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Editorials |

Clinical Practice Improvement Initiatives: Don't Be Satisfied With the Early Results

Marin H. Kollef, MD, FCCP
Author and Funding Information

Marin H. Kollef, MD, FCCP, Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, 660 South Euclid Ave, Campus Box 8052, St. Louis, MO 63110; e-mail: mkollef@dom.wustl.edu

Dr. Kollef is Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine.


This research was supported in part by the Barnes-Jewish Hospital Foundation.

Dr. Kollef has served on the Speaker's Bureau for Merck, Pfizer, Bard Medical, and Kimberly Clark.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;136(2):335-338. doi:10.1378/chest.09-0637
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Extract

In this issue of CHEST (see page 426), Levin et al1 describe their experience with an infection control program aimed at technicians employing portable radiology equipment in the ICU setting. These investigators showed that an intervention aimed at improving infection control measures using an alcohol hand rub and changing gloves before and after each contact with the patient or radiology equipment significantly reduced colonization of the radiology equipment with Gram-negative bacteria (reduction 39 to 0%; p < 0.001). Additionally, these authors demonstrated that Acinetobacter baumannii colonization of portable radiology equipment, originating from a patient, occurred during the observation period. Of equal clinical importance was the finding that the infection control program deteriorated significantly during a third observation period conducted 5 months after completion of the intervention period. This deterioration was related to a decrease in compliance with the measures contained within the infection control program. This study highlights the importance of monitoring practice improvement changes following the intervention phase where the involvement and compliance of the participants is generally at its highest level. The high level of compliance during the intervention phase is usually due to the knowledge that individuals' compliance with the intervention and clinical outcomes are being prospectively monitored.

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