Hospital Infection Control Programs Research Articles

Infections Associated with Medtronic Duet External Ventricular Drains - Rhode Island Hospital, Providence, Rhode Island, January 2023-January 2024.

External ventricular drains (EVDs) are medical devices that are inserted into the ventricles of the brain to drain excess fluid, manage intracranial hypertension, monitor intracranial pressure, and administer medications. Unintentional disconnections and breaks or fractures (breaks) of EVDs or associated drainage system components can result in cerebrospinal fluid (CSF) leakage and increased risk for EVD-associated infections. After replacement of Integra Life Sciences EVD systems with Medtronic Duet EVD systems at Rhode Island Hospital in mid-September 2023, a threefold increase was observed in the prevalence of positive CSF cultures, from 2.8 per 1,000 days with an EVD in place (EVD days) during January-September 2023 to 11.4 per 1,000 EVD days during October 2023-January 2024 (rate ratio [RR] = 5.7; 95% CI = 1.5-22.0; p = 0.01) and an eightfold increase in the prevalence of infections, from 0.7 to 6.5 per 1,000 EVD days (RR = 9.8; 95% CI = 1.1-87.3; p = 0.04). An investigation by Rhode Island Hospital Infection Control during December 2023-January 2024 identified frequent reports of disconnections and breaks of the Medtronic Duet EVD system. A search of the Food and Drug Administration Manufacturer and User Facility Device Experience database identified 326 reports nationwide of disconnection and breaks of components of the Duet EVD system, including 175 during 2023. A Medical Product Safety Network report was filed. The Duet EVD product was ultimately recalled in January 2024, citing disconnections of the EVD system and reports of CSF leakage and infection. Given the widespread use of EVD systems by neurosurgery centers and the risk for EVD-associated infections, a strategy for future consideration by hospital infection prevention and control programs might be inclusion of EVD-associated infections in hospital surveillance programs to rapidly identify increases in these events and determine factors related to such infections to prevent additional infections.

Impact of the COVID-19 pandemic on infection control nurses: A path analysis of job stress, burnout, and turnover intention

A infection control nurse (ICN) has played substantial roles in infection control and epidemiology programs in hospitals to protect patients and coworkers during the coronavirus disease 2019 (COVID-19) pandemic. This study aimed to explore the association between intention to leave in ICNs and job stress and burnout. This cross-sectional study was conducted among ICNs working in hospitals with ≥200 beds in South Korea from October 1 to 22, 2021. Variables included were related to general and job characteristics specific to COVID-19, as well as measures of job stress, burnout, and turnover intention for ICNs from previous studies. Path analysis was used to examine the relationships between job stress, burnout, turnover intention, and COVID-19-related work characteristics. A total of 203 participants were included, of whom 95% were women. The results showed that work intensity in COVID-19 infection control was significantly associated with job stress (P<.001) and burnout (P=.035). Furthermore, job stress (P=.019) and burnout (P<.001) were positively correlated with turnover intention. In a pandemic with emerging infectious diseases, strategies to reduce turnover among ICNs and ensure a sufficient workforce are crucial to reducing work intensity, considering the factors that affect job stress and burnout.

The Development of a Clinical Registry Digital Database on Invasive Fungal Infections in India: Advancing Epidemiological Understanding and Patient Care.

A well-structured digital database is essential for any national priority project as it can provide real-time data analysis and facilitate quick decision making. In recent times, particularly after the COVID-19 pandemic, invasive fungal infections (IFIs) have emerged as a significant public health challenge in India, affecting vulnerable population, including immunocompromised individuals. The lack of comprehensive and well-structured data on IFIs has hindered efforts to understand their true burden and optimize patient care. To address this critical knowledge gap, the ICMR has undertaken a Pan-India pioneer initiative to develop a network of Advanced Mycology Diagnostic research centres in different geographical zones of the country (ICMR-MycoNet). Under the aegis of this project, a clinical registry on IFIs in the ICUs is initiated. This process paper presents a detailed account of the steps involved in the establishment of a web-based data entering and monitoring platform to capture data electronically, ensuring robust and secure data collection and management. This system not only allows participating ICMR-MycoNet centres to enter patient information directly into the database using standardized Case Report Form (CRF) but also includes data validation checks to ensure the accuracy and completeness of entered data. It is complemented by a real-time, web-based, and adaptable data visualization platform. This registry aims to provide crucial epidemiological insights, promote evidence-based hospital infection control programs, and ultimately improve patient outcomes in the face of this formidable healthcare challenge.

