title: Infection prevention practices in adult intensive care units in a large community hospital system after implementing strategies to reduce health care-associated, methicillin-resistant Staphylococcus aureus infections.
abstract: BACKGROUND
  A range of strategies and approaches have been developed for preventing health care-associated infections. Understanding the variation in practices among facilities is necessary to improve compliance with existing programs and aid the implementation of new interventions.
  
  
  METHODS
  In 2009, HCA Inc administered an electronic survey to measure compliance with evidence-based infection prevention practices as well as identify variation in products or methods, such as use of special approach technology for central vascular catheters and ventilator care. Responding adult intensive care units (ICUs) were those considering participation in a clinical trial to reduce health care-associated infections.
  
  
  RESULTS
  Responses from 99 ICUs in 55 hospitals indicated that many evidenced-based practices were used consistently, including methicillin-resistant Staphylococcus aureus (MRSA) screening and use of contact precautions for MRSA-positive patients. Other practices exhibited wide variability including discontinuation of precautions and use of antimicrobial technology or chlorhexidine patches for central vascular catheters. MRSA decolonization was not a predominant practice in ICUs.
  
  
  CONCLUSIONS
  In this large, community-based health care system, there was substantial variation in the products and methods to reduce health care-associated infections. Despite system-wide emphasis on basic practices as a precursor to adding special approach technologies, this survey showed that these technologies were commonplace, including in facilities where improvement in basic practices was needed.
authors: Clinical Services Group, HCA Inc, Nashville, TN 37203, USA. Julia.moody@hcahealthcare.com
authors: Julia
authors: J
authors: Moody
authors: Edward
authors: E
authors: Septimus
authors: Jason
authors: J
authors: Hickok
authors: Susan S
authors: SS
authors: Huang
authors: Richard
authors: R
authors: Platt
authors: Adrijana
authors: A
authors: Gombosev
authors: Leah
authors: L
authors: Terpstra
authors: Taliser
authors: T
authors: Avery
authors: Julie
authors: J
authors: Lankiewicz
authors: Jonathan B
authors: JB
authors: Perlin
mesh_terms: D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006764:Hospitals, Community; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000592:standards; D007362:Intensive Care Units; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires