Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-19T11:09:46.119Z Has data issue: false hasContentIssue false
  • English
  • Français

Changing the Infection Control Paradigm From Off-Line to Real Time The Experience at Millard Fillmore Health System

Published online by Cambridge University Press:  02 January 2015

James R. Carr ,
Paul Fitzpatrick ,
Joseph L. Izzo ,
Thomas J. Cumbo ,
Mary C. Birmingham ,
Martin H. Adelman ,
Joseph A. Paladino ,
Stephen C. Hanson  and
Jerome J. Schentag
James R. Carr*
Affiliation:
Department of Medicine, Infection Management Division, System Administration and the Clinical Pharmacokinetics Laboratory, Millard Fillmore Health System, Buffalo, New York
Paul Fitzpatrick
Affiliation:
Department of Medicine, Infection Management Division, System Administration and the Clinical Pharmacokinetics Laboratory, Millard Fillmore Health System, Buffalo, New York
Joseph L. Izzo
Affiliation:
Department of Medicine, Infection Management Division, System Administration and the Clinical Pharmacokinetics Laboratory, Millard Fillmore Health System, Buffalo, New York
Thomas J. Cumbo
Affiliation:
Department of Medicine, Infection Management Division, System Administration and the Clinical Pharmacokinetics Laboratory, Millard Fillmore Health System, Buffalo, New York
Mary C. Birmingham
Affiliation:
Department of Medicine, Infection Management Division, System Administration and the Clinical Pharmacokinetics Laboratory, Millard Fillmore Health System, Buffalo, New York
Martin H. Adelman
Affiliation:
Department of Medicine, Infection Management Division, System Administration and the Clinical Pharmacokinetics Laboratory, Millard Fillmore Health System, Buffalo, New York
Joseph A. Paladino
Affiliation:
Department of Medicine, Infection Management Division, System Administration and the Clinical Pharmacokinetics Laboratory, Millard Fillmore Health System, Buffalo, New York
Stephen C. Hanson
Affiliation:
Department of Medicine, Infection Management Division, System Administration and the Clinical Pharmacokinetics Laboratory, Millard Fillmore Health System, Buffalo, New York
Jerome J. Schentag
Affiliation:
Department of Medicine, Infection Management Division, System Administration and the Clinical Pharmacokinetics Laboratory, Millard Fillmore Health System, Buffalo, New York
*
Millard Fillmore Health System, Infection Management Division, 3 Gates Cir, Buffalo, NY 14209
Get access Rights & Permissions [Opens in a new window]

Abstract

In 1993, several departments at Millard Fillmore Health System joined efforts to initiate a new approach to infection control. The main emphasis of this program is to move infection control to a real-time mode to manage patient outcomes daily. The principal objective was to decrease the number of nosocomial infections by 10%, with a particular emphasis on surgical-site infections. Besides real-time surveillance, we are critically evaluating several aspects of the management of nosocomial infections.

High-level computer support has been the framework upon which this program was built. We have micro-computers that are linked directly to microbiology, pharmacy, billing, and admissions, downloading data several times daily. An expert software system merges all of the data, and from this we can target patients for real-time interventions. The computer system allows all inpatients to be screened for either infection control or antibiotic management inter ventions on a daily basis, with minimal time being spent on data collection and maximal efforts devoted to inter ventions at the bedside.

Additionally, the infection management program will assist in maintaining the extraordinarily low expenditures on antimicrobial agents. During 1993, the Millard Fillmore Health System spent $924,884 on antibiotics, an amount approximately 50% that of comparably sized hospitals.

Type
Readers' Forum
Information
Infection Control & Hospital Epidemiology , Volume 18 , Issue 4 , April 1997 , pp. 255 - 259
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1997

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Ballow, CH, Schentag, JJ. Trends in antibiotic utilization and bacterial resistance. Diagn Microbiol Infect Dis 1992;15:37S–42S.CrossRefGoogle ScholarPubMed
2. Schentag, JJ, Ballow, CH, Fritz, AL, et al. Changes in antimicrobial agent usage resulting from interactions among clinical pharmacy, the infectious disease division, and the microbiology laboratory. Diagn Microbiol Infect Dis 1993;16:255–264.CrossRefGoogle ScholarPubMed
3. Schentag, JJ, Paladino, JA, Birmingham, MC, Carr, JR, Hanson, SC. Use of benchmarking techniques to justify the evolution of a hospital antibiotic management program. J Pharm Technol 1995;11:203–210.CrossRefGoogle Scholar
4. Martone, WJ, Jarvis, WR, Culver, DH, Haley, RW. Incidence and nature of endemic and epidemic nosocomial infections. In: Bennett, JV, Brachman, PS, eds. Hospital Infections. 3rd ed. Boston, MA: Little Brown and Co; 1992:577–596.Google Scholar
5. Carr, JR, Fitzpatrick, PE, Cumbo, TJ, Schentag, JJ. A reduction in oral vancomycin use and a concomitant reduction in vancomycin-resistant Enterococcus . Infect Control Hosp Vol. 18 No. 4 Epidemiol 1996;17(suppl):P25. Abstract 59.Google Scholar
6. Schentag, JJ, Nix, DE, Adelman, MH. Mathematical examination of dual individualization principles. Relationships between AUC above MIC and area under the inhibitory curve (AUIC) for cefmenoxime, ciprofloxacin, and tobramycin. DICP 1991;25:1050–1057.CrossRefGoogle Scholar
7. Forrest, A, Nix, DE, Ballow, CH, Goss, TF, Birmingham, MC, Schentag, JJ. Pharmacodynamics of intravenous ciprofloxacin in seriously ill patients. Antimicrob Agents Chemother 1993;37:1073–1081.CrossRefGoogle ScholarPubMed
8. Holmberg, SD, Solomon, SL, Blake, PA. Health and economic impacts of antimicrobial resistance. Rev Infect Dis 1987;9:1065–1078.CrossRefGoogle ScholarPubMed
9. Raad, II, Hohn, DC, Gilbrath, J, et al. Prevention of central venous catheter-related infections by using maximal sterile barrier precautions during insertion. Infect Control Hosp Epidemiol 1994;15:231–238.Google Scholar