Hospital Infection Management Research Articles

Significance of Ongoing Training and Professional Development in Optimizing Healthcare-associated Infection Prevention and Control.

The employees who work in infection prevention and control (IPC) are very important in the field of health-care because they are committed to protecting patients, staff, and visitors from the risk of acquiring infections while in the hospital. The complexity of infection control in hospitals is alwaysgrowing in tandem with the rapid developments that are being made in medical technology andpractices. IPC personnel are required to maintain vigilance and continually improve their monitoringof the entire health-care process due to the ongoing development of IPC guidelines and regulations, the fluctuating infection risks, and the emergence of new infectious diseases. As a result, individuals involved in the prevention and control of infections in health-care settings absolutely need to participate in continual training and professional development. This reviewemphasizes the need of relevant professionals to engage in ongoing training and professional development to maintain their skills in the area of healthcare-associated infection control and prevention. Personnel working in IPC may more effectively react to newly discovered health risks andmake certain that hospital infection (HI) management gets the appropriate attention if they have atimely and in-depth awareness of best practices. They are better able to maintain their composure, react correctly, and deliver the most effective infection control and prevention techniques for the health-care system, all while increasing awareness about the significance of effective HI management.

Clinical significance of negative fluid balance and infection management in the treatment of acute respiratory distress syndrome caused by severe novel coronavirus infection

To explore the clinical significance of negative fluid balance and infection management in the treatment of acute respiratory distress syndrome (ARDS) caused by severe novel coronavirus infection. A retrospective survey was conducted. Patients with ARDS caused by severe novel coronavirus infection who were hospitalized in the department of critical care medicine of the Third Affiliated Hospital of Gansu University of Chinese Medicine and received non-invasive ventilator assisted ventilation were selected as the research objects. The fluid intake and output of all patients were accurately counted every day, and the fluid intake of the next day was adjusted according to the output of the previous day. According to the fluid negative balance, and whether the hospital infection management measures were complied with during the treatment and inspection of the patients, 45 patients with a negative fluid balance of more than 200 mL/d and strict management of nosocomial infection were taken as the observation group, and 48 patients with a negative fluid balance of less than 200 mL/d and no strict management of nosocomial infection were taken as the control group. The general data, weaning success rate, endotracheal intubation rate, mortality, as well as laboratory indicators such as white blood cell count (WBC), procalcitonin (PCT), C-reactive protein (CRP) after treatment were compared between the two groups. There were no significant differences in gender (male: 51.1% vs. 52.1%), age (years old: 66.31±15.92 vs. 67.50±13.59), acute physiology and chronic health evaluation II (APACHE II: 18.98±4.81 vs. 18.54±4.35) between the observation group and the control group (all P > 0.05), indicating that the baseline data were balanced and comparable. Compared with the control group, the weaning success rate of the observation group significantly increased [53.3% (24/45) vs. 31.2% (15/48), P = 0.031], endotracheal intubation rate significantly decreased [22.2% (10/45) vs. 43.8% (21/48), P = 0.028], mortality significantly reduced [20.0% (9/45) vs. 41.7% (20/48), P = 0.024], laboratory indicators WBC, PCT and CRP levels were significantly reduced [WBC (×109/L): 8.085±4.136 vs. 16.898±7.733, CRP (mg/L): 82.827±52.680 vs. 150.679±74.625, PCT (μg/L): 3.142±2.323 vs. 7.539±5.939, all P < 0.01]. Fluid negative balance and infection management have significant clinical significance in the treatment of severe novel coronavirus infection with ARDS.

The pre-analytical process management status and influencing factors of laboratory test before prescribing antimicrobial in developing country

IntroductionThe results of laboratory testing are crucial basis for clinicians to prescribe antimicrobial. Laboratory testing is a highly complex process, and increasing evidence suggests that errors and obstacles in the pre-analytical process (PP) will affect reasonable antimicrobial use. However, PP was an easily neglected link in hospital infection management and the current situation of it and the influencing factors of management are not clear.MethodsA cross-sectional survey was conducted in the department of clinical, specimen collection, transportation, and inspection in 109 secondary and tertiary hospitals in Central China. The rate of antimicrobial susceptibility test request (AST) and related indexes of above departments were calculated to describe the situation. Management characteristics (frequency of training etc.) were described as proportions and fractional probit regression analysis was used to determine the influencing factors.ResultsThe average rate of non restricted-use antimicrobial was 63%, the restricted-use was 86%, the special-use was 95%. The zero obstacle rate of specimen collection was 27.3%, of specimen transportation was 19.4% and of inspection feedback was 61.7%. There was a difference between the secondary and tertiary hospitals on non restricted-use (X2 = 22.968, P < 0.001); restricted-use (X2 = 29.466, P < 0.001); special-use (X2 = 27.317, P < 0.001). Taking non restricted-use as an example, training (OR = 0.312, 95%CI: 0.148,0.429), low-frequency appraisal (OR = 0.153, 95%CI: 0.082,0.224), guidance (OR = 0.32, 95%CI: 0.237,0.403) and information technology (OR = 0.104, 95%CI: 0.009,0.199) were positive factors.ConclusionsThere were substantial differences in the rate of AST request in clinical department between secondary and tertiary hospitals. The zero obstacle rate in collection, transportation and inspection department were still low. In most departments, training and performance appraisal were positive factors, guidance and information technology were positive supporting factors.

