199291 Surveying Organizational Characteristics in the Implementation of Infection Control in US Hospitals

Monday, November 9, 2009: 1:05 PM

Ann F. Chou, PhD, MPH , College of Public Health & College of Medicine, University of Oklahoma, Oklahoma City, OK
Kimberly McCoy, MS , VA Medical Center, Indianapolis, IN
Bradley Doebbeling, MD, MSc , Indiana University School of Medicine, Indianapolis, IN
  
Background: An increase in antimicrobial resistance (AMR) brings challenges to the healthcare system, with implications on patient safety, costs, and quality. Although AMR surveillance programs have demonstrated the extent of problems, little information exists on how AMR varies by organizational characteristics.

Objective: This study aims to describe current organizational practices, differentiated by AMR rates of Methicillin resistant S. Aureus (MRSA), Vancomycin resistant enterococci (VRE), Ceftazidime resistanct Klebsiella species (K-ESBL), and Quinolone resistant Escherichia coli (QREC).

Methods: An analytic dataset was created using survey responses of 448 Infection Control Professionals from the Epidemiology and Control of AMR Study and hospital characteristics from the American Hospital Association Survey. Point estimates for AMR rates were calculated using the ridit method, validated via antibiograms. AMR rates were compared across organizational processes for infection control, resources, leadership, and size using the Jonckheere-Terpstra test. Hospitals characteristics were compared using the Cochran-Mantel-Haenszel mean score statistic.

Results: MRSA and K-ESBL rates decreased with implementation of infection control measures, resources allocation, and leadership. VRE rates decreased with implementation of infection control measures while QREC rates decreased with better resources. All AMR rates increased as bedsize increased. Urban hospitals reported higher MRSA and VRE and teaching institutions had higher MRSA, VRE, and QREC rates. VA hospitals reported higher MRSA and K-ESBL rates.

Conclusions: AMR rates decreased when hospitals implemented processes, dedicated resources, and demonstrated leadership for infection control. Examining relationships between AMR rates and organizational characteristics provides insights into challenges of preventing infections and offer strategies to implement best practices.

Learning Objectives:
To describe organizational practices, differentiated by antimicrobial resistance rates

Keywords: Infectious Diseases, Management

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Have conducted research in this area
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Infectious Disease Epidemiology
See more of: Epidemiology