title: Improved patient safety through reduced airway infection rates in a paediatric cystic fibrosis programme after a quality improvement effort to enhance infection prevention and control measures.
abstract: OBJECTIVE
  To reduce the risk of pathogen transmission between patients with cystic fibrosis (CF) and decrease the rate of acquisition of new CF pathogens in our patients.
  
  
  METHODS
  Using the Model for Improvement, we developed a new process for infection prevention and control in our outpatient CF clinics.
  
  
  METHODS
  Paediatric CF programme at Ann & Robert H. Lurie Children's Hospital of Chicago; approximately 180 paediatric patients aged birth to 21 years.
  
  
  METHODS
  All paediatric patients enrolled in the Cystic Fibrosis Foundation Patient Data Registry at this institution.
  
  
  METHODS
  Implemented contact precautions with all patients, regardless of respiratory tract culture results.
  
  
  METHODS
  Respiratory tract culture rates of specific pathogens by quarter were compared prior to and after implementation.
  
  
  RESULTS
  Our percentage of patients with a positive respiratory tract culture for Pseudomonas aeruginosa dropped from 30% to 21% (p<0.0001) and for methicillin-resistant Staphylococcus aureus (MRSA) dropped from 10.8% to 8.7% (p=0.008).
  
  
  CONCLUSIONS
  Use of contact precautions by all care providers, for all patients, regardless of respiratory tract culture results resulted in decreased P aeruginosa and MRSA infection rates.
authors.affiliation: Division of Pulmonary Medicine, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, , Chicago, Illinois, USA.
authors.forename: Adrienne P
authors.initials: AP
authors.lastname: Savant
authors.forename: Catherine
authors.initials: C
authors.lastname: O'Malley
authors.forename: Stacy
authors.initials: S
authors.lastname: Bichl
authors.forename: Susanna A
authors.initials: SA
authors.lastname: McColley
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003550:Cystic Fibrosis / Q000382:microbiology* / Q000503:physiopathology / Q000628:therapy*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D017053:Infection Control / Q000458:organization & administration*; D008297:Male; D061214:Patient Safety / Q000706:statistics & numerical data*; D011322:Primary Prevention / Q000458:organization & administration; D015397:Program Evaluation; D011552:Pseudomonas Infections / Q000517:prevention & control; D058996:Quality Improvement; D012141:Respiratory Tract Infections / Q000382:microbiology / Q000517:prevention & control* / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D013203:Staphylococcal Infections / Q000517:prevention & control; D014481:United States
keywords: Healthcare Quality Improvement; Implementation Science; Infection Control; Paediatrics