Control Of Healthcare-associated Infections Research Articles

Management actions for prevention and control of healthcare-associated infections: A grounded theory approach.

To understand the management actions for prevention and control of health care-associated infections (HAIs) performed by health professionals. Prevention of nosocomial infections has evidence-based practice at its essence, but not all institutions are successful in implementing prevention methodology. Qualitative research with Grounded Theory methodological framework. The research was carried out in two southern Brazilian hospitals. Data collected were employed through open interviews with 21 health professionals and managers. This process occurred concurrently with the data analysis, through constant comparative analysis. The understanding of the co-responsibility of managerial actions emerged as a central phenomenon of the theoretical model. Management actions for the prevention and control of HAIs are a collective phenomenon, in which co-responsibility sustains the effectiveness of the offered assistance. The behaviours of health teams in the face of structural and human weaknesses influence the construction of a supportive relationship in the effectiveness of patient safety actions. The sharing of responsibilities between professionals and the actions of prevention and control of HAIs arising from this conduct positively influence the promotion of safer and improved quality care. Nursing managers should consider applying the tools to prevent and control HAIs and generate in-depth discussion to promote institution's cultural changes.

SPiNCAR: A systematic model to evaluate and guide actions for tackling AMR.

BackgroundItaly records very alarming levels antimicrobial resistance (AMR), so a National Action Plan on Antimicrobial resistance (PNCAR) was developed, adopting the AMR European Union’s recommendations based on the results of the ECDC site visit of January 2017. For achieving PNCAR objectives, it is necessary to support and harmonize the implementation of recommendations in all the different healthcare levels (regional authorities and local trusts), so the SPiNCAR project was launched to create a tool for reaching this goal.MethodsWe developed a framework based on a scientific literature and national and international guidelines. Firstly, we identified the major intervention areas for tackling AMR, then, for each area, we built a set of standards, both for regional authorities than for local trusts. Every standard is composed by a set of essential and additional criteria, which refer to a minimum or supplemental performance level respectively. The contents were firstly discussed by the project’s team during face-to-face kick-off meetings, then confirmed with Delphi methodology and finally validated through a pilot study.ResultsThe final framework consists of seven different areas that reflect the PNCAR structure: Governance, Surveillance and Monitoring, Appropriate Use of antimicrobials, Healthcare-associated Infections (HAIs) control and prevention, Education and Training, Alliance among Stakeholders, Implementation. The total number of standards for the regional framework was 34 with 264 criteria and for the local version 36 criteria with 279 standards.ConclusionThe ongoing use of this tool, developed on international evidences and recommendations that were tailored on the Italian specific context, allows monitoring the improvement achieved over time and plan the next steps.

The Consolidated Framework for Implementation Research: a reflection on researchers' experiences of its benefits and challenges and the lessons learnt from using it.

In healthcare implementation research, there is little discussion of researchers' experiences of using frameworks, including the Consolidated Framework for Implementation Research (CFIR). To identify and discuss the benefits and challenges encountered and the lessons learnt from researchers' experiences of using the CFIR in different contexts and phases of research. This article synthesises the reflections of nursing and public health researchers on their experiences of using the CFIR across four separate healthcare-associated infection prevention and control implementation studies. The CFIR's benefits and challenges, the resolutions to these challenges and the lessons learnt from the application of the framework were discussed. Identified benefits included the framework's adaptability and flexibility, and its provision of structure and shared language for research. Translation to another language and differentiating between domains and constructs were challenges. Nurse researchers may find this article useful when considering use of the CFIR, or to anticipate and prepare to overcome the challenges highlighted when using the framework.

Nursing Students' Perceptions on Healthcare-Associated Infection Control and Prevention Teaching and Learning Experience in Portugal.

Healthcare-associated infections (HAI) are one of the major concerns worldwide, posing significant challenges to healthcare professionals’ education and training. This study intended to measure nursing students’ perceptions regarding their learning experiences on HAI prevention and control. In the first phase of the study, a cross-sectional and descriptive study with a convenience sample composed of undergraduate nursing students from Portugal, Spain, Poland, and Finland was conducted to develop the InovSafeCare questionnaire. In the second phase, we applied the InovSafeCare scale in a sample of nursing students from two Portuguese higher education institutions to explore which factors impact nursing students’ adherence to HAI prevention and control measures in clinical settings. In phase one, the InovSafeCare questionnaire was applied to 1326 students internationally, with the instrument presenting adequate psychometric qualities with reliability results in 14 dimensions. During phase two, the findings supported that Portuguese nursing students’ adherence to HAI prevention and control measures is influenced not only by the curricular offerings and resources available in academic settings, but also by the standards conveyed by nursing tutors during clinical placements. Our findings support the need for a dedicated curricular focus on HAI prevention and control learning, not only through specific classroom modules, innovative resources, and pedagogical approaches, but also through a complementary and coordinated liaison between teachers and tutors in academic and clinical settings.

