Application of bundle strategies in the management of multidrugresistant organisms

Abstract:

ObjectiveTo explore the application of bundle strategies in the management of multidrugresistant organisms(MDROs).MethodsFrom July 1,2013, bundle intervention measures were applied in the management of MDROs from inpatients in a tertiary firstclass hospital, the implementation of isolation measures for MDROinfected/colonized patients were monitored, AprilJune 2013 was preintervention group, JulySeptember 2013 was the first stage of intervention, OctoberDecember 2013 was the second stage of intervention, the qualified rate of each measure and incidence of  MDRO infection per 1 000 patientdays before and after intervention were compared.ResultsFrom April to December 2013, a total of 3 430 nonrepetitive isolates were detected. The qualified rate of doctors’ order “contact isolation ” before intervention and in the second stage of intervention were  78.14% and 95.95% respectively; the qualified rate of hanging bedside isolation signs, providing bedside quickdrying hand disinfectant, and patients wearing blue wristbands before intervention were 52.70%, 66.89%, and 87.16% respectively，and in the second intervention stage were all 100.00%. The qualified rate of disinfection of medical supplies and environment, as well as patients’ bed assignments before intervention were 23.65% and 15.54% respectively, in the second stage were 79.79% and 77.66% respectively. Health care workers’ awareness rate of hand hygiene knowledge, hand hygiene compliance rate, and  hand hygiene correct rate  before intervention were 69.70%,45.76%, and 76.35% respectively; in the second stage were 90.23%, 87.50%, and 94.58% respectively；the qualified rate of implementation of each isolation measure before intervention and in different stages after intervention were all significantly different(all P<0.01). The incidence of MDRO infection per 1 000 patientdays before intervention, in the first and second intervention stages were 3.24‰, 2.63‰, and 2.20‰ respectively.ConclusionAfter the monitoring and intervention in MDROs with bundle management strategies, the qualified rate of each measure improved, incidence of MDRO infection per 1 000 patientdays decreased.