Impact of Multidisciplinary Collaborative Intervention on Isolation Implementation in Prevention and Control of Multi-drug Resistance Infection.

Contact precautions, especially the initiation of isolation, are important measures to prevent and control multidrug-resistant organisms (MDROs). However, the implementation in clinical practice remains weak. This study aimed to analyze the impact of multidisciplinary collaborative intervention on isolation implementation in multidrug-resistant infection, and determine the factors that affect the implementation of isolation measures. A multidisciplinary collaborative intervention related to isolation was conducted at a teaching tertiary hospital in central China on November 1, 2018. The information of 1338 patients with MDRO infection and colonization at 10 months before and after the intervention was collected. Then, the issuance of isolation orders was retrospectively analyzed. Univariate analysis and multivariate logistic regression analysis were performed to analyze the factors that affected the isolation implementation. The overall issuance rate of isolation orders was 61.21%, which increased from 33.12% to 75.88% (P<0.001) after the implementation of the multidisciplinary collaborative intervention. The intervention (P<0.001, OR=0.166) was a promoting factor for the issuance of isolation orders, in addition to the length of stay (P=0.004, OR=0.991), department (P=0.004), and microorganism (P=0.038). The isolation implementation remains far lower than policy standards. Multidisciplinary collaborative interventions can effectively improve the compliance to isolation measures implemented by doctors, thereby promoting the standardized management of MDROs, and providing reference for further improving the quality of hospital infection management.

Trending prevalence of healthcare-associated infections in a tertiary hospital in China during the COVID-19 pandemic

BackgroundThe purpose of this study was to demonstrate both the four-year prevalence trend of healthcare-associated infections (HAIs) in a large tertiary hospital and the trend regarding the prevalence of HAIs following the outbreak of coronavirus disease 2019 (COVID-19) in order to provide evidence of hospital infection management during the COVID-19 pandemic.MethodsBased on the hospital’s electronic nosocomial infection databases related to HAIs, we retrospectively identified the HAI cases to assess the epidemiological characteristics of HAIs from January 1, 2018, to December 31, 2021, in a large tertiary hospital in China. Similarly, the trends of HAIs after the COVID-19 outbreak and the seasonal variation of HAIs were further analyzed.ResultsThe HAI cases (n = 7833) were identified from the inpatients (n = 483,258) during the 4 years. The most frequently occurring underlying cause of HAIs was respiratory tract infections (44.47%), followed by bloodstream infections (11.59%), and urinary tract infections (8.69%). The annual prevalence of HAIs decreased from 2.39% in 2018 to 1.41% in 2021 (P = 0.032), with the overall prevalence of HAIs significantly decreasing since the outbreak of COVID-19 (2.20% in 2018–2019 vs. 1.44% in 2020–2021, P < 0.001). The prevalence of respiratory tract infections decreased most significantly; whereas, overall, the prevalence of HAIs was significantly greater during the winter compared with the rest of the year.ConclusionsNot only did the annual prevalence of HAIs decrease from 2018 to 2021, but it also significantly decreased since the start of the COVID-19 pandemic, particularly respiratory tract infections. These results provide evidence for the need to prevent HAIs, especially during the winter season.

