Ina Willemsen1, Julie Jefferson2, Leonard Mermel3, Jan Kluytmans4. 1. Department of Microbiology and Infection Control, Amphia Hospital, Breda, the Netherlands. Electronic address: iwillemsen@amphia.nl. 2. Department of Epidemiology & Infection Control, Rhode Island Hospital, Providence, RI, USA. 3. Department of Epidemiology & Infection Control, Rhode Island Hospital, Providence, RI, USA; Department of Medicine, Warren Alpert Medial School of Brown University, Providence, RI, USA. 4. Department of Microbiology and Infection Control, Amphia Hospital, Breda, the Netherlands; Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht University, Utrecht, the Netherlands.
Abstract
BACKGROUND: The infection risk scan (IRIS) is a tool to measure the quality of infection control (IC) and antimicrobial use in a standardized way. We describe the feasilibility of the IRIS in a Dutch hospital (the Netherlands, NL) and a hospital in the United States (US). METHODS: Cross-sectional measurements were performed. Variables included a hand hygiene indicator, environmental contamination, IC preconditions, personal hygiene of health care workers, use of indwelling medical devices, and use of antimicrobials. RESULTS: IRIS was performed in 2 wards in a US hospital and 4 wards in a Dutch hospital. Unjustified use of medical devices: none in the US hospital, 2.2% in the Dutch hospital; inappropriate use of antibiotics: 11.7% (US), 19% (NL); items considered not clean: 10% (US); 36% (NL); shortcomings preconditions: 6 of 20 (US), 6 of 40 (NL); health care workers with rings, watches, or long sleeves: 34 of 43 (US), none in the NL hospital; and hand hygiene actions per patient/day: 41 (US) and 10 (NL). US data judged against the Dutch guidelines and vice versa revealed remarkable differences. CONCLUSIONS: We showed the feasibility of using the IRIS in a US hospital. The method provided insight in IC local performance. This method could be the first step to standardize the measurement of the quality of IC and antimicrobial use. However, if the IRIS is used for benchmarking between hospitals in different regions, this should be done in the context of regional guidelines and policies.
BACKGROUND: The infection risk scan (IRIS) is a tool to measure the quality of infection control (IC) and antimicrobial use in a standardized way. We describe the feasilibility of the IRIS in a Dutch hospital (the Netherlands, NL) and a hospital in the United States (US). METHODS: Cross-sectional measurements were performed. Variables included a hand hygiene indicator, environmental contamination, IC preconditions, personal hygiene of health care workers, use of indwelling medical devices, and use of antimicrobials. RESULTS: IRIS was performed in 2 wards in a US hospital and 4 wards in a Dutch hospital. Unjustified use of medical devices: none in the US hospital, 2.2% in the Dutch hospital; inappropriate use of antibiotics: 11.7% (US), 19% (NL); items considered not clean: 10% (US); 36% (NL); shortcomings preconditions: 6 of 20 (US), 6 of 40 (NL); health care workers with rings, watches, or long sleeves: 34 of 43 (US), none in the NL hospital; and hand hygiene actions per patient/day: 41 (US) and 10 (NL). US data judged against the Dutch guidelines and vice versa revealed remarkable differences. CONCLUSIONS: We showed the feasibility of using the IRIS in a US hospital. The method provided insight in IC local performance. This method could be the first step to standardize the measurement of the quality of IC and antimicrobial use. However, if the IRIS is used for benchmarking between hospitals in different regions, this should be done in the context of regional guidelines and policies.