Improved patient safety through reduced airway infection rates in a paediatric cystic fibrosis programme after a quality improvement effort to enhance infection prevention and control measures

BMJ Qual Saf. 2014 Apr:23 Suppl 1:i73-i80. doi: 10.1136/bmjqs-2013-002315.

Abstract

Objective: To reduce the risk of pathogen transmission between patients with cystic fibrosis (CF) and decrease the rate of acquisition of new CF pathogens in our patients.

Design: Using the Model for Improvement, we developed a new process for infection prevention and control in our outpatient CF clinics.

Setting: Paediatric CF programme at Ann & Robert H. Lurie Children's Hospital of Chicago; approximately 180 paediatric patients aged birth to 21 years.

Participants: All paediatric patients enrolled in the Cystic Fibrosis Foundation Patient Data Registry at this institution.

Interventions: Implemented contact precautions with all patients, regardless of respiratory tract culture results.

Measurement: Respiratory tract culture rates of specific pathogens by quarter were compared prior to and after implementation.

Results: Our percentage of patients with a positive respiratory tract culture for Pseudomonas aeruginosa dropped from 30% to 21% (p<0.0001) and for methicillin-resistant Staphylococcus aureus (MRSA) dropped from 10.8% to 8.7% (p=0.008).

Conclusions: Use of contact precautions by all care providers, for all patients, regardless of respiratory tract culture results resulted in decreased P aeruginosa and MRSA infection rates.

Keywords: Healthcare Quality Improvement; Implementation Science; Infection Control; Paediatrics.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Cystic Fibrosis / microbiology*
  • Cystic Fibrosis / physiopathology
  • Cystic Fibrosis / therapy*
  • Databases, Factual
  • Female
  • Humans
  • Infection Control / organization & administration*
  • Male
  • Patient Safety / statistics & numerical data*
  • Primary Prevention / organization & administration
  • Program Evaluation
  • Pseudomonas Infections / prevention & control
  • Quality Improvement
  • Respiratory Tract Infections / microbiology
  • Respiratory Tract Infections / prevention & control*
  • Respiratory Tract Infections / therapy
  • Retrospective Studies
  • Risk Assessment
  • Staphylococcal Infections / prevention & control
  • United States