Control of Healthcare-Associated Infections using Silver Nanoparticles in Radiology.

Aims:The control of healthcare-associated infections (HCAIs) is a significant concern in the field of radiology due to multiple contact-transmitted pathogens on imaging devices. The antimicrobial effects of silver nanoparticles (AgNPs) in preventing HCAIs and their effects on imaging quality were evaluated.Methods:The antimicrobial effects of AgNPs were tested on prevalent contact-transmitted pathogens present in radiology examination rooms, including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococci (VRE), Pseudomonas aeruginosa, and Acinetobacter baumannii. Furthermore, we investigated the effects of AgNPs on X-ray image quality using humanoid head and hand phantom.Results:AgNPs did not affect the quality of X-ray images. They had antimicrobial effects against Gram-positive Bacillus, including MRSA, VRE, and Gram-negative Bacillus, including P. aeruginosa and A. baumannii.Conclusion:AgNPs are considered effective in controlling HCAIs in radiology through sterilization by coating shooting devices and accessories where physical contact between patients and healthcare professionals is frequent.

Using a Massive Open Online Course (MOOC) to promote infection prevention and control learning in healthcare education

Background: The prevention of healthcare-associated infections (HAIs) is one of the most important subjects in healthcare education. Aim: The aim of this study was to describe Finnish, Spanish, Portuguese, and Polish healthcare students’ perspectives on learning about HAIs using a Massive Open Online Course (MOOC). This study is part of the Erasmus+ project ‘Educating students for innovative infection prevention and control (IPC) practices in healthcare settings’ (InovSafeCare). Methods: The descriptive cross-sectional research design was used to describe healthcare students’ perspectives on learning about HAIs using the InovSafeCare MOOC (ISC-MOOC). The participants (N = 135) were students recruited from partner institutions. The project group developed a semi-structured questionnaire that was used for data collection, containing questions of technical and pedagogical usability. The data were analyzed by statistical methods and content analysis. Results: The ISC-MOOC facilitated healthcare students’ independent learning and promoted their knowledge of HAI prevention and control. Study materials were easy to use (84%), and the media of the study materials were of high standard (83%). Some technical problems (14%) were also identified with the use of the materials. The study materials were relevant (70%) for IPC learning but should also be provided in different languages. Conclusion: The MOOC will strengthen the role of the students as future healthcare professionals and will also be usable for those healthcare professionals who need to update their skills with today’s HAI requirements. MOOC should also be translated into other languages other than English.

Acts and Public Notices on Healthcare-associated Infection Control & Prevention in the Republic of Korea

Acts and Public Notices on Healthcare-associated Infection Control & Prevention in the Republic of Korea

Factors Associated with Intention to Comply with Infection Control Guidelines in Physicians and Nurses: An Analysis Based on the Theory of Planned Behavior

Purpose: This study aimed to identify factors affecting physicians and nurses’ intention to comply with healthcare-associated infection control guidelines, based on the theory of planned behavior.Methods: This study was a cross-sectional, descriptive survey. Data were collected using self-report questionnaires from 169 doctors and nurses at a tertiary hospital. Pearson correlation analysis and multiple regression analysis were used to analyze the factors influencing intention to comply with healthcare-associated infection control guidelines.Results: The mean score of intention to comply with infection control guidelines was 17.17±2.60 points (possible range 3-21 points). The intention to comply with infection control guidelines was positively associated with subjective norms and perceived behavioral control over compliance with healthcare-associated infection control guidelines. In the multiple regression analysis, perceived behavioral control was the only significant predictor of intention to comply with healthcare-associated infection control guidelines.Conclusion: In order to encourage doctors and nurses to comply with infection control guidelines, it is necessary to provide resources, enhance the work environment, and utilize strategies to increase perceived behavioral control over compliance with infection control guidelines.

Evaluation of an Access-Risk-Knowledge (ARK) Platform for Governance of Risk and Change in Complex Socio-Technical Systems

Three key challenges to a whole-system approach to process improvement in health systems are the complexity of socio-technical activity, the capacity to change purposefully, and the consequent capacity to proactively manage and govern the system. The literature on healthcare improvement demonstrates the persistence of these problems. In this project, the Access-Risk-Knowledge (ARK) Platform, which supports the implementation of improvement projects, was deployed across three healthcare organisations to address risk management for the prevention and control of healthcare-associated infections (HCAIs). In each organisation, quality and safety experts initiated an ARK project and participated in a follow-up survey and focus group. The platform was then evaluated against a set of fifteen needs related to complex system transformation. While the results highlighted concerns about the platform’s usability, feedback was generally positive regarding its effectiveness and potential value in supporting HCAI risk management. The ARK Platform addresses the majority of identified needs for system transformation; other needs were validated in the trial or are undergoing development. This trial provided a starting point for a knowledge-based solution to enhance organisational governance and develop shared knowledge through a Community of Practice that will contribute to sustaining and generalising that change.

Establishment of the Program for Hierarchical Prevention and Control of Sudden Infectious Diseases Based on the Coronavirus Disease 2019: Experience of Peking Union Medical College Hospital

In the current situation of Corona virus disease 2019， “to prevent import from abroad and to defend internal rebound” is the general principle. Facing the changes in the epidemic situation， especially the winter and spring epidemics， it is a huge challenge to carry out a scientific, precise and flexible program for the prevention and control of healthcare-associated infections so that to ensure the safety of healthcare workers and patients. After more than a year of anti-epidemic work， Peking Union Medical College Hospital has summarized and formulated a four-level retractable and releasable hierarchical program of prevention and control. It is dynamically adjusted according to the responsive level of public health emergencies in Beijing and the relevant regulations of epidemic prevention and control. Various departments can also respond quickly to ensure the resumption of work. This program provides reference for the prevention and control of coronavirus disease 2019 and other sudden infectious diseases.

Obstacles of Patient Safety Culture Implementation to Prevent and Control of Healthcare-Associated Infections (Hais) During Covid-19 Pandemic: A Phenomenological Study

Background: The implementation of patient safety is an effective strategy in preventing and managing Healthcare-Associated Infections (HAIs). Objective: This study aimed to explore the obstacles in implementing the patient safety culture by dental co-assistant (co-ass) on prevention and control of HAIs in the covid-19 pandemic. Method: This study used a qualitative method with a phenomenological study approach. The sample in this study was 16 key informants consisting of 10 dental co-assistant, five dental nurses, and one hospital director. The sampling technique used the purposive sampling technique. Results: The results of this study indicate that there were five obstacles in implementing the patient safety culture to prevent and control HAIs, including 1) the rules were not strict in the implementation of patient safety culture; 2) poor attitude by the dental co-assistant (co-ass); 3) the facilities are not feasible to support the implementation of patient safety culture; 4) inadequate patient safety culture guidelines, and 5) lack of supervision in the implementation of patient safety culture. Conclusion: The results of this study provide important information related to obstacles faced by dental co-assistant in the implementation of patient safety culture to prevent and control HAIs during the covid 19 pandemic. The dental co-assistant should focus on the implementation of patient safety culture to suppress the occurrence of HAIs.

Nursing Students' Perceptions on Healthcare-Associated Infection Control and Prevention Teaching and Learning Experience: Development and Validation of a Scale in Four European Countries.

Healthcare-associated infections are one of the major concerns worldwide. This study presents the development and the validation process of the InovSafeCare scale and aimed at identifying and measuring the ecosystem variables related to healthcare-associated infection (HCAI) prevention and control practices in European nurse students. Qualitative and quantitative approaches were used to (1) elaborate an item pool related to the educational environment, the healthcare setting environment, and the attitudes, beliefs, and performance of the nursing students regarding HCAI prevention and control and (2) analyze psychometric properties of the scale using factor analysis. The validated InovSafeCare scale was applied to undergraduate nursing students of five European Higher Education Institutions. The partial least square structural equation modeling (PLS-SEM) method with SMART-PLS3 software was used. The study sample consists of 657 nursing students, who responded a self-report inventory. From the analyzed data were identified 14 factors. The InovSafeCare scale reveals good validity and reliability of the dimensions in different European countries.

PPE for SARS-Cov-2 and the utility of single-use aprons

Journal of Paramedic PracticeVol. 13, No. 10 CommentPPE for SARS-Cov-2 and the utility of single-use apronsWesley HowarthWesley HowarthEmail for correspondence: E-mail Address: [email protected].Paramedic, North West Ambulance Service NHS Trust, Bolton, UKSearch for more papers by this authorWesley HowarthPublished Online:5 Oct 2021https://doi.org/10.12968/jpar.2021.13.10.431AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Brown J, Gregson FKA, Shrimpton A et al.. A quantitative evaluation of aerosol generation during tracheal intubation and extubation. Anaesthesia. 2020. https://doi.org/10.1111/anae.15292 Google ScholarCenters for Disease Control and Prevention. 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Attitude of Patient Safety and Awareness of Standard Precautions for Healthcare Associated Infection Control in Senior Nursing Students

Attitude of Patient Safety and Awareness of Standard Precautions for Healthcare Associated Infection Control in Senior Nursing Students

Nosocomial infections as one of the most important problems of healthcare system.

