title: Automated tracking and ordering of precautions for multidrug-resistant organisms.
abstract: BACKGROUND
  The transmission and infection risk associated with multidrug-resistant organism (MDRO) carriers necessitates surveillance and tracking to provide proper contact precautions. As MDROs increase in scope, automated electronic health record (EHR) systems may help with surveillance demands.
  
  
  METHODS
  We created a system for MDROs and Clostridium difficile tracking that automated the following 3 main surveillance and tracking activities: monitoring of microbiology results and initiation of chart-based flags, ordering of contact precautions on admission, and ensuring appropriate removal of precautions.
  
  
  RESULTS
  Automation saved 43 infection preventionist hours per 1,000 admissions, in addition to previously unquantified hours spent reviewing MDRO history for every admission. Automatic retiring of certain MDRO flags ensured removal of contact precautions after a specified time. A point-prevalence assessment for eligibility for discontinuation found that all precautions were appropriate, with none eligible for removal. By integrating microbiology data, EHR tracking flags, and automated orders, this system assured rapid and comprehensive placement of patients into contact precautions without requiring oversight by infection prevention personnel.
  
  
  CONCLUSIONS
  We show that automated systems embedded within EHRs can ensure tracking and application of appropriate contact precautions while simultaneously producing tremendous time savings for infection prevention programs.
authors: Epidemiology and Infection Prevention Program, University of California Irvine Health, Orange, CA.
authors: Kathleen A
authors: KA
authors: Quan
authors: Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, CA. Electronic address: scousins@uci.edu.
authors: Sarah M
authors: SM
authors: Cousins
authors: Health Affairs Information Services, UC Irvine Health, Orange, CA.
authors: Darlene D
authors: DD
authors: Porter
authors: Health Affairs Information Services, UC Irvine Health, Orange, CA.
authors: Robert A
authors: RA
authors: Puppo
authors: Epidemiology and Infection Prevention Program, University of California Irvine Health, Orange, CA; Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, CA.
authors: Susan S
authors: SS
authors: Huang
mesh_terms: D016360:Clostridioides difficile; D016358:Contact Tracing / Q000379:methods*; D003428:Cross Infection / Q000517:prevention & control / Q000635:transmission*; D024901:Drug Resistance, Multiple, Bacterial; D057286:Electronic Health Records; D006801:Humans; D017053:Infection Control / Q000379:methods*; D062486:Public Health Surveillance / Q000379:methods; D017748:Time Management
keywords: Clostridium difficile; Isolation; Multidrug-resistant organism; Precautions