Targeted Infection Control Practices in Japanese Hospitals for Multidrug-Resistant Organisms: Guidance From the Public Health Center.

Introduction The study conducted by the Kawaguchi City Public Health Center (PHC) in 2023 on hospital infection control (IC) programs revealed that hospitals can improve their IC programs if the PHC provides training sessions (TSs) that have numerical effects. In this study, we expected that we could help hospitals develop their IC practices by providing targeted guidance. This study aimed to clarify targeted guidance on IC practices and TS programs to develop hospitals'hospitals' IC programs on multidrug-resistant organisms (MDROs) by examining hospitals'hospitals' IC programs in reference to the study conducted in 2023 and other case reports. Methods In June 2022, the Kawaguchi City PHC conducted TSs for 19 hospitals and eight affiliated (AFs) clinics with beds, providing guidelines and practices on infection control (IC) for MDROs. After the TSs, we sent a questionnaire to these hospitals and affiliated clinics. The questionnaire inquired about current and planned IC policies, hand hygiene compliance programs (HHCPs), the usefulness of the TSs conducted by the PHC, and IC programs that the facilities intended to implement or develop in the future. This study examined the relationship between the perceived usefulness of the information provided and the IC programs planned for development, referencing a study conducted in 2023 and other case reports. Results Seventeen hospitals and six AFs with beds responded to the survey, yielding an 85.2% response rate. IC policies for methicillin-resistant Staphylococcus aureus (MRSA) were prepared by 21 hospitals (91.3%), whereas only five hospitals (21.7%) had prepared IC policies for carbapenem-resistant Enterobacteriaceae. Regarding HHCPs, an increase in the availability of alcohol-based hand sanitizer was identified by 17 hospitals (73.9%), while 13 hospitals (56.5%) reported using posters or symbols, 12 hospitals (52.2%) reported using TS and hand sanitizers, and nine hospitals (39.1%) assessed HH compliance and provided feedback. Furthermore, nine hospitals (39.1%) identified HHCPs and Environmental Cleaning (EC) for carbapenemase-producing Enterobacteriaceae (CPE) as useful information. There was a statistically significant association between TSs on HHCPs and the development of new HHCPs (p = 0.027). Additionally, information on EC for CPE was significantly associated with the development of staff cohorting strategies (p = 0.007). However, TS programs were not significantly connected to EC, nor were TSs to be developed. Conclusion The PHC should advise hospitals to assess if their HHCPs effectively contribute to improving HH compliance. It is essential for the PHC to furnish hospitals with resources and information that aid in the development of EC training. Additionally, the PHC should support the creation of specific and effective TS programs focused on EC or TS development. Conducting surveys to identify barriers to implementing staff cohorting strategies is also recommended. We propose that TS programs should include quantifiable data on HHCPs and EC, such as.

Public Health Centers' Training Session Programs to Develop Programs on Infection Control Practices for Multidrug-Resistant Organisms in Hospitals in Kawaguchi City, Japan.

