Premium
Significant reductions in methicillin‐resistant Staphylococcus aureus bacteraemia and clinical isolates associated with a multisite, hand hygiene culture‐change program and subsequent successful statewide roll‐out
Author(s) -
Grayson M Lindsay,
Jarvie Lisa J,
Martin Rhea,
Johnson Paul D R,
Jodoin Meryanda E,
McMullan Celene,
Gregory Roger H C,
Bellis Kaye,
Cunnington Katie,
Wilson Fiona L,
Quin Diana,
Kelly AnneMaree
Publication year - 2008
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2008.tb01820.x
Subject(s) - medicine , hygiene , methicillin resistant staphylococcus aureus , bacteremia , staphylococcus aureus , surgery , emergency medicine , antibiotics , microbiology and biotechnology , pathology , biology , bacteria , genetics
Objective: To assess the efficacy of a multimodal, centrally coordinated, multisite hand hygiene culture‐change program (HHCCP) for reducing rates of methicillin‐resistant Staphylococcus aureus (MRSA) bacteraemia and disease in Victorian hospitals. Design, participants and setting: A pilot HHCCP was conducted over a 24‐month period (October 2004 to September 2006) in six Victorian health care institutions (4 urban, 2 rural; total beds, 2379). Subsequently, we assessed the efficacy of an identical program implemented throughout Victorian public hospitals over a 12‐month period (beginning between March 2006 and July 2006). Main outcome measures: Rates of hand hygiene (HH) compliance; rates of MRSA disease (patients with bacteraemia and number of clinical isolates per 100 patient discharges [PD]). Results: Mean HH compliance improved significantly at all pilot program sites, from 21% (95% CI, 20%–22%) at baseline to 48% (95% CI, 47%–49%) at 12 months and 47% (95% CI, 46%–48%; range, 31%–75%) at 24 months. Mean baseline rates for the number of patients with MRSA bacteraemia and the number of clinical MRSA isolates were 0.05/100 PD per month (range, 0.00–0.13) and 1.39/100 PD per month (range, 0.16–2.39), respectively. These were significantly reduced after 24 months to 0.02/100 PD per month for bacteraemia ( P = 0.035 for trend; 65 fewer patients with bacteraemia) and 0.73/100 PD per month for MRSA isolates ( P = 0.003; 716 fewer isolates). Similar findings were noted 12 months after the statewide roll‐out, with an increase in mean HH compliance (from 20% to 53%; P < 0.001) and reductions in the rates of MRSA isolates ( P = 0.043) and bacteraemias ( P = 0.09). Conclusions: Pilot and subsequent statewide implementation of a multimodal HHCCP was effective in significantly improving HH compliance and reducing rates of MRSA infection.