Infection Control Link Nurse Program: An interdisciplinary approach in targeting health care-acquired infection

• Published in: American journal of infection control 2014-04, Vol.42 (4), p.353-359
• Main Authors: Sopirala, Madhuri M., MD, MPH, Yahle-Dunbar, Lisa, RN, CIC, Smyer, Justin, MLS(ASCP)CM, MPH, Wellington, Linda, RN, CIC, Dickman, Jeanne, MT, CIC, Zikri, Nancy, PhD, MPH, Martin, Jennifer, RN, MPH, Kulich, Pat, RN, CIC, Taylor, David, PhD, Mekhjian, Hagop, MD, Nash, Mary, PhD, Mansfield, Jerry, PhD, Pancholi, Preeti, PhD, Howard, Mary, RN, Chase, Linda, PhD, Brown, Susan, RN, Kipp, Kristopher, RN, Lefeld, Kristen, MHA, Myers, Amber, MPH, Pan, Xueliang, PhD, Mangino, Julie E., MD
• Format: Article
• Language: English
• Subjects: Bacteremia - epidemiology; Bacteremia - microbiology; Bacteremia - prevention & control; Biological and medical sciences; Confidence intervals; Cross Infection - epidemiology; Cross Infection - microbiology; Cross Infection - prevention & control; Disinfectants - administration & dosage; Drug Utilization; Epidemiology. Vaccinations; General aspects; Hand hygiene; Hands; Handwashing; Hospitals, University; Human infectious diseases. Experimental studies and models; Humans; Hygiene; Incidence; Infection Control; Infection Control - methods; Infection Control - organization & administration; Infection prevention; Infectious Disease; Infectious diseases; Intervention; Liaison; Medical sciences; Methicillin-Resistant Staphylococcus aureus - isolation & purification; MRSA; Multi-disciplinary; Nosocomial; Nosocomial infections; Nurses; Patient safety; Staphylococcal Infections - epidemiology; Staphylococcal Infections - microbiology; Staphylococcal Infections - prevention & control; Staphylococcus infections
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2013.10.007

Background We describe a successful interdisciplinary liaison program that effectively reduced health care-acquired (HCA), methicillin-resistant Staphylococcus aureus (MRSA) in a university hospital setting. Methods Baseline was from January 2006 to March 2008, and intervention period was April 2008 to September 2009. Staff nurses were trained to be liaisons (link nurses) to infection prevention (IP) personnel with clearly defined goals assigned and with ongoing monthly education. HCA-MRSA incidence per 1,000 patient-days (PD) was compared between baseline and intervention period along with total and non-HCA-MRSA, HCA and non-HCA-MRSA bacteremia, and hand soap/sanitizer usage. Hand hygiene compliance was assessed. Results A reduction in MRSA rates was as follows in intervention period compared with baseline: HCA-MRSA decreased by 28% from 0.92 to 0.67 cases per 1,000 PD (incidence rate ratio, 0.72; 95% confidence interval: 0.62-0.83, P < .001), and HCA-MRSA bacteremia rate was reduced by 41% from 0.18 to 0.10 per 1,000 PD (incidence rate ratio, 0.59; 95% confidence interval: 0.42-0.84, P  = .003). Total MRSA rate and MRSA bacteremia rate also showed significant reduction with nonsignificant reductions in overall non-HCA-MRSA and non-HCA-MRSA bacteremia. Hand soap/sanitizer usage and compliance with hand hygiene also increased significantly during IP. Conclusion Link nurse program effectively reduced HCA-MRSA. Goal-defined metrics with ongoing re-education for the nurses by IP personnel helped drive these results.