible S. aureus, 96 (73.3%) occurred in inpatients, and 65 (49.6%) were associated with a vascular access device. The health care-associated SAB rate was 1.1 per 1000 separations in the first 9 months, and fell by 55% to 0.51 per 1000 separations in the subsequent 18 months. We estimated that there were 80 fewer SAB episodes (95% CI, 20–140) than expected had the initial rate remained unchanged, a notional saving of $1.75 million to Austin Health over 27 months. About 16 hours per month of clinical nurse consultant time was required to maintain the program, representing a 0.1 equivalent full-time position, or a cost of $7000–$9000 per year. Conclusion: Introducing a structured program to investigate all health care-associated SABs, rather than only infections with methicillin-resistant S. aureus, revealed a large underrecognised burden of potentially preventable infections. The program was simple and lowcost, and the rate of health care-associated SAB has fallen significantly since its |
| Databáze: | OpenAIRE |
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