Introduction The Kawaguchi City Public Health Center (PHC) conducted training sessions focusing on infection control practices on multidrug-resistant organisms (MDROs) for 19 hospitals and eight affiliated clinics (AFs) with beds in June 2022. Issues with infection control programs were identified via a survey implemented following the training sessions. These included providing feedback on infection control policies for MDROs, hand hygiene compliance programs (HHCPs), environmental cleaning (EC), and training sessions programs that hospitals or AFs with beds (hospitals) intended to implement in the future or develop (to be developed). We planned to examine whether the PHC training sessions programs have an effect on the development of hospital infection control programs designed to address these issues. The purpose of this study is to clarify the training session program provided by the Kawaguchi City PHC, which was effective in developing hospital infection control programs based on the results of the survey conducted after the training session. Methods In June 2023, a second training session that offered information on infection control practices was completed for 30 hospitals. This was followed by sending a questionnaire. We examined infection control programs to be developed and analyzed associations with the first learned information by training session (the first learned information). Results Twenty-four hospitals responded to the survey with a response rate of 80.0%. Half the respondents (12, 50.0%) had prepared for the infection control policy on carbapenem-resistant Enterobacteriaceae (CRE), 11 hospitals (45.8%) had provided feedback on HHC, and four (16.7%) planned to conduct feedback on HHC. HHCPs were planned to be developed by 19 hospitals (79.2%), EC by five hospitals (20.8%), training sessionby 12 hospitals (50.0%), and screening of MDROs upon hospital admission (AS) by nine hospitals (37.5%). The first learned information, "the prevention of healthcare-associated infections and cost savings by implementing cleaning bundles (the effects of cleaning bundles)," was identified by 10 hospitals (41.7%), and "specific programs on providing feedback effective for developing hand hygienecompliance (specific feedback)" was learned by eight hospitals (33.3%). The first learned information regarding specific feedback was significantly associated with HHCPs to be developed (p = 0.044). The first learned information on the effects of cleaning bundles was significantly associated with HHCPs and HHC feedback to be developed (p = 0.023, 0.034). The training sessionprograms were not significantly connected to EC, training session, or AS to be developed. Conclusions Infection control programs to be developed were linked to the provision of information on numerical effects by implementing specific feedback and cleaning bundles. We suggest that the PHC should develop infection control programs for the hospitals and provide training sessions, including numerical effects.

Compliance Analysis Of Hand Hygiene Regulation Implementation At Dr. M. Goenawan Partowidigdo Pulmonary Hospital Based On Who Multimodal Hand Hygiene Improvement Strategy

The Hospital Infection Prevention and Control Program (HIPCP) is an effort to reduce the risk of Healthcare-Associated Infections (HAIs), including hand hygiene compliance. WHO issued the Multimodal Hand Hygiene Improvement Strategy as one of the strategies to tackle low hand hygiene compliance. Dr. M. Goenawan Partowidigdo Pulmonary Hospital (RSPG) has implemented hand hygiene regulations referring to the current policies, but it has not met the target over the last three years. This study aims to analyze the implementation of the regulation of hand hygiene compliance at RSPG according to the WHO Multimodal Hand Hygiene Improvement Strategy, using an analytical descriptive qualitative approach with a case study method. The analysis uses the combination of the theory of George Edward III, Weaver, and the WHO Multimodal Hand Hygiene Improvement Strategy. WHO Multimodal Hand Hygiene Improvement Strategy assessment was conducted by scoring the Hand Hygiene Self-Assessment Framework (HHSAF). The results showed the lowest percentage of HHSAF scores on the bureaucratic structure variable, but the most important variable was the resource variable, namely human resources, related to activeness and behavior issues. These issues were obtained from in-depth interviews developed from structured questions on HHSAF. Hand Hygiene of RSPG is at an intermediate level. Researchers recommend behavioral enforcement with appreciative inquiry in addition to reward and punishment as an effort to improve compliance with the implementation of hand hygiene regulations at RSPG.

