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Title: Staphylococcus aureus bacteraemia as a quality indicator for hospital infection control.
Austin 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
Publication information: 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.
Gov't Doc #: 19807631
Type: Journal Article
Subjects: Bacteremia.epidemiology.etiology.prevention & control
Cross Infection.epidemiology.etiology.prevention & control
Infection Control.standards
Methicillin-Resistant Staphylococcus aureus
Quality Indicators, Health Care
Staphylococcal Infections.epidemiology.etiology.prevention & control
Staphylococcus aureus
Appears in Collections:Journal articles

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