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Implementation of strategies to prevent and control the emergence and spread of antimicrobial-resistant microorganisms in U.S. hospitals.

Ward MM, Diekema DJ, Yankey JW, Vaughn TE, BootsMiller BJ, Pendergast JF, Doebbeling BN. Implementation of strategies to prevent and control the emergence and spread of antimicrobial-resistant microorganisms in U.S. hospitals. Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America. 2005 Jan 1; 26(1):21-30.

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OBJECTIVE: To examine the extent to which the strategies recommended by the National Foundation for Infectious Diseases (NFID)-Centers for Disease Control and Prevention (CDC) co-sponsored workshop, Antimicrobial Resistance in Hospitals: Strategies to Improve Antimicrobial Use and Prevent Nosocomial Transmission of Antimicrobial-Resistant Microorganisms, have been implemented and the relationship between the degree of implementation and hospital culture, leadership, and organizational factors. DESIGN: Survey. SETTING: A representative sample of U.S. hospitals stratified by teaching status, bed size, and geographic region. PARTICIPANTS: Infection control professionals. RESULTS: Surveyed hospitals had implemented strategies to optimize the use of antimicrobials and to detect, report, and prevent transmission of antimicrobial-resistant microorganisms. Multivariate analyses found that hospitals with a greater degree of implementation of the NFID-CDC strategic goals were more likely to have management support, education of staff, and interdisciplinary groups specifically to address these issues; they were also more likely to engage in benchmarking on broader quality of care indicators. CONCLUSIONS: Most surveyed hospitals had implemented some measures to address the NFID-CDC recommendations; however, hospitals need to do much more to improve antimicrobial use and to increase their efforts to detect, report, and control the spread of antimicrobial resistance. A supportive hospital administration must foster a culture of ongoing support, education, and interdisciplinary work groups focused on this important issue to successfully accomplish these goals.

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