Table 1 Management strategic axis and actions retained by the steering committee
Quality process implementation | Operational team: |
1. Care quality improvement approach | |
2. Identification of 4 “quality control nurses” among the staff nurses | |
3. Definition of desired outcomes | |
4. Procedure reference tool validation | |
5. Random observation of procedure compliance | |
6. Procedure compliance evaluation by a computerized feedback tool | |
Hospital Hygiene Division: | |
7. Hygiene counselling and infections epidemiologic monitoring | |
Hospital Executive Board: | |
8. Bioengineer consultant recruitment | |
All HCW and visitors: | |
9. Anonymous “at risk for infection event” declaration | |
Effective communication | Head of the paediatric department: |
10. Regular reports on MRSA infections management to the hospital executive board, health care branch, department of health quality safety and patient experience | |
11. External audit request | |
Operational team: | |
12. Monthly internal feedback audits | |
13. Monthly report display in units | |
Infections epidemiologic monitoring | Staff nurses: |
14. Routine weekly MRSA screening | |
Physicians: | |
15. Retrospective and prospective data collection | |
Hospital Hygiene Division: | |
16. Case–control study to identify risk factors for MRSA infections in hospitalized newborns | |
17. Regular environmental and medical device cultures | |
Department of bacteriology: | |
18. MRSA clinical isolates genotyping | |
Hand-hygiene, contact precautions, HCW and patients families clothing and flow issues improvement | Hospital Hygiene Division: |
19. Intensive HCW, families and visitors information and training | |
20. HCW, families and visitors work clothing + protective clothing implementation | |
21. Reinforced barrier precautions for MRSA colonization | |
22. Posted isolation cards | |
Standardisation of procedures for the insertion and the continuous care of peripherally inserted central venous catheters, care of invasive medical devices | Staff nurses: |
23. Central venous lines insertion and care checklist | |
24. Invasive medical devices care checklist | |
Units cleaning | Cleaning staff: |
25. Cleaning procedure implementation | |
26. Cleaning procedure assessment | |
27. Cleaning checklist | |
28. Cleaning staff overwork lowering (2 recruitments) | |
29. Room cleaning intensification (3 daily cleanings versus 1) | |
30. Standardized disinfection of external medical devices |