NWT RESEARCH DATABASE

Regions: North Slave Region

Tags: health, health care, hospitals

Objective(s): To determine the prevalence of MRSA, VRE and C. difficile colonization and infection among adults hospitalized in Canadian hospitals.

Project Description: Primary Study Objectives: • To determine the prevalence of MRSA and VRE colonization and infection among adults hospitalized in Canadian hospitals; • To determine the prevalence of C. difficile infection among adults hospitalized in Canadian hospitals. Secondary Study Objectives: • To describe demographic and select clinical/epidemiologic features of patients with prevalent MRSA, VRE, and C. difficile infection in Canadian hospitals; • To determine institutional characteristics associated with MRSA, VRE, and C. difficile infection rates. All 406 acute-care hospitals in Canada with at least 50 inpatient beds will be approached to participate in this point-prevalence survey (hospitals identified from the Canadian Hospital Association [CHA] 2008 database, Volume 15.1). A letter inviting healthcare facilities to participate in the prevalence survey will be sent by e-mail to each facility’s Infection Prevention & Control professional (ICP). If there has been no response to this initial mailing, the ICP will be contacted a second time by e-mail, and if required, an attempt will also be made to contact the individual by telephone. Eligible patients will include acute adult inpatients (usually = 18 years of age) hospitalized in a participating hospital on the day of the survey (please note that hospitals may use their own cut-off age for identifying adult patients). Long-term care patients in these hospitals will be included if the long-term care beds are physically associated with a medical unit in the acute-care hospital, or if patients are awaiting transfer/placement to a long-term care facility. Other (free-standing) long-term care facilities, rehabilitation hospitals, complex care facilities and psychiatric hospitals will not be included. It is anticipated that at least 250 (62%) hospitals will be willing and able to participate. Data to be collected for each patient with MRSA, VRE, and CDI include: (i) age; (ii) sex; (iii) hospital service on the day of the survey (medicine, surgery, obstetrics/gynecology, intensive care unit, etc.); (iv) for MRSA, whether the most recent isolate was obtained as a clinical specimen (to determine the presence of an infection), or as a screening/surveillance specimen (eg. nose swab); (v) whether the patient was thought to be infected (using standard definitions) or colonized; (vi) the anatomic site of the isolate (nose, skin, surgical site, respiratory, blood, urine, etc); (vii) whether the organism was thought to be healthcare-associated (index facility or other healthcare facility) or community-acquired (using CNISP definitions); (viii) whether the organism was initially identified during the current admission or a previous admission; (ix) whether the organism was thought to have been acquired during this admission or a previous admission; (x) for C. difficile infection, whether this represented a first episode or recurrence. Data will also be obtained to describe each participating hospital: (i) number of admitted inpatients in the hospital on the survey date (at midnight); (ii) total number of inpatient beds; (iii) number of ICU beds; (iv) hospital location (city, province, postal code); (v) type of facility (adults only, mixed adults-pediatrics); (vi) type of facility (teaching vs non-teaching hospital); (vii) scope of services provided (acute trauma, burns, oncology, stem-cell transplants, solid organ transplants, neurosurgery, cardiac surgery, dialysis, etc); (viii) number of FTE infection control professionals (ICPs). All of the data are to be collected by a hospital Infection Control Professional (ICP) or appropriately trained delegate under the ICP’s supervision. In order to maintain confidentiality, each hospital will be assigned a numeric code, and each patient will also be assigned a unique study number for entry into the database. No personal identifying data will be provided to the study investigators. Consequently, Review Ethics Board (REB) approval may not be required at all participating hospital sites. However, hospitals may submit the proposal to their local REB for approval. The hope is that the infection control staff at the Health Authority will receive some educational benefit from the training and participation in the study. The ability to share the data after the study may be helpful. Communication of the results will be by the staff of the Stanton Regional Health Authority. The study will provide summary results of the SRHA's own data back to the hospital, as well as sharing the data reports from the entire study. The fieldwork for this study will be conducted from November 30, 2010 to December 31, 2010.