Favorable impact of an infection control network on nosocomial infection rates in community hospitals.
OBJECTIVE
To describe an infection control network (the Duke Infection Control Outreach Network [DICON]) and its impact on nosocomial infection rates in community hospitals.


METHODS
Prospective cohort study of rates of nosocomial infections and exposures of employees to bloodborne pathogens in hospitals during the first 3 years of their affiliation with DICON. Attributable cost and mortality estimates were obtained from published studies.Setting. Twelve community hospitals in North Carolina and Virginia.


RESULTS
During the first 3 years of hospital affiliation with DICON, annual rates of nosocomial bloodstream infections at study hospitals decreased by 23% (P = .009). Annual rates of nosocomial infection and colonization due to methicillin-resistant Staphylococcus aureus decreased by 22% (P = .002), and rates of ventilator-associated pneumonia decreased by 40% (P = .001). Rates of exposure of employees to bloodborne pathogens decreased by 18% (P = .003).


CONCLUSIONS
The establishment of an infection control network within a group of community hospitals was associated with substantial decreases in nosocomial infection rates. Standard surveillance methods, frequent data analysis and feedback, and interventions based on guidelines and protocols from the Centers for Disease Control and Prevention were the principal strategies used to achieve these reductions. In addition to lessening the adverse clinical outcomes due to nosocomial infections, these reductions substantially decreased the economic burden of infection: the decline in nosocomial bloodstream infections and ventilator-associated pneumonia alone yielded potential savings of 578,307 US dollars to 2,195,954 US dollars per year at the study hospitals.
Department of Medicine and Infection Control, Duke University Medical Center, Durham, NC 27710, USA. kaye0001@mc.duke.edu
Keith S
KS
Kaye
John J
JJ
Engemann
Evelyn M
EM
Fulmer
Connie C
CC
Clark
Edwin M
EM
Noga
Daniel J
DJ
Sexton
D017714:Community-Acquired Infections / Q000453:epidemiology; D003428:Cross Infection / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D017052:Hospital Mortality; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods*; D016106:Methicillin Resistance; D009657:North Carolina / Q000453:epidemiology; D018571:Sentinel Surveillance; D014768:Virginia / Q000453:epidemiology