Effectiveness of Comprehensive Implementation of Individualized Bundling Infection Control Measures for Prevention of Healthcare-Associated Infections in General Medical Wards

  • Dr Montri Korbkitjaroen, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok , Thailand, Thailand
  • Miss Sribenja Vaithayapichet, Siriraj Hospital, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok , Thailand, Thailand
  • Mrs Kanchana Kachintorn, Siriraj Hospital, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok , Thailand, Thailand
  • Miss Duangporn Jintanothaitavorn, Siriraj Hospital, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok , Thailand, Thailand
  • Mrs Natcha Wiruchkul, Siriraj Hospital, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok , Thailand, Thailand
  • Prof Visanu Thamlikitkul, Siriraj Hospital, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok , Thailand, Thailand

Objectives: To determine effectiveness of comprehensive individualized bundling infection control measures in reducing HAI.
Methods: This was a cluster randomized controlled study in 8 general medical wards at Siriraj Hospital. The wards were randomly allocated to 4 control wards and 4 intervention wards. The patients in control wards received regular healthcare as well as regular measures for prevention of HAI. The patients in intervention wards received additional measures. Each patient in intervention wards was visited by infection control team once a day on weekdays until he/she left the hospital. The infection control team identified risk factors for developing HAI for each patient and co-ordinate with local team for eliminating or minimizing such risk factors of each patient and encouraged responsible personnel to comply with infection control measures appropriate for each patient.
Results: From January to April 2009, there were 954 patients in intervention wards and 920 patients in control wards. The characteristics of the patients in both groups were not significantly different. Prevalence of HAI in intervention wards was significantly less than that in control wards (5.6% vs. 9.2%, p=0.003). VAP and CAUTI rates in intervention wards were also significantly less than those in control wards whereas CABSI rates were not significantly different. Six episodes of HAI in intervention wards could have been avoided.
Conclusion: Comprehensive individualized bundling infection control measures was effective in reducing HAI in general medical wards at Siriraj Hospital and the target of overall prevalence of HAI in general medical wards should not exceed 4.9%.