Reducing Healthcare-Associated Infections using an Infection Control Network

项目摘要 医疗保健相关感染(HAI)通常是由耐多药微生物(MDRO)引起的。MDRO 是一种与日俱增的流行病，与显著的发病率、死亡率和成本有关。一项重要的战略， 缓解这一流行病是通过感染控制预防措施来防止MDRO的传播。这些 只有在医疗保健提供者很早就意识到患者已知 有以前或新的MDRO感染经历。目前，对MDRO的识别分别在每个 医院：提供者手动审查患者记录以了解MDRO的历史。信息很少被共享 在设施之间，识别仅限于设施级别的监测；区域人口监测 不存在。没有办法知道呈现病例的患者是否在另一家机构诊断为MDRO。这 导致对感染控制预防措施的延迟或未被认识到的需要，使传播永久化 MDRO。需要进行人口监测，以提高对MDRO感染患者的认识，并 促进人群水平的研究；需要区域临床决策支持(CDS)以更有效地预防 与医疗保健相关的MDRO的传播。 使用卫生信息交换(HIE)的生物监测可以填补这些空白。我们的目标是减少医疗保健- 通过创建一个区域电子感染控制网络，将MDRO联系起来。这个网络的目标是 为HIE中的组织提供监测和CDS，并建立人口层面的平台 学习。中心假设是区域性感染控制网络将提高每个人的能力 建立一个机构，以快速识别MDRO感染并实施预防传播的干预措施。一个 以前的项目已经证明了针对MRSA的感染控制网络在减少禽流感方面的有效性。我们 将在这一成功的基础上开发软件来处理进入我们HIE的微生物学报告，以便 1)确定有7种不同MDRO感染的患者，以及2)实施CDS。我们将评估 网络在减少与医疗保健相关的MDRO方面的准确性和效果，以及其促进 对MDRO感染的人群水平研究。 我们相信这个项目是创新的，因为它利用HIE来提供自动监控 与医疗保健相关的MDRO感染，并在多个机构之间提供CDS。这个项目意义重大 因为它通过自动识别与医疗保健相关的 并提供CDS警报，以确保及时安排感染控制干预措施。

Project Summary Healthcare-associated infections (HAI) are often caused by multidrug-resistant organisms (MDROs). MDROs are a growing epidemic associated with significant morbidity, mortality, and cost. An essential strategy for mitigating this epidemic is to prevent transmission of MDROs through infection control precautions. These measures can be implemented only if healthcare providers are aware - early on - that a patient is known to have a previous or new MDRO infection. Currently, recognition of MDROs occurs independently at each hospital: providers manually review patient records for a history of MDROs. Information is rarely shared between facilities, and recognition is limited to facility-level surveillance; regional population surveillance does not exist. There is no way to know if a presenting patient had an MDRO diagnosed at another institution. This leads to a delayed or unrecognized need for infection control precautions, perpetuating transmission of MDROs. Population surveillance is needed to improve recognition of patients with MDRO infections and to facilitate population-level studies; regional clinical decision support (CDS) is needed to more effectively prevent transmission of healthcare-associated MDROs. Biosurveillance using a health information exchange (HIE) can fill these gaps. Our goal is to reduce healthcare- associated MDROs by creating a regional electronic infection control network. The objective of this network is to provide surveillance and CDS for organizations in an HIE and establish a platform for population-level studies. The central hypothesis is that a regional infection control network will improve the ability of each institution to quickly identify MDRO infections and to implement interventions to prevent transmission. A previous project has proven the effectiveness of a MRSA-specific infection control network to reduce HAIs. We will build upon this success to develop software to process microbiology reports coming into our HIE in order to 1) identify patients with seven different MDRO infections, and 2) implement CDS. We will evaluate the accuracy and effect of the network in reducing healthcare-associated MDROs, and its ability to facilitate population-level studies of MDRO infections. We believe that this project is innovative because it leverages an HIE to provide automated surveillance of healthcare-associated MDRO infections and deliver CDS across multiple institutions. The project is significant because it improves recognition and control of HAIs by automating identification of healthcare-associated MDROs and by providing CDS alerts to ensure timely ordering of infection control interventions.