For nearly two decades and no matter what measures it took, Jackson Memorial Hospital, Miami, struggled to prevent carbapenem-resistant Acinetobacter baumannii infections.
Even developing a set of bundled prevention interventions failed to affect infection rates. The interventions included patient screening tests upon admission to the intensive care unit and weekly thereafter, isolation and separation of patients’ testing positive for A. baumannii, weekly sampling of surfaces to assess thoroughness of cleaning and hand-hygiene interventions.
But, when the infection control department started to email comprehensive weekly reports — including the number and location of newly discovered cases — to physician, hospital nursing, medical and administrative leaders, the rate of A. baumannii transmission decreased by 63 percent, according to the research team from the University of Miami Miller School of Medicine.
Overall acquisition of new cases of carbapenem-resistant A. baumannii decreased to 1.93 per 10,000 patient days from 5.13 during the period starting June 2010 through June 2013, according to a study published in the May issue of the American Journal of Infection Control.
The authors wrote that regular communication allowed the infection control department to create a sense of accountability for new cases that unified both the leadership and providers toward the common goal of decreasing new cases of A. baumannii. “The weekly reports established peer pressure and accountability across the units,” says Silvia Munoz-Price, M.D., one of the lead authors of the study and medical director of the infection control unit at Jackson Memorial.
Besides the increased communication, specific actions resulted in the decrease in cases, including an increase in environmental cleaning, early identification of colonized patients and separation between colonized and noncolonized patients, and hand-hygiene awareness campaigns.
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