PMID- 29541449
OWN - NLM
STAT- MEDLINE
DCOM- 20190719
LR  - 20191210
IS  - 2047-2994 (Electronic)
IS  - 2047-2994 (Linking)
VI  - 7
DP  - 2018
TI  - The infection risk scan (IRIS): standardization and transparency in infection 
      control and antimicrobial use.
PG  - 38
LID - 10.1186/s13756-018-0319-z [doi]
LID - 38
AB  - BACKGROUND: Infection control needs user-friendly standardized instruments to 
      measure the compliance to guidelines and to implement targeted improvement 
      actions. This abstract describes a tool to measure the quality of infection 
      control and antimicrobial use, the Infection Risk Scan (IRIS). It has been 
      applied in a hospital, several nursing homes and a rehabilitation clinic in the 
      Netherlands. METHOD: The IRIS consists of a set of objective reproducible 
      measurements, combining patient- and healthcare related variables, such as: hand 
      hygiene compliance, environmental contamination using ATP measurements, 
      prevalence of resistant microorganisms by active screening, availability of 
      infection control preconditions, personal hygiene of healthcare workers, 
      appropriate use of indwelling medical devices and appropriate use of 
      antimicrobials. Results are visualized in a spider plot using traffic light 
      colors to facilitate the interpretation. RESULTS: The IRIS provided ward specific 
      results within the hospital that were the basis for targeted improvement programs 
      resulting in measurable improvements. Hand hygiene compliance increased from 43% 
      to 66% (more than 1000 observations per IRIS, p < 0.000) and ATP levels were 
      significantly reduced (p < 0.000). In the nursing homes, large differences were 
      observed with environmental contamination as common denominator. Most remarkable 
      were the difference in Extended Spectrum Beta-Lactamase Enterobacteriaceae 
      (ESBL-E) prevalence (mean 11%, range 0-21%). CONCLUSION: The bundle approach and 
      visualization of the IRIS makes it a useful infection prevention tool providing 
      standardization and transparency. Targeted interventions can be started based on 
      the results of the improvement plot and repeated IRIS can show the effect of 
      interventions. In that way, a quality control cycle with continuous improvement 
      can be achieved.
FAU - Willemsen, Ina
AU  - Willemsen I
AUID- ORCID: 0000-0003-3112-6848
AD  - 1Laboratory for Microbiology and Infection Control, Amphia Hospital, PO Box 
      90158, 4800 RK Breda, The Netherlands.
AD  - Center for Infectious Disease Expertise and Research (CIDER), Tilburg, The 
      Netherlands.
FAU - Kluytmans, Jan
AU  - Kluytmans J
AD  - 1Laboratory for Microbiology and Infection Control, Amphia Hospital, PO Box 
      90158, 4800 RK Breda, The Netherlands.
AD  - 3Julius Center for Health Sciences and Primary Care, UMC Utrecht, Utrecht, the 
      Netherlands.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20180309
PL  - England
TA  - Antimicrob Resist Infect Control
JT  - Antimicrobial resistance and infection control
JID - 101585411
RN  - 0 (Anti-Infective Agents)
RN  - EC 3.5.2.6 (beta-Lactamases)
SB  - IM
MH  - Anti-Infective Agents/*standards/therapeutic use
MH  - Benchmarking/standards
MH  - Cross Infection/prevention & control
MH  - Drug Resistance, Bacterial
MH  - Drug Utilization/*standards
MH  - Enterobacteriaceae/pathogenicity
MH  - Enterobacteriaceae Infections/epidemiology
MH  - Hand Hygiene/standards
MH  - Health Personnel
MH  - Hospitals/standards
MH  - Humans
MH  - Infection Control/*standards
MH  - Infections/*drug therapy/epidemiology
MH  - Netherlands/epidemiology
MH  - Nursing Homes
MH  - Prevalence
MH  - Quality Improvement
MH  - Quality Indicators, Health Care
MH  - Reference Standards
MH  - Rehabilitation Centers/standards
MH  - Risk Factors
MH  - Risk Management/standards
MH  - beta-Lactamases
PMC - PMC5845162
OTO - NOTNLM
OT  - Antimicrobial resistance
OT  - Benchmarking
OT  - Guidelines
OT  - Infection prevention
COIS- According to the Dutch regulation for research with human subjects, neither 
      medical nor ethical approval was required to conduct the surveillance since it 
      was part of the local hospital/nursing home policy, patients/residents provided 
      oral informed consent and all data were processed anonymously. The, non-invasive, 
      perianal swabs were collected as part of the local hospital policy which is 
      considered routine care. The periodically performed surveys for the presence of 
      multi drug resistant micro-organisms are part of the infection control policy in 
      our hospital. This includes contact tracing, active search in patients with risk 
      factors and routinely check-ups like the yearly prevalence survey. Swabs were not 
      specifically collected for the purposes of this publication.Not applicableThe 
      interest declare that they have no competing interests.Springer Nature remains 
      neutral with regard to jurisdictional claims in published maps and institutional 
      affiliations.
EDAT- 2018/03/16 06:00
MHDA- 2019/07/20 06:00
PMCR- 2018/03/09
CRDT- 2018/03/16 06:00
PHST- 2017/11/14 00:00 [received]
PHST- 2018/02/11 00:00 [accepted]
PHST- 2018/03/16 06:00 [entrez]
PHST- 2018/03/16 06:00 [pubmed]
PHST- 2019/07/20 06:00 [medline]
PHST- 2018/03/09 00:00 [pmc-release]
AID - 319 [pii]
AID - 10.1186/s13756-018-0319-z [doi]
PST - epublish
SO  - Antimicrob Resist Infect Control. 2018 Mar 9;7:38. doi: 
      10.1186/s13756-018-0319-z. eCollection 2018.