Getting Hospitals to Zero
STRIVE (States Targeting Reduction in Infections via Engagement) was a national initiative funded by the Centers for Disease Control and Prevention (CDC) and aimed at improving infection control practices and strengthening health care-associated infection prevention stakeholder relationships at the local level.
Background
As the lead contractor, AHA’s Health Research & Educational Trust (HRET) recruited more than 400 hospitals nationwide to complete a 12-month STRIVE intervention program.
STRIVE used evidence-based HAI reduction strategies and relationship-based methods to address HAI rates in hospitals with a high cumulative attributable difference in Clostridioides difficile infection and at least one other of these HAIs: central line-associated bloodstream infection, catheter-associated urinary tract infection, or methicillin-resistant Staphylococcus aureus infection.
HRET, along with the CDC and other expert partners, provided personalized technical assistance and online training. Courses addressed a wide range of topics, including environmental cleaning, patient and family engagement, and building a business case for infection prevention
Key Findings
A report evaluating the STRIVE program shows that new state-based alliances aimed at prevention are forming and behavioral changes are happening. Some hospitals achieved zero infections for the first time. Some measured moderate improvements. And others maintained their zero status.
Yet in aggregate, the findings revealed no statistically significant differences in infection rate changes during the intervention period. It’s important to note that this new data doesn’t conclude that the practices were ineffective; rather they indicate that challenges are unique to each hospital and more work needs to be done.
Recommended Training
Infection Control (11 Courses) | CDC
The 11-course STRIVE online training series is now available to all health care professionals at no charge and accredited for continuing education. It offers foundational infection prevention strategies that cut across all HAIs and socioadaptive solutions, such as leadership engagement, to address attitudinal and cultural changes. There are also HAI-specific courses for CAUTI, MRSA bacteremia, CLABSI, and CDI prevention.
The courses can be used for new employee training and ongoing all-staff “refresher” training.
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Developed by national infection prevention experts, the curriculum focuses on foundational and HAI-specific prevention practices. There are 3 training modules that cover competency based training, audits and feedback.
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Developed by national infection prevention experts, the curriculum focuses on foundational and HAI-specific prevention practices. There are 3 training modules that cover hand hygiene:
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Developed by national infection prevention experts, the curriculum focuses on foundational and healthcare-associated infection (HAI)-specific prevention practices. There is one training module that covers Strategies for Preventing Healthcare Associated Infections.
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Developed by national infection prevention experts, the curriculum focuses on foundational and targeted infection prevention practices. There are 3 training modules that cover Environmental Cleaning.
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Developed by national infection prevention experts, the curriculum focuses on foundational and targeted infection prevention practices. Four training modules cover Personal Protective Equipment.
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Developed by national infection prevention experts, the curriculum focuses on foundational and targeted infection prevention practices. There is one training module that covers Patient and Family Engagement.
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Developed by national infection prevention experts, the curriculum focuses on foundational and targeted infection prevention practices. There are two training modules that cover Building a Business Case for Infection Prevention.
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Developed by national infection prevention experts, the curriculum focuses on foundational and healthcare-associated infection (HAI)-specific prevention practices. There are 7 training modules that cover CAUTI.
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Developed by national infection prevention experts, the curriculum focuses on foundational and targeted infection prevention practices. There are 5 training modules that cover MRSA Bacteremia.
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Developed by national infection prevention experts, the curriculum focuses on foundational and targeted infection prevention practices. There are 7 training modules that cover CLABSI.
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Developed by national infection prevention experts, the curriculum focuses on foundational and targeted infection prevention practices. There are 6 training modules that cover CDI.
Developed by: Centers for Disease Control and Prevention (CDC)
Environmental Services (4 Courses) | APIC
A 4-module STRIVE online training course specifically for environmental services technicians and their important role in infection prevention and control is also available at no charge. The tools and resources are provided in both English and Spanish.
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This module defines what an infection is, reviews the chain of infection, and discusses how important environmental cleaning is to break the chain of infection.
- A ready-to-use presentation for trainers English | Spanish
- Learners’ version in PowerPoint format English | Spanish
- Presentation facilitator notes and guidelines for trainers, for use in live sessions English
- Narrated audio version of the presentation English | Spanish
- Flashcards English | Spanish
- Infographics English | Spanish
- Checklists for discharge and daily cleaning inspection processes
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This module provides information on what basic personal protective equipment (PPE) is, how to don and doff it, and when and how to use it during routine EVS activities.
- A ready-to-use presentation in PowerPoint format English | Spanish
- Narrated audio version of the presentation English | Spanish
- Flashcards English | Spanish
- Infographics depicting “Do’s and Don’ts” of glove use English | Spanish
- Checklist for donning and doffing PPE and fit-checking respirator English | Spanish
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This module covers safety practices EVS personnel should follow to protect themselves, other staff, patients, and visitors when using chemical disinfectants.
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This module covers best practices for cleaning and low-level disinfection of environmental surfaces in occupied patients rooms and at the time of patient discharge or transfer, as well as how to evaluate adequate cleaning.
- A ready-to-use presentation in PowerPoint format English | Spanish
- Narrated audio version of the presentation English | Spanish
- Flashcards English | Spanish
- Infographic on cleaning occupied rooms English | Spanish
- Checklists for monitoring room cleanliness using ATP technology and UV light inspection
Developed by: Association for Professionals in Infection Control and Epidemiology, Inc. (APIC)
Additional Resources
- Reducing Health Care–Associated Infection | By Jay Bhatt, DO, MPH; Sue Collier, MSN, RN
- Using the Health Care Physical Environment to Prevent and Control Infection: A Best Practice Guide to Help Health Care Organizations Create Safe, Healing Environments | ASHE: Optimizing Health Care Facilities
- Full Report: States Targeting Reduction in Infections via Engagement (STRIVE) | ACP
- Infection Control and Prevention Resources | AHA