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[The Infection RIsk Scan in clinical practice: improving infection prevention and antibiotic use through
I Willemsen1, J A J W Kluytmans
1Amphia Ziekenhuis, Laboratorium voor microbiologie en infectiepreventie, Breda.
Objective:
The increase in Highly Resistant Micro-Organisms (HRMO) in hospitals and nursing homes requires an intensification of infection prevention measures. This paper describes a new, standardised approach to infection prevention and monitoring of antibiotic use.
Design:
Cross-sectional, observational study.
Method:
The Infection RIsk Scan (IRIS) measures a number of objectifiable variables in the field of infection prevention, including the dissemination of HRMO, the use of antibiotics and indwelling medical devices, environmental contamination, hand hygiene and personal hygiene of healthcare workers, and various infection control preconditions. The scan converts the measurements into a risk profile and an improvement chart, a graphic presentation that is easy to understand for care professionals, managers and patients. Based on the results, targeted improvements can be made by a department or institution, and a quality cycle can be started in which the scans are repeated.
Results:
The IRIS has been successfully applied in 5 hospital departments, a rehabilitation clinic and 19 nursing homes. In the hospital departments, 3 IRIS cycles resulted in a significant improvement in hand hygiene compliance (43% to 66%, p<0.001) and a significant reduction in environmental contamination. In one nursing home, the IRIS resulted in a previously undetected outbreak of HRMO being discovered.
Conclusion:
The IRIS method makes it possible to compare departments and institutions and can therefore provide an impetus for standardization of measurements of risks and results in the field of infection prevention, antibiotic use and resistance.
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