Skip to main content Accessibility help
×
Home
Hostname: page-component-7ccbd9845f-2c279 Total loading time: 0.458 Render date: 2023-01-28T04:11:57.376Z Has data issue: true Feature Flags: { "useRatesEcommerce": false } hasContentIssue true

Implementation of Strategies to Prevent and Control the Emergence and Spread of Antimicrobial-Resistant Microorganisms in U.S. Hospitals

Published online by Cambridge University Press:  21 June 2016

Marcia M. Ward*
Affiliation:
Department of Health Management and Policy, University of Iowa, Iowa City, Iowa Center for Research in the Implementation of innovative Strategies in Practice (CRIISP) at the Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
Daniel J. Diekema
Affiliation:
Department of Internal Medicine, University of Iowa, Iowa City, Iowa Center for Research in the Implementation of innovative Strategies in Practice (CRIISP) at the Iowa City Veterans Affairs Medical Center, Iowa City, Iowa Department of Pathology, University of Iowa, Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
Jon W. Yankey
Affiliation:
Center for Research in the Implementation of innovative Strategies in Practice (CRIISP) at the Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
Thomas E. Vaughn
Affiliation:
Department of Health Management and Policy, University of Iowa, Iowa City, Iowa Center for Research in the Implementation of innovative Strategies in Practice (CRIISP) at the Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
Bonnie J. BootsMiller
Affiliation:
Department of Internal Medicine, University of Iowa, Iowa City, Iowa Center for Research in the Implementation of innovative Strategies in Practice (CRIISP) at the Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
Jane F. Pendergast
Affiliation:
Department of Biostatistics, University of Iowa, Iowa City, Iowa
Bradley N. Doebbeling
Affiliation:
Health Services Research and Development, Center on Implementing Evidence-Based Practice, Roudebush Veterans Affairs Medical Center; the Regenstrief Institute, Inc.; and the Department of Internal Medicine, Indiana University Center for Health Services & Outcomes Research, Indiana University School of Medicine, Indianapolis, Indiana
*
Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, IA 52242-1008marcia-m-ward@uiowa.edu

Abstract

Objective:

To examine the extent to which the strategies recommended by the National Foundation for Infectious Diseases (NFID)-Centers for Disease Control and Prevention (CDC) co-sponsored workshop, Antimicrobial Resistance in Hospitals: Strategies to Improve Antimicrobial Use and Prevent Nosocomial Transmission of Antimicrobial-Resistant Microorganisms, have been implemented and the relationship between the degree of implementation and hospital culture, leadership, and organizational factors.

Design:

Survey.

Setting:

A representative sample of U.S. hospitals stratified by teaching status, bed size, and geographic region.

Participants:

Infection control professionals.

Results:

Surveyed hospitals had implemented strategies to optimize the use of antimicrobials and to detect, report, and prevent transmission of antimicrobial-resistant microorganisms. Multivariate analyses found that hospitals with a greater degree of implementation of the NFID–CDC strategic goals were more likely to have management support, education of staff, and interdisciplinary groups specifically to address these issues; they were also more likely to engage in benchmarking on broader quality of care indicators.

Conclusions:

