lou ann bruno, md chief of infectious diseases and medical director of infection prevention...
TRANSCRIPT
Lou Ann Bruno, MDChief of Infectious Diseases and Medical
Director Of Infection Prevention
2006-2008 NHSN Benchmark Med-Surg ICU: 2.2
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Goal: No More Than 1 MRSA-VAP Case During the First 6 Months of 2009
0
1
2
3
4
5
6
7
8
Per 1
000
Venti
lato
r Day
s
2005 2006 2007 2008
VAP MRSA VAP
0
1
2
3
4
5
6
7
8
Jan Feb Mar Apr May
VAP MRSA VAP
No VAP
2006-2008 NHSN Benchmark Med-Surg ICU: 2.2
Active Surveillance Initiated 2/6/07
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Multidisciplinary Team • Nursing
– Frontline staff– Unit manager– Leadership
• Respiratory Therapy– Frontline staff– Manager
• Infection Prevention– IP– Medical Director
• Environmental Services– Frontline staff– Manager
• Respiratory Care Management
• Infection Prevention Practices– Compliance with hand
hygiene and contact precautions
• Environmental Disinfection Cleaning
Please refer to the Cambridge Health Alliance storyboard for additional details
Actions• Multidisciplinary audits for
compliance 24/7– Hand hygiene– Contact precaution– HOB elevation
• Feedback/Coaching• New signage
– HOB elevation– Order for donning & removing
PPE• Vent bundle order sheet and
sedation vacation protocol laminated & attached to every vent
• Revised policy for HME & in-line suction catheter changes
• Developed oral care policy• Retrained environmental
service staff• Trained respiratory therapists
re: procedure for vent cleaning
• Implemented a process for monitoring disinfection cleaning
• Developed patient/family educational materials
• Clarifying responsibility for cleaning of all patient care equipment
• Purchased larger trash barrels for patient rooms
Please refer to the Cambridge Health Alliance storyboard for additional details
Lessons Learned• Beneficial to engage frontline staff, managers,
site leadership and physicians• Active intervention (coaching) is effective• Reserve time to meet on a regular basis and
have leadership communicate that the project is an institutional priority
• Communicate and display process and outcome measures to all stakeholders
• Beneficial to participate in this Coalition effort