A mandatory influenza vaccination program for HCP was essential to achieving high vaccination rates, despite years of intensive vaccination campaigns focused on increasing accessibility and convenience. Mandatory vaccination policies appear to successfully capture a large portion of HCP who are not opposed to receipt of the vaccine but who have not made vaccination a priority.

e In a retrospective cohort study of 1,140 patients harboring methicillin-resistant Staphylococcus aureus, the nasal burden was low in 31%, category 1؉ to 2؉ in 54%, and category 3؉ to 4؉ in 15%. There was a significant trend in infection risk with increasing nasal burden (P ‫؍‬ 0.007). In multivariate models, high nasal burden remained significantly associated with invasive infection.

C. difficile PCR testing identifies both colonized and infected patients, making it critical to only test patients that meet clinical criteria for C. difficile infection (CDI). We implemented an automated order-entry protocol that reduced inappropriate testing by 64% and hospital-onset (HO) CDI Standardized Infection Ratio (SIR) from 1.62 to 0.82.

Background:The transmission and infection risk associated with multidrug-resistant organism (MDRO) carriers necessitates surveillance and tracking to provide proper contact precautions. As MDROs increase in scope, automated electronic health record (EHR) systems may help with surveillance demands.Methods: We created a system for MDROs and Clostridium difficile tracking that automated the following 3 main surveillance and tracking activities: monitoring of microbiology results and initiation of chart-based flags, ordering of contact precautions on admission, and ensuring appropriate removal of precautions.Results: Automation saved 43 infection preventionist hours per 1,000 admissions, in addition to previously unquantified hours spent reviewing MDRO history for every admission. Automatic retiring of certain MDRO flags ensured removal of contact precautions after a specified time. A point-prevalence assessment for eligibility for discontinuation found that all precautions were appropriate, with none eligible for removal. By integrating microbiology data, EHR tracking flags, and automated orders, this system assured rapid and comprehensive placement of patients into contact precautions without requiring oversight by infection prevention personnel. Conclusion:We show that automated systems embedded within EHRs can ensure tracking and application of appropriate contact precautions while simultaneously producing tremendous time savings for infection prevention programs.

No abstract

Most health care personnel who tested positive using the asymptomatic testing pathway reported symptoms consistent with ). Asymptomatic cases declined to 0 after vaccination.

Objective:To assess the impact of a newly developed Central-Line Insertion Site Assessment (CLISA) score on the incidence of local inflammation or infection for CLABSI prevention.Design:A pre- and postintervention, quasi-experimental quality improvement study.Setting and participants:Adult inpatients with central venous catheters (CVCs) hospitalized in an intensive care unit or oncology ward at a large academic medical center.Methods:We evaluated CLISA score impact on insertion site inflammation and infection (CLISA score of 2 or 3) incidence in the baseline period (June 2014–January 2015) and the intervention period (April 2015–October 2017) using interrupted times series and generalized linear mixed-effects multivariable analyses. These were run separately for days-to-line removal from identification of a CLISA score of 2 or 3. CLISA score interrater reliability and photo quiz results were evaluated.Results:Among 6,957 CVCs assessed 40,846 times, percentage of lines with CLISA score of 2 or 3 in the baseline and intervention periods decreased by 78.2% (from 22.0% to 4.7%), with a significant immediate decrease in the time-series analysis (P < .001). According to the multivariable regression, the intervention was associated with lower percentage of lines with a CLISA score of 2 or 3, after adjusting for age, gender, CVC body location, and hospital unit (odds ratio, 0.15; 95% confidence interval, 0.06–0.34; P < .001). According to the multivariate regression, days to removal of lines with CLISA score of 2 or 3 was 3.19 days faster after the intervention (P < .001). Also, line dwell time decreased 37.1% from a mean of 14 days (standard deviation [SD], 10.6) to 8.8 days (SD, 9.0) (P < .001). Device utilization ratios decreased 9% from 0.64 (SD, 0.08) to 0.58 (SD, 0.06) (P = .039).Conclusions:The CLISA score creates a common language for assessing line infection risk and successfully promotes high compliance with best practices in timely line removal.

Substantial discordance between NHSN and claims-based CLABSI indicators persists. Compared with standardized CDC chart review criteria, claims data often had both coding omissions and misclassification of non-CLABSI infections as CLABSI. Additionally, claims did not identify any additional CLABSIs for CDC reporting. NHSN criteria are a more consistent interhospital standard for CLABSI reporting.