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Title: | Staphylococcus aureus bacteraemia as a quality indicator for hospital infection control. |
Authors: | Dendle, Claire;Martin, Rhea D;Cameron, Donna R;Grabsch, Elizabeth A;Mayall, Barrie C;Grayson, M Lindsay;Johnson, Paul D R |
Affiliation: | Medical Education Unit, Austin Health, Heidelberg, Victoria, Australia, Australia |
Issue Date: | 5-Oct-2009 |
Citation: | Medical Journal of Australia; 191(7): 389-92 |
Abstract: | To evaluate the practicality and effectiveness of a new program that made health care-associated Staphylococcus aureus bacteraemia (SAB) a quality indicator at Austin Health.Roll-out of the program over 9 months and review over 27 months from January 2006. Every episode of SAB at Austin Health was promptly reviewed, and classified as community- or health care-associated and as inpatient- or non-inpatient-related. Feedback was provided to treating clinicians for every SAB episode considered potentially preventable, and education-based interventions were introduced where appropriate.Episodes of SAB associated with health care at Austin Health per 1000 separations (hospital discharges) per month.We identified 131 episodes of health care-associated SAB, of which 90 (68.7%) were caused by methicillin-susceptible S. aureus, 96 (73.3%) occurred in inpatients, and 65 (49.6%) were associated with a vascular access device. The health care-associated SAB rate was 1.1 per 1000 separations in the first 9 months, and fell by 55% to 0.51 per 1000 separations in the subsequent 18 months. We estimated that there were 80 fewer SAB episodes (95% CI, 20-140) than expected had the initial rate remained unchanged, a national saving of $1.75 million to Austin Health over 27 months. About 16 hours per month of clinical nurse consultant time was required to maintain the program, representing a 0.1 equivalent full-time position, or a cost of $7000-$9000 per year.Introducing a structured program to investigate all health care-associated SABs, rather than only infections with methicillin-resistant S. aureus, revealed a large under-recognised burden of potentially preventable infections. The program was simple and low-cost, and the rate of health care-associated SAB has fallen significantly since its introduction. |
Internal ID Number: | 19807631 |
URI: | http://ahro.austin.org.au/austinjspui/handle/1/10898 |
URL: | http://www.ncbi.nlm.nih.gov/pubmed/19807631 |
Type: | Journal Article |
Subjects: | Bacteremia.epidemiology.etiology.prevention & control Cross Infection.epidemiology.etiology.prevention & control Humans Infection Control.standards Methicillin-Resistant Staphylococcus aureus Quality Indicators, Health Care Staphylococcal Infections.epidemiology.etiology.prevention & control Staphylococcus aureus Victoria.epidemiology |
Appears in Collections: | Journal articles |
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