ePrevention Epicenter of Emory (PEACH) Projects

The Prevention Epicenter of Emory and Collaborating Healthcare Facilities (PEACH) program has 13 currently active research projects

PEACH projects can be grouped into one of four categories

Core Projects

Emory-led projects conducted in Atlanta-area healthcare facilities

Pre-ALERT, InPART RX, FAIR, CHAMPIONS

Lead Collaborative Projects

Emory-led multisite collaborative projects conducted with other Prevention Epicenter sites

REACT, RAISE, IMPRESS

Participating Collaborative Projects

Collaborative Projects led by other Prevention Epicenter sites that Emory is participating in

FACE MDRO, CLEAN HEME, BCx Stewardship

Current PEACH Related Projects

Other Related HAI and MDRO Prevention Projects

EASIL, PAINTS

Pre-ALERT Predicting Admissions Likely Colonized with Antibiotic Resistant Bacteria to Trigger Detection and Isolation

Jessica Howard-Anderson, Pre-ALERT Lead Investigator

The Pre-ALERT project integrates CDC-funded Georgia Emerging Infections Program (GA EIP) population-based surveillance data from the eight-county Atlanta Metropolitan area (~4.2 million persons) with regional hospital discharge data to create statistical prediction models for identifying newly admitted patients at high risk for carriage or infection with an MDRO.

The goal is to develop a validated prediction model that will be integrated as a real-time alert into the Emory medical records system to notify infection control staff for prompt containment measures.

InPART RX Inpatient Provider Antibiotic Rate Benchmarking to Reduce Unnecessary Prescribing

Scott Fridkin, Co-Principal Investigator

InPART RX is a collaborative research study aiming to measure the impact of a planned quality improvement initiative to reduce unnecessary antibiotic prescribing by Hospital Medicine Service Providers. We are investigating whether clinicians receiving a personalized report comparing their antibiotic prescribing to their peers will modify their prescribing habits in favor of current best practices.

This will be a quasi-experimental cluster randomized study across 4 hospitals. Comparison will utilize a risk-adjusted prescribing metric focusing on broad-spectrum agents often used empirically to treat MDROs such as Pseudomonas aeruginosa.

FAIR A Randomized Controlled Trial of Fecal Microbiota Transplant for Antibiotic-Resistant Infections in Inpatients

Mike Woodworth, FAIR Lead Investigator

The FAIR project is a clinical trial for hospital inpatients investigating whether Microbiome Therapeutics (MT) can be used to eradicate patient MDRO colonization. The overall goal is to estimate the safety and efficacy of MT while also investigating whether reductions in healthcare environmental MDRO contamination and interruption of subsequent transmission can be achieved.

The long-term goals of our work are to translate advances in microbiome science to innovate antibiotic-sparing MDRO therapies for patients and populations.

CHAMPIONS Collaborative Human Factors and Microbiology Approaches to Prevent Infections in Post-acute Care

Joel Mumma, CHAMPIONS Lead Investigator

CHAMPIONS is a skilled nursing facility (SNF)-based infection prevention study that seeks to utilize human factors engineering methods to identify healthcare worker (HCW) interventions that can reduce the environmental bioburden of MDROs.

This multidisciplinary study will engage HCWs in designing, implementing, and evaluating novel, human factors-informed interventions that focus on improvements to their care tasks and work systems. This research addresses infection prevention knowledge gaps in post-acute care with the goal of reducing MDRO colonization that has been reported in up to 40% of SNF residents.

Lead Collaborative Projects

RAISE

Reductions in Healthcare-associated Infections After Implementation of a System to Electronically Monitor Hand Hygiene

Lindsey Gottlieb, RAISE Lead Investigator

The RAISE project is an implementation study of an inpatient electronic hand hygiene (HH) monitoring system. Such systems have advantages over traditional ways of monitoring hand hygiene, including increased number and variety of observations and are less subject to bias. The goal of this project is to use the data generated by this new system to examine its impact on hand hygiene compliance and HAI/MDRO rates at the facility and regional levels.

IMPRESS

Impact of Prehospital Sepsis Recognition on Timely Antibiotic Administration and Subsequent Adverse Events Update

Carmen Polito, IMPRESS Lead Investigator

The IMPRESS project is a multicenter clinical trial to evaluate the impact of a validated prehospital screening tool administered by EMS personnel on timeliness to sepsis evaluations, interventions, and subsequent adverse events in emergency departments. Sepsis, the body’s extreme response to an infection, is a time-sensitive life-threatening condition. The lack of reliable sepsis recognition at the initial healthcare touchpoint is a critical gap in improving patient safety and represents a substantial opportunity for improvement.

