Infection Control Committee February 23, 2011 Confidential QI.
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Transcript of Infection Control Committee February 23, 2011 Confidential QI.
Infection Control CommitteeFebruary 23, 2011
Confidential QI
UW Medicine MRSA and CLA-BSIJanuary -- November 2010
0
5
10
15
20
25
30
Jan-10 Feb-10 Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10Sep-10 Oct-10 Nov-10
Num
ber
of H
arm
Eve
nts
0.00
0.20
0.40
0.60
0.80
1.00
1.20
1.40
Rat
e pe
r 10
00 p
t-da
ys
UWMC Total MRSA+CLA-BSIHMC Total MRSA + CLA-BSIRate per 1000 pt-daysLinear (Rate per 1000 pt-days)
Confidential QI
Goal: 0.9 per 1000 pt-days
2010: 1.01 per 1000 pt-days
UW Medicicine Nosocomial MRSA*2009 -- 2010
0
5
10
15
20
25
30
35
Jan-09
Feb-09
Mar-09
Apr-09
May-09
Jun-09
Jul-09
Aug-09
Sep-09
Oct-09
Nov-09
Dec-09
Jan-10
Feb-10
Mar-10
Apr-10
May-10
Jun-10
Jul-10
Aug-10
Sep-10
Oct-10
Nov-10
Num
ber
of N
ew M
RS
A C
ases
-0.10
0.10
0.30
0.50
0.70
0.90
1.10
1.30
1.50
Rat
e pe
r 10
00 p
t-da
ys
UWMC Cases
HMC Cases
Rate per 1,000 pt-days
Linear (Rate per 1,000 pt-days)
*Colonization and infection
2009 2010 (through Nov)HMC 154 127UWMC 63 39
Confidential QI
UW Medicine CLA-BSI(2010 ICU and Acute Care)
0
2
4
6
8
10
12
Jan-10 Feb-10 Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10
Num
ber
of C
LA-B
SI
0.0
0.2
0.4
0.6
0.8
1.0
1.2
1.4
1.6
1.8
2.0
Rat
e pe
r 10
00 c
athe
ter-
days
UWMC CLA-BSI Cases
HMC CLA-BSI Cases
Rate per 1000 catheter-days
Linear (Rate per 1000catheter-days)
HMC: 49 CLA-BSI, 1.9 per 1000 catheter-daysUWMC: 26 CLA-BSI, 0.6 per 1000 catheter-daysTotal: 75 CLA-BSI, 1.0 per 1000 catheter-days
Healthcare-Associated Infections per 1,000 pt-days(MRSA, CLA-BSI, VAP, CA-UTI)
2010-2011
0.0
1.0
2.0
3.0
4.0
5.0
6.0
Jan-10 Feb-10 Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11
Rat
e pe
r 10
00 p
t-da
ys
Confidential QI
Goal < 4.0 per 1000 pt-days
Healthcare-Associated Infection Cases(MRSA, CLA-BSI, VAP, CA-UTI)
2010-2011
0
10
20
30
40
50
60
70
Jan-10 Feb-10 Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11
Num
ber
of C
ases
CA-UTIVAPCLA-BSIMRSA
Confidential QI
0
4
8
12
16
20
Rate
Per
1,0
00 A
dm
issio
ns
..
