%0 Journal Article
%T Improving implementation of infection control guidelines to reduce nosocomial infection rates: pioneering the report card.
%A Yinnon AM
%A Wiener-Well Y
%A Jerassy Z
%A Dor M
%A Freund R
%A Mazouz B
%A Lupyan T
%A Shapira S
%A Attias D
%A Assous MV
%A Kopuit P
%A Block C
%A Raveh D
%A Freier-Dror Y
%A Moses AE
%A Benenson S
%J J Hosp Infect
%V 81
%N 3
%D Jul 2012
%M 22627068
%F 8.944
%R 10.1016/j.jhin.2012.04.011
%X <B>BACKGROUND: </B>Two detailed checklists were developed, based on published infection control guidelines, for daily use by infection control practitioners in departments and operating rooms.<BR><B>OBJECTIVE: </B>To assess the impact of the checklists on nosocomial infection rates in three hospitals over the course of one year.<BR><B>METHODS: </B>The checklists included 20 subheadings (± 150 items). Project nurses conducted rounds in the study (but not control) departments; during each round, the nurses selected 15-20 items for observation, marked the checklists according to appropriateness of observed behaviour and provided on-the-spot corrective education. Rates of adherence to the checklist, antibiotic use, number of obtained and positive cultures, and positive staff hand and patient environment cultures were reported monthly as a report card to relevant personnel and administrators. The rate of nosocomial infections was determined in the first and last months.<BR><B>RESULTS: </B>The baseline nosocomial infection rate was similar in the study and control departments: 37/345 (11%) and 26/270 (10%) respectively. In the last month, the rate in the study department decreased to 16/383 (4%) (P<0.01); in the control it decreased insignificantly to 21/248 (8%) (not significant). No significant trends were detected in the number of obtained cultures, positive cultures, or antibiotic use. Adherence to guidelines ranged from 75% to 94% between the hospitals (P<0.001): the overall rate increased from 80% to 91% (P<0.01).<BR><B>CONCLUSIONS: </B>The use of checklists during the conduct of infection control rounds, combined with monthly reports, was associated with a significant decrease in nosocomial infections in study departments.