Results of a multicentre randomised controlled trial of statistical process control charts and structured diagnostic tools to reduce ward-acquired meticillin-resistant Staphylococcus aureus: the CHART Project

Curran, E., Harper, P., Loveday, H., Gilmour, H., Jones, S., Benneyan, J., Hood, J. and Pratt, R. (2008) Results of a multicentre randomised controlled trial of statistical process control charts and structured diagnostic tools to reduce ward-acquired meticillin-resistant Staphylococcus aureus: the CHART Project. Journal of Hospital Infection, 70(2), pp. 127-135. (doi: 10.1016/j.jhin.2008.06.013)

Abstract

Statistical process control (SPC) charts have previously been advocated for infection control quality improvement. To determine their effectiveness, a multicentre randomised controlled trial was undertaken to explore whether monthly SPC feedback from infection control nurses (ICNs) to healthcare workers of ward-acquired meticillin-resistant Staphylococcus aureus (WA-MRSA) colonisation or infection rates would produce any reductions in incidence. Seventy-five wards in 24 hospitals in the UK were randomised into three arms: (1) wards receiving SPC chart feedback; (2) wards receiving SPC chart feedback in conjunction with structured diagnostic tools; and (3) control wards receiving neither type of feedback. Twenty-five months of pre-intervention WA-MRSA data were compared with 24 months of post-intervention data. Statistically significant and sustained decreases in WA-MRSA rates were identified in all three arms (P > 0.001; P = 0.015; P > 0.001). The mean percentage reduction was 32.3% for wards receiving SPC feedback, 19.6% for wards receiving SPC and diagnostic feedback, and 23.1% for control wards, but with no significant difference between the control and intervention arms (P = 0.23). There were significantly more post-intervention ‘out-of-control’ episodes (P = 0.021) in the control arm (averages of 0.60, 0.28, and 0.28 for Control, SPC and SPC + Tools wards, respectively). Participants identified SPC charts as an effective communication tool and valuable for disseminating WA-MRSA data.

• Item Type: Articles
• Keywords: Statistical process control charts; Surveillance feedback; Meticillin-resistant Staphylococcus aureus (MRSA); Healthcare-associated infection; Healthcare quality improvement
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Gilmour, Mr Harper and Curran, Ms Evonne
• Authors: Curran, E., Harper, P., Loveday, H., Gilmour, H., Jones, S., Benneyan, J., Hood, J., and Pratt, R.
• Subjects: R Medicine > R Medicine (General); Q Science > QR Microbiology
• College/School: College of Medical Veterinary and Life Sciences
• Journal Name: Journal of Hospital Infection
• ISSN: 0195-6701