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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
Summary
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.