“MROs can be a RIOT.” Development of an electronic risk assessment tool to rationalise the use of single rooms and personal protective equipment when caring for admitted patients with known Multi-resistant Organisms
Sue Gonelli1, Nicole Elms1, Kylie Lambert1,2, Kim Heriot1, Karen Bradshaw1, , 1Peninsula Health, Frankston, VIC, Australia2Bass Coast Health, Bass Coast, VIC, Australia
Our health service aimed to develop a simple tool to ensure the best use of limited resources in managing admitted patients with known multi-resistant organisms (MROs). The tool, based on transmission risk factors, enabled nursing staff at the bedside to determine isolation requirements and use of additional Personal Protective Equipment (PPE).
The Risk of Infectious Organism Transmission (RIOT) tool allocates a score to patients based on the type of organisms, presence of wounds or indwelling devices, continence, and cognitive levels. An additional score related to the type of ward the patient is admitted to e.g. oncology/surgical completes the assessment. High scores prompt use of single rooms and additional precautions including gown and gloves to enter patient rooms. We used ongoing monitoring of clinical isolates to determine MRO transmission.
The tool was paper based initially, with Infection Prevention and Control Unit (IPaCU) staff completing the tool and monitoring its use on ward rounds. Education sessions were held at ward level to promote use. The tool has now been incorporated into the electronic medical record (EMR) and is widely used across all sites. IPaCU staff are able to order the score to be completed by the bedside nurse via the EMR. There are built in prompts to guide the bedside nurse on PPE and room allocation.
The tool is simple to use and well accepted by the staff as a useful infection prevention resource. There have been no discernable increase in MRO clinical isolates since the tool was introduced.
Biography
Sue has worked in infection control for over 15 years. She has completed a graduate certificate in Infection Control through Adelaide University in 2011 and was recently appointed manager of Infection Prevention and Control at Peninsula Health in 2021. She is passionate about the RIOT tool as she was involved in its inception from the very beginning.