Infections due to Clostridium difficile, MRSA or VRE: Clinical and System Reviews, Incident Analyses
In addition to surveillance and outbreak investigation a system review maybe indicated to identify potential causes of outbreaks and determine appropriate recommendations.
Occurrences of harm are often complex with many contributing factors. Organizations need to:
- Measure and monitor the types and frequency of these occurrences.
- Use appropriate analytical methods to understand the contributing factors.
- Identify and implement solutions or interventions that are designed to prevent recurrence and reduce the risk of harm.
- Have mechanisms in place to mitigate consequences of harm when it occurs.
To develop a more in-depth understanding of the care delivered to patients, chart audits, incident analyses and prospective analyses can be helpful in identifying quality improvement opportunities. Links to key resources for听conducting chart audits听补苍诲听analysis methods听are included in听Hospital Harm Improvement Resources Introduction.听听
If your surveillance, outbreak investigation or system review reveals that your cases of听C.听difficile, MRSA or VRE are linked to breaks in infection prevention and control practices, these resources maybe helpful:听听
Organizations
Canadian
- Infection Prevention and Control Canada: Resources and Publications听
- Provincial Infection Control Network of British Columbia (PICNet): Guidelines and Toolkits听
- Public Health Agency of Canada, Infection Control Guideline Series听听 听
- Public Health Ontario: Infection Prevention and Control听
International
- World Health Organization: Infection Prevention and Control听
- Association for Professionals in Infection Control and Epidemiology: Practice guidance for infection prevention听
- Centers for Disease Control and Prevention (CDC) : Infection Control听
Infection Prevention and Control Programs
Canadian
- Government of Manitoba. Routine practices and additional precautions: Preventing the transmission of infection in health care.听Winnipeg, MB: Government of Manitoba; 2012. Available at:听听
- Health Quality Ontario.听Improvement map: Infection prevention and control.听Available at:听听
- Provincial Infectious Diseases Advisory Committee (PIDAC).听Best practices for infection prevention and control programs in Ontario.听Toronto, ON: Public Health Ontario; 2012. Available at:
International
- National Institute for Health and Care Excellence (NICE).听Healthcare-associated infections.听2016. Available at:听
- NICE.听Infection prevention and control. 2014. Available at:听
- World Health Organization (WHO). Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level. 2016. Available at 听
Routine Practices and Additional Precautions
Canadian
- Public Health Agency of Canada (PHAC).听Routine practices and additional precautions for preventing the transmission of infection in healthcare settings.听2017. Available at:听
- Provincial Infectious Diseases Advisory Committee (PIDAC). Routine practices and additional precautions in all health care settings. Public Health Ontario; 2012. Available at: 听
Hand Hygiene
Canadian
- Health Quality Ontario.听Improvement map: Hand hygiene.听Available at:听
- Provincial Infectious Diseases Advisory Committee (PIDAC).听Best practices for hand hygiene in all health care settings.听4th听Ed. Toronto, ON: Public Health Ontario; 2014. Available at: 听
International
- Centers for Disease Control and Prevention (CDC).听Hand hygiene guideline.听CDC; 2002. Available at:听
- World Health Organization (WHO).听WHO guidelines on hand hygiene in health care.听Geneva; WHO: 2009. Available at:听
Best Practices in Environmental Cleaning
Canadian
- Provincial Infectious Diseases Advisory Committee (PIDAC).听. Toronto, ON: Public Health Ontario; 2018. Available at:听听听
- Provincial Infection Control Network of British Columbia (PICNet). British Columbia best practices for environmental cleaning for prevention and control of infections in all healthcare settings and programs. Vancouver, BC: PICNet; 2016. Available at:听
International
- Centers for Disease Control and Prevention (CDC).听.听CDC; 2016. Available at:听
Best Practices in Hospital Surveillance and Screening for Patients at High Risk for Presence of MRAS and/or VRE听
Canadian
