An Introduction to STRIVE
Authors: Michael R. Bell, David T. Kuhar
Journal: Annals of Internal Medicine (2019)

Supplement: STRIVE1 October 2019An Introduction to STRIVEFREEMichael R. Bell, MD and David T. Kuhar, MDMichael R. Bell, MDCenters for Disease Control and Prevention, Atlanta, Georgia (M.R.B., D.T.K.) and David T. Kuhar, MDCenters for Disease Control and Prevention, Atlanta, Georgia (M.R.B., D.T.K.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-3440 SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Health care continues to change rapidly, growing increasingly complex with greater acuity of patients, delivery of more care outside of traditional acute care settings, and ongoing challenges related to staffing and personnel turnover. Despite this, we remain determined to provide safe care for every patient and a safe workplace for each of our staff. Such determination requires every health care facility, whether an urban tertiary care center or a critical access hospital, an ambulatory surgery center or a skilled-nursing facility, to ensure that everyone providing patient care or working to support the environment of care is prepared to do their part to prevent the spread of infections. Not only does each facility need to do its part, the frequent movement of patients from one care setting to the next means that infection prevention and control (IPC) efforts must also be coordinated across the range of facility types that make up modern health care.Gaps in IPC have led to outbreaks and infections across the nation, demonstrating a need for more robust training for health care personnel. Patients have been harmed by errors in safe injection practices that lead to outbreaks of bloodborne pathogens, outbreaks related to insufficient environmental cleaning and disinfection, transmission of pathogens due to incorrect device reprocessing, spread of antibiotic resistant bacteria related to failures in hand hygiene, and incorrect use of protective equipment. Each of these issues demonstrates the importance of health care personnel having a clear understanding of how infections are transmitted and what must be done to prevent transmission—especially in an era of pathogens for which few treatment options remain.STRIVE (States Targeting Reduction in Infections via Engagement) is a multisector, 3-year program supported by the Centers for Disease Control and Prevention and coordinated by the American Hospital Association's Health Research & Educational Trust to improve IPC practices and build linkages to align IPC efforts among state hospital associations, state health departments, and other key health care–associated infection prevention stakeholders, such as quality innovation networks/quality improvement organizations. Since 2015, about 450 sites in 28 states and the District of Columbia have been engaged, targeting high-burden outcomes including infections caused by Clostridioides difficile and methicillin-resistant Staphylococcus aureus, as well as device-associated infections in health care. In addition to building state-level connections for infection prevention, STRIVE incorporates training modules providing standardized content and implementation options for key topics in IPC, including maintenance of asepsis during invasive procedures; correct adherence to isolation precautions; safe injection practices; and correct cleaning, disinfection, and/or sterilization of reusable medical equipment.Training for IPC in health care is a complex and challenging undertaking that must address the specific learning needs of the wide range of personnel types and be delivered in a way that integrates well with the work of the facility. Existing frameworks for professional education and licensure, mandated training, and human resources onboarding processes continue to be important; however, there is an urgent need for broader uptake of IPC knowledge and implementation beyond direct clinical care delivery. The staff who clean and disinfect the health care environment are a crucial link for preventing infection transmission. Those making decisions to purchase equipment and manage materials in health care need to anticipate related IPC needs and hazards. Facilities engineers in charge of water systems and air handling need information related to infection risks. Staff who first encounter patients arriving for assessment and care must know when to trigger IPC practices.STRIVE's network-driven approach to quality improvement provides technical resources from partners, as well as the training modules to support IPC leads and the institutions they serve. By demonstrating the utility of robust networks that leverage local and regional capabilities, this approach provides an important strategy to share and replicate successes and extend quality improvement opportunities to facilities that might not implement them alone. When every facility is able to make systematic progress in protecting patients, and each individual engaged in health care delivery is able to understand and mitigate infection transmission risks, we will have taken a big step toward providing perfect care for every patient. Comments0 CommentsSign In to Submit A Comment Author, Article, and Disclosure InformationAffiliations: Centers for Disease Control and Prevention, Atlanta, Georgia (M.R.B., D.T.K.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-3440.Corresponding Author: Michael R. Bell, MD, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329-4027; e-mail, [email protected]gov.Current Author Addresses: Drs. Bell and Kuhar: Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329-4027.This article is part of the Annals supplement "States Targeting Reduction in Infections via Engagement (STRIVE)," which was supported by the Health Research & Educational Trust and built upon work made possible by the Centers for Disease Control and Prevention, STRIVE Program (contract 200-2015-88275). Nextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAnnals On Call - Striving to Decrease Hospital Infection Robert M. Centor and Jennifer Meddings Metrics Cited byAir travel during COVID-19 pandemic-how safe it is? – A public health perspectivePalsgraf Meets Medicine: Physician Beware! — The Unidentified Non-patient and the Duty of CareReducing Health Care–Associated Infection: Getting Hospitals and Health Systems to ZeroJay Bhatt, DO, MPH and Sue Collier, MSN, RN 1 October 2019Volume 171, Issue 7_SupplementPage: S1KeywordsDisinfectionHealth careHealth care facilitiesHealth care qualityHealth promotionInfectious disease controlPatientsQuality improvementStaphylococcal infection ePublished: 1 October 2019 Issue Published: 1 October 2019 PDF downloadLoading ...