Prevention of Healthcare Associated Infections
Under the Northeast Health Care Quality Foundation's (NHCQF's) current contracts as the Medicare QIO for the States of Maine, New Hampshire and Vermont, our work with providers to improve the quality of health care affords us the opportunity to observe quality improvement activities of various providers which may be interesting and beneficial for others. The process described below for preventing hospital acquired infections was developed by Fletcher Allen Health Care (FAHC) in Burlington, Vermont and NHCQF has obtained their permission to share this process with other providers.
FAHC established a corporate goal of zero preventable hospital acquired infections and implemented interventions that reflect the facility's culture of patient safety. These interventions include:
- Training and education:
- Expanded education and training of resident physician staff to include both infection prevention theory and practical application.
- New enhanced training approach with environmental services staff to promote adequate cleaning of the patient's environment. This approach includes use of fluorescent marks to monitor thoroughness of the cleaning process with immediate feedback and incentives for good work.
- Increasing the number of infection prevention "eyes" at the bedside. Two nurses from each patient care unit have partnered with the Infection Prevention team as Infection Prevention Advocates. These nurses were provided with 16 hours of infection prevention training and meet monthly for additional education and networking to share "best practices".
- Measurement and feedback:
- A composite infection measure combining hospital acquired MRSA infection, C. difficile infection and primary bloodstream infection reported monthly.
- By targeting ZERO these healthcare associated infections are each reviewed for lessons learned the entire care team including nursing, physicians, radiology, IV Therapy, surgeons etc. are asked to review cases.