- Canadian Agency for Drugs and Technologies in Health (CADTH).听Methicillin-resistant Staphylococcus aureus (MRSA) screening and discontinuation of precautions in hospitals: Clinical effectiveness and guidelines.听CADTH; 2011. Available at:听
- Provincial Infectious Diseases Advisory Committee (PIDAC).听Best practices for surveillance of health care-associated infections. Toronto, ON: Public Health Ontario; 2014. Available at: 听
- Provincial Infectious Diseases Advisory Committee (PIDAC).听Annex A: Screening, testing and surveillance for antibiotic-resistant organisms (AROs).听Toronto, ON: Public Health Ontario; 2013. Available at: 听
International
- Lee TB, Montgomery OG, Marx J, Olmsted RN, Scheckler WE. Recommended practices for surveillance: Association for Professionals in Infection Control and Epidemiology (APIC).听AJIC.听2007; 35: 427-440. doi:10.1016/j.ajic.2007.07.002. Available at:听听听
Best Practices for Outbreak Management
Canadian
- Population and Public Health Division, Ministry of Health and Long-Term Care.听Institutional/facility outbreak management protocol, 2018.听Government of Ontario; 2018.听 Available at:听听
- Provincial Infectious Diseases Advisory Committee (PIDAC).听Annex C: Testing, surveillance and management of Clostridium difficile in all health care settings.听Toronto, ON: Public Health Ontario; 2013. Available at: 听
International
- Campbell, EA. Chapter 12: Outbreak investigations.听听APIC Text of Infection Control and Epidemiology.听Reston, VA: APIC; 2014.听听
- Centers for Disease Control and Prevention (CDC). Healthcare-associated infection (HAI) outbreak investigation toolkit. CDC; 2013. Available at:
- World Health Organization (WHO).听. Geneva; WHO: 2014. Available at:听
Antimicrobial Stewardship
Canadian
- Do Bugs Need Drugs?听
- Nakamachi Y, West S, Dresser L, Morris AM. Developing and expanding hospital antimicrobial stewardship: The Ontario experience.听CCDR Suppl.听2015; 41S-4. https://doi.org/10.14745/ccdr.v41is4a04. Available at:听
- Public Health Ontario.听Antimicrobial stewardship.听Available at:听
International
- Centers for Disease Control and Prevention (CDC).听Core elements of hospital antibiotic stewardship programs.听CDC; 2017. Available at:听
Interagency Coordination Group on Antimicrobial Resistance (IACG).听. World Health Organization; 2018. - National Institute for Health and Care Excellence (NICE).听Antimicrobial stewardship. NICE Quality Standard; 2016. Available at:听
- NICE. Antimicrobial stewardship: Systems and processes for effective antimicrobial medicine use.听NICE Guideline; 2015. Available at:听听
Best Practices for IPAC for Clostridium difficile (C. difficile), MRSA and VRE
Canadian
- Health PEI.听Prince Edward Island infection prevention and control methicillin-resistant staphylococcus aureus (MRSA) guideline.听Prince Edward Island Department of Health and Wellness; 2016. Available at:听听
- Prince Edward Island (PEI) Department of Health and Wellness.听Provincial vancomycin-resistant enterococci (VRE) guideline.听PEI Department of Health and Wellness; 2009. Available at:听
- Provincial Infection Control Network of British Columbia (PICNet). Antibiotic resistant organisms prevention and control guidelines for healthcare facilities.听Vancouver, BC: PICNet; 2013. Available at:听
- Provincial Infectious Diseases Advisory Committee (PIDAC).听Review of literature for evidence-based best practices for VRE control. Toronto, ON: Public Health Ontario; 2012. Available at:听听
- Public Health Agency of Canada (PHAC).听Clostridium difficile infection: Infection prevention and control guidance for management in acute care settings. Ottawa, ON: PHAC; 2013. Available at:听
International
- Association for Professionals in Infection Control and Epidemiology (APIC).听, 2nd听Ed. Washington, DC: APIC; 2010. Available at:听
Patient Education and Engagement
Canadian
- Patient Engagement Action Team. 2017.听Engaging Patients in Patient Safety 鈥� a Canadian Guide.听Canadian Patient Safety Institute. Last modified February 2018. Available at: /en/resources/engaging-patients-in-patient-safety-a-canadian-guide/
- 日本无码. Hand hygiene: Working with patients and families. Edmonton, AB: CPSI; 2016.
International
- Centers for Disease Control and Prevention (CDC).听.听CDC; 2016. Available at:听
- CDC.听.听CDC; 2015. Available at: 听
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Infections due to Clostridium difficile, MRSA or VRE
