CASE STUDY

Infection rate reduced by 75% in 9 months. 

Facility: 90-bed skilled, long-term care facility in Arkansas

Problem:

This facility had a high number of monthly infections that were being treated with antibiotics, mostly respiratory, but UTIs as well. 

Solution:

We took a proactive approach.  We focused heavily on process and outcome surveillance from a targeted approach.

  • We used PCR diagnostic testing at the earliest symptoms that indicated the resident may have an infection. This eliminated lengthy wait times for results of tests such as culture and sensitivities.

  • We also focused on finding holes in policies and procedures, did a lot of tracking and trending to determine commonalities between residents with the same pathogen, and educated and empowered the staff- making sure that the education that we presented was understood.

  • We made Performance Improvement Plans and used a multi-disciplinary approach to ensure that the program was consistent, and goals were reached.

Antibiotics were not prescribed unless a bacterial pathogen was present and the resident met the criteria.

We started with a baseline test on all residents. 17 residents had the same viral pathogen.  8 of those residents were being actively treated with antibiotics with a diagnosis of upper respiratory infection.  We were able to stop antibiotics for the residents that did not need them.  The other 9 residents were closely monitored and enhanced environmental cleaning measures.  3 of those residents became symptomatic within the following 4 days: cough, nasal drainage, and low-grade fever.  Knowing they had a viral pathogen; these residents were treated symptomatically and not placed on antibiotics.  Symptoms resolved a few days later.

Outcome:

Over the course of 9 months the overall infection rate was reduced by 75%.