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Use of a medical alert tool is associated with faster time to placement in contact precautions in patients with
Geneva M Wilson1, Cara Ray2, R Lorie Jacob2
1Center of Innovation for Complex Chronic Healthcare Edward Hines Jr. VA Hospital, Hines, IL; Department of Preventive Medicine, Center for Health Services and Outcomes Research, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Background:
Placing patients on contact precautions (CP) reduces the spread of infection. VA Bug Alert (VABA) was developed to notify VA infection control staff of new patients with multidrug-resistant organism (MDRO) colonization or infection. This study examined the link between VABA use and CP initiation.
Methods:
Patients who had an MDRO-positive culture were included. Medical chart reviews were conducted on 660 admissions for evidence of a CP order. Logistic regression determined the likelihood of patients being placed into CP within 24 hours of admission. Kaplan-Meier survival analysis assessed whether VABA utilization was associated with a shorter time to CP.
Results:
The final analysis included 659 admissions. Half of the patients were placed into CP within 24 hours of admission. High VABA use had a 69% increased likelihood of being placed into CPs within 24 hours compared to low. Kaplan-Meier analysis showed that patients at facilities in the highest tertile of VABA use had faster time to CP (median 2.1 h) than those in the lower tertiles (median 6.3 hours) (P = .036).
Conclusions:
VABA use is associated with earlier and more rapid placement into CP, demonstrating the alert system's effectiveness in rapidly identifying MDRO patients to reduce the spread of infection.
Insights
The VA Bug Alert (VABA) system significantly speeds up the placement of patients on contact precautions (CP) for multidrug-resistant organisms (MDROs). Higher VABA use correlates with faster CP initiation, reducing infection spread.
Area of Science:
- Infectious Disease Epidemiology
- Healthcare Quality Improvement
- Public Health Surveillance
Background:
- Contact precautions (CP) are crucial for limiting healthcare-associated infections.
- Multidrug-resistant organisms (MDROs) pose a significant threat in healthcare settings.
- The VA Bug Alert (VABA) system aims to streamline the identification of patients with MDROs.
Purpose of the Study:
- To investigate the association between VA Bug Alert (VABA) system utilization and the timely initiation of contact precautions (CP).
- To determine if VABA implementation impacts the speed of CP for patients with multidrug-resistant organisms (MDROs).
Main Methods:
- Retrospective chart review of 660 patient admissions with MDRO-positive cultures.
- Logistic regression analysis to assess the likelihood of CP initiation within 24 hours.
- Kaplan-Meier survival analysis to evaluate the time to CP based on VABA usage levels.
Main Results:
- Half of the patients were placed on CP within 24 hours of admission.
- Facilities with high VABA use showed a 69% increased likelihood of timely CP compared to low-use facilities.
- Kaplan-Meier analysis revealed significantly faster CP initiation (median 2.1 hours) in facilities with the highest VABA use tertile.
Conclusions:
- VA Bug Alert (VABA) system use is directly associated with earlier and more rapid implementation of contact precautions.
- The VABA system effectively identifies patients with MDROs, contributing to reduced infection transmission.
- This highlights the system's value in enhancing infection control practices within the VA system.
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