title: Certification in infection control matters: Impact of infection control department characteristics and policies on rates of multidrug-resistant infections.
abstract: BACKGROUND
  The study objective is to describe infection control policies aimed at multidrug-resistant organisms (MDRO) in California hospitals and assess the relationship among these policies, structural characteristics, and rates of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) bloodstream infections and Clostridium difficile infections.
  
  
  METHODS
  Data on infection control policies, structural characteristics, and MDRO rates were collected through a 2010 survey of California infection control departments. Bivariate and multivariable Poisson and negative binomial regressions were conducted.
  
  
  RESULTS
  One hundred eighty hospitals provided data (response rate, 54%). Targeted MRSA screening upon admission was reported by the majority of hospitals (87%). The majority of hospitals implemented contact precautions for confirmed MDRO and C difficile patients; presumptive isolation/contact precautions for patients with pending screens were less frequently implemented. Few infection control policies were associated with lower MDRO rates. Hospitals with a certified infection control director had significantly lower rates of MRSA bloodstream infections (P < .05).
  
  
  CONCLUSIONS
  Although most California hospitals are involved in activities to decrease MDRO, there is variation in specific activities utilized with the most focus placed on MRSA. This study highlights the importance of certification and its significant impact on infection rates. Additional research is needed to confirm these findings.
authors.affiliation: Columbia University School of Nursing, New York, NY, USA. Mp2422@columbia.edu
authors.forename: Monika
authors.initials: M
authors.lastname: Pogorzelska
authors.forename: Patricia W
authors.initials: PW
authors.lastname: Stone
authors.forename: Elaine L
authors.initials: EL
authors.lastname: Larson
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D001424:Bacterial Infections / Q000382:microbiology / Q000517:prevention & control*; D002140:California; D016360:Clostridioides difficile / Q000187:drug effects; D003625:Data Collection; D024901:Drug Resistance, Multiple, Bacterial; D016983:Enterococcus / Q000187:drug effects; D006761:Hospitals; D006801:Humans; D017053:Infection Control / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D007362:Intensive Care Units; D008004:Licensure / Q000331:legislation & jurisprudence / Q000592:standards*; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents