VA Funds Two New Antimicrobial Resistance and HAI Prevention Programs

Dr. Nasia Safdar

It wasn't long ago, that many of us were concerned about the lack of attention that antimicrobial resistance was receiving, particularly in regard to funding for research and also infection prevention programs. Yet over the last few years, there has been increased attention throughout the US including the release of the National Action Plan to Combat Antibiotic-Resistant Bacteria and increased funding for CDC, NIH and AHRQ. Besides the lack of novel interventions that extra research funding will help tackle, another huge barrier to preventing MDRO and HAI is lack of information on how to successfully implement the few interventions we have within hospitals and healthcare systems.

It is this gap between efficacy and effectiveness that VA's Quality Enhancement Research Initiative (QUERI) seeks to fill. QUERI's mission is to "improve the health of Veterans by supporting the more rapid implementation of effective clinical practices into routine care." And it is the goal of QUERI investigators to "ask crucial questions regarding the intended and unintended impacts of implementing new treatments or programs – and the best strategies for speeding their adoption into practice."

Dr. Charlesnika Evans

With that background it is incredibly exciting to announce that VA has funded two new QUERI programs that target MDRO and HAI.

The first program titled "Building Implementation Science for VA Healthcare-Associated Infection Prevention" is led by Dr. Nasia Safdar in Madison. Dr. Safdar and her team partnered with VA's National Center for Patient Safety to achieve two broad aims. First, they will implement and evaluate an evidence-based intervention - daily chlorhexidine bathing of hospitalized Veterans for prevention of HAI. Second, they will establish a VHIN (VA Healthcare-Associated Infection Prevention Network) and assess current practices and needs related to HAI prevention. The long-term goal is to utilize the VHIN as a platform for VA facilities seeking to undertake pragmatic implementation science initiatives related to HAI prevention. You can read much more about her program that began in October 2015, here.

Dr. Michael Rubin

The second program titled "Combating Antimicrobial Resistance through Rapid Implementation of Available Guidelines and Evidence" or CARRIAGE is set to begin in October 2016 and aims to address the growing concern of antimicrobial resistance through strategies implemented across VA patient care settings. The three projects will evaluate hand hygiene surveillance methods, enhance the implementation of new CRE prevention guidelines and promote judicious use of antibiotics through a multi-hospital antibiotic timeout program. The program directors are Michael Rubin, MD PhD (Salt Lake City) Charlesnika Evans, PhD, MPH (Hines, IL); and Eli Perencevich, MD MS (COI alert)

The next few years promise to be an exciting time for MDRO and HAI prevention in VA and throughout the US as we develop, test and implement new methods to enhance patient safety.