{Reference Type}: Journal Article
{Title}: Improving implementation of infection control guidelines to reduce nosocomial infection rates: pioneering the report card.
{Author}: Yinnon AM;Wiener-Well Y;Jerassy Z;Dor M;Freund R;Mazouz B;Lupyan T;Shapira S;Attias D;Assous MV;Kopuit P;Block C;Raveh D;Freier-Dror Y;Moses AE;Benenson S;
{Journal}: J Hosp Infect
{Volume}: 81
{Issue}: 3
{Year}: Jul 2012
{Factor}: 8.944
{DOI}: 10.1016/j.jhin.2012.04.011
{Abstract}: BACKGROUND: Two detailed checklists were developed, based on published infection control guidelines, for daily use by infection control practitioners in departments and operating rooms.
OBJECTIVE: To assess the impact of the checklists on nosocomial infection rates in three hospitals over the course of one year.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.