Östergötland County Council (LiÖ) uses three customised programme in the fight against health-care associated infections apart from conventional methods. The first is a project for registration of infections in all hospitals, “the second is a local STRAMA initiative aiming at improving infection control and to improve the adequate use of antibiotics, and the third programme concerns monthly measurement of compliance to hygiene rules.
Registration of health-care associated infections started in the year 2000 at a few departments but since 2003 it comprises all wards at the three hospitals. The project was initiated by the Unit for Hospital Hygiene at the County Council and is also coordinated there. Most of the work, however, is done locally. In the project three key infections are registered namely bacteraemia, catheterrelated urinary infection and Clostridium difficile diarrhoea. Moreover three department specific infection types may be registered. The incidence of infection is measured on a monthly basis. High figures are followed by local improvement measures.
The results after five years of registration are promising for urinary tract infection and for bacteraemia. The rate of Clostridium difficile infection on the other handis not decreasing. As seen in the following figure the incidence of bactaeremia was decreasing until 2005, but has since risen a little.
Further information on the project can be obtained from Ewa Davidsson at the Unit for Hospital Hygiene (ewa.davidsson@lio.se).
A local STRAMA organisation was instituted by the County Councilin 2006 with participation from the following units: Patient safety unit, Departments of Microbiology and Infectious diseases, Unit of Hospital Hygiene and Hospital Pharmacy.
The aim of this organisation is to create a dialogue with all clinical departments on the use of antibiotics in order to reduce antimicrobial resistance.
Compliance to hygiene rules
Hygiene rules to be followed by the staff have been decided nationally by the National Board of Health and Welfare, in the form of a dress code and frequent use of hand disinfection with alcohol. To measure the extent to which these rules are followed in the County Council more than 300 observers have been educated by the Unit for Hospital Hygiene. In each ward, at all hospitals and outpatient clinics in the county, there are at least two observers. Each month they register their colleagues’ behavior on a standard protocol. The results are presented on a graph, which is fed back to the departments and wards on a regular basis. Compliance to hygiene rules has increased from around 55% to almost 80% in two years.