Most surveyed hospitals had implemented some measures to address the NFID–CDC recommendations; however, hospitals need to do much more to improve antimicrobial use and to increase their efforts to detect, report, and control the spread of antimicrobial resistance. A supportive hospital administration must foster a culture of ongoing support, education, and interdisciplinary work groups focused on this important issue to successfully accomplish these goals.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Shlaes, DM, Gerding, DN, John, JF, et al.Society for Healthcare Epidemiology of America and Infectious Diseases Society of America joint committee on the prevention of antimicrobial resistance: guidelines for the prevention of antimicrobial resistance in hospitals. Clin Infect Dis 1997;25:584599.CrossRefGoogle Scholar
2.Goldmann, DA, Weinstein, RA, Wenzel, RP, et al.Strategies to prevent and control the emergence and spread of antimicrobial-resistant microorganisms in hospitals. JAMA 1996;275:234240.CrossRefGoogle Scholar
3.Cohen, ML. Epidemiology of drug resistance: implications for a post-antimicrobial era. Science 1992;257:10501055.CrossRefGoogle Scholar
4.Centers for Disease Control and Prevention. Staphylococcus aureus resistant to vancomycin: United States, 2002. MMWR 2002;51:565566.Google Scholar
5.Goldmann, DA, Huskins, WC. Control of nosocomial antimicrobial-resistant bacteria: a strategic priority for hospitals worldwide. Clin Infect Dis 1997;24(suppl 1):S139S145.CrossRefGoogle ScholarPubMed
6.Jarvis, WR. Preventing the emergence of multidrug-resistant microorganisms through antimicrobial use controls: the complexity of the problem. Infect Control Hosp Epidemiol 1996;17:490495.CrossRefGoogle Scholar
7.McGowan, JE Jr, Tenover, FC. Control of antimicrobial resistance in the health care system. Infect Dis Clin North Am 1997;11:297311.CrossRefGoogle ScholarPubMed
8.Gaynes, R. The impact of antimicrobial use on the emergence of antimicrobial-resistant bacteria in hospitals. Infect Dis Clin North Am 1997;11:757765.CrossRefGoogle Scholar
9.Shay, DK, Goldmann, DA, Jarvis, WR. Reducing the spread of antimicrobial-resistant microorganisms. Pediatr Clin North Am 1995;42:703716.CrossRefGoogle ScholarPubMed
10.Boyce, JM. Vancomycin-resistant enterococcus: detection, epidemiology, and control measures. Infect Dis Clin North Am 1997;11:367384.CrossRefGoogle ScholarPubMed
11.Casewell, MW. New threats to the control of methicillin-resistant Staphylococcus aureus. J Hosp Infect 1995;30(suppl):465471.CrossRefGoogle ScholarPubMed
12.The Hospital Infection Control Practices Advisory Committee. Recommendations for preventing the spread of vancomycin resistance: recommendations of the Hospital Infection Control Practices Advisory Committee (HICPAC). Am J Infect Control 1995;23:878894.Google Scholar
13.Garner, JS. Hospital Infection Control Practices Advisory Committee, Centers for Disease Control and Prevention: guideline for isolation precautions in hospitals. Infect Control Hosp Epidemiol 1996;17:5380.CrossRefGoogle ScholarPubMed
14.Duncan, RA. Controlling use of antimicrobial agents. Infect Control Hosp Epidemiol 1997;18:260266.CrossRefGoogle ScholarPubMed
15.Martone, WJ. Spread of vancomycin-resistant enterococcci: why did it happen in the United States? Infect Control Hosp Epidemiol 1998;19:539545.CrossRefGoogle Scholar
16.Diekema, DJ, Pfaller, MA, Jones, RN, et al.Survey of bloodstream infections due to gram-negative bacilli: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, and Latin America for the SENTRY Antimicrobial Surveillance Program, 1997. Clin Infect Dis 1999;29:595607.Google Scholar
17.Wakefield, DS, Pfaller, M, Massanari, RM, Hammons, GT. Variation in methicillin-resistant Staphylococcus aureus occurrence by geographic location and hospital characteristics. Infect Control 1987;8:151157.CrossRefGoogle ScholarPubMed
18.Dillman, DA. Mail and Internet Surveys: The Tailored Design Method, ed. 2. New York: John Wiley and Sons; 2000.Google Scholar
19.Beekmann, SE, Vaughn, TE, McCoy, KD, et al.Hospital bloodborne pathogens programs: program characteristics and blood and body fluid exposure rates. Infect Control Hosp Epidemiol 2001;22:7382.CrossRefGoogle ScholarPubMed
20.McCoy, KD, Beekmann, SE, Ferguson, KJ, et al.Monitoring adherence to standard precautions. Am J Infect Control 2001;29:2431.CrossRefGoogle ScholarPubMed
21.Vaughn, TE, Ward, MM, Doebbeling, BN, Uden-Holman, T, Clarke, WT, Woolson, REOrganizational and provider characteristics fostering smoking cessation clinical guideline adherence: an empirical look. Journal of Ambulatory Care Management 2002;25:1731.CrossRefGoogle ScholarPubMed