0
20
40
60
80
100
MR
SA
Ca
se
s
Nosoc MRSA Cases 87 84 88 72 71 62 72 63 46 40 27 41 30 36 39 37
Admits 4,4894,8044,8544,510 4,5434,6844,8644,6184,8635,0775,1354,823 4,7604,8615,2854,946
MRSA Rate 19.4 17.5 18.1 16.0 15.6 13.2 14.8 13.6 9.5 7.9 5.3 8.5 6.3 7.4 7.4 7.5
QE Mar 2007
QE Jun
2007
QE Sep 2007
QE Dec 2007
QE Mar 2008
QE Jun
2008
QE Sep 2008
QE Dec 2008
QE Mar 2009
QE Jun
2009
QE Sep 2009
QE Dec 2009
QE Mar 2010
QE Jun
2010
QE Sep 2010
QE Dec 2010
Confidential QI
HMC Nosocomial MRSA Rates
Quarterly
Source: Infection Control, for more information, please contact Dr. Tim Dellit, [email protected]
Number of Cases2007: 331 Cases2008: 268 Cases2009: 154 Cases2010: 142 Cases
HMC Nosocomial MRSA Acquisition RatesJanuary 2007 -- January 2011
0
10
20
30
40Ja
n-0
7
Ma
r-0
7
Ma
y-0
7
Ju
l-0
7
Se
p-0
7
No
v-0
7
Ja
n-0
8
Ma
r-0
8
Ma
y-0
8
Ju
l-0
8
Se
p-0
8
No
v-0
8
Ja
n-0
9
Ma
r-0
9
Ma
y-0
9
Ju
l-0
9
Se
p-0
9
No
v-0
9
Ja
n-1
0
Ma
r-1
0
Ma
y-1
0
Ju
l-1
0
Se
p-1
0
No
v-1
0
Ja
n-1
1 0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
Total # MRSA Overall Overall Rate per 1000 Pt days
Num
ber
of N
osoc
omia
l MR
SA
Rat
e pe
r 10
00 p
t-da
ys
HMC Nosocomial MRSAFebruary 2010-January 2011
0
5
10
15
20
25
30
35
40
45
Nu
mb
er
of
No
so
co
mia
l M
RS
A
.
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
Rate
pe
r 1
000
pt-
days
Last 12 months
Jan 2011 cases
Rate per 1000 pt-days
Last 12 months• 138 cases• 1.0 per 1000 pt-days
8E Nosocomial MRSA2010-2011
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
Jan-10 Feb-10 Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11
Rate
per
1000 p
t-days
8E
Acute Care
ICU
Hospital
8E: 3.2 per 1000 patient-days
Confidential QI
Nosocomial Carbapenem-Resistant AcinetobacterJanuary 2004 -- December 2010
0.0
5.0
10.0
15.0
20.0
25.0
Jan-
04
May
-04
Sep
-04
Jan-
05
May
-05
Sep
-05
Jan-
06
May
-06
Sep
-06
Jan-
07
May
-07
Sep
-07
Jan-
08
May
-08
Sep
-08
Jan-
09
May
-09
Sep
-09
Jan-
10
May
-10
Sep
-10
Rat
e pe
r 10
00 a
dmis
sion
s
Confidential QI
New Acquisition Nosocomial C. difficileJanuary 2009 -- February 2011
0
2
4
6
8
10
12
14
16
18
20
J-0
9
F-0
9
M-0
9
A-0
9
M-0
9
J-0
9
J-0
9
A-0
9
S-0
9
O-0
9
N-0
9
D-0
9
J-1
0
F-1
0
M-1
0
A-1
0
M-1
0
J-1
0
J-1
0
A-1
0
S-1
0
O-1
0
N-1
0
D-1
0
J-1
1
Nu
mb
er
of
No
soco
mia
l C.
diff
icile
.
0.0
0.2
0.4
0.6
0.8
1.0
1.2
1.4
1.6
1.8
Ra
te p
er
10
00
pt.
da
ys
No of Noso Cases Rate per 1000 Pt Days
HMC Nosocomial VRE, 2010-11 Colonization and Infection
0
2
4
6
8
10
12
14
16
Num
ber
of n
osoc
omia
l VR
E
.
.
.
0.0
0.2
0.4
0.6
0.8
1.0
1.2
1.4
Rat
e pe
r 10
00 p
atie
nt-d
ays
.
Screen
Screen & Clinical
Clinical
Rate
AST expands from TSICU to all ICUs
Environmental Cleaning AuditsJanuary 2011
0
10
20
30
40
50
60
70
80
90
100
Unit
Per
cent
of S
ites
Cle
aned
HMC ICU Central Line-Associated Bloodstream Infections 2008- 2011
0
1
2
3
4
5
6
7
Num
ber o
f inf
ectio
ns
.
