Table 1.
Management strategic axis and actions retained by the steering committee
| Quality process implementation |
Operational team: |
| 1. Care quality improvement approach | |
| 2. Identification of 4 “quality control nurses” among the staff nurses | |
| 3. Definition of desired outcomes | |
| 4. Procedure reference tool validation | |
| 5. Random observation of procedure compliance | |
| 6. Procedure compliance evaluation by a computerized feedback tool | |
| Hospital Hygiene Division: | |
| 7. Hygiene counselling and infections epidemiologic monitoring | |
| Hospital Executive Board: | |
| 8. Bioengineer consultant recruitment | |
| All HCW and visitors: | |
| 9. Anonymous “at risk for infection event” declaration | |
| Effective communication |
Head of the paediatric department: |
| 10. Regular reports on MRSA infections management to the hospital executive board, health care branch, department of health quality safety and patient experience | |
| 11. External audit request | |
| Operational team: | |
| 12. Monthly internal feedback audits | |
| 13. Monthly report display in units | |
| Infections epidemiologic monitoring |
Staff nurses: |
| 14. Routine weekly MRSA screening | |
| Physicians: | |
| 15. Retrospective and prospective data collection | |
| Hospital Hygiene Division: | |
| 16. Case–control study to identify risk factors for MRSA infections in hospitalized newborns | |
| 17. Regular environmental and medical device cultures | |
| Department of bacteriology: | |
| 18. MRSA clinical isolates genotyping | |
| Hand-hygiene, contact precautions, HCW and patients families clothing and flow issues improvement |
Hospital Hygiene Division: |
| 19. Intensive HCW, families and visitors information and training | |
| 20. HCW, families and visitors work clothing + protective clothing implementation | |
| 21. Reinforced barrier precautions for MRSA colonization | |
| 22. Posted isolation cards | |
| Standardisation of procedures for the insertion and the continuous care of peripherally inserted central venous catheters, care of invasive medical devices |
Staff nurses: |
| 23. Central venous lines insertion and care checklist | |
| 24. Invasive medical devices care checklist | |
| Units cleaning |
Cleaning staff: |
| 25. Cleaning procedure implementation | |
| 26. Cleaning procedure assessment | |
| 27. Cleaning checklist | |
| 28. Cleaning staff overwork lowering (2 recruitments) | |
| 29. Room cleaning intensification (3 daily cleanings versus 1) | |
| 30. Standardized disinfection of external medical devices |