Assessing implementation of prevention and infection control programs in armenian hospitals during the COVID-19 pandemic

Aim of the study was to assess the current state of implementating key aspects of infection prevention and control (IPC) in Armenian hospitals, defined by the main WHO components, using the survey tool IPCAF (Infection Prevention and Control Assessment Framework). Materials and methods. 113 hospitals were involved in the study. All participants filled out the IPCAF questionnaire, consisting of 8 sections (each rated up to 100 points) devoted to various IPC aspects. Depending on the total final score, IPC programs were divided into the following categories: advanced (601800 points), intermediate (401600 points), basic (201400 points) and inadequate (0200 points). The study conducted a descriptive analysis of the overall IPCAF score as well as score evaluation of the relevant core components and some selected questions of particular interest. Results. The 2021 total average score for all IPCAF components for all hospitals in Armenia is 578.07.9 points, which is currently regarded as an intermediate level. At the same time, 47 (41.6%) hospitals were assigned to the advanced category, 63 (55.7%) to the average category and 3 (2.7%) to the basic category. Analysis of the main IPC components (CC, Core component) revealed that the maximum average scores were obtained for the components CC2 (IPC Guidelines) 80.8 points, CC8 (Creating a safe environment in medical premises, as well as materials and equipment for IPC) 75.5 points and CC7 (Workload, staffing and number of beds) 75.2 points. The lowest average scores were obtained for the key components: CC4 (Surveillance for healthcare-associated infections) with 54.7 points and CC3 (IPC education and training) with 59.5 points. Conclusion. Legislative and practical changes implemented in the real world during the novel coronavirus infection (COVID-19) pandemic have significantly contributed to improved scores for many key components of IPC programs. The study found that the IPCAF is a useful tool for assessing IPC standards and identifying gaps, regardless of a country economic development level. In our opinion, the re-use of IPCAF in all medical institutions should be encouraged, which is important for monitoring changes and trends in IPC, as well as proposing individual strategies in the development and improvement of IPC.

Challenges of and corrective recommendations for healthcare-associated infection’s case findings and reporting from local to national level in Iran: a qualitative study

BackgroundThe accuracy of health care−associated infections (HAIs) statistics in many countries is questionable and the main reasons of this inaccuracy are not well-known. The study aim was to explore inhibitors of and corrective recommendations for HAIs case findings and reporting in some of Iran hospitals.MethodsSixteen face-to-face interviews and an expert panel were performed with expertise of infection prevention and control (IPC) programs in hospitals, and Deputies of Health and Treatment in medical university and Ministry of Health from Feb 2018 to May 2019. Using conventional content analysis, code, subcategories and categories were developed.ResultThree categories emerged including improper structure preparation, conflict of interest, and inadequate motivation. Allocating distinct budget and adequate staff to IPC programs, developing a user-friendly surveillance system and engaging physicians and nurses for HAIs reporting are the main corrective recommendations accepted by the expert panel.ConclusionDespite the improvement in growing case-findings and reporting of HAIs in Iran, there are many challenges which inhibit accurate case finding and reporting of HAIs. So it is necessary to update the structure, system and rules to reach accurate HAIs data in Iran.

Evaluation of an oral care bundle for reduction of nonventilator hospital-acquired pneumonia in a community hospital

Objectives: We sought to determine the relationship between an oral-care bundle that includes use of new oral care devices, education of best practices for performing oral care, and daily audits to measure compliance with oral care best practices and the reduction of nonventilator hospital-acquired pneumonia (NV-HAP) and NV-HAP–associated sepsis and mortality outcomes. Methods: Havasu Regional Medical Center (HRMC) is a 171-bed acute-care community hospital in Lake Havasu City, Arizona. The hospital inpatient units measured in this quasi-experimental study were the medical surgical telemetry ortho unit (MTSO), the intermediate care unit (IMC), and the ICU.There were 30,838 hospital patient days in 2021. NV-HAP were captured as patients coded as an NV-HAP and being discharged in 2021. Sepsis was captured as sepsis being documented with the source being identified as a NV-HAP with a discharge date in 2021. Mortality was captured by coding of an NV-HAP and mortality with a time of death documented in 2021. Results: From January 1, 2021, to June 4, 2021, during the baseline period before the oral-care bundle was implemented, HRMC had 12,415 patient days and experienced a NV-HAP rate of 1.2 per 1,000 patient days and a sepsis rate of 0.56 per 1,000 patient days with the source documented as NV-HAP, and mortality rate of 0.32 per 1,000 patient days with a code of NV-HAP. HRMC used June 5, 2021, as their implementation period of the bundle, which included a new oral-care device, multilevel education to staff on best practices for oral care, and daily audits to measure compliance with oral-care best practices. During the postimplementation period, HRMC had 18,413 patient days, a NV-HAP rate of 0.54 per 1,000 patient days, a sepsis rate of 0.33 per 1,000 patient days with source documented as NV-HAP, and a mortality rate of 0.16 per 1,000 patient days with a code for NV-HAP. Conclusions: From June 5, 2021, to December 31, 2021, after the implementation of the oral-care bundle, the NV-HAP rate decreased by 58%, the sepsis rate with source documented as NV-HAP decreased by 41%, and the morality rate documented as NV-HAP decreased by 50%. Hospital infection control programs should consider implementation of a robust oral-care bundle that includes best-practices education and auditing to monitor staff compliance as a potential strategy to reduce NV-HAP.Funding: NoneDisclosures: None

Isolation and characterisation of carbapenem-resistant Pseudomonas aeruginosa from hospital environments in tertiary care hospitals in Dhaka, Bangladesh

Increasing evidence of carbapenem-resistant Pseudomonas aeruginosa (CRPA) infection in healthcare facilities poses an alarming threat to public health. There is little evidence on the occurrence of this organism in Bangladeshi hospitals. We collected 117 environmental swab samples from two tertiary care hospitals in Dhaka, Bangladesh and tested for Pseudomonas species by nonselective enrichment of swabs followed by plating on Cetrimide agar. We confirmed the isolates as P. aeruginosa by API 20NE test and polymerase chain reaction Polymerase Chain Reaction (PCR) for 16S rRNA gene. We analysed P. aeruginosa isolates for susceptibility against 15 clinically important antibiotics and tested the carbapenem-resistant isolates for metallo β-lactamase (MBL). All CRPA isolates were characterised for carbapenem-resistant genes, virulence genes and biofilm formation genes. Of 117 swab samples, 82 (70%) were tested positive for P. aeruginosa. All P. aeruginosa isolates were multidrug-resistant, and 39% (n=32) of isolates were CRPA. Around 56% (n=18) of CRPA were MBL-producing; 22% (n=7) of isolates were positive for carbapenemase gene blaNDM followed by 16% (n=5) for blaVIM and 13% (n=4) for blaIMP. Sequencing identified these genes as blaNDM-1, blaIMP-13, blaVIM-2 variants. Based on optical density values, 94% (n=30) of CRPA isolates were capable of producing biofilms. All CRPA isolates (n=32) were positive for at least 1 of 6 biofilm-associated genes and 4 of 12 virulence genes tested in the study. Hospital environments in Bangladesh are contaminated with highly virulent CRPA, which might be a potential source of hospital-acquired infections, accentuating the need for strengthening hospital infection control programs.

Coronavirus Diseases (covid -19) and Mucormycosis: A Mini-Review

Introduction: Mucormycosis is an opportunistic infection emerging as a major public health problem during the COVID-19 pandemic. Predisposing factors such as Diabetes mellitus (DM) as well as use of corticosteroids in COVID-19 patients act as a key role for the surge of the disease. However, the epidemiological factors, site of the infections, demographic details, morbidity and mortality of the patients were not well documented, so we undertook the study to review the published original articles, case series, and case report on mucormycosis associated with COVID-19 with predisposing factors such as DM and the use of corticosteroids, Methods: On analysis of 30 articles from India as well as from other countries. Results: After analysis of the available data, it was found that mucormycosis is predominantly seen in males in the age of 50±5. The common site of the infection was rhino-orbital mucormycosis followed by rhino orbital cerebral. Pre-existing DM was the most significant risk factor followed by corticosteroid treatment along with hospitals supplying oxygen to patients. The hospital environment also play a significant role for the sudden rise of the disease. Conclusion: To overcome this severe situation in the future, there is a need to maintain optimal hyperglycemia in the population, avoid overuse of corticosteroids, and proper hospital infection control (HIC) program in order to reduce the burden of fatal mucormycosis.

