Impact Of Infection Control Measures Research Articles

Impact of Infection Control Measures on Effectiveness of Cognitive Stimulation Therapy

AbstractBackgroundPeople living with dementia are at higher risk of contracting and dying from SARS‐CoV‐2. Protection measures such as wearing a mask remained necessary in dementia service facilities, despite their limiting effects on communication and interactions. Their impacts on existing evidence‐based psychosocial interventions offered in these facilities, such as Cognitive Stimulation Therapy (CST), are yet unknown.MethodMixed‐methods study using data from a larger randomised controlled trial partially disrupted by the COVID‐19 pandemic. People with mild or moderate dementia randomised into receiving CST (n = 72) were compared with those receiving usual care (n = 72) for cognitive (ADAS‐Cog) and quality of life (QoL‐AD) changes. To investigate the impact of infection control measures on CST effectiveness, interaction effect between timing of enrolment (before vs after COVID‐19 outbreak) and intervention group was tested. Focus groups were conducted with persons with dementia who have received CST and their families (n = 22).ResultParticipants who received CST reported better quality of life (B = 4.195, F = 28.159, p <0.001) compared with those who received usual care, controlling for demographics and antidementia medications. For cognition, an interaction effect was observed (F = 4.557, p = 0.036) between timing of enrolment and group. CST maintained cognition only in groups before COVID‐19 outbreak (marginal means of ADAS‐Cog improvement: +0.453 in CST vs ‐1.465 in usual care) but not in groups after the outbreak (‐2.104 vs +0.716). Persons living with dementia and their families reported difficulties hearing, being heard, recognising and interacting with other CST group members, and reduced efforts in participation due to discomfort wearing a mask,ConclusionInfection control measures may reduce the cognitive benefits of CST, which may be due to their effects on speech intelligibility and other interactions in a psychosocial intervention group. In the post‐COVID era, alternative measures such as virtual CST delivered via an online meeting platform should be investigated.

“It took so much of the humanness away”: Health care professional experiences providing care to dying patients during COVID-19

COVID-19 has affected healthcare in profound and unprecedented ways, distorting the experiences of patients and healthcare professionals (HCPs) alike. One area that has received little attention is how COVID-19 affected HCPs caring for dying patients. The goal of this study was to examine the experiences of HCPs working with dying patients during the COVID-19 pandemic. Between July 2020–July 2021, we recruited HCPs (N = 25) across Canada. We conducted semi-structured interviews, using a qualitative study design rooted in constructivist grounded theory methodology. The core themes identified were the impact of the pandemic on care utilization, the impact of infection control measures on provision of care, moral distress in the workplace, impact on psychological wellbeing, and adaptive strategies to help HCPs manage emotions and navigate pandemic imposed changes. This is the first Canadian study to qualitatively examine the experiences of HCPs providing care to dying patients during the COVID-19 pandemic. Implications include informing supportive strategies and shaping policies for HCPs providing palliative care.

Genomic Characterization of Carbapenem-Resistant Acinetobacter baumannii (CRAB) in Mechanically Ventilated COVID-19 Patients and Impact of Infection Control Measures on Reducing CRAB Circulation during the Second Wave of the SARS-CoV-2 Pandemic in Milan, Italy.

COVID-19 has significantly affected hospital infection prevention and control (IPC) practices, especially in intensive care units (ICUs). This frequently caused dissemination of multidrug-resistant organisms (MDROs), including carbapenem-resistant Acinetobacter baumannii (CRAB). Here, we report the management of a CRAB outbreak in a large ICU COVID-19 hub Hospital in Italy, together with retrospective genotypic analysis by whole-genome sequencing (WGS). Bacterial strains obtained from severe COVID-19 mechanically ventilated patients diagnosed with CRAB infection or colonization between October 2020 and May 2021 were analyzed by WGS to assess antimicrobial resistance and virulence genes, along with mobile genetic elements. Phylogenetic analysis in combination with epidemiological data was used to identify putative transmission chains. CRAB infections and colonization were diagnosed in 14/40 (35%) and 26/40 (65%) cases, respectively, with isolation within 48 h from admission in 7 cases (17.5%). All CRAB strains belonged to Pasteur sequence type 2 (ST2) and 5 different Oxford STs and presented blaOXA-23 gene-carrying Tn2006 transposons. Phylogenetic analysis revealed the existence of four transmission chains inside and among ICUs, circulating mainly between November and January 2021. A tailored IPC strategy was composed of a 5-point bundle, including ICU modules' temporary conversion to CRAB-ICUs and dynamic reopening, with limited impact on ICU admission rate. After its implementation, no CRAB transmission chains were detected. Our study underlies the potentiality of integrating classical epidemiological studies with genomic investigation to identify transmission routes during outbreaks, which could represent a valuable tool to ensure IPC strategies and prevent the spread of MDROs. IMPORTANCE Infection prevention and control (IPC) practices are of paramount importance for preventing the spread of multidrug-resistant organisms (MDROs) in hospitals, especially in the intensive care unit (ICU). Whole-genome sequencing (WGS) is seen as a promising tool for IPC, but its employment is currently still limited. COVID-19 pandemics have posed dramatic challenges in IPC practices, causing worldwide several outbreaks of MDROs, including carbapenem-resistant Acinetobacter baumannii (CRAB). We present the management of a CRAB outbreak in a large ICU COVID-19 hub hospital in Italy using a tailored IPC strategy that allowed us to contain CRAB transmission while preventing ICU closure during a critical pandemic period. The analysis of clinical and epidemiological data coupled with retrospective genotypic analysis by WGS identified different putative transmission chains and confirmed the effectiveness of the IPC strategy implemented. This could be a promising approach for future IPC strategies.

