Dataset Information

Development and implementation of a centralized surveillance infection prevention program in a multi-facility health system: A quality improvement project.

ABSTRACT:

Objective

To develop, implement, and evaluate the effectiveness of a unique centralized surveillance infection prevention (CSIP) program.

Design

Observational quality improvement project.

Setting

An integrated academic healthcare system.

Intervention

The CSIP program comprises senior infection preventionists who are responsible for healthcare-associated infection (HAI) surveillance and reporting, allowing local infection preventionists (LIPs) a greater portion of their time to non-surveillance patient safety activities. Four CSIP team members accrued HAI responsibilities at 8 facilities.

Methods

We evaluated the effectiveness of the CSIP program using 4 measures: recovery of LIP time, efficiency of surveillance activities by LIPs and CSIP staff, surveys characterizing LIP perception of their effectiveness in HAI reduction, and nursing leaders' perception of LIP effectiveness.

Results

The amount of time spent by LIP teams on HAI surveillance was highly variable, while CSIP time commitment and efficiency was steady. Post-CSIP implementation, 76.9% of LIPs agreed that they spend adequate time on inpatient units, compared to 15.4% pre-CSIP; LIPs also reported more time to allot to non-surveillance activities. Nursing leaders reported greater satisfaction with LIP involvement with HAI reduction practices.

Conclusion

CSIP programs are a little-reported strategy to ease burden on LIPs with reallocation of HAI surveillance. The analyses presented here will aid health systems in anticipating the benefit of CSIP programs.

SUBMITTER: Snyder GM

PROVIDER: S-EPMC10031579 | biostudies-literature | 2023

REPOSITORIES: biostudies-literature

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Publications

Development and implementation of a centralized surveillance infection prevention program in a multi-facility health system: A quality improvement project.

Snyder Graham M GM Wagester Suzanne S Harris Patricia L PL Valek Abby L AL Hodges Jacob C JC Bilderback Andrew L AL Kader Fazrina F Tanner Colleen A CA Metzger Amy P AP DiNucci Susan E SE Colaianne Bonnie V BV Chung Ashley A Zapf Rachel L RL Kip Paula L PL Minnier Tamra E TE

Antimicrobial stewardship & healthcare epidemiology : ASHE 20230322 1

<h4>Objective</h4>To develop, implement, and evaluate the effectiveness of a unique centralized surveillance infection prevention (CSIP) program.<h4>Design</h4>Observational quality improvement project.<h4>Setting</h4>An integrated academic healthcare system.<h4>Intervention</h4>The CSIP program comprises senior infection preventionists who are responsible for healthcare-associated infection (HAI) surveillance and reporting, allowing local infection preventionists (LIPs) a greater portion of the ...[more]

PMID: 36970425

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Project description:PurposePostoperative atrial fibrillation (POAF) has an incidence of 20-60% in cardiac surgery. The Society of Cardiovascular Anesthesiologists and the European Association of Cardiothoracic Anaesthesiology Practice Advisory have recommended postoperative beta blockers and amiodarone for the prevention of POAF. By employing quality improvement (QI) strategies, we sought to increase the use of these agents and to reduce the incidence of POAF among our patients undergoing cardiac surgery.MethodsThis single-centre QI initiative followed the traditional Plan, Do, Study, Act (PDSA) cycle scientific methodology. A POAF risk score was developed to categorize all patients undergoing cardiac surgery as either normal or elevated risk. Risk stratification was incorporated into a preprinted prescribing guide, which recommended postoperative beta blockade for all patients and a postoperative amiodarone protocol for patients with elevated risk starting on postoperative day one (POD1). A longitudinal audit of all patients undergoing cardiac surgery was conducted over 11 months to track the use of prophylactic medications and the incidence of POAF.ResultsFive hundred and sixty patients undergoing surgery were included in the QI initiative from 1 December 2020 to 1 November 2021. The baseline rate of POAF across all surgical subtypes was 39% (198/560). The use of prophylactic amiodarone in high-risk patients increased from 13% (1/8) at the start of the project to 41% (48/116) at the end of the audit period. The percentage of patients receiving a beta blocker on POD1 did fluctuate, but remained essentially unchanged throughout the audit (34.8% in December 2020 vs 46.7% in October 2021). After 11 months, the overall incidence of POAF was 29% (24.9% relative reduction). Notable reductions in the incidence of POAF were observed in more complex surgical subtypes by the end of the audit, including multiple valve replacement (89% vs 56%), aortic repair (50% vs 33%), and mitral valve surgery (45% vs 33%).ConclusionsThis single-centre QI intervention increased the use of prophylactic amiodarone by 28% for patients at elevated risk of POAF, with no change in the early postoperative initiation of beta blockers (46.7% of patients by POD1). There was a notable reduction in the incidence of POAF in patients at elevated risk undergoing surgery.

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Dataset Information

Development and implementation of a centralized surveillance infection prevention program in a multi-facility health system: A quality improvement project.

Objective

Design

Setting

Intervention

Methods

Results

Conclusion

Publications

Development and implementation of a centralized surveillance infection prevention program in a multi-facility health system: A quality improvement project.

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