Prevalence of intestinal parasites, Salmonella and Shigella species among food handlers working in a tertiary care hospital of South India

Background: Infected food handlers act as potential sources of food borne illnesses. Consequences of such outbreaks in healthcare settings are more severe affecting their vulnerable sick patients. We aimed to determine the prevalence of intestinal parasites, Salmonella and Shigella species, and associated risk factors in our hospital food handlers in this cross-sectional study. Materials and Methods: Data on sociodemographic details, past medical illness, hygiene awareness practices, occupational prophylaxis undertaken were collected from 110 food handlers in hospital kitchen area. Their stool samples were collected for microbiological analyses of common intestinal parasites using saline and Lugol’s iodine wet mount preparations. Stool samples were inoculated onto Selenite F broth and subcultured onto Nutrient agar, MacConkey’s agar, Salmonella Shigella agar for isolation of Salmonella, Shigella species. Chi-square test and Odds ratio were used to determine risk factors in infected food handlers. Results: Only 4 (3.6%) food handlers were positive for intestinal parasites of Entamoeba histolytica (1.8%), Ascaris lumbricoides (0.9%) and Giardia lamblia (0.9%). None had Salmonella or Shigella species isolated from stool culture. All infected food handlers were aged over 50 years. Noncompliance to hand hygiene standards and illiteracy rates raised above 50 years. Conclusion: The negligible prevalence of intestinal parasites, Salmonella and Shigella species in food handlers testify our efficient hospital infection control program. Age over 50 years, uneducated and incompetent in hand hygiene practices were predominant risk factors for IPI. Scrupulous occupational health screening and trainings targeting high risk food handlers above 50 years of age, could prevent enteric pathogen spread in healthcare settings.

Joint Healthcare Infection Society (HIS) and Infection Prevention Society (IPS) guidelines for the prevention and control of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities

Joint Healthcare Infection Society (HIS) and Infection Prevention Society (IPS) guidelines for the prevention and control of meticillin-resistant Staphylococcus aureus (MRSA) in healthcare facilities

High Prevalence of Methicillin-Resistant Staphylococcus aureus among Healthcare Facilities and Its Related Factors in Myanmar (2018-2019).

Background: Antimicrobial resistance (AMR) is a growing global health problem. Staphylococcus aureus (SA) is a common bacterium associated with a variety of community and hospital infections. Methicillin-resistant Staphylococcus aureus (MRSA) accounts for most SA related morbidity and mortality. In this study, we determined the prevalence and factors associated with SA and MRSA in Myanmar. Methods: We collected the data retrospectively by reviewing an electronic register containing the results of bacterial culture and antibiotic susceptibility testing of biological specimens received from healthcare facilities during 2018–2019. Results: Of the 37,798 biological specimens with bacterial culture growth, 22% (8244) were Gram-positive. Among the Gram-positive bacteria, 42% (2801) were SA, of which 48% (1331) were judged as MRSA by phenotypic methods. The prevalence of MRSA was higher in the older age groups, in female patients, in urine specimens and specimens received from the intensive care unit and dermatology departments. One site (Site F) had the highest MRSA prevalence of the seven AMR sentinel sites. Most SA isolates were sensitive to vancomycin (90%) by phenotypic methods. Conclusions: The high prevalence of MRSA indicates a major public health threat. There is an urgent need to strengthen the AMR surveillance and hospital infection control program in Myanmar.

Surveillance of device-associated infections at a tertiary care hospital of Punjab

Background: Surveillance of health-care-associated infections (HAIs) plays a key role in the hospital infection control programme and reduction of HAIs. Device-associated infections (DAIs) are an important cause of excessive stay and mortality. The prevalence of HAIs is underreported from developing nations due to a lack of systematic surveillance.Aims and Objectives: The aim of the study was to know the rate and microbiological profile of DAIs.Materials and Methods: This surveillance study was conducted over a period of 2 years. Patients with indwelling devices were included. The data were collected and analysed by infection control team and labelled DAIs as per the CDC guidelines. The rates of HAIs and the profile of pathogens isolated were analysed.Results: A total of 294 patients developed DAIs, of which 181 were male and 113 were female. A total of 239 device-associated infections were reported in 2019 and 55 in 2020 and overall rate of DAIs was 1.81 and 0.58/1000 device days, respectively. Among DAIs, 50 were ventilator-associated pneumonia (VAP), 71 central line-associated bloodstream infections (CLABSI) and 173 catheter-associated urinary tract infection (CAUTI) cases. Overall, the rate was 2.02,1.21,1.21/1000 device days for VAP, CLABSI and CAUTI, respectively. In DAI's, majority were males and maximum cases developed after 6–10 days, 15 days and 11–15 days of device use in VAP/CAUTI and CLABSI, respectively. Gram-negative isolates (85.1%) were predominant, and among these, most common were Klebsiella spp, Acinetobacter spp and Escherichia coli. A high rate of multidrug resistance was observed.Conclusions: The present surveillance shows high resistance pattern of Gram-negative organisms causing DAIs. To reduce the risk of infection in hospitalised patients, DA-HAI surveillance is of primary importance as it helps in implementing preventive measures.

Construction and validation of instrument to assess the quality of infection control programs.

To build and validate an instrument to assess hospital infection control programs. Methodological study that was developed in seven stages. The instrument items were categorized into the structure, process and result components. 10 expert judges participated, who evaluated the psychometric properties and validated the content using the Likert scale. The pre-test was carried out with 98 health professionals, from April to July 2018. For reliability analysis, Cronbach's alpha test was used. Regarding the content validity index, the score made by expert judges ranged from 0.777 to 1.00, with mean of 0.902 (± 0.076). The Cronbach's alpha test showed good internal consistency of the items (0.82). An instrument to assess hospital infection control programs was developed and validated, which showed good reliability and can be efficiently used at national level.

Costing models for hospital infection control program in healthcare set up: ABC our experience

Background: Activity based costing (ABC) model for health care associated infections is very much important for patients, health care providers, and payers to make a rational and informed decisions about the patient pertinent care and also for the allocation of resources. The objective of the present study is to develop a ABC model to determine the various cost factors involved in treating health care associated infected patient. The costs for individual health care associated infections will be based on calculating both the direct cost and the indirect cost which are associated with the disease. Objectives: Assessing the various factors contributing to the development of ABC costing model for HAI and develop a costing model taking all the possible factors into consideration. Methods: Defining of the activities and process of HAI for the given institution as per the standard regulatory / recommendatory guidelines. System analysis and costing of process for the various activities for implementation of the HAI system. Results: Various parameters for HAI as per ABC model has been explained for health care associated infections. Conclusion: ABC Costing model helps to identify the factors responsible for setting health care and the cost involved in it.

Costing models for hospital infection control program in healthcare set up: ABC our experience

Costing models for hospital infection control program in healthcare set up: ABC our experience

Quality of Hospital Infection Control Programs in Low- and Middle-income Countries: A National Survey

