Problems: The multiple physical, cognitive, and emotional requirements inherent to nursing practice constitute significant factors in decreased vigilance during risk management (Fletcher and Bedwell, 2014). Compliance with infection control measures by general duty nurses is suboptimal (Jackson et al. 2014, Ward 2012). Infection control measures are perceived negatively and are considered to be an increase in the workload (Ward, 2012). Outbreak management is a complex process that justifies the need to develop tools for providing timely case management to ensure compliance.

The medical literature abounds with acronyms facilitating management of the medical condition of patients (ABC, PQRST, SBAR) (McCrory et al., 2012). Research carried out with search engines such as CINAHL and Medline has shown that there are no acronyms summarizing the steps in the management of health care-related infections.

Methodology

1- A review of the written documentation and guidelines (MSSS, 2013; 2014) pertaining to nosocomial infection management led us to identify 5 key steps in managing such infections.

2- Determination of the 5 main chronological steps in nosocomial infection management through a grey literature review.

3- Development of an acronym following the criteria for development of cognitive aids adapted to the health care setting (Fletcher & Bedwell, 2014):
-easy to remember
-succinct
-corresponding to the chronological order of the measures to be carried out
-relevant to the measures to be carried out
-proven
-based on the needs of the health care setting

4- Testing on the units during outbreaks and adjustments based on the assessment of the nurses

We are proposing RADAR, the first bilingual acronym applicable to all infectious agents and clinical settings, whose objective is to serve as a clinical tool for recognition and early detection, adequate case management, and reduced transmission of infections.

Repérer les cas qui correspondent à la définition
Appliquer les précautions additionnelles
Dépister
Anticiper la survenue de nouveaux cas en rehaussant l’hygiène des mains et la désinfection du matériel partagé
Ré-évaluer les besoins de maintenir les précautions additionnelles

Recognizing the early signs
Applying additional precautions
Detecting through screening
Anticipating other cases
Re-evaluating the necessity to maintain the initial precautions

Strengths:
• Appreciated and used by management and health care teams.
• Can be easily integrated into the vocabulary used by the caregivers (e.g., I applied RADAR and have now reached the screening stage.)
• Ensures that the steps are followed in the case management of patients who have an infection.
• Optimizes the presentation of decision algorithms.
• Its application can help reduce the transmission of infections.

Limitations:
• Requires an adaptation for suspected micro-organisms using algorithms.

Conclusion:
Tested in CHSLD, the acronym RADAR has been greatly appreciated by management and health care teams. Its use facilitated the establishment of the right measures, at the right time, which contributed to optimizing the presentation of decision algorithms, and outbreak management, including the duration and attack rate of the outbreak.

The use of the acronym RADAR has proven to be an effective method of communication for optimizing the case management of patients presenting with problems of infection, as part of a pilot project in a long-term residential care centre (CHSLD).

The potential of this tool in a short-term context would be an avenue to explore and evaluate through a more in-depth study.

Contact Information:

Title: Clinical Nurse, Infection Prevention and Control

Contact information: labou-chacra.csssl@ssss.gouv.qc.ca

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