Influence of public health and infection control interventions during the severe acute respiratory syndrome coronavirus 2 pandemic on the in-hospital epidemiology of pathogens: in hospital versus community circulating pathogens

BackgroundThe first detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Germany was reported in early February 2020. In addition, extensive control measures on the coronavirus disease 2019 (COVID-19) pandemic have been placed in Germany since March 2020. These include contact and travel restrictions, distance rules, mandatory wearing of face masks and respirators, cancellation of mass events, closures of day-care centers, schools, restaurants and shops, isolation measures, and intensified infection control measures in medical and long-term care facilities. Changes in demand or access to health care services and intensified control measures can lead to changes in transmission dynamics and imply effects on the overall occurrence of infectious diseases in hospitals.MethodsTo analyze the impact of infection control measures implemented in public on infectious diseases in hospitals, surveillance data from Marburg University Hospital were analyzed retrospectively. The analysis was conducted from January 2019 to June 2021, referred to hospital occupancy and mobility data in the county of Marburg-Biedenkopf, and correlated to control measures in hospitals and the general population.ResultsThe COVID-19 pandemic and associated measures immediately impacted the occurrence of infectious diseases at the Marburg University Hospital. Significant changes were detected for virus-associated respiratory and gastrointestinal diseases. The massive drop in norovirus infections was significantly affected by the onset of the pandemic (P = 0.028). Similar effects were observed for rotavirus (up to − 89%), respiratory syncytial virus (up to − 98%), and adenovirus infections (up to − 90%). The decrease in gastrointestinal and respiratory virus detection rates was significantly affected by the decline in mobility (P < 0.05). Of note, since April 2020, there have been no detected influenza cases. Furthermore, Clostridioides difficile-related infections declined after late 2020 (− 44%). In contrast, no significant changes were detected in the prevalence of susceptible and drug-resistant bacterial pathogens. In particular, the detection rates of methicillin-resistant Staphylococcus aureus isolates or multidrug resistant (MDR) and extended drug resistant (XDR) bacteria remained constant, although the consumption of hand disinfectants and protective equipment increased.ConclusionsThe COVID-19 pandemic and associated public health measures had a significant impact on infectious diseases and the detection of pathogens at the Marburg University Hospital. Significant changes were observed for community transmissible infections, while no such effects on pathogens primarily associated with nosocomial transmission could be detected.

Blocking the Prevalence of Adenoviral Conjunctivitis in Premature Infants by a Combined Disinfection Method.

This study aimed to determine the cause of the outbreak of nosocomial adenoviral conjunctivitis in the Neonatal Intensive Care Unit (NICU) and the impact of infection control measures. The objectives of the present study included investigating the association between hospital-borne infection and adenoviral conjunctivitis, analyzing the possible risk factors, and setting bundled infection control measures, which were adjusted according to the control effect. This study also aimed to observe the effects of different intervention measures on controlling adenoviral conjunctivitis. During the first and second intervention periods, 635 and 597 patients in the NICU were enrolled, respectively. Ophthalmoscopy was performed in 188 ( first intervention) and 184 (second intervention) patients (P > 0.05) 417 and 457 times, respectively (P < 0.001). During the first intervention and second interventions, 13 patients and no patient had adenoviral conjunctivitis, respectively (P < 0.001). All adenoviral conjunctivitis cases were reported 6-27 days (mean, 12 days) after ophthalmoscopy. Hydrogen peroxide disinfection bundled measures can effectively restrict the prevalence of adenoviral conjunctivitis associated with ophthalmoscopy in premature infants.

Effects of COVID-19 Infection Control Measures on the Festival and Event Sector in Poland and Norway

The COVID-19 pandemic has had a strong impact on the functioning of the event industry. This article aims to present the impact of infection control measures on the event sector. In addition, the article compares the infection control measures implemented in Poland and Norway. The COVID-19 infection measures analysis is the first stage of a project to build the resilience of the event sector. The study was conducted based on secondary data (analysis of documents and public statistics, with the support of the literature). The research used the descriptive method and comparisons. The results of the study confirmed the following research hypotheses according to which: (1) uncertainty is conducive to overreactions, both of the government and entities from the event sector; (2) mutual trust between government and society reduces the need for restrictions; and (3) the lack of mutual trust between government and society increases uncertainty. Furthermore, the inability to meet people, limited access to culture, and the need to work from home contributed to the deterioration of societies’ quality of life and mental health. This means that the pandemic has an adverse impact on achieving the Sustainable Development Goals (SDG 3 and 8).

Real-time imaging of airflow patterns and impact of infection control measures in ophthalmic practice: a pandemic perspective.

To analyze exhaled airflow patterns in a clinical scenario and the impact of infection control practices and room air circulation in context of the COVID-19 pandemic. Raghudeep Eye Hospital, India. Experimental study. Ten patients attending ophthalmic outpatient clinic (OPD) and operating room (OR) were included. Using Schlieren imaging, exhaled airflow patterns were documented with/without an N95 mask or face shield during respiratory activities. Recordings were performed with and without room air conditioning turned on. Exhaled airflow patterns in OPD and OR when using vs not using these infection control measures and the impact of room air circulation on these were compared. Five patients each in OPD and OR were included. There was a forward stream of exhaled air from the patient's mouth/nose during all respiratory activities. An N95 mask dampened its intensity and forward transmission. Taping the mask around the nasal bridge further reduced airflow leakage. A mechