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The Minnesota Collaborative Healthcare-Associated Infection Network (CHAIN) Award for Excellence commends the infection prevention and antibiotic stewardship efforts of health care teams working to build safer health care environments. The awards are presented annually by the Collaborative Healthcare-Associated Infection Network (CHAIN). We had many great initiatives submitted this year and we will be featuring a brief summary of each nomination in the coming months. We hope the lessons learned will provide you with innovative ideas that are useful to you regarding patient safety and quality of care. On September 27th at the CHAIN conference, Park Nicollet Methodist Hospital in Minneapolis and Regions Hospital in St. Paul received the CHAIN Awards. The efforts of Park Nicollet Methodist Hospital and Regions Hospital led to enhanced care delivery, patient safety and patient experiences. Congratulations to both hospitals on their receipt of CHAIN Awards!
Regions Hospital received the CHAIN Award for its Infection Prevention Isolation Precautions Utilization Improvement Team.
A goal of infection prevention programs is to interrupt transmission of organisms within health care settings. Regions Hospital had a protocol to initiate contact precautions for patients either colonized or infected with specific pathogens including Methicillin-resistant Staphylococcus aureus (MRSA). While this approach is still supported by the CDC, several reports have described that contact precatutions can also lead to patient stress, decreased medical attention and more adverse events.
Regions began an initiative to reduce unnecessary use of contact precautions for MRSA in order to improve the patient experience while maintaining a safe patient care environment. Based on a review of existing literature regarding the use of isolation and an examination of approaches to MRSA screening, the hospital determined that its existing policies for isolation and screening were likely too stringent and that it lacked a standard process to routinely review admissions for proactive isolation discontinuation.
With the support of leaders, front-line colleagues and the hospital's Patient and Family Council, Regions Hospital discontinued routine patient screening for MRSA in its intensive care units and emphasized horizontal interventions, including bath treatment with chlorhexidine gluconate – a product that kills germs – for all inpatients with central lines and preoperatively for all surgical patients. Similarly, the hospital continues to monitor its robust hand hygiene program, bundled prevention practices and environmental cleaning to ensure high compliance.
Supported by a daily review of patients with a history of MRSA, Regions refined its utilization of vertical interventions. These include contact precautions for only those patients who met specific risk criteria for MRSA infection as well as targeted MRSA screening for high-risk populations. Together, these interventions resulted in no statistically significant change in infections, indicating that the focus on horizontal measures remained effective with no unintended consequences from practice changes. The hospital also saw a 16 percent decrease in isolation days for patients and a 54 percent decrease in MRSA screenings.
MDH Recommendations for Prevention and Control of
Methicillin-Resistant Staphylcoccus aureus (MRSA) in Acute Care
Facilities is currently under review and revised recommendations are
anticipated in early 2018. Current recommendations encourage facilities to
conduct MRSA risk assessments to determine which units if any should have
active surveillance testing implemented. HICPAC continues to recommend Contact
Precautions for any patient infected
or colonized with MRSA.
Stay tuned, in our next HAI newsletter we will be featuring the work of Park Nicollet Methodist Hospital in Minneapolis...
What is CHAIN?
The Collaborative Healthcare-Associated Infections Network (CHAIN) represents a partnership formed in 2011 between the Minnesota Chapter of the Association for Professionals in Infection Control and Epidemiology (APIC-Minnesota), the Minnesota Department of Health, the Minnesota Hospital Association, and Stratis Health. In early 2017, CHAIN expanded membership to include organizations representing providers across care settings.
CHAIN coordinates across the continuum of health care delivery, and supports patients, individuals, and their families to prevent harm from infections acquired in the process of care and combat antibiotic resistance.
By leveraging our collective capacity and resources, integrating and aligning related initiatives, and breaking down silos and barriers to implementation of best practices, CHAIN serves as a resource to the health care community and each other.
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