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Table 1 Management strategic axis and actions retained by the steering committee

From: Successful control of a Methicillin-resistant Staphylococcus aureus outbreak in a neonatal intensive care unit: a retrospective, before-after study

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