Implementation of the Infection Risk Scan (IRIS) in nine hospitals in the Belgian-Dutch border region (i-4-1-Health project)
i-4-1-Health Study Group
(2022) Antimicrobial Resistance and Infection Control, volume 11
(Article)
Abstract
BACKGROUND: A tool, the Infection Risk Scan has been developed to measure the quality of infection control and antimicrobial use. This tool measures various patient-, ward- and care-related variables in a standardized way. We describe the implementation of this tool in nine hospitals in the Dutch/Belgian border area and the
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obtained results. METHODS: The IRIS consists of a set of objective and reproducible measurements: patient comorbidities, (appropriate) use of indwelling medical devices, (appropriate) use of antimicrobial therapy, rectal carriage of Extended-spectrum beta-lactamase producing Enterobacterales and their clonal relatedness, environmental contamination, hand hygiene performance, personal hygiene of health care workers and presence of infection prevention preconditions. The Infection Risk Scan was implemented by an expert team. In each setting, local infection control practitioners were trained to achieve a standardized implementation of the tool and an unambiguous assessment of data. RESULTS: The IRIS was implemented in 34 wards in six Dutch and three Belgian hospitals. The tool provided ward specific results and revealed differences between wards and countries. There were significant differences in the prevalence of ESBL-E carriage between countries (Belgium: 15% versus The Netherlands: 9.6%), environmental contamination (median adenosine triphosphate (ATP) level Belgium: 431 versus median ATP level The Netherlands: 793) and calculated hand hygiene actions based on alcohol based handrub consumption (Belgium: 12.5/day versus The Netherlands: 6.3/day) were found. CONCLUSION: The Infection risk Scan was successfully implemented in multiple hospitals in a large cross-border project and provided data that made the quality of infection control and antimicrobial use more transparent. The observed differences provide potential targets for improvement of the quality of care.
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Keywords: Benchmarking, Guidelines, Infection prevention, Surveillance, Public Health, Environmental and Occupational Health, Microbiology (medical), Infectious Diseases, Pharmacology (medical)
ISSN: 2047-2994
Publisher: BioMed Central Ltd.
Note: Funding Information: The i-4-1 Health project was financed by the Interreg V Flanders-The Netherlands program, the cross-border cooperation program with financial support from the European Regional Development Fund (ERDF) (0215). Additional financial support was received from the Dutch Ministry of Health, Welfare and Sport (325911), the Dutch Ministry of Economic Affairs (DGNR-RRE/14191181), the Province of Noord-Brabant (PROJ-00715/PROJ-01018/PROJ-00758), the Belgian department of Agriculture and Fisheries (no reference), the Province of Antwerp (1564470690117/1564470610014) and the Province of East-Flanders (E01/subsidie/VLNL/i-4-1 Health). The ATP luminometers and ATP surface swabs were kindly provided by 3M. Selective and non-selective agar plates, FecalSwabs® and tryptic soy broths used for the detection of ESBL-E were kindly provided by bioMérieux (Marcy l’Etoile, France) and Copan Italy (Brescia, Italy), respectively. The authors are free to publish the results from the project without interference from the funding bodies, bioMérieux, Copan Italy or 3M. Funding Information: We are grateful to the infection control practitioners in the participating hospitals for their contribution to the collection of epidemiological data and to the microbiology technicians in the participating laboratories for their contribution to the collection of the microbiological and the whole genome sequence data. Lieke Van Alphen (Maastricht University Medical Center+, Maastricht, The Netherlands), Nicole van den Braak (Avans University of Applied Sciences, Breda, The Netherlands), Caroline Broucke (Agency for Care and Health, Brussels, Belgium), Anton Buiting (Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands), Liselotte Coorevits (Ghent University Hospital, Ghent, Belgium), Sara Dequeker (Agency for Care and Health, Brussels, Belgium and Sciensano, Brussels, Belgium), Jeroen Dewulf (Ghent University, Ghent, Belgium), Wouter Dhaeze (Agency for care and Health, Brussels, Belgium), Bram Diederen (ZorgSaam Hospital, Terneuzen, The Netherlands), Helen Ewalts (Regional Public Health Service Hart voor Brabant, Tilburg, The Netherlands), Herman Goossens (University of Antwerp, Antwerp, Belgium and Antwerp University Hospital, Antwerp, Belgium), Inge Gyssens (Hasselt University, Hasselt, Belgium), Casper den Heijer (Regional Public Health Service Zuid-Limburg, Heerlen, The Netherlands), Christian Hoebe (Maastricht University Medical Center+, Maastricht, The Netherlands and Regional Public health Service Zuid-Limburg, Heerlen, The Netherlands), Casper Jamin (Maastricht University Medical Center+, Maastricht, The Netherlands), Patricia Jansingh (Regional Public Health Service Limburg Noord, Venlo, The Netherlands), Jan Kluytmans (Amphia Hospital , Breda, The Netherlands and University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands), Marjolein Kluytmans-van den Bergh (Amphia Hospital , Breda, The Netherlands and University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands), Stefanie van Koeveringe (Antwerp University Hospital, Antwerp, Belgium), Sien De Koster (University of Antwerp, Antwerp, Belgium), Christine Lammens (University of Antwerp, Antwerp, Belgium), Isabel Leroux-Roels (Ghent University Hospital, Ghent, Belgium), Hanna Masson (Agency for Care and Health, Brussels, Belgium), Ellen Nieuwkoop (Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands), Anita Van Oosten (Admiraal De Ruyter Hospital, Goes, The Netherlands), Natascha Perales Selva (Antwerp University Hospital of Antwerp, Antwerp, Belgium), Merel Postma (Ghent University, Ghent, Belgium), Stijn Raven (Regional Public Health Service West-Brabant, Breda, The Netherlands), Veroniek Saegeman (University Hospitals Leuven, Leuven, Belgium), Paul Savelkoul (Maastricht University Medical Center+, Maastricht, The Netherlands), Annette Schuermans (University Hospitals Leuven, Leuven, Belgium), Nathalie Sleeckx (Experimental Poultry Centre, Geel, Belgium), Krista van der Slikke (Regional Public Health Service Zeeland, Goes , The Netherlands), Arjan Stegeman (Utrecht University, Utrecht, The Netherlands), Tijs Tobias (Utrecht University, Utrecht, The Netherlands), Paulien Tolsma (Regional Public Health Service Brabant Zuid-Oost, Eindhoven, The Netherlands), Jacobien Veenemans (Admiraal De Ruyter Hospital, Goes, The Netherlands), Dewi van der Vegt (PAMM Laboratory for Pathology and Medical Microbiology, Veldhoven, The Netherlands), Martine Verelst (University Hospitals Leuven, Leuven, Belgium), Carlo Verhulst (Amphia Hospital, Breda, The Netherlands), Pascal De Waegemaeker (Ghent University Hospital, Ghent, Belgium), Veronica Weterings (Amphia Hospital, Breda, The Netherlands), Clementine Wijkmans (Regional Public Health Service Hart voor Brabant, Tilburg, The Netherlands), Patricia Willemse-Smits (Elkerliek Hospital, Helmond, The Netherlands), Ina Willemsen (Amphia Hospital, Breda, The Netherlands). Publisher Copyright: © 2022, The Author(s).
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