COMMUNICATION STRATEGIES USED DURING AN OUTBREAK OF VANCOMYCIN-RESISTANT ENTEROCOCCUS

Kennedy C*, Gillis G, Garcia M, Jolley BA, Humar A, Turchet S, McCumber T, Izatt S, Cardella C, Lior L, Litt M, Conly J,

Infection Control Unit, The Toronto Hospital, University of Toronto, Toronto, ON, and Laboratory Centre for Disease Control, Health Canada, Ottawa, ON

A two site tertiary care 1200 bed teaching hospital recently experienced Canada's first outbreak
of vancomycin-resistant Enterococcus (VRE). A total of 38 colonized and 1 infected patient were identified between August 5 and October 31 of 1995 with all but three of the patients coming from the renal/dialysis service. A variety of communication strategies were used during the course of the outbreak which received considerable media attention. At the outset a multi-disciplinary group was formed, chaired by the division head of Nephrology, which became a forum to educate, update and problem solve with the principle hospital staff involved in the outbreak. Written communication was provided to hospital staff to avoid confusion. A "superbug" newspaper article was addressed by a "patient and family information sheet" written by Infection Control, and provided as a service to the patients and their families by Public and Community Affairs. Further written and verbal bulletins were developed to educate general hospital staff on the mechanisms of transmission of VRE and the importance of environmental cleaning in its control. As the numbers of colonized patients receiving dialysis increased, information sheets were created specifically for this group. In addition, all hospital staff were informed through the weekly hospital newsletter and an Infection Control bulletin on VRE. A second bulletin was issued reinforcing the importance of body substance precautions (BSP) in the prevention of transmission of VRE. Handwashing and other posters were used as reminders. Later, as colonized patients were reintegrated, an update sheet was issued to all patients and their families. In any outbreak setting, especially one in which the media is involved, a coordinated multi-disciplinary approach and effective communication strategies are important elements.

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