Congress Abstracts 2005

50

NURSE-DEVELOPED SURVEILLANCE PROTOCOL TO DECREASE VRE INFECTIONS IN IMMUNOCOMPROMISED PATIENTS. Lucy Mauney, RN, BSN, OCN^®, Duke University Health System, Durham, NC, and Katrina Green, RN, Duke University Hospital, Durham, NC.

Approximately 2 million nosocomial infections occur in the United States each year with nearly half caused by antibiotic-resistant organisms. Organisms that have consistently been susceptible to all antimicrobial agents have developed resistance not only to the classic agents, but to newer agents as well. VRE is one of the most troublesome bacterial strains of present concern, and a major cause of morbidity and mortality among immunocompromised patients. Hospital Infection Control Practices Advisory Committee (HICPAC) cites recommendations for every hospital to develop a comprehensive plan to detect, prevent, and control infection and colonization with VRE.

This poster will describe and review the impact an active surveillance protocol had on decreasing the number of nosocomial-acquired VRE infections among patients on an inpatient hematology/oncology unit. Our project was aimed at identifying as many colonized patients as possible so that infection control measures could be implemented to decrease transmission and reduce the number of patients infected with VRE.

The poster will discuss the protocol which included identifying and isolating high-risk patients upon admission; increasing staff education through monthly inservices with the hospital infection control department; and increasing patient education by distributing pamphlets that include information about nosocomial infection and contact isolation procedures.

Prior to March of 2002, mortality associated with VRE reached nearly 100%. The active surveillance protocol was implemented (n = 75) and over the next 6 months, as a result of increased screening, there was an increase in detection of VRE colonization. Because patients were isolated as part of the protocol, there was a 34% decrease in nosocomial-acquired VRE infections.

A well-designed surveillance protocol decreases mortality through identification and isolation of high-risk patients and increasing education among patients and staff. Active surveillance for VRE in high-risk patients had a significant impact on limiting the spread of VRE: the rate of nosocomial-acquired VRE decreased by 34%. Other oncology nurses may use similar approaches to improve infection control measures in practice, to decrease nosocomial VRE infections, thereby decreasing mortality associated with VRE, and to increase compliance with HICPAC recommendations.