Reducing Carbapenem-Resistant Enterobacteriaceae Using the Targeted Solution Tool: A Quality Improvement Project.

Background: Carbapenem-resistant Enterobacteriaceae (CRE) is a worldwide urgent health problem. Hand hygiene (HH) is an effective intervention to reduce the spread of CRE. Local Problem: In 2017, an increase in the rate of health care–associated (HA) CRE colonization was observed in a large multiorgan transplant center in Italy. This study aimed to reduce the HA-CRE colonization rates by improving HH compliance. Methods: A pre-/post-intervention project was conducted from November 2017 through December 2020. Interventions: The DMAIC (Define, Measure, Analyze, Improve, and Control) framework was used to implement the HH Targeted Solution Tool (TST). Results: Hand hygiene compliance increased from 49% to 76.9% after the Improve phase (P =.0001), and to 81.9% after the second Control phase (P =.0001). The rate of HA-CRE decreased from 24.9% to 5.6% (P =.0001). Conclusions: Using the DMAIC framework to implement the TST can result in significant improvements in HH compliance and HA-CRE colonization rates. [ABSTRACT FROM AUTHOR]