Healthcare-associated infections (HAI) are commonly defined as adverse events resulting from the provision of healthcare. The reduction of risk arising from the spread of pathogenic microorganisms in the hospital environment is a considerable challenge in the context of the proper functioning of the medical services sector. The financial costs of hospitals resulting from HAI are a serious problem for the Polish healthcare system. The spread of strains with a high level of drug resistance in individual hospitals is associated with the local epidemiological situation. In 2015-2017, there was a high increase in the number of infections caused by New Delhi strains. The highest increase due to this strain occurred in Mazowieckie and Podlasie provinces. The dynamics of infection caused by New Delhi strains throughout Poland in 2015-2016 indicated an increase of 278.7%. In 2017, the phenomenon of antibiotic abuse in all regions of Poland was 24% higher than the EU average. One of the reasons is the insufficient number of diagnostic tests ordered by both general practitioners and doctors representing hospital care. In 2016-2017, the average number of microbiological tests in diagnosing hospital infections performed annually within the entire territory of Poland was 50% lower than in European Union countries and the number recommended by WHO. Increased, and at the same time inappropriate antibiotic therapy led to a build-upof drug resistance among bacterial species of significant clinical importance. The current epidemiological situation imposes the necessity for constant HAI control and broadly understood rationalization of the guidelines of hospital antibiotic policy.

Leadership, Governance and Resources in the Prevention and Control of Healthcare Associated Infections (HAIs) At Hospital X Yogyakarta

Hospitals are required to provide quality, accountable and transparent health services, especially for patient safety assurance. Nosocomial infections (Hospital Acquired Infection) or HAIs are infections that occur in patients during hospitalization. The incidence of phlebitis in January 2019 was 13%, September 2019 was 6%. Meanwhile, the Minister of Health Decree No. 29/2008, the standard incidence of HAIs in the hospital should not be more than 1.5%. Leadership, governance and resources have a strong role to play in improving the patient safety system that has been established. The research objective was to analyze the implementation of prevention and control of HAIs on the aspects of leadership, governance, and hospital resources.
 This qualitative descriptive case study research with informants consisting of the leadership, the PPI team and hospital staff were taken by purposive sampling with the validity test technique through triangulation. Collecting data by interview, observation and documentation. Data analysis uses data reduction methods, data presentation and conclusion / verification.
 Leadership and governance as an effort to prevent and control HAIs in hospitals with the formation of the Infection Prevention and Control Committee (PPI), a Prevention Control Nurse (IPCN) officer was appointed with activities and reports on the results of supervision. However, reports on the results of supervision have not been optimally socialized only in the form of information conveyed through information boards / announcement boards. Resources can be fulfilled properly with the availability of a sufficient number of IPCLNs with their main duties, the availability of budget and supporting facilities while still taking into account the availability of isolation rooms for infectious cases in hospitals that do not yet exist.
 It is necessary to socialize the results of supervision and the PPI program through the assignments of the Head of the Inpatient Installation and through the IPCN Nurses in the room as well as the provision of information boards in each room for information media on the results of supervision and the PPI program.

Geographical information system and spatial\u2013temporal statistics for monitoring infectious agents in hospital: a model using Klebsiella pneumoniae complex

BackgroundThe emergence and spread of antimicrobial resistance and infectious agents have challenged hospitals in recent decades. Our aim was to investigate the circulation of target infectious agents using Geographic Information System (GIS) and spatial–temporal statistics to improve surveillance and control of healthcare-associated infection and of antimicrobial resistance (AMR), using Klebsiella pneumoniae complex as a model.MethodsA retrospective study carried out in a 450-bed federal, tertiary hospital, located in Rio de Janeiro. All isolates of K. pneumoniae complex from clinical and surveillance cultures of hospitalized patients between 2014 and 2016, identified by the use of Vitek-2 system (BioMérieux), were extracted from the hospital's microbiology laboratory database. A basic scaled map of the hospital’s physical structure was created in AutoCAD and converted to QGis software (version 2.18). Thereafter, bacteria according to resistance profiles and patients with carbapenem-resistant K. pneumoniae (CRKp) complex were georeferenced by intensive and nonintensive care wards. Space–time permutation probability scan tests were used for cluster signals detection.ResultsOf the total 759 studied isolates, a significant increase in the resistance profile of K. pneumoniae complex was detected during the studied years. We also identified two space–time clusters affecting adult and paediatric patients harbouring CRKp complex on different floors, unnoticed by regular antimicrobial resistance surveillance.ConclusionsIn-hospital GIS with space–time statistical analysis can be applied in hospitals. This spatial methodology has the potential to expand and facilitate early detection of hospital outbreaks and may become a new tool in combating AMR or hospital-acquired infection.

