Improved patient safety through reduced airway infection rates in a paediatric cystic fibrosis programme after a quality improvement effort to enhance infection prevention and control measures.

Abstract

To reduce the risk of pathogen transmission between patients with cystic fibrosis (CF) and decrease the rate of acquisition of new CF pathogens in our patients. Using the Model for Improvement, we developed a new process for infection prevention and control in our outpatient CF clinics. Paediatric CF programme at Ann & Robert H. Lurie Children's Hospital of Chicago; approximately 180 paediatric patients aged birth to 21 years. All paediatric patients enrolled in the Cystic Fibrosis Foundation Patient Data Registry at this institution. Implemented contact precautions with all patients, regardless of respiratory tract culture results. Respiratory tract culture rates of specific pathogens by quarter were compared prior to and after implementation. Our percentage of patients with a positive respiratory tract culture for Pseudomonas aeruginosa dropped from 30% to 21% (p<0.0001) and for methicillin-resistant Staphylococcus aureus (MRSA) dropped from 10.8% to 8.7% (p=0.008). Use of contact precautions by all care providers, for all patients, regardless of respiratory tract culture results resulted in decreased P aeruginosa and MRSA infection rates.