.
.
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
5.0
Rat
e pe
r 100
0 ce
ntra
l lin
e-da
ys
.
PICC-Related
TLC or Double-Lumen
Other Central Line
Rate
Linear (Rate)
Confidential QI
HMC ICU Catheter-Associated Blood Stream Infections Quarterly Rates, 2010
0.0
2.0
4.0
6.0
8.0
10.0
12.0
Rate
per
1000 c
ath
ete
r-days
. .
Jan-MarApr-JunJul-Sep
Oct-DecNHSN 2006-8
Jan-Mar 3.5 2.7 1.0 2.0 2.2
Apr-Jun 10.6 1.1 0.0 4.0 3.8
Jul-Sep 4.2 1.3 1.0 0.9 1.7
Oct-Dec 0.0 1.6 0.0 4.1 1.7
NHSN 2006-8 5.5 2.6 2.5 3.6 3.4
BPICU MCICU NICU TSICU Total ICU
Confidential QI
HMC CLA-BSI by Service2011 ICU and Acute Care
0
1
2
3
Service
Nu
mb
er
of c
ase
s C
LA
-BS
I
0.0
0.5
1.0
1.5
2.0
2.5
3.0
Ra
te p
er
10
00
ce
ntr
al-l
ine
d
ays
.
.
Number of Cases 2011
January 2011
2010 Rate per 1000 line-days
2011 Total2 CLA-BSI1.0 per 1000 catheter-days
Confidential QI
HMC ICU CLA-BSI and Bundle Documentation
0.0
1.0
2.0
3.0
4.0
5.0
Jan-08
Mar-08
May-08
Jul-08
Sep-08
Nov-08
Jan-09
Mar-09
May-09
Jul-09
Sep-09
Nov-09
Jan-10
Mar-10
May-10
Jul-10
Sep-10
Nov-10
Jan-11
0%
20%
40%
60%
80%
100%Rate per 1000 catheter daysBundle DocumentationLinear (Rate per 1000 catheter days)Linear (Bundle Documentation)
Confidential QI
Rat
e pe
r 10
00 c
athe
ter-
days
Cen
tral
Lin
e B
undl
e C
ompl
ianc
e
HMC Central Line Utilization2009 - 2010
0.00
0.10
0.20
0.30
0.40
0.50
0.60
0.70
0.80
0.90
1.00
2009-Q1 2009-Q2 2009-Q3 2009-Q4 2010-Q1 2010-Q2 2010-Q3 2010-Q4
Devic
e U
tiliz
atio
n R
atio
.
BPICU
MCICU
NICU
TSICU
Total
Confidential QI
0.0
5.0
10.0
15.0
20.0
25.0
0
10
20
30
40
50
60
70
80
VAP Cases 77 48 76 65 53 51 36 43 23 50 31 34 27 24 27 20
Vent Days 3,705 3,403 4,012 3,943 3,901 3,865 3,998 3,636 2,844 3,617 3,035 2,881 2,575 2,597 2,721 2,213
VAP Rate 20.8 14.1 18.9 16.5 13.6 13.2 9.0 11.8 8.1 13.8 10.2 11.8 10.5 9.2 9.9 9.0
QE Mar 2007
QE Jun
2007
QE Sep 2007
QE Dec 2007
QE Mar 2008
QE Jun
2008
QE Sep 2008
QE Dec 2008
QE Mar 2009
QE Jun
2009
QE Sep 2009
QE Dec 2009
QE Mar 2010
QE Jun
2010
QE Sep 2010
QE Dec 2010
Ventilator-Associated PneumoniaQuarterly
Rat
e pe
r 1,
000
vent
-day
s
Confidential QISource: Infection Control, for more information, please contact Dr. Tim Dellit, [email protected]
Number of Cases2007: 266 Cases2008: 183 Cases2009: 138 Cases2010: 98 Cases
HMC Ventilator-Associated PneumoniaJanuary 2010 -- January 2011
0
2
4
6
8
10
12
14
16
18
Jan-10 Feb-10 Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11
Nu
mb
er
of
VA
P
.
