Marla Clifton

Achieving balance between implementing effective infection prevention and control practices and maintaining a home-like setting in U.S. Department of Veterans Affairs nursing homes

HighlightsNursing homes present unique challenges for infection prevention and control.Use of medical devices can predispose nursing home residents to infections.National collaborative VA CAUTI and CLABSI prevention initiatives were implemented.VA nursing homes experienced a nationwide reduction of 51% for CAUTIs.VA nursing homes experienced a nationwide reduction of 25% for CLABSIs. &NA; Nursing homes present a unique challenge for implementing infection prevention and control practices while striving to maintain a home‐like environment. Medical devices such as urinary catheters and central venous catheters have become a part of nursing home care but can predispose residents to associated infections. Because evidence‐based prevention bundles were implemented, catheter‐associated urinary tract infections (CAUTIs) and central line‐associated bloodstream infections (CLABSIs) were monitored in all U.S. Department of Veterans Affairs (VA) nursing homes, and outcomes were evaluated. Bundle components for CLABSIs focused on insertion technique, site selection, and routine assessment of central line necessity, while the CAUTI bundle focused on insertion technique, appropriate indication, and routine assessment of urinary catheter necessity. From October 2010 through September 2016, VA nursing homes reported nationwide reductions of CAUTIs (51.2%; P < .0001) and CLABSIs (25.0%; P = .0009).

289Occurrence of Methicillin-Resistant Staphylococcus aureus (MRSA) Surgical Site Infections (SSIs) of Total Knee and Total Hip Arthroplasty (TKA and THA) Procedures within Veterans Health Administration Medical Centers

289. Occurrence of Methicillin-Resistant Staphylococcus aureus (MRSA) Surgical Site Infections (SSIs) of Total Knee and Total Hip Arthroplasty (TKA and THA) Procedures within Veterans Health Administration Medical Centers Stephen Kralovic, MD, MPH; Martin Evans, MD; Loretta Simbartl, MS; Judith Whitlock, RN, MSN, APRN; Marla Clifton, RN, MSN, CIC; Rajiv Jain, MD; Gary Roselle, MD; National Infectious Diseases Service, Department of Veterans Affairs Central Office, Cincinnati, OH; Division of Infectious Diseases, University of Cincinnati, Cincinnati, OH; Cincinnati VA Medical Center, Cincinnati, OH; Department of Veterans Affairs Central Office National Infectious Diseases Service MRSA/MDRO Prevention Office, Lexington, KY; Lexington VA Medical Center, Lexington, KY; Department of Veterans Affairs, Veterans Health Administration Central Office Patient Care Services, Washington, DC