Grants

"We believe this new approach will make surveillance of multi-drug resistant organisms more focused and cost-effective. The bottom line is that it will improve patient safety and quality of care" Mohamed H. Yassin, MD, PhD, Director of Infection Control, UPMC Mercy

HORIZONTAL SURVEILLANCE FOR MULTIDRUG-RESISTANT ORGANISMS (MDRO) VS. CURRENT VERTICAL SURVEILLANCE: COST EFFECTIVE ANALYSIS

Grant Application

Mohamed H. Yassin , MD, PhD UPMC Mercy

Proposed Innovation

The spread of multidrug-resistant organisms (MDRO) represents a challenge to patient safety and quality of care. Surveillance — an essential tool in infection prevention — seeks to identify the impact of disease, detect any change, and monitor the effectiveness of prevention programs.

Surveillance is performed either vertically (focused on a particular pathogen) or horizontally (focused on high-risk population). This project aims to demonstrate that enhanced surveillance of the high-risk population is more cost-effective than the current vertical strategy.

Improvements in Action

Through this project, a screening tool will be developed to evaluate patients and identify those at high risk for MDRO based on having two of the following five criteria:

  • Admission from a nursing home or long-term care facility
  • Readmission within 90 days
  • Presence of a chronic open wound (more than 30 days)
  • Having a tracheostomy
  • Having a chronic indwelling catheter, such as feeding tube, urinary catheter, intravenous catheter, or bowel diversion

Once an alert is activated, surveillance cultures will be taken by the nurse and sent to the microbiology lab for processing. Those who test positive for MDRO colonization will be targeted for hospital associated infection prevention measures, including hand hygiene, contact precautions, and chlorhexidine bathing. High-risk patients who test negative would only need to follow hand hygiene prevention measures with no need for isolation.

Patients not identified as high risk for MDRO colonization will not be tested.

Results – In Progress

An analysis will be performed to determine the differences between the current vertical practice and the horizontal surveillance. Focusing efforts on high-risk patients is expected to result in surveillance efforts that are more precise, while decreasing the burden on the nursing and microbiology lab staff. It also is expected to reduce unnecessary costs.