PB2277: ANALYSIS ON POLLUTION STATUS AND INFLUENCING FACTORS OF NURSES’ UNIFORMS IN HEMATOLOGY GENERAL WARD

Background: In clinical work, nurses are the direct caregivers of patients, and they need to cooperate with doctors to observe patients’ conditions and carry out a number of clinical operations. Therefore, the contamination of nurses’ uniforms should be taken into account by hospital infection control workers. Contaminated nurses’ uniforms will reduce the quality of nursing and affect the treatment and rehabilitation of diseases, especially the hematological tumors patients who with low immunity. According to the study, nurses should change cleaning. Aims: Investigate and analyze the contamination of nurses’ uniforms after different working hours in hematology general ward, in order to providing some references to improve the quality of hospital infection management. Methods: From July to November 2021, front-line clinical nurses in the hematology general ward of a tertiary hospital in Chongqing were selected as the research objects by convenience sampling method. Samples were taken from different parts of the nurse at 8 different times, which including when changing clean uniform, and 1h, 3h, 6h, 2d, 3d, 4d and 5d after changing clean uniforms. Results: In this study, a total of 264 qualified specimens were collected from 33 nurses’ uniforms. Descriptive analysis showed that the bacterial colony counts of cuff, abdomen and front chest at the 6th hour after changing clean uniforms were (11.30±3.56) CFU/cm2, (8.79±2.33) CFU/cm2, and (11.06±2.71)CFU/cm2 and the qualified rates of cleanliness were 0, 9.1% and 3.0% respectively. Multiple linear regression analysis showed that, at the 6th hour after changing clean uniforms, the main influence factors of the bacterial colony count on the cuffs were work times, environmental humidity and the height of nurse, the fore chests were work times and the height of nurse, and the abdomens were work times, the total number of patients and the number of first-grade patients (all P<0.05). After 5 days, the main influence factors of the bacterial colony count on the cuffs were work times and the total number of patients, the fore chests were work times and the height of nurse, and the abdomens were work times and the total number of patients (all P<0.05). Summary/Conclusion: It is necessary for nurses in general hematology department to increase the frequency of changing nurses’ uniforms and improve the cleanliness to ensure the nursing quality and patient safety. For nursing managers, it is essential to optimize the allocation of human resources further and provide necessary infection protection equipment to reduce the risk of hospital-acquired infection caused by the serious pollution of nurses’ work clothes.

The Role of PDCA Cycle in Improving the Quality of Hospital Infection Management

The Role of PDCA Cycle in Improving the Quality of Hospital Infection Management

The Role of Hospital Infection Management in Dealing with Public Health Emergencies

The Role of Hospital Infection Management in Dealing with Public Health Emergencies

Prevention and Control of COVID-19 after Resuming General Hospital Functions.

During the COVID-19 pandemic, many general hospitals have been transformed into designated infectious disease care facilities, where a large number of patients with COVID-19 infections have been treated and discharged. With declines in the number of hospitalizations, a major question for our healthcare systems, especially for these designated facilities, is how to safely resume hospital function after these patients have been discharged. Here, we take a designated COVID-19-care facility in Wuhan, China, as an example to share our experience in resuming hospital function while ensuring the safety of patients and medical workers. After more than 1200 patients with COVID-19 infections were discharged in late March, 2020, our hospital resumed function by setting up a three-level hospital infection management system with four grades of risk of exposure. Moreover, we also took measures to ensure the safety of medical personnel in different departments including clinics, wards, and operation rooms. After all patients with COVID-19 infections were discharged, during the five months of regular function from April to September in 2020, no positive cases have been found among more than 40,000 people in our hospital, including hospital staff and patients.

Application Value of Surgical Nursing Management in Hospital Infection Management

Application Value of Surgical Nursing Management in Hospital Infection Management

Quality Management for Point-Of-Care Testing of Pathogen Nucleic Acids: Chinese Expert Consensus.

COVID-19 continues to circulate globally in 2021, while under the precise policy implementation of China’s public health system, the epidemic was quickly controlled, and society and the economy have recovered. During the pandemic response, nucleic acid detection of SARS-CoV-2 has played an indispensable role in the first line of defence. In the cases of emergency operations or patients presenting at fever clinics, nucleic acid detection is required to be performed and reported quickly. Therefore, nucleic acid point-of-care testing (POCT) technology for SARS-CoV-2 identification has emerged, and has been widely carried out at all levels of medical institutions. SARS-CoV-2 POCT has served as a complementary test to conventional polymerase chain reaction (PCR) batch tests, thus forming an experimental diagnosis platform that not only guarantees medical safety but also improves quality services. However, in view of the complexity of molecular diagnosis and the biosafety requirements involved, pathogen nucleic acid POCT is different from traditional blood-based physical and chemical index detection. No guidelines currently exist for POCT quality management, and there have been inconsistencies documented in practical operation. Therefore, Shanghai Society of Molecular Diagnostics, Shanghai Society of Laboratory Medicine, Clinical Microbiology Division of Shanghai Society of Microbiology and Shanghai Center for Clinical Laboratory have cooperated with experts in laboratory medicine to generate the present expert consensus. Based on the current spectrum of major infectious diseases in China, the whole-process operation management of pathogen POCT, including its application scenarios, biosafety management, personnel qualification, performance verification, quality control, and result reporting, are described here. This expert consensus will aid in promoting the rational application and robust development of this technology in public health defence and hospital infection management.

The Use of a Three-in-One Practice-Management-Innovation Training Model in the Construction of an Infection Control Team.

