title: Infection control link nurse program: an interdisciplinary approach in targeting health care-acquired infection.
abstract: BACKGROUND
  We describe a successful interdisciplinary liaison program that effectively reduced health care-acquired (HCA), methicillin-resistant Staphylococcus aureus (MRSA) in a university hospital setting.
  
  
  METHODS
  Baseline was from January 2006 to March 2008, and intervention period was April 2008 to September 2009. Staff nurses were trained to be liaisons (link nurses) to infection prevention (IP) personnel with clearly defined goals assigned and with ongoing monthly education. HCA-MRSA incidence per 1,000 patient-days (PD) was compared between baseline and intervention period along with total and non-HCA-MRSA, HCA and non-HCA-MRSA bacteremia, and hand soap/sanitizer usage. Hand hygiene compliance was assessed.
  
  
  RESULTS
  A reduction in MRSA rates was as follows in intervention period compared with baseline: HCA-MRSA decreased by 28% from 0.92 to 0.67 cases per 1,000 PD (incidence rate ratio, 0.72; 95% confidence interval: 0.62-0.83, P < .001), and HCA-MRSA bacteremia rate was reduced by 41% from 0.18 to 0.10 per 1,000 PD (incidence rate ratio, 0.59; 95% confidence interval: 0.42-0.84, P = .003). Total MRSA rate and MRSA bacteremia rate also showed significant reduction with nonsignificant reductions in overall non-HCA-MRSA and non-HCA-MRSA bacteremia. Hand soap/sanitizer usage and compliance with hand hygiene also increased significantly during IP.
  
  
  CONCLUSIONS
  Link nurse program effectively reduced HCA-MRSA. Goal-defined metrics with ongoing re-education for the nurses by IP personnel helped drive these results.
authors.affiliation: Division of Infectious Diseases, The Ohio State University Wexner Medical Center, Columbus, OH; Department of Clinical Epidemiology, The Ohio State University Wexner Medical Center, Columbus, OH. Electronic address: madhuri.sopirala@uchealth.com.
authors.forename: Madhuri M
authors.initials: MM
authors.lastname: Sopirala
authors.affiliation: Department of Clinical Epidemiology, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Lisa
authors.initials: L
authors.lastname: Yahle-Dunbar
authors.affiliation: Department of Clinical Epidemiology, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Justin
authors.initials: J
authors.lastname: Smyer
authors.affiliation: Department of Clinical Epidemiology, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Linda
authors.initials: L
authors.lastname: Wellington
authors.affiliation: Department of Clinical Epidemiology, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Dickman
authors.affiliation: Department of Clinical Epidemiology, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Nancy
authors.initials: N
authors.lastname: Zikri
authors.affiliation: Department of Clinical Epidemiology, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Martin
authors.affiliation: Department of Clinical Epidemiology, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Pat
authors.initials: P
authors.lastname: Kulich
authors.affiliation: Department of Clinical Epidemiology, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: David
authors.initials: D
authors.lastname: Taylor
authors.affiliation: Health System Administration, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Hagop
authors.initials: H
authors.lastname: Mekhjian
authors.affiliation: Health System Nursing Administration, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Mary
authors.initials: M
authors.lastname: Nash
authors.affiliation: Health System Nursing Administration, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Jerry
authors.initials: J
authors.lastname: Mansfield
authors.affiliation: Department of Pathology, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Preeti
authors.initials: P
authors.lastname: Pancholi
authors.affiliation: Health System Nursing Administration, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Mary
authors.initials: M
authors.lastname: Howard
authors.affiliation: Health System Nursing Administration, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Linda
authors.initials: L
authors.lastname: Chase
authors.affiliation: Health System Nursing Administration, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Susan
authors.initials: S
authors.lastname: Brown
authors.affiliation: Health System Nursing Administration, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Kristopher
authors.initials: K
authors.lastname: Kipp
authors.affiliation: Department of Clinical Epidemiology, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Kristen
authors.initials: K
authors.lastname: Lefeld
authors.affiliation: Department of Clinical Epidemiology, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Amber
authors.initials: A
authors.lastname: Myers
authors.affiliation: Center for Biostatistics, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Xueliang
authors.initials: X
authors.lastname: Pan
authors.affiliation: Division of Infectious Diseases, The Ohio State University Wexner Medical Center, Columbus, OH; Department of Clinical Epidemiology, The Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Julie E
authors.initials: JE
authors.lastname: Mangino
mesh_terms: D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*; D004202:Disinfectants / Q000008:administration & dosage; D004363:Drug Utilization; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods* / Q000458:organization & administration; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D009726:Nurses; D013203:Staphylococcal Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control*
chemical_list: D004202:Disinfectants
keywords: Hand hygiene; Handwashing; Infection prevention; Liaison; MRSA; Multi-disciplinary; Nosocomial; Patient safety