Prof. Lisa Hall1, A/Prof Greg Merlo1,3, Ms Belinda Henderson4, Dr Louise Marquart-Wilson1, Ms Elizabeth Underwood1, Mr Matthew McDonnell5, Dr Naomi Runnegar5,6, Dr Margaret Lindsay5, Ms Fiona Caristo1, Ms Paola Vasquez-Vasquez1, Dr Geoffrey Playford5
1School of Public Health, University Of Queensland, Herston, Australia, 2Department of Infectious Diseases, University of Melbourne, Parkville, Australia , 3Healthcare Improvement Unit, Clinical Excellence Queensland, Herston, Australia , 4Queensland Infection Prevention and Control Unit, Queensland Department of Health, Herston, Australia, 5Princess Alexandra Hospital, Woolloongabba, Australia, 6School of Medicine, University Of Queensland, Herston, Australia
Biography:
Prof Lisa Hall is a Professor in Epidemiology at the University of Queensland. She is internationally recognized for her innovative and collaborative research underpinned by her expertise in epidemiology, implementation science and evaluation. Lisa's work focuses on strategies to improve the surveillance and prevention of infections and antimicrobial resistance.
Abstract:
Introduction
Bloodstream infections (BSIs) are a leading cause of healthcare-associated morbidity and mortality, with a significant portion being preventable. Despite this, BSIs remain common, particularly in Australian hospitals. Princess Alexandra Hospital in Queensland has implemented a surveillance program that focuses on the preventability of BSIs, with continuous loop, real-time audit-feedback to teach clinicians about preventable factors and possible actions. This study evaluated the program’s implementation and impact on reducing infections.
Methods
A Type I hybrid implementation-effectiveness design was used, combining interrupted time series analysis of BSI data from 2002-2023 and focus group discussions with the Infection Management Service team members and ward-based clinicians. Interrupted time series analysis was used to assess the impact of the Staphylococcus aureus bacteraemia (SAB) prevention initiative introduced in November 2011. Statistical analysis employed segmented regression using negative binomial regression with robust standard errors. Focus group data were analysed via the Consolidated Framework for Implementation Research (CFIR).
Results
The intervention resulted in a significant immediate reduction in SAB rates (incidence rate ratio, IRR=0.746, 95% CI: 0.583–0.953, p=0.019), and a declining trend in monthly rates was also noted post intervention (IRR=0.998, 95% CI: 0.996 – 1.000, p=0.040). Focus group feedback identified enablers, including effective collaboration and challenges such as needing to address inconsistent documentation and differing perceptions of the program’s intent.
Conclusion
The program’s shift to focus on preventability contributed to a reduction in SAB. The findings support the scalability of similar programs and highlight the importance of continuous feedback and adaptability in infection control practices.