Background: One of the strategies to reduce healthcare-associated infections (HAIs) and promote the quality of disease prevention and control actions is the creation of a hospital infection control program. This program is a set of deliberately and systematically developed actions aimed toward reducing the incidence and severity of infections to the maximum extent possible. In Brazil, studies on the subject still need to be improved; they focus on structural and process assessments, especially the survey of continuing education indicators as a quality requirement for the prevention of HAIs. The organizational context does not contribute to the success of the program, and difficulties remain in implementing recommendations and in implementing patient safety policies. Objective: To analyze hospital infection control programs in relation to quality components. Methods: This cross-sectional epidemiological study was conducted in health services located in the 5 official regions of Brazil: Midwest, Northeast, North, Southeast, and South. To select the study sites, nonprobabilistic sampling using the snowball technique was used. The potential study population consisted of 114 hospital infection control services. Health professionals responded to the structured instrument sent electronically via e-mail, and other health services near their locality, until reaching a national proportion. We used the “Hospital Infection Control Program Evaluation Questionnaire”; it consists of 36 multiple-choice questions. This tool was validated by 96 expert judges using the Cronbach’s alpha test (0.82) and the content validity index (0.88). A data analysis was performed using the multivariate principal component analysis technique (PCA). Results: Overall, 13 PCA components (Fig. 1) were used to build a score for measuring the performance of the hospital infection control program (ie, IQPC score). The Southern region had the best performance of the hospital infection control program (mi = 1.50; P = .02) (Fig. 2), private administration (mi = 0.45; P = .05), of hospitals that contained 300 beds or (mi = 1.38; P &lt; .01), hospitals that used the NHSN criterion for HAI surveillance (mi = 2.12; P &lt; .01), and those who searched prospective activity as a surveillance method (mi = 0.51; P &lt; .01). Conclusions: The quality of nosocomial infection control programs still needs to be improved among health services, highlighting the need to invest in small, publicly managed hospitals that use retrospective active surveillance methods.Funding: NoneDisclosures: None

An Exploratory Study to Assess the Knowledge and Attitude Regarding Nosocomial Infection Amongst Nurses working in Civil Hospital, Jalandhar

Introduction: Hospital Infection – also called ‘Nosocomial Infection’ affects both patient and hospital. The term ‘Nosocomial’ is derived from the Greek word “NosoKomeion”, meaning health care facility. The English word Nosocomial is derived from the Greek work meaning ‘Hospital’. Therefore a nosocomial infection is one that is acquired while in hospital or other health agency [1]. Nosocomial infections are very common in both, developed and developing countries. Hospital acquired infections are unnecessary burden to patients as well as for public health department. These are responsible for many deaths and increased morbidity rate in indoor patients. Nosocomial infections may cause functional disability, emotional, psychological and physiological stress and may reduce the quality of life of the client [2]. They not only affect the general health condition of the patients, but they also results in financial instability. The greatest contributor of the financial instability in the patients with nosocomial infections is a longer duration of stay in the hospital premises. The duration of stay varies from 3 days for gynecological procedures to about 20 days for orthopedic procedures and about 30 days for general surgery cases. Other costs include drugs, isolation, and the use of other alternative /complimentary therapies [3]. The three issues which face any patient contemplating treatment in India, namely, how safe is the blood at the hospital, what’s the state of nursing and post-operative care and what’s the rate of infection needed to be addressed and it of adherence to these infection control policies that India is not gaining worldwide acceptance as a main player field of medical Tourism [4]. An effective hospital infection control programme would benefit patients and their care and release considerable resources for alternative use. In India, results from many studies conducted by private hospital conclude the rate of Hospital Acquired Infection at 20-25% in agreement with WHO figures. The issues of hospital-acquired infections are now being given worldwide. Most of the big hospitals in India have set up elaborate protocols to check the infection rate and contain the risk of community acquired as well as hospital acquired infections. So, as to limit the spread antigen resistance [5]. Objectives: 1. To study the level of knowledge and attitude regarding Nosocomial infections amongst nurses working in Civil Hospital, Jalandhar. 2. To develop tools to assess the knowledge and attitude of working nurses regarding Nosocomial infection in Civil Hospital, Jalandhar. 3. To implement tools and collect data for assessing the knowledge and attitude regarding Nosocomial infection amongst nurses working in Civil Hospital, Jalandhar. 4. To analyse the data by using the statistical measures. Material and Methods: A exploratory research design was used assess the knowledge and attitude regarding nosocomial infection amongst nurses working in the civil hospital, Jalandhar. Convenient purposive sampling technique was used to select the 40 nurses. Informed written consent was taken from each student. Result: The maximum 42.5% of nurses were having very good knowledge regarding nosocomial infection whereas 40% were having excellent knowledge and only 17.5% were having good knowledge regarding nosocomial infections. Conclusion: The study revealed that students has some knowledge regarding nosocomial infection.