Hospital Monitors Infectious Diseases Using Real-Time Surveillance

Cynthia Johnson , March 17, 2010

Waguespack now receives alerts on MDRO patients, which allows her to notify the shift supervisor of the unit. From there, the supervisor can assess the patient to determine if he or she needs to be in isolation again.

"Here we are on the front end getting a jump on trying to prevent infections, especially with those multi-drug resistant organisms," says Waguespack. "That is something that I did not have in place before."

Prior to the system, Waguespack says she would have had to rely on the memory of the nurses on duty to recognize the patient. While the hospital is small and has many repeat patients, she says it is impossible to expect the nursing staff to remember each individual.

"From a patient perspective, I would rather go to a facility where someone is gathering information and can look at patterns and trends versus one where they relied on a staff member's memory," says Scott.

The alerts also come in handy when an ailing patient is unable to answer questions and doesn't have a family member present to assist them.

"You may not get that information," says Waguespack. "Whereas, if you have a computer system like IC Insight, it automatically triggers it and it's there."

The real-time time technology in Quantros comes with a hefty price tag. However, with CMS refusing to pay for hospital acquired infections, facilities and health systems are now beginning to find room in their budgets. They calculate that they can save more money, comply with regulations, and ensure patient safety by signing off on the purchase.

Coping with compliance

Beginning in January 2010, hospitals were required to comply with The Joint Commission's NPSGs. Waguespack points out that one of the goals is to prevent MDROs from spreading.

"Based on your risk assessment, if you have a high influx of patients who are coming in with MRSA or another organism, the goals say that you should put some type of tracking or alert system into place," says Waguespack. "I didn't have to develop anything, because it was already there with IC Insight. That came into play in almost perfect timing."

Waguespack can now customize reports to focus on a particular organism or a particular activation. The data from the charting, laboratory, and pharmacy systems all get pulled into the report.

The system also looks at antimicrobial therapy. If the hospital has a patient who may have been on a specific drug and culture reports come back showing it is resistant, then an alert displays. The facility doesn't have to rely on a laboratory technician to contact the hospital pharmacy to alert them that the medication is not working.

"We don't have to have someone nit-picking through all the records," says Waguespack. "It gives us an alert, so turnaround time is much, much quicker."

In the future, Waguespack may need to comply with state reporting regulations. Although the state of Louisiana does not require mandatory reporting, Waguespack says the system has capabilities that ensure that the facility will be in line with mandatory reporting if it becomes a requirement in the future.

"It uses a specific format and data that's going to be required when you get up to the point when you're going to have to do that," says Waguespack. "We haven't gotten to the point where we can automatically report it because those systems aren't talking with the specific state systems. But it's still easier because it's there."

Having her final say

The healthcare system is now in the process of sharing best practices with one another. According to Scott, having Waguespack share her experiences working with the system will help her sister hospitals grasp the benefits that they can experience if they welcome the technology as she did. It will also provide them with the opportunity to become consistent in their use of the Quantros system.

"When we do have to start reporting up to the state, we want to make sure we're reporting the same thing—that we're comparing apples to apples," says Waguespack. "That's going to be critical."

According to Waguespack, users need to recognize that the system doesn't replace the role of the infection preventionist. If the system raises an alert for an infection that is not truly an infection, the infection preventionist must use his or her own judgment to go into the system and add comments.

"I have the final say," says Waguespack.

In January, St. Elizabeth Hospital was re-accredited by The Joint Commission. During the process, surveyors told Waguespack that her infection control and prevention (ICP) program was "best practice." Surveyors found no issues at all in regards to the hospital's compliance with NPSGs.

Cynthia Johnson is the editor of Medicine On The 'Net, a monthly newsletter from HealthLeaders Media.

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