Providing Timely Infection Data to Nurse Leaders Using a Automated Surveillance System Reduces Infection Rates

Purpose:
We explored the use of "real-time" reports from an automated infection surveillance system. The project sought to reduce Nosocomial Infection Markers(NIMs)and Hospital-Acquired Infection(HAI)Rates by more rapidly providing feedback to nurse leaders and bedside staff on occurring infections.

Significance:
A benchmarking tool allows comparison of rates to other hospitals. Hospitals ranked as “excellent” receive funding from Blue Cross & Blue Shield of Alabama for the cost of the system as well as quality tiering points. Our hospital ranked as ‘average' and sought methods to improve the ranking score.

Strategy and Implementation:
Traditional infection rate reporting makes it hard for bedside nurses to identify practices with the patients who have untoward outcomes. NIM patient information is available weekly. NIM patient level information is provided to nursing leaders to share with bedside staff members each week. Caregivers review almost real-time cases and are asked to answer four questions: 1) What happened?; 2) Why did it happen?; 3) What did you do to fix it?; 4) How do you know it's been fixed? . Information gathered is shared in a monthly HAI team meeting where common variables and opportunities for improvement are identified. Rapid cycle quality improvement methods are used to implement change.

Evaluation:
Prior to the project, NIM rates for 2010 averaged 3.30%, ranging from 4.42% to 2.25%. Weekly sharing of NIM information with nursing leaders began in March,2011. Since implementation, NIM rates have averaged 1.95%, ranging from 2.37% to 1.38%; representing a 40.9% decrease in the total NIM rate.

Implications for Practice:
Providing “real-time” data on HAI's to nurses gives a face to numbers, associating patients that nurses have cared for to their own individual care provided. Practices that may contribute to the acquisition of infection can be identified more readily. Consequently, infection rates decrease.