This is the competitiverenewalapplicationfor the CDC 'Epi-Centersfor Preventionof Healthcare-AssociatedInfections'grant fromWashingtonUniversitySchoolof Medicine(WUSM) & BJCHealthcare.We have been a CDC Epi-Centerfor the past 8 years.BJCis an integratedhealthcaredeliverysystemwith 12 hospitalsin Missouri& Illinoisincluding2 'US News & World Report' top 10 hospitals(BarnesJewish Hospital& St. LouisChildrensHospital),3 large communityhospitals,3 smallsuburbanhospitals,4 small ruralhospitals, 6 longtermcare facilities,a dialysisnetwork& an ambulatorysurgery center.The infection controlprogramsof all BJCfacilitiesareintegratedwithcommonpolicies& procedures,surveillance, electronic data repositories&, expertpharmacy& microbiologyinformaticssystems.WUSM & BJC havea longhistorystudyingriskfactors,outcomes,& costsof healthcareassociatedinfections& theyhave developed& implementedmultiplesuccessfulinterventionstoreduceinfectionsindiversehealthcare settings.We proposeto continuetowork collaborativelywithCDC & otherEpi-Centersto performresearch todecreasethe riskof healthcareacquiredinfections,antibioticresistance,& otheradverseevents.
Our Specific Aims are to: 1) Evaluatethe effectivenessof 0.125% chlorhexidinebodywashestoreducemethicillin-resistant Staphylococcus aureus (MRSA) in 2 ICUsperforming activesurveillance for MRSA; 2) Determine the efficacy of academic detailing by a antimicrobial stewardship team to improve antimicrobial use & evaluate a computerized expert system to improve antibiotic use in4 ICUs; 3) Evaluate the accuracy & efficiency of 2 C. difficile-associated disease (CDAD)surveillance methods, ICD-9 codes & electronic microbiology reports, & compare CDAD rates by these methods with traditional infection control surveillance in 4 hospitals; 4) Use real time electronically collected data including type, dose, & timing of surgical prophylactic antibiotics, blood glucose, ICD-9 codes, microbiology & antibiotic data at 3 hospitals to determine compliance v,ith recommendationsfor surgical antibiotic prophylaxis & the effect of noncompliance on surgical site infection (SSI) rates, the incidence of hyperglycemia& its effect on SSI rates, &the accuracy of electronic surveillancecompared to traditional infection control surveillance; andIdentify specific including timing failing hospital by performinga prospective case controlstudy of medication use in fallers & non fallers, to guide development5o)f interventions to dmecerdeiacasetiothnes risk of falltihnegirindhoosesp, irtoaulitze,d&patientsa.ssociated with inthePFERFO._J,',A,N_SEITE(S) (organ_.a'Jon,citys.tate)Washington University680 South Euclid AvenueSt. Louis, MO 63110PHS 3.=$(Rev. (3C_'04) Page 2 FormPage 2 P_='_E'_I'_mat!esSgator,'ProgramDirector(Last, First, Middle): Fraser, Victoria J.I__'-'YPERSO,%.%ELSee L,'_tru_Jens.Use continuabbn pages as needed to provide the requiredinformation in the format shown below.S_ _%_ PrL',,_'--;Ia,,!west_g3torL.ist another key personnelin alphabeticalorder, last namefirst.N_e eRA CommonsUser Name Organization Roleon ProjectFraser, V_ctoriaJ VICKYFRASER WashingtonUniversity PIBabcock, Hilary HILBABCOCK WashingtonUniversity InvestigatorCamins, Bernard BCAMINS WashingtonUniversity InvestigatorCoopersmith,Craig COOPERSMITHC WashingtonUniversity InvestigatorDubberke, Eric R ERIKDUBBERKE WashingtonUniversity InvestigatorElvrard,Alexis ALEXlSELWARD Washington University Investigator Kollef, Marin Washington University Investigator McDonald, Jay Washington University InvestigatorOIsen, Margaret OLSENM Washington University InvestigatorWarren, David K DAVIDWARREN Washington University Co-PIWoeltje, Keith KEITHWOELTJE Washington University Investigator OTHER SlG.%'.rC'-Ai NT CO,NTRIBUTORS P_a.,':'_. Organization Roleon Project Hollenbeak, Christopher PennsylvaniaState University Collaborator Murphy,Denise BJC Healthcare CollaboratorHuman Embryonic Stem Cells [] No [] YesIf theprop<:_edprojectinvolveshumanembryonicstem cells,list below the registrationnumberofthespecificcellline{s)from the followinglist:h,,'_:llstemcetls nih aov/reoistry/index asp. Use continuationpages as needed. If,as'3e'_'._. c_-'='_be re,'erencedat this;lb'nein. cludea statementhatonefromtheReqistr]/willbeused.CeTIUneDisclosure Permission Statement. Ap_lic._bTteo SBIPJSTrR Only, See instructions.[] Yes [] NoPHS 3-=-3(Re,,,.0_3,'_4) Page 3 Form Page 2-continuedNumbetrhefoflowingpagesconsecutivetlhyroughouttheapplicationD.onotusesuffixesuchas4a.4b. P._.._,._!Invest_jator/ProgramDirector (Last, First, Middle): Fraser, Victoria JTr,e r.a.,'=ecf t._.eprLn_palinvestigatorlprogram director must be provided at the top of each pnnted pageand each continuation page. RESEARCH GRANT TABLE OF CONTENTS Page NumbersFace Page ....:............................................................................................................................................. 1Description,
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