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Weekly email updates decreased transmission of A. baumannii
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The transmission of Acinetobacter baumannii at a Florida hospital decreased by 63% when comprehensive weekly reports of the infection were sent to the hospital leadership, researchers from the University of Miami Miller School of Medicine have found.
“This is the first study to examine the effect of mass electronic dissemination of results from a bundle of interventions,” the researchers wrote in the American Journal of Infection Control. “Weekly electronic communications were associated with a striking decrease in the rate of new acquisitions of A. baumannii at our institution probably because of a combination of education, communication, feedback and peer pressure.”
The researchers analyzed hospital data obtained from 2010 to June 30, 2013, to determine the outcome of implementing a bundle of infection control interventions. The interventions included the following:
- Patient screening tests upon admission to the ICU and then weekly;
- Isolation and separation of patients testing positive for A. baumannii;
- Weekly sampling of surfaces in the hospital environment to assess cleaning;
- Hand hygiene interventions, including random cultures of health care workers’ hands;
- Observing patient-shared objects; and
- Monthly meetings to discuss issues relating to the interventions.
In phase 1 of the study (2010-2011), the interventions had been implemented, but there was no change in infection rates. In phase 2 of the study (2011-2012), the medical director of infection control began sending weekly emails to hospital leadership that included data obtained from the interventions. In phase 3 (2012-2013), the interventions continued, but weekly emails ceased due to only scattered acquisitions.
The three phases represented 1.1 million patient-days. In phase 1 of the study, the overall acquisition rate of new cases of carbapenem-resistant A. baumannii was 5.13 per 10,000 patient-days. In phase 3, the acquisition rate was 1.93 per 10,000 patient-days, a decrease of 63%.
“These regular, highly visible communications allowed us to create a sense of accountability for new cases that unified both the leadership and providers toward the common goal of decreasing new acquisitions of carbapenem-resistant A. baumannii,” the researchers wrote. “These weekly emails not only packaged information on the number and locations of new acquisitions of A. baumannii, but also described and explained the results of environmental initiatives, hand culture results and identification of shared objects among patients.”
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