Introduction of the VITEK 2 Compact and Implementation of EUCAST Guidelines in a Microbiology Department

The aims of this project were to introduce the VITEK 2 Compact and to implement European Committee Antimicrobial Susceptibility Testing guidelines in a small microbiology department. The VITEK 2 Compact is an automated analyser for the identification and antimicrobial susceptibility testing of bacteria and has been associated with decreased sample turn-around-times, cost savings and improved detection of multi-drug resistant organisms. There are 10 different guidelines for the clinical interpretation of antimicrobial susceptibility data. A national decision was made in 2010 to harmonise susceptibility data reporting in Ireland, by adopting European Committee Antimicrobial Susceptibility Testing guidelines. This will enable the comparison of data between institutions at the patient, national and internationally level. The HSE Change Model was used to guide the change process. A vision for change, aligned with the organisations strong commitment to quality was created along with the key stakeholders. The vision was communicated along with the drivers for change. A plan was developed and implemented which included validation of the new processes and a training program. Mini-successes during the initial stages of the project were celebrated to ensure mainstreaming. Donabedian’s structure, process, outcome model was used for evaluation. Results demonstrated cost savings of €2.90-€10.28 per isolate and reduced turn-around-times of 1-20 hours, depending on organism complexity. Higher scores for external quality assurance samples were achieved in a direct comparison with historical procedures, demonstrating both trainee proficiency and process accuracy. Consumable costs and turn-around times were standardised irrespective of pathogen complexity and resistance. The turn-around-times for healthcare associated infections has been decreased by 20 hours, which has the potential to have a positive impact on infection control in the organisation. The implementation of the VITEK 2 Compact and European Committee Antimicrobial Susceptibility Testing guidelines will also facilitate the application of national guidelines for the control of multi-drug resistant organisms in the department.