ObjectiveThis study aims to explore the role of a three-in-one practice, management, and innovation training model (also called as three-in-one practice-management-innovation training model) in the construction of an infection control team.MethodsThis study retrospectively analyzed the position structure, mastery of professional knowledge, and working methods of the full-time and part-time personnel of the Changzhou Cancer Hospital, compared the training content of Jiangsu Hospital Infection Control Center with the actual situation of the hospital, and formulated and implemented a three-in-one practice-management-innovation training model. First, the team members were selected for the construction and management of the Hospital Infection Management Department according to the relevant responsibility and management requirements, and their learning and mastery of the basic knowledge and skills concerning infection control were completed based on their professional roles. In line with the regulations of the hospital and department, full-time personnel were ensured of having the opportunity to participate in provincial- and municipal-level academic exchanges and then learn from each other, through collaboration between doctors and nurses, how to exercise basic management skills. At the same time, a fair competitive incentive mechanism was established through the three-level network of the hospital infection committee, the hospital infection management department, and nosocomial infection management department to implement innovative project-based management and cultivate an awareness of hospital infection control in all employees.ResultsThe professional structure of the full-time infection control personnel has been optimized, the awareness of the infection control team concerning active participation in practice has gradually increased, and infection control management and innovation has been significantly improved.ConclusionAfter the selection of an infection control management team and the delivery of well-planned training, the quality of infection control management has improved.

Study on the application of tracking methodology and PDCA circulation management in quality control of hospital infection management.

Study on the application of tracking methodology and PDCA circulation management in quality control of hospital infection management.

The Prevention and Control Experience of Maternal Health Care from Chengu, China During the COVID-19 Epidemic.

Four months after the first case of COVID-19 was diagnosed in Wuhan, the national epidemic has been effectively controlled in China. In Chengdu, the capital city of Sichuan Province, several management measures, which have been proven to be effective, are taken to prevent pregnant women from being infected with COVID-19. Firstly, Chengdu formulated and issued the “Working Opinions on the Management of Maternal Women during the Epidemic Period of COVID-19 Infection” immediately after the outbreak. Secondly, some basic information of pregnant women returning from high-risk areas and countries is requested to be reported on a daily basis. Thirdly, a group of experts in Obstetrics, Pediatrics and Hospital Infection Management supervise the implementation of the COVID-19 health care services for pregnant women in primary care institutes. Fourthly, the list of health institutes providing services for confirmed and suspected cases was determined and announced to the public by the government promptly. Additionally, the prevention of mother to infant transmission of HIV is continually strictly practiced during the period of the COVID-19 epidemic. Lastly, all inpatients in the health facilities of Chengdu, including maternity hospitals, are required to have a COVID-19 RT-PCR test to further prevent nosocomial infection. Now, many people living in high-risk countries are coming to Chengdu, and it is therefore necessary to make the prevention and control measures a long-term process.

Effect of standardization of process management on hospital infection management in ultrasound department.

Effect of standardization of process management on hospital infection management in ultrasound department.

Awareness and Utilization among Dental Workers: Hospital Infection Management

Awareness and Utilization among Dental Workers: Hospital Infection Management

Expert consensus on nursing management for patients undergoing primary percutaneous coronary intervention during the COVID-19 pandemic.

Expert consensus on nursing management for patients undergoing primary percutaneous coronary intervention during the COVID-19 pandemic.

Improve the Center Supply Room to Ensure the Quality System for Disinfection and Sterilization

The disinfection supply room is a very important department of the hospital. Its main job is to provide sterile equipment and dressings for various activities in the hospital. It is an important department in the hospital infection management process. Doing a good job in the control and management of the disinfection supply room is the main link to ensure the prevention and control of hospital infections. The quality of management directly affects modern clinical medical work. Therefore, the hospital supply room should be strengthened and improved to ensure that all items can be safely used in the work process, which can effectively avoid the occurrence of cross-infection incidents in the hospital.

浅谈基层医疗机构医院感染管理现状及对策

浅谈基层医疗机构医院感染管理现状及对策

Application of failure mode and effects analysis on hospital infection control for gynecological malignant tumor

Objective To explore the effects of failure mode and effects analysis (FMEA) on hospital infection prevention for gynecological malignant tumor. Methods From January 2017 to December 2018, we selected 25 nurses and clinical staff of Department of Obstetrics and Gynecology in Union Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology as subjects by cluster sampling. And then, the gynecology hospital infection control group was built. Group members assessed the department's risk of hospital infection by FMEA and put forward improvements for the high risk factors. We compared the risk priority number (RPN) of gynecological malignant tumor patients, catheter-related bloodstream infection (CRBSI) and incidence of hospital infection before and after implementing FMEA. Results After implementing FMEA, the total score of RPN risk factors of gynecological malignant tumor patients decreased compared with those before implementation with statistical differences (P 0.05) . Conclusions FMEA has good application effects on hospital infection prevention for gynecological malignant tumor patients which can effectively reflect the weak link of hospital infection management to reduce the incidence of hospital infection of gynecological malignant tumor patients. Key words: Gynecology; Neoplasms; Hospital infection; Failure mode and effects analysis