REACT

Response to Emerging Antimicrobial Resistance with Ring Containment Microbiota Therapy

Mike Woodworth, REACT Lead Investigator

The REACT project is a clinical trial investigating whether Microbiome Therapeutics (MT) can be used to decolonize patients with MDROs and reduce transmission among Long Term Acute Care Hospital (LTACH) and ventilator capable Skilled Nursing Facility (vSNF) patients. The primary study endpoints are safety and efficacy of the MT while also investigating whether the therapies can reduce secondary transmission among healthcare residents, thus reducing overall MDRO prevalence in the facility. The long-term goals of our work are to translate advances in microbiome science to innovate antibiotic-sparing MDRO therapies for patients and populations.

FACE-MDRO

FACE-MDRO (Fecal Microbiota Transplantation to Address Colonization and Environmental Contamination with Multidrug-Resistant Organisms) is a multisite collaborative project led by the University of Pennsylvania Prevention Epicenter. The project is a microbiome therapeutic clinical trial for patients completing a course of antibiotics for an MDRO infection in the inpatient setting. This project will evaluate both de-colonization of MDROs from the gastrointestinal tract and the impact on the healthcare environment. (Mike Woodworth, FACE-MDRO Lead Investigator)

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BCx Stewardship

The Blood Culture Stewardship project is a multisite collaborative project led by the Johns Hopkins University Prevention Epicenter to develop a crude blood culture utilization benchmark for medical ICU and medicine floor patients. Blood cultures are one of the most utilized microbiologic tests in hospitalized patients, yet studies have shown high rates of contamination and a low percentage of positive tests, suggesting overutilization. There is a need to optimize diagnostic stewardship to ensure bacteremia detection but also reduce unnecessary antibiotics and wasted resources. (Jessica Howard-Anderson, BCx Lead Investigator)

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CLEAN HEME

(Chlorohexidine Effectiveness Assessment in Non-ICU Hematology-Oncology Bone Marrow Transplantation Units)
Emory University Hospital is one of 5 centers participating in a multisite collaborative project lead by the Chicago Epicenter to evaluate a novel tool to improve effectiveness of Chlorhexidine bathing on the prevention of Central Line Associated Blood Stream Infections (CLABSIs) in Bone Marrow Transplant Inpatient Units. The study will also estimate the impact of the standard of care change to routine CHG bathing on baseline CLABSI rates in these BMT units over time, through evaluation of retrospective data. (Scott Fridkin - Co-Principal Investigator; Jay Varkey - CLEAN HEME Co-Investigator; Ahmed Babiker - CLEAN HEME Co-Investigator)

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PEACH-related Projects

PAINTS Povidone-Iodine to Stop Access Related Infections and Transmission of Staphylococcus aureus

The PAINTS study is an Agency for Healthcare Research and Quality (AHRQ)-funded research initiative led by the University of Wisconsin that seeks to evaluate the effectiveness, feasibility, and acceptability of using povidone-iodine nasal swabs to prevent Staphylococcus aureus infections among hemodialysis patients. Hemodialysis patients are at an increased risk for healthcare-associated infections due to their chronic, indwelling catheters and frequent healthcare facility visits. The primary outcomes for this study are to assess whether usage of povidone-iodine reduces S. aureus prevalence and evaluate patient and staff satisfaction with its administration in a dialysis setting.

EASIL Emory Antibiotic Stewardship in Long-term Care

The EASIL study is a program to develop accessible tools and strategies for skilled nursing facilities (SNFs) to strengthen antibiotic stewardship programs at their facilities. Improvements include creating a platform for incorporating local antibiotic resistance data into customized reports that can be used by the facility to guide best prescribing practices. The overall goal of the SNF stewardship programs will be to reduce the incidence of adverse effects related to unnecessary antibiotic use.

Past Projects

COPING

COVID-19 Prevention in Nursing Homes

The COPING study was a prospective, longitudinal cohort study that began in the summer of 2020 during the ongoing outbreak of SARS-CoV-2 in the United States. An estimated, 1,700 front-line healthcare personnel (HCP) were enrolled and followed for over 6 months to assess seroprevalence and incidence of COVID-19.