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Implementation of Strategies to Prevent and Control the Emergence and Spread of Antimicrobial-Resistant Microorganisms in U.S. Hospitals

Published online by Cambridge University Press:  21 June 2016

Marcia M. Ward*
Affiliation:
Department of Health Management and Policy, University of Iowa, Iowa City, Iowa Center for Research in the Implementation of innovative Strategies in Practice (CRIISP) at the Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
Daniel J. Diekema
Affiliation:
Department of Internal Medicine, University of Iowa, Iowa City, Iowa Center for Research in the Implementation of innovative Strategies in Practice (CRIISP) at the Iowa City Veterans Affairs Medical Center, Iowa City, Iowa Department of Pathology, University of Iowa, Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
Jon W. Yankey
Affiliation:
Center for Research in the Implementation of innovative Strategies in Practice (CRIISP) at the Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
Thomas E. Vaughn
Affiliation:
Department of Health Management and Policy, University of Iowa, Iowa City, Iowa Center for Research in the Implementation of innovative Strategies in Practice (CRIISP) at the Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
Bonnie J. BootsMiller
Affiliation:
Department of Internal Medicine, University of Iowa, Iowa City, Iowa Center for Research in the Implementation of innovative Strategies in Practice (CRIISP) at the Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
Jane F. Pendergast
Affiliation:
Department of Biostatistics, University of Iowa, Iowa City, Iowa
Bradley N. Doebbeling
Affiliation:
Health Services Research and Development, Center on Implementing Evidence-Based Practice, Roudebush Veterans Affairs Medical Center; the Regenstrief Institute, Inc.; and the Department of Internal Medicine, Indiana University Center for Health Services & Outcomes Research, Indiana University School of Medicine, Indianapolis, Indiana
*
Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, IA 52242-1008marcia-m-ward@uiowa.edu

Abstract

Objective:

To examine the extent to which the strategies recommended by the National Foundation for Infectious Diseases (NFID)-Centers for Disease Control and Prevention (CDC) co-sponsored workshop, Antimicrobial Resistance in Hospitals: Strategies to Improve Antimicrobial Use and Prevent Nosocomial Transmission of Antimicrobial-Resistant Microorganisms, have been implemented and the relationship between the degree of implementation and hospital culture, leadership, and organizational factors.

Design:

Survey.

Setting:

A representative sample of U.S. hospitals stratified by teaching status, bed size, and geographic region.

Participants:

Infection control professionals.

Results:

Surveyed hospitals had implemented strategies to optimize the use of antimicrobials and to detect, report, and prevent transmission of antimicrobial-resistant microorganisms. Multivariate analyses found that hospitals with a greater degree of implementation of the NFID–CDC strategic goals were more likely to have management support, education of staff, and interdisciplinary groups specifically to address these issues; they were also more likely to engage in benchmarking on broader quality of care indicators.

Conclusions:

Most surveyed hospitals had implemented some measures to address the NFID–CDC recommendations; however, hospitals need to do much more to improve antimicrobial use and to increase their efforts to detect, report, and control the spread of antimicrobial resistance. A supportive hospital administration must foster a culture of ongoing support, education, and interdisciplinary work groups focused on this important issue to successfully accomplish these goals.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

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