Analysis of Continuous Prevalence Survey of Healthcare-Associated Infections Based on the Real-Time Monitoring System in 2018 in Shandong in China

Background Healthcare-associated infection (HAI) is a serious threat to the safety of patients worldwide. The prevalence survey is widely used to explore and study the characteristics of HAI. However, the annual continuous prevalence survey of hospital-acquired infections has not been reported so far. Aim This study is aimed at examining the occurrence and development trend of HAIs dynamically and accurately. Methods An annual continuous HAI prevalence survey based on the real-time monitoring system was conducted in representative hospitals from different regions in Shandong in China. Findings. A total of 64 hospitals participated in the survey, and 2,741,433 patients were monitored in 2018. The highest prevalence of HAIs in Shandong was 3.83% (February 15), the lowest was 1.85% (February 28), and the average was 2.45%. The percentile distribution of prevalence of HAIs in this study was as follows: P10, 2.23%; P25, 2.31%; P50, 2.41%; P75, 2.55%; and P90, 2.73%. Conclusion This study dynamically and accurately showed the occurrence and development trend of HAIs in Shandong in 2018. The results of this study can be used as a reference for the HAI prevalence survey in various medical institutions in Shandong and provide the basis for the regional HAI prevention and control strategy.

Modeling transmission of pathogens in healthcare settings.

Mathematical, statistical, and computational models provide insight into the transmission mechanisms and optimal control of healthcare-associated infections. To contextualize recent findings, we offer a summative review of recent literature focused on modeling transmission of pathogens in healthcare settings. The COVID-19 pandemic has led to a dramatic shift in the modeling landscape as the healthcare community has raced to characterize the transmission dynamics of SARS-CoV-2 and develop effective interventions. Inequities in COVID-19 outcomes have inspired new efforts to quantify how structural bias impacts both health outcomes and model parameterization. Meanwhile, developments in the modeling of methicillin-resistant Staphylococcus aureus, Clostridioides difficile, and other nosocomial infections continue to advance. Machine learning continues to be applied in novel ways, and genomic data is being increasingly incorporated into modeling efforts. As the type and amount of data continues to grow, mathematical, statistical, and computational modeling will play an increasing role in healthcare epidemiology. Gaps remain in producing models that are generalizable to a variety of time periods, geographic locations, and populations. However, with effective communication of findings and interdisciplinary collaboration, opportunities for implementing models for clinical decision-making and public health decision-making are bound to increase.

Incidence of Surgical Site Infections in Multicenter Study-Implications for Surveillance Practice and Organization.

Introduction: WHO core components of healthcare-associated infections (HAIs) prevention and control include their surveillance system. In Poland, there are no widespread multi-center infection surveillance networks based on continuous, targeted, active methodology. One of the most important form of HAIs are surgical site infections (SSIs). The aim of this study was to analyze the incidence of SSIs, in the context of seasonal differentiation. Seasonal differentiation could be connected with weather conditions, but it also can be affected by personnel absence due to holidays and furlough. The second aspect may influence organization of work and increased absenteeism may contribute to lowering the quality of patient care. Healthcare associated infections are the phenomenon which can be especially affected by such factors. Methods: The data used originate from the targeted, active surveillance reports obtained from the six years period, based on the ECDC recommendations. Results: Highest incidence rates of SSIs were found after operations performed in June and August, equal to 1.8% and 1.5% respectively and the lowest in October was 0.8%. These differences were statistically significant: for June incidence: OR 1.6, 95% CI 1.03–2.5, p = 0.015. Another approach showed a significant difference between the level of incidence in the period from November to January together with from June to August (1.35%), comparing to the rest of the year (1.05%). Also the rates of enterococcal and Enterobacterales infections were significantly higher for the period comprising months from November till January and from June to August. In Poland these are periods of increased number of absences associated with summer, national and religious holidays. Conclusions: Our results show that the short-term surveillance data limited to several days or months are not sufficient to obtain a valuable description of the epidemiological situation due to HAI. Efforts should be undertaken in order to implement wide net of hospital acquired infections, including SSI on the country level.