Long-Term Outcome of Infection Control for Methicillin-Resistant Staphylococcus Aureus and Kaizen Approach with Problem-Solving

摘要

Background : Methicillin-resistant Staphylococcus aureus (MRSA) results in longer hospitalization, increased expenses, and poorer patient prognosis. The aim of this study is 1) to investigate the short-term outcome of MRSA outbreak and the prevention in our surgical ward, and 2) to evaluate the long-term outcome of a 7-year experience of infection control, and 3) to report the effectiveness of intervention of quality improvement by industry problem-solving method for the eradication of a new occurrence of MRSA patients. Methods : Between April 2009 and October 2019, we retrospectively studied the improvement activity for infection control and preventative measures in our surgical ward. The daily alcohol use for hand hygiene was measured (ml/patient/day) and the monthly number of occurrences of new MRAS patients was investigated. We used the industry problem-solving method as the Kaizen of infection control for the eradication of a new Methicillin-resistant Staphylococcus aureus occurrence in the surgical ward. Results : There was an inverse correlation between the increased amount of alcohol use for hand hygiene and the decreased number of new MRSA patients. In the long-term outcome, the amount of alcohol use has gradually decreased and the MRSA patients have been occasionally observed; these facts should display the difficulty to maintain a strict infection control. By the use of the problem-solving method, there continued for 7 months no new MRSA patients between June 2018 and December 2018. However, once the amount of alcohol use for hand hygiene decreased below 40 ml/patient/day, three new MRSA patients were detected. It displayed an inverse correlation between the decreased amount of alcohol use for hand hygiene and the increased number of new MRSA patients. Conclusion : The daily monitoring and measuring of the amount of alcohol use for hand hygiene and to know the current number of new occurrence of MRSA patients will become a meaningful tool. By performing the Kaizen with a problem-solving method, it will contribute to the multi-professional team to visualize the process of quality improvement for infection control.