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Favorable Impact of an Infection Control Network on Nosocomial Infection Rates in Community Hospitals

Published online by Cambridge University Press:  21 June 2016

Keith S. Kaye ,
John J. Engemann ,
Evelyn M. Fulmer ,
Connie C. Clark ,
Edwin M. Noga  and
Daniel J. Sexton
Keith S. Kaye*
Affiliation:
Department of Medicine and Infection Control, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina
John J. Engemann
Affiliation:
Department of Medicine and Infection Control, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina
Evelyn M. Fulmer
Affiliation:
Duke Infection Control Outreach Network, Durham, North Carolina
Connie C. Clark
Affiliation:
Duke Infection Control Outreach Network, Durham, North Carolina
Edwin M. Noga
Affiliation:
Duke Infection Control Outreach Network, Durham, North Carolina
Daniel J. Sexton
Affiliation:
Department of Medicine and Infection Control, Duke University Medical Center, Durham, North Carolina Duke Infection Control Outreach Network, Durham, North Carolina
*
Box 3152, Duke University Medical Center, Durham, NC 27710 ([email protected])
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Abstract

Objective.

To describe an infection control network (the Duke Infection Control Outreach Network [DICON]) and its impact on nosocomial infection rates in community hospitals.

Design.

Prospective cohort study of rates of nosocomial infections and exposures of employees to bloodborne pathogens in hospitals during the first 3 years of their affiliation with DICON. Attributable cost and mortality estimates were obtained from published studies.

Setting.

Twelve community hospitals in North Carolina and Virginia.

Results.

During the first 3 years of hospital affiliation with DICON, annual rates of nosocomial bloodstream infections at study hospitals decreased by 23% (P = .009). Annual rates of nosocomial infection and colonization due to methicillin-resistant Staphylococcus aureus decreased by 22% (P = .002), and rates of ventilator-associated pneumonia decreased by 40% (P = .001). Rates of exposure of employees to bloodborne pathogens decreased by 18% (P = .003).

Conclusions.

The establishment of an infection control network within a group of community hospitals was associated with substantial decreases in nosocomial infection rates. Standard surveillance methods, frequent data analysis and feedback, and interventions based on guidelines and protocols from the Centers for Disease Control and Prevention were the principal strategies used to achieve these reductions. In addition to lessening the adverse clinical outcomes due to nosocomial infections, these reductions substantially decreased the economic burden of infection: the decline in nosocomial bloodstream infections and ventilator-associated pneumonia alone yielded potential savings of $578,307 to $2,195,954 per year at the study hospitals.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 27 , Issue 3 , March 2006 , pp. 228 - 232
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2006

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References

1.Gaynes, R, Richards, C, Edwards, J, et al. Feeding back surveillance data to prevent hospital-acquired infections. Emerg Infect Dis 2001; 7:295–298.Google Scholar
2.Richards, C, Emori, TG, Edwards, J, Fridkin, S, Tolson, J, Gaynes, R. Characteristics of hospitals and infection control professionals participating in the National Nosocomial Infections Surveillance System 1999. Am J Infect Control 2001; 29:400–403.Google Scholar
3.Centers for Disease Control and Prevention (CDC). Monitoring hospital-acquired infections to promote patient safety—United States, 1990-1999. MMWR Morb Mortal Wkly Rep 2000; 49:149–153.Google Scholar
4.Engemann, JJ, Fulmer, E, Clark, CC, Sexton, DJ, Kaye, KS. The impact of resistance on infection control units in community hospitals in the Duke Infection Control Outreach Network (DICON). Paper presented at 12th Annual Scientific Meeting of the Society for Healthcare Epidemiology of America; April 6-9, 2002; Salt Lake City, Utah; abstract 9.Google Scholar
5.Britt, MR, Burke, JP, Nordquist, AG, Wilfert, JN, Smith, CB. Infection control in small hospitals: prevalence surveys in 18 institutions. JAMA 1976; 236:1700–1703.Google Scholar
6.Boyce, JM. Hospital epidemiology in smaller hospitals. Infect Control Hosp Epidemiol 1995; 16:600–606.Google Scholar
7.de Oliveira, TC, Branchini, ML. Infection control in a Brazilian regional multihospital system. Am J Infect Control 1999; 27:262–269.Google Scholar
8.Horan, TC, Emori, TG. Definitions of key terms used in the NNIS System. Am J Infect Control 1997; 25:112–116.Google Scholar
9.National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 to June 2002, issued August 2002. Am J Infect Control 2002; 30:458–475.CrossRefGoogle Scholar
10.Kleinbaum, DG, Kupper, L.L., Morgenstern, H. Epidemiologic Research. Principles and Quantitative Methods. London: Lifetime Learning Publications; 1982.Google Scholar
11.Maki, DG, Stolz, SM, Wheeler, S, Mermel, LA. Prevention of central venous catheter-related bloodstream infection by use of an antiseptic-impregnated catheter: a randomized, controlled trial. Ann Intern Med 1997; 127:257–266.CrossRefGoogle ScholarPubMed
12.Orsi, GB, Di Stefano, L, Noah, N. Hospital-acquired, laboratory-confirmed bloodstream infection: increased hospital stay and direct costs. Infect Control Hosp Epidemiol 2002; 23:190–197.Google Scholar
13.Pittet, D, Tarara, D, Wenzel, RP. Nosocomial bloodstream infection in critically ill patients: excess length of stay, extra costs, and attributable mortality. JAMA 1994; 271:1598–1601.Google Scholar
14.Pittet, D, Harbarth, S. What techniques for diagnosis of ventilator-associated pneumonia? Lancet 1998; 352:83–84.Google Scholar
15.Shorr, AF, O'Malley, PG. Continuous subglottic suctioning for the prevention of ventilator-associated pneumonia: potential economic implications. Chest 2001;119:228–235.CrossRefGoogle ScholarPubMed
16.Zack, JE, Garrison, T, Trovillion, E, et al. Effect of an education program aimed at reducing the occurrence of ventilator-associated pneumonia. Crit Care Med 2002; 30:2407–2412.Google Scholar
17.Warren, DK, Shukla, SJ, Olsen, MA, et al. Outcome and attributable cost of ventilator-associated pneumonia among intensive care unit patients in a suburban medical center. Crit Care Med 2003; 31:1312–1317.Google Scholar
18.OANDA. Foreign exchange services and trading. Available at: http://www.oanda.com/. Accessed February 21, 2006.Google Scholar
19.Kirkland, KB, Briggs, JP, Trivette, SL, Wilkinson, WE, Sexton, DJ. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol 1999; 20:725–730.Google Scholar
20.Whitehouse, JD, Friedman, ND, Kirkland, KB, Richardson, WJ, Sexton, DJ. The impact of surgical-site infections following orthopedic surgery at a community hospital and a university hospital: adverse quality of life, excess length of stay, and extra cost. Infect Control Hosp Epidemiol 2002; 23:183–189.Google Scholar
21.Haley, RW, Tenney, JH, Lindsey, JO 2nd, Garner, JS, Bennett, JV. How frequent are outbreaks of nosocomial infection in community hospitals? Infect Control 1985; 6:233–236.Google Scholar
22.Haley, RW, Culver, DH, White, JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol 1985; 121:182–205.Google Scholar