0
2
4
6
8
10
12
14
16
Ra
te p
er
10
00
ve
nt-
da
ys
HMC VAP by Unit2011
0.0
5.0
10.0
15.0
20.0
25.0
BPICU MCICU NICU TSICU
Unit
Ra
te p
er
10
00
ve
nt-
da
ys
.
2010 Q12010 Q22010 Q32010 Q4NHSN
HMC JAN VAP Bundle Compliance
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
HOB Oral Care CHG rinse SedationAwakening
SBT DVT GI/Tube feeds
Bundle Element .
Per
cent
Com
plia
nt
.
1/6/2011
1/13/2011
1/20/2011
1/27/2011
Confidential QI
HMC CA-UTI November 2009 -- January 2011
0
5
10
15
20
25
30
35
40
Num
ber
of C
A-U
TI
. .
0
1
2
3
4
5
6
7
8
9
10
Rat
e pe
r 10
00 f
oley
-day
s
.
Number
Rate
Linear (Rate)
Confidential QI
HMC CA-UTI January 2011
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
Rate per 1000 cather-days 2.6 6.7 3.9 6.0
Acute CareAcute Care
NHSNICU ICU NHSN
Confidential QI
HMC Catheter-Associated UTI, By Service, 2011
0
10
20
30
40
50
60
70
80
90
Nu
mb
er
of
CA
-UT
Is
.
0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
8.0
9.0
10.0
Ra
te P
er
10
00
ca
the
ter-
da
ys
Number of Cases Jan-Dec 2010
Jan 2011
Rate per 1000 foley-days
Confidential QI
HMC Foley Catheter Utilization 2009-2011
0.00
0.10
0.20
0.30
0.40
0.50
0.60
0.70
0.80
0.90
1.00
Fo
ley c
ath
ete
r u
tiliz
atio
n r
atio
.
Acute 0.30 0.31 0.29 0.26 0.28 0.26 0.25 0.28 0.29 0.31 0.28 0.27 0.26 0.27 0.28
ICU 0.76 0.79 0.80 0.75 0.79 0.79 0.80 0.77 0.81 0.83 0.76 0.73 0.74 0.77 0.78
Overall 0.41 0.43 0.42 0.38 0.40 0.40 0.39 0.41 0.42 0.44 0.40 0.38 0.38 0.40 0.41
Nov-09 Dec-09 Jan-10 Feb-10 Mar-10 Apr-10 May-10 Jun-10 Jul-10 Aug-10 Sep-10 Oct-10 Nov-10 Dec-10 Jan-11
HMC Hand Hygiene Compliance by Profession, Jan 2010 - Jan 2011
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
% C
ompl
ianc
e
.
MD/ARNP 82% 81% 91% 83% 80% 77% 80% 83% 75% 74% 78% 87% 80%
Nurse/MA/HA 95% 92% 86% 89% 87% 84% 85% 91% 82% 86% 77% 91% 88%
Other 86% 85% 86% 85% 91% 84% 84% 95% 76% 84% 77% 84% 78%
Grand Total 88% 86% 88% 87% 85% 81% 83% 89% 78% 81% 78% 89% 85%
Jan10 Feb10 Mar10 Apr10 May10 Jun10 Jul10 Aug10 Sep10 Oct10 Nov10 Dec10 Jan11
Hand Hygiene Compliance by ServiceJanuary 2011
89%
92%
100%
92%
100%
77%
70%
Medicine
Ortho
Surgery
Burn
Neurology
Peds
MD's in ED
% Compliance
Confidential QISource: Infection Control, for more information, please contact Dr. Tim Dellit, [email protected]
HMC Lab-Confirmed Influenza in Hospitalized PatientsFor week 9 ending February 26, 2011
0
2
4
6
8
10
12
14
31 32 34 35 36 38 39 40 41 42 43 44 45 46 47 48 50 51 52 1 2 3 4 5 6 7 8 9
Week
Num
ber o
f hos
pita
lizat
ions
.
2009-2010
2010-2011
