《Active surveillance Checklist》由会员分享，可在线阅读，更多相关《Active surveillance Checklist（5页珍藏版）》请在金锄头文库上搜索。
1、 Joint Commission on Accreditation of Healthcare Organizations Checklist for Active Surveillance of MDROs This tool is meant to serve as a practical resource for leaders tasked with developing and implementing an active surveillance program. In addition to identifying the essential steps to ensure t
2、hat the program is both effective and efficient, notes are provided (in italics) to specifically highlight the rationale for each step and to identify particular pitfalls that may be associated with the completion (or omission) of each step.Pre-planning1. Identify the population(s) targeted for scre
3、ening. This may be driven by external expectations or mandates. If internally driven, it should be informed by institutional risk assessment (incorporating prevalence and severity of infections and MDRO trends). Potential pitfalls in this step include the delineation of a population or program scope
4、 that is not appropriate for the goal of the program (see #2).2. Identify program goals. Without clearly defined goals, an active surveillance program cannot be examined for performance effectiveness and cannot be compared to other clinical and non-clinical programs to properly evaluate the appropri
5、ateness of continued institutional support. Joint Commission on Accreditation of Healthcare Organizations 3. Complete performance assessment for current interventions/practices. The effectiveness of active surveillance is dependent on the application of evidence-based measures to ensure that such pa
6、thogens are not disseminated to other vulnerable patients. Prior attention must be given to correcting poor adherence with hand hygiene and isolation precautions to expect there to be an impact with deployment of active surveillance.Screening Logistics4. Who will be screened? Specify target populati
7、on(s), as previously discussed.5. When will subjects be screened? The minimal standard for screening patients entails collection of specimens at the time of admission to the hospital or targeted unit. A more comprehensive approach is to periodically collect additional surveillance specimens from tho
8、se patients not found to be colonized at admission. One clear benefit to the collection of follow-up swabs is the capacity to use the frequency of new acquisition events as a more precise measure of the effectiveness of the active surveillance program in general. Joint Commission on Accreditation of
9、 Healthcare Organizations 6. How will subjects be screened? No clear consensus is available regarding which body sites must be surveyed in order to maximize the effectiveness and efficiency of a screening program. Most published studies and experts agree that nasal specimens are essential to detect
10、MRSA and peri-rectal or stool samples for VRE. 7. What laboratory methods will be used? Culture-based methods are familiar and routine in nearly all clinical labs. PCR-based methods require more resources but yield faster turnaround time for results.8. What will be done with the results? Patients ma
11、y be placed on precautions presumptively while screening results are pending. There may be an existing organizational policy for managing and monitoring colonized patients. Subjects may be offered the opportunity for decolonization therapy.Rollout9. Ensure inventory of resources. Sufficient capacity
12、 must exist to manage the collection and processing of specimens (nursing, laboratory, and infection control), the analysis of results Joint Commission on Accreditation of Healthcare Organizations (laboratory staff and equipment), and follow-up measures (supplies and rooms for isolation).10. Engage
13、all stakeholders Frontline staff must be made aware of rationale, methods, and implications. Detailed scripting regarding these same issues should be developed for consistent communication to patients and families. Laboratory personnel must be apprised of revised workflow. Patients and families requ
14、ire uniform information about the implications and management of colonization.11. Complete ongoing performance assessment Overall program goal (which is aligned with institutional goals) must be distilled to operational goals. Examples include quantification of infections, new colonization events, t
15、imeliness of specimen collection, compliance with program specifications, and appropriateness of isolation precautions. Program must include evaluation of potential unintended consequences (patient satisfaction, patient safety, incidence of other problem pathogens).12. Re-evaluation Consider revisio
16、ns to program practices and operations as well as policies affected by the program when evidence indicates change is appropriate. Joint Commission on Accreditation of Healthcare Organizations Evaluate the feasibility and potential benefit of rollout to other institutional settings (depending on the findings of risk assessment).
