Evaluation of a successful vancomycin-resistant Enterococcus prevention intervention in a community of health care facilities.
BACKGROUND
In April 1997, vancomycin-resistant enterococci (VRE) emerged in several health care facilities in the Siouxland region and a VRE Task Force was formed. From 1997 through 1999, an evaluation of VRE prevalence at 30 facilities was performed.


METHODS
In 1999, we conducted a survey and focus groups of health care workers to address initial reactions to VRE, feasibility of the Task Force recommendations, and lessons learned.


RESULTS
Personnel at 29 (97%) facilities surveyed completed the questionnaire, and 15 health care workers from 11 facilities participated in 5 focus groups. The outcomes of expanded education and improved awareness of VRE for patients and health care workers were ranked the No. 1 priority overall and by long-term care facility personnel. Respondents agreed that Task Force recommendation adherence had significantly improved infection control (83%) and that the Task Force was an appropriate mechanism to coordinate infection control efforts (90%). Focus groups commented that it was most difficult to educate family members about VRE; they expressed concern about variation between VRE policies, especially between acute care and long-term care facilities, and about the quality of life of isolated patients.


CONCLUSIONS
Our data illustrate that this intervention has been far-reaching and include the development of a health care infrastructure that may be used as a model to address additional health care issues (eg, emerging pathogens or biological threats).
Sohn
A H
AH
Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Ostrowsky
B E
BE
Sinkowitz-Cochran
R L
RL
Quirk
S B
SB
Jarvis
W R
WR
D016983:Enterococcus / Q000187:drug effects* / Q000472:pathogenicity; D017144:Focus Groups; D016908:Gram-Positive Bacterial Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D019983:Guideline Adherence; D006306:Health Surveys; D006764:Hospitals, Community / Q000592:standards*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007484:Iowa; D010353:Patient Education as Topic; D010356:Patient Isolation; D010564:Personnel, Hospital; D015995:Prevalence; D011795:Surveys and Questionnaires; D020713:Vancomycin Resistance