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MiBAlert-a new information tool to fight multidrug-resistant bacteria in the hospital setting

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@article{33d77e7e66cf498994d6606c7e393698,
title = "MiBAlert-a new information tool to fight multidrug-resistant bacteria in the hospital setting",
abstract = "BACKGROUND: Although the timely isolation of patients is an essential intervention to limit spread of drug-resistant bacteria, information about the colonization status is often unavailable or lost when patients are readmitted or transferred between hospitals. Therefore, carriers of drug resistant bacteria are not recognized sufficiently early, and proper and timely isolation precautions are not taken. Consequently, resistant bacteria of public health concerns including vancomycin resistant enterococci (VRE) and methicillin resistant Staphylococcus aureus (MRSA) can spread epidemically. To ensure timely identification and proper isolation of such patients we developed an automatic real-time alert of carriers of drug resistant bacteria.OBJECTIVES: The aim of this paper is to describe the system, called MiBAlert, and share the initial experiences in connection with an outbreak of VRE in the greater Copenhagen area (the Capital region), Denmark.METHODS: We obtained data on cases of VRE from hospitals in Copenhagen during the period when the first version of MiBAlert was implemented and log-data on the use of MiBAlert. Furthermore, a survey was conducted among 88 staff members to investigate their experiences of MiBAlert.RESULTS: The alert is a tool directed toward healthcare personnel accessing the electronic health record (EHR) and those further involved in the care and treatment of the patient. It is based on a web service using data from the national microbiological database, MiBa. MiBAlert is a real-time electronic non-intrusive alert generated automatically in the header of the EHR each time record is accessed. On February 15, 2015 a pilot version of MiBAlert was launched. All positive tests for VRE throughout 1year were shown with alert status by MiBAlert visible to all medical staff with access to EHR. The alert system was automatically updated directly in the EHR across the five hospitals in the Capital region. We found that the system performed satisfactorily, being operational 24/7 all 135 trial days, apart from 72min, for all the hospitals. Of the staff who responded to the survey, 82% considered that MiBAlert overall improved compliance with isolation precautions regarding VRE-positive patients. We found a marked decline of new patients infected or colonized with VRE concomitant with the implementation of MiBAlert and the survey results.CONCLUSION: We found that MiBAlert was a valuable tool in a bundle approach to counter a multiple hospital outbreak of VRE, and that it has a great potential to improve the control of other drug-resistant bacteria.",
keywords = "Clinical Alarms/utilization, Cross Infection/prevention & control, Denmark, Drug Resistance, Multiple, Electronic Health Records, Enterococcus/physiology, Gram-Positive Bacterial Infections/microbiology, Hospitals/statistics & numerical data, Humans, Infection Control/methods, Methicillin-Resistant Staphylococcus aureus/physiology, Microbial Sensitivity Tests, Staphylococcal Infections/microbiology, Vancomycin Resistance",
author = "Bente Olesen and Jacob Anh{\o}j and Rasmussen, {Kenneth Palle} and K{\aa}re M{\o}lbak and Marianne Voldstedlund",
note = "Copyright {\textcopyright} 2016 Elsevier Ireland Ltd. All rights reserved.",
year = "2016",
month = nov,
doi = "10.1016/j.ijmedinf.2016.09.001",
language = "English",
volume = "95",
pages = "43--48",
journal = "International Journal of Medical Informatics",
issn = "1386-5056",
publisher = "Elsevier Ireland Ltd",

}

RIS

TY - JOUR

T1 - MiBAlert-a new information tool to fight multidrug-resistant bacteria in the hospital setting

