Measuring compliance with HICPAC guidelines: A snapshot of Florida hospitals

• Published in: American journal of infection control Vol. 33; no. 5; p. e93
• Main Author: Fauerbach, L.
• Format: Journal Article
• Language: English
• Published: Mosby, Inc 01.06.2005
• ISSN: 0196-6553; 1527-3296
• DOI: 10.1016/j.ajic.2005.04.112

ISSUE: Key guidelines for hand hygiene, prevention of intravascular infection, and prevention of pneumonia have been released by HICPAC. The recommendations have been implemented with varying success. A survey was designed to assay the level of guideline compliance in Florida. PROJECT: Members of the state infection control organization (FPIC) were surveyed in September 2004. Questions were asked about the implementation of recommendations and performance measures from three HICPAC guidelines (hand hygiene, catheter-related infections, and prevention of pneumonia). RESULTS: Seventeen of 22 responders indicated that ventilator associated pneumonia (VAP) was monitored, with 82% using NNIS definitions and reporting rates by ventilators days (88%). The majority monitored VAP in the intensive care units (ICUs) only. The majority of responders had standard operating procedures for influenza vaccination, but less than 50% had a method to monitor for eligible patients. Less than half of the responders had set a goal for employee vaccination rates and reported a wide range (15%–95%) for employee vaccination during the previous year. Most programs tracked respiratory syncytial virus (RSV) and Aspergillus. No clear methodology for finding undiagnosed Legionella cases was reported. IV prevention guideline had been out for 2 years, but implementation of all recommendations was not universal. Surveillance and compliance monitoring were only done in 53% of responders. Chlorhexidine gluconate (CHG) is used by the majority of responders although not for all indications. Antimicrobial catheter were used only few facilities. A CHG-impregnated patch was used by 25%. Most facilities had elaborate IV/CVL training for non-physician providers but rarely trained or certified the physicians. Tubing and site changes for peripheral lines were according to the HICPAC guidelines 90% of the time. All responders were challenged to monitor the discontinuation of catheters when they were no longer needed. Survey participants reported a high level of compliance with the hand hygiene guideline recommendations although the frequency and intensity of monitoring compliance varied. LESSONS LEARNED: HICPAC guidelines help to influence infection control practice in Florida, but many opportunities still exit for complete implementation. Infection prevention and control professionals can learn implementation strategies from each other.