The Infection Control Link Nurse Program: Implications for Acute Rehabilitation Facilities

Sunday, November 1, 2009

Cindy Gatens, MN, RN, CRRN-A
Rehabilitation Nursing, The Ohio State University Medical Center, Columbus, OH
Madhuri M. Sopirala, MD
Department of Clinical Epidemiology, Ohio State University Medical Center, Columbus, OH
Pat Kulich, RN, CIC
Epidemiology, Ohio State University Medical Center, Columbus, OH
Maureen Musto, MS, RN, CRRN, ACNS-BC
Rehabilitation Nursing, Ohio State University Medical Center, Columbus, OH

Learning Objective 1: Describe the Link Nurse role in preventing transmission of multi drug resistant organisms by improving hand hygiene and contact isolation compliance among health care workers.

Learning Objective 2: Identify the overall effectiveness and improvement in quality patient care as a result of the collaboration between the Department of Clinical Epidemiology and Rehabilitation Nursing.

Infection prevention in the inpatient rehabilitation setting is essential to continuous quality improvement. Patients are at increased risk for infection due to extended length of stay, bladder management issues requiring urinary tract instrumentation, dermal pressure ulcers, and surgical sites. Our 60 bed rehabilitation unit is part of a large academic medical center. Patients with multi drug resistant organisms (resistant to>2 antibiotics from >2 antibiotic classes) were routinely placed in contact isolation. Staff are required to sanitize hands before and after patient contact. The Link Nurse Program, developed by the Department of Clinical Epidemiology in collaboration with the Department of Nursing selected nurse from throughout the institution, and they attended a 2 day educational program to develop expertise regarding infection control issues.  The Link Nurse then serves as a "Link" between the patient care units and the infection control team. The Rehabilitation unit Link Nurse attended the session and subsequest monthly seminars conducted by epidemiology to reinforce knowledge and skills. The information was shared with staff on the patient care units through individual coaching, staff meetings, and bulletin boards.  The Rehabilitation Link Nurse empowered the staff to remind colleagues of hand hygiene and contact isolation at the time of a breach in compliance. Contact isolation compliance improved from 12.5% (August 2008) to 90% (December 2008). Hand hygiene compliance improved to >90%. The overall effectiveness of the program will be evaluated one year from implementation; our preliminary results indicate that the quality of patient care has improved.