AU - Olesen, Bente

AU - Anhøj, Jacob

AU - Rasmussen, Kenneth Palle

AU - Mølbak, Kåre

AU - Voldstedlund, Marianne

N1 - Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

PY - 2016/11

Y1 - 2016/11

N2 - BACKGROUND: Although the timely isolation of patients is an essential intervention to limit spread of drug-resistant bacteria, information about the colonization status is often unavailable or lost when patients are readmitted or transferred between hospitals. Therefore, carriers of drug resistant bacteria are not recognized sufficiently early, and proper and timely isolation precautions are not taken. Consequently, resistant bacteria of public health concerns including vancomycin resistant enterococci (VRE) and methicillin resistant Staphylococcus aureus (MRSA) can spread epidemically. To ensure timely identification and proper isolation of such patients we developed an automatic real-time alert of carriers of drug resistant bacteria.OBJECTIVES: The aim of this paper is to describe the system, called MiBAlert, and share the initial experiences in connection with an outbreak of VRE in the greater Copenhagen area (the Capital region), Denmark.METHODS: We obtained data on cases of VRE from hospitals in Copenhagen during the period when the first version of MiBAlert was implemented and log-data on the use of MiBAlert. Furthermore, a survey was conducted among 88 staff members to investigate their experiences of MiBAlert.RESULTS: The alert is a tool directed toward healthcare personnel accessing the electronic health record (EHR) and those further involved in the care and treatment of the patient. It is based on a web service using data from the national microbiological database, MiBa. MiBAlert is a real-time electronic non-intrusive alert generated automatically in the header of the EHR each time record is accessed. On February 15, 2015 a pilot version of MiBAlert was launched. All positive tests for VRE throughout 1year were shown with alert status by MiBAlert visible to all medical staff with access to EHR. The alert system was automatically updated directly in the EHR across the five hospitals in the Capital region. We found that the system performed satisfactorily, being operational 24/7 all 135 trial days, apart from 72min, for all the hospitals. Of the staff who responded to the survey, 82% considered that MiBAlert overall improved compliance with isolation precautions regarding VRE-positive patients. We found a marked decline of new patients infected or colonized with VRE concomitant with the implementation of MiBAlert and the survey results.CONCLUSION: We found that MiBAlert was a valuable tool in a bundle approach to counter a multiple hospital outbreak of VRE, and that it has a great potential to improve the control of other drug-resistant bacteria.

AB - BACKGROUND: Although the timely isolation of patients is an essential intervention to limit spread of drug-resistant bacteria, information about the colonization status is often unavailable or lost when patients are readmitted or transferred between hospitals. Therefore, carriers of drug resistant bacteria are not recognized sufficiently early, and proper and timely isolation precautions are not taken. Consequently, resistant bacteria of public health concerns including vancomycin resistant enterococci (VRE) and methicillin resistant Staphylococcus aureus (MRSA) can spread epidemically. To ensure timely identification and proper isolation of such patients we developed an automatic real-time alert of carriers of drug resistant bacteria.OBJECTIVES: The aim of this paper is to describe the system, called MiBAlert, and share the initial experiences in connection with an outbreak of VRE in the greater Copenhagen area (the Capital region), Denmark.METHODS: We obtained data on cases of VRE from hospitals in Copenhagen during the period when the first version of MiBAlert was implemented and log-data on the use of MiBAlert. Furthermore, a survey was conducted among 88 staff members to investigate their experiences of MiBAlert.RESULTS: The alert is a tool directed toward healthcare personnel accessing the electronic health record (EHR) and those further involved in the care and treatment of the patient. It is based on a web service using data from the national microbiological database, MiBa. MiBAlert is a real-time electronic non-intrusive alert generated automatically in the header of the EHR each time record is accessed. On February 15, 2015 a pilot version of MiBAlert was launched. All positive tests for VRE throughout 1year were shown with alert status by MiBAlert visible to all medical staff with access to EHR. The alert system was automatically updated directly in the EHR across the five hospitals in the Capital region. We found that the system performed satisfactorily, being operational 24/7 all 135 trial days, apart from 72min, for all the hospitals. Of the staff who responded to the survey, 82% considered that MiBAlert overall improved compliance with isolation precautions regarding VRE-positive patients. We found a marked decline of new patients infected or colonized with VRE concomitant with the implementation of MiBAlert and the survey results.CONCLUSION: We found that MiBAlert was a valuable tool in a bundle approach to counter a multiple hospital outbreak of VRE, and that it has a great potential to improve the control of other drug-resistant bacteria.

KW - Clinical Alarms/utilization

KW - Cross Infection/prevention & control

KW - Denmark

KW - Drug Resistance, Multiple

KW - Electronic Health Records

KW - Enterococcus/physiology

KW - Gram-Positive Bacterial Infections/microbiology

KW - Hospitals/statistics & numerical data

KW - Humans

KW - Infection Control/methods

KW - Methicillin-Resistant Staphylococcus aureus/physiology

KW - Microbial Sensitivity Tests

KW - Staphylococcal Infections/microbiology

KW - Vancomycin Resistance

U2 - 10.1016/j.ijmedinf.2016.09.001

DO - 10.1016/j.ijmedinf.2016.09.001

M3 - Journal article

C2 - 27697231

VL - 95

SP - 43

EP - 48

JO - International Journal of Medical Informatics

JF - International Journal of Medical Informatics

SN - 1386-5056

ER -

ID: 55448879