22.Vaughn, TE, McCoy, K, BootsMiller, BJ, et al.Organizational predictors of adherence to ambulatory care screening guidelines. Med Care 2002;40:11721185.CrossRefGoogle ScholarPubMed
23.Harrell, FE Jr. Regression Modeling Strategies: With Applications to Linear Models, Logistic Regression, and Survival Analysis. New York: Springer-Verlag; 2001.CrossRefGoogle Scholar
24.Harrell, FE, Lee, KL, Califf, RM, Pryor, DB, Rosati, RA. Regression modeling strategies for improved prognostic prediction. Stat Med 1984;3:143152.CrossRefGoogle Scholar
25.Lawton, RM, Fridkin, SKGaynes, RP, McGowan, JE Jr, Intensive Care Antimicrobial Resistance Epidemiology (ICARE) Hospitals. Practices to improve antimicrobial use at 47 US hospitals: the status of the 1997 SHEA/IDSA position paper recommendations. Infect Control Hosp Epidemiol 2000;21:256259.CrossRefGoogle ScholarPubMed
26.Lundstrom, T, Pugliese, G, Bartley, J, Cox, J, Guither, C. Organizational and environmental factors that affect worker health and safety and patient outcomes. Am J Infect Control 2002;30:93106.CrossRefGoogle ScholarPubMed
27.Solberg, LI. Guideline implementation: what the literature doesn't tell ns. Journal of Quality Improvement 2000;26:525537.CrossRefGoogle Scholar
28.Solberg, LI, Brekke, ML, Fazio, CJ, et al.Lessons from experienced guideline implementers: attend to many factors and use multiple strategies. Journal of Quality Improvement 2000;26:171188.CrossRefGoogle ScholarPubMed
29.Institute of Medicine. Crossing the Quality Chasm. Washington, DC: National Academy Press; 2004:137140.Google ScholarPubMed
30.Lammers, JC, Cretin, S, Gilman, S, Calingo, E. Total quality management in hospitals. Med Care 1996;34:463478.CrossRefGoogle ScholarPubMed
31.Gershon, RRM, Karkashian, CD, Vlahov, D, et al.Compliance with universal precautions in correctional health care facilities. Journal of Occupational and Environmental Medicine 1999;41:181189.CrossRefGoogle ScholarPubMed
32.Grosch, JW, Gershon, RRM, Murphy, LR, Dejoy, DM. Safety climate dimensions associated with occupational exposure to blood-borne pathogens in nurses. Am J Ind Med 1999(suppl 1):122124.3.0.CO;2-L>CrossRefGoogle ScholarPubMed
33.Doebbeling, BN, Vaughn, TE, Woolson, RF, et al.Benchmarking Veterans Affairs medical centers in the delivery of preventive health services. Med Care 2002;40:540554.CrossRefGoogle ScholarPubMed
34.Drachmen DA Benchmarking patient satisfaction at academic health centers. Journal of Quality Improvement 1996;22:359367.CrossRefGoogle ScholarPubMed
35.Weissman, NW, Allison, JJ, Kiefe, CI, et al.Achievable benchmarks of care: the ABCs of benchmarking. J Eval Clin Pract 1999;5:269281.CrossRefGoogle ScholarPubMed
36.O'Neal, PV, Oxean, YA, Ma, Y. Benchmarking mechanical ventilation services in teaching hospitals. J Med Syst 2002;26:227240.CrossRefGoogle ScholarPubMed
37.Ellis, J. Sharing the evidence: clinical practice benchmarking to improve continuously the quality of care. J Adv Nursing 2000;32:215225.CrossRefGoogle Scholar
38.Grabert, M, Schweiggert, F, Holl, RW. A framework for diabetes documentation and quality management in German: 10 years of experience with DPV. Comput Methods Programs Biomed 2002;69:115121.CrossRefGoogle Scholar
39.Nora, JJ, Diekema, DJ, Vaughn, TE, et al.Antimicrobial resistance (AMR) in epidemiologically-important organisms in U.S. hospitals. Presented at the 39th Annual Meeting of the Infectious Diseases Society of America; October 25-28, 2001; San Francisco, CA.Google Scholar
17
Cited by

Save article to Kindle

To save this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Implementation of Strategies to Prevent and Control the Emergence and Spread of Antimicrobial-Resistant Microorganisms in U.S. Hospitals
Available formats
×

Save article to Dropbox

To save this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about saving content to Dropbox.

Implementation of Strategies to Prevent and Control the Emergence and Spread of Antimicrobial-Resistant Microorganisms in U.S. Hospitals
Available formats
×

Save article to Google Drive

To save this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you used this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about saving content to Google Drive.

Implementation of Strategies to Prevent and Control the Emergence and Spread of Antimicrobial-Resistant Microorganisms in U.S. Hospitals
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *