Ability to export data from the Microbiology Laboratory to a text file. We will try to use the WHO BacLink software to assist in this task. This program can capture data from many Laboratory Information Systems but it is necessary to ensure that it will work in each participating hospital.
Not mandatory: Ability to install the Microbiological Electronic Form for microbiological culture requests for the purpose of being able to have the information needed (most frequent microorganism in a given clinical scenario) for the development of the Local Empirical Therapy guideline. At the beginning, and since there is no historical information, we should be able to match every microbiological isolation of the past two years with a clinical scenario among the defined ones in each Center. To help in this task in theVegaBajaHospitalthere has already been prepared a table of correspondence between our own list of CC and the International Classifications of Diseases, ICD-9 and ICD-10.
Availability of processed antibiotic use data as DDD/1000 patients-day or DDD/1000 inhabitants-day. If this is not possible it would be necessary to have data about the gross consumption of antibiotics, attendance data by Service (bed-days) as well as codes which allow us the calculation.
A local committee consisting of, at least, a microbiologist, a pharmacist and an infectious diseases specialist, for the project management at local level.
The decision of the local Infections Commission to encourage doctors to use the project information, particularly the Empirical Therapy guidelines. In this sense it is very useful to suppress culture requests on paper and make mandatory culture request in the electronic form (at the Vega Baja Hospital, failure to do this task makes it impossible to fill in the application for the culture). This approach will require clinicians, at least, to check the recommendations of the Guidelines. These recommendations may be ignored but it is hard to believe that they would go on using foreign guides (Sandford, etc.) if local information is available.
It would also be interesting to incorporate routine hospital hygiene data which will allow more complete analysis. The technical difficulty of adding this type of information is minimal.
It must not be forgotten that all the above information will not leave the hospital. The system locally installed will host a series of software programs ready to locally run all necessary data transformations.