Evaluation of a successful vancomycin-resistant Enterococcus prevention intervention in a community of health care facilities

Background: In April 1997, vancomycin-resistant enterococci (VRE) emerged i n several health care facilities in the Siouxland region and a VRE Task For ce was formed. From 1997 through 1999, an evaluation of VRE prevalence at 3 0 facilities was performed. Methods: In 1999, we conducted a survey and focus groups of health care wor kers to address initial reactions to VRE, feasibility of the Task Force rec ommendations, and lessons learned. Results: Personnel at 29 (97%) facilities surveyed completed the questionna ire, and 15 health care workers from 11 facilities participated in 5 focus groups. The outcomes of expanded education and improved awareness of VRE fo r patients and health care workers were ranked the No. 1 priority overall a nd by long-term care facility personnel. Respondents agreed that Task Force recommendation adherence had significantly improved infection control (83% ) and that the Task Force was an appropriate mechanism to coordinate infect ion control efforts (90%). Focus groups commented that it was most difficul t to educate family members about VRE; they expressed concern about variati on between VRE policies, especially between acute care and long-term care f acilities, and about the quality of life of isolated patients. Conclusions: Our data illustrate that this intervention has been far-reachi ng and include the development of a health care infrastructure that may be used as a model to address additional health care issues (eg, emerging path ogens or biological threats).