Healthcare acquired infection and antibiotic resistance prevention using a proactive detection and focused intervention programme
Infections acquired within healthcare settings are one of the top risks faced by healthcare systems worldwide. This global problem is particularly of concern when viewed against the backdrop of the growing resistance of microbial infections to antibiotic treatment.
According to Dr Dena van den Bergh, Netcare’s director of Quality Leadership, ”Effective infection risk management programmes using appropriate rule-based technology can, however, meaningfully reduce the risk of infections, improve patient outcomes and support antibiotic stewardship to preserve the effectiveness of antibiotics for future generations.”
“This has been tangibly addressed in the South African context by Netcare’s implementation of a sophisticated new technology known as Bluebird, across 47 of the group’s hospitals following a successful pilot project introduced in 2012,” notes Dr Van Den Bergh, who added that Bluebird was chosen after diligently assessing competing products.
“It is critical that hospitals are vigilant and able to identify any potential infection risks, as well as to respond rapidly to ensure that these are quickly combated. This has become even more important in recent years with the development of more treatment-resistant forms of microbes, the so-called ‘superbugs’.”
“We have been able to work with Intelligent Medical Systems to adapt the Bluebird system to fit our hospitals’ needs and our specific hospital environments. The power and functionality of the Bluebird system is demonstrated by its ability to immediately send electronic laboratory reports to the laptops and/or mobile devices of infection prevention practitioners, pharmacists, nursing unit managers and other members of the hospital leadership team.
The system integrates laboratory data with Netcare’s patient master data and antibiotic prescription data to enable quick identification of infection prevention and antibiotic stewardship opportunities, which are flagged as alerts. Bluebird standardises and streamlines workflow, which ensures that infection prevention practitioners, nursing leaders and pharmacists can prioritise specific focus areas ensuring early engagement with doctors to the benefit of the patient,” explains Dr Van Der Bergh.
We are pleased to have been able to work collaboratively with the Bluebird developers to tailor the workflow to support the highly innovative pharmacist-driven antibiotic stewardship programme, which has been introduced to great effect within Netcare facilities across South Africa.
The achievements of this programme were highlighted in a research paper recently published in Lancet Infectious Diseases on behalf of the Netcare multi-disciplinary antimicrobial stewardship teams. The Netcare programme achieved an 18% reduction in the consumption of antibiotics by in-hospital patients and demonstrated that a meaningful reduction in antibiotic usage can be achieved through a number of basic interventions.
“Following the original Bluebird system pilot programme, an additional antibiotic stewardship phase was adapted for the Netcare hospital setting and introduced to extend the implementation of further coordinated interventions designed to improve and measure the appropriate use of antibiotics. We are excited to be monitoring the additional impact this may have on our antibiotic stewardship process and outcome measures.”
Jacques du Plessis, managing director of Netcare’s Hospital division emphasises that, since the Bluebird system is now fully operational across all 47 hospitals, it can be used to monitor infection prevention and antibiotic stewardship interventions at group level, and resources and expertise can be deployed to support local hospital teams. Detailed information and recorded interventions can also be analysed to improve surveillance, while specific identified trends within certain regions and hospitals are available in management reports and can be used to inform national and regional policy.
“The timeous availability of information has enabled Netcare hospitals to firmly establish infection prevention and antibiotic stewardship as a management priority for the hospital leadership teams. It has also assisted us greatly in creating a multi-disciplinary approach to patient care and has proved to be an important enabling tool eliminating delays previously experienced in the access of vital information. In addition, data is available in more user friendly formats to present to hospital committee structures such as the Netcare physician advisory boards as well as antibiotic stewardship and infection control committees at each hospital. Our next steps will include working with our specialists to investigate how we can provide a practical interface for doctors in Netcare facilities,” explains Du Plessis.
Dr Adri Kok, a specialist physician practising at Netcare Union and Netcare Clinton hospitals, and president of the Faculty of Consulting Physicians of SA (FCPSA), says it has been extremely valuable to be able to work together with pharmacists, nurses and the infection prevention practitioners to address the growing risk of multidrug-resistant infections.
“The entire team involved in taking care of patients in hospital realises the importance of protecting our available antibiotics. The aim is to use these appropriately, to identify patients at risk and to treat infections effectively. We must maintain the attitude that antibiotics are a scarce resource to be protected as we strive to provide excellent care to our patients,” says Dr Kok.
Dr Van Den Bergh summarised just a few of the many benefits of using the Bluebird technology to support the Netcare infection risk and AMS management programmes as follows:
- Reduction in infection rates through early detection and containment of infections
- Reduction in antibiotic usage and mitigating the risk of the development of resistant microbes
- Reduction in the costs of patient care by reducing avoidable infections, decrease in length of stay and promoting the appropriate use of antibiotics
- Improved multi-disciplinary teamwork in patient care and infection risk management.
“Netcare places the highest priority on infection prevention and has implemented the Bluebird system as a tool to substantially reinforce our existing initiatives in this regard, as well as to assist us in strengthening our ground breaking group-wide antibiotic stewardship programme. The rollout has been a significant success within Netcare and we look forward to exploring how this technology can further strengthen our programmes and positively impact patient care and outcomes,” concludes Dr Van Den Bergh.