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Improving care practices for patients with multidrug-resistant organisms: one facility's evolution
V A Kennedy1, S R Steinfeld, G L Sims
1Infection Prevention & Management Associates, Inc., Houston, P.O. Box 31337, TX, 77231-1337 USA. vkennedy@infectionprevention.com
Abstract:
The care of patients with multidrug-resistant organisms (MDROs) varies in rehabilitation settings. Implementation of strict contact isolation in some facilities may limit patients from reaching their rehabilitation goals. This article describes our rehabilitation and long-term acute care facility's efforts to develop a policy that would enable patients with MDROs to meet their rehabilitation goals within a safe environment. A multidisciplinary team developed a two-track care process allowing staff to quickly identify appropriate activities for these patients. The team also developed educational materials for staff and families, addressed cleaning practices, and standardized the criteria for follow-up cultures and discontinuation of isolation. The MDRO policy was instituted throughout the hospital in August 1999. The incidence of nosocomially acquired MDROs has decreased slightly from the baseline rate of .076 per 100 patient days to .039 per 100 patient days during the 4-month period following the implementation of the policy.
Insights
This study outlines a new policy for managing patients with multidrug-resistant organisms (MDROs) in rehabilitation settings. The policy balances patient rehabilitation goals with infection control, leading to a decrease in nosocomial MDROs.
Area of Science:
- Infectious Diseases
- Rehabilitation Medicine
- Hospital Administration
Background:
- Patient care for multidrug-resistant organisms (MDROs) varies in rehabilitation settings.
- Strict isolation protocols can impede patient rehabilitation progress.
- A need exists for policies balancing infection control and rehabilitation goals for MDRO patients.
Purpose of the Study:
- To describe the development and implementation of a policy enabling MDRO patients to achieve rehabilitation goals safely.
- To create a sustainable care model for MDRO patients in a rehabilitation and long-term acute care facility.
Main Methods:
- A multidisciplinary team developed a two-track care process for MDRO patients.
- Educational materials for staff and families were created.
- Cleaning practices, follow-up cultures, and isolation discontinuation criteria were standardized.
Main Results:
- The MDRO policy was implemented in August 1999.
- A slight decrease in nosocomially acquired MDROs was observed, from 0.076 to 0.039 per 100 patient days within four months post-implementation.
Conclusions:
- The developed policy successfully enabled MDRO patients to meet rehabilitation goals within a safe environment.
- The policy contributed to a reduction in the incidence of nosocomially acquired MDROs.
- This approach offers a model for other facilities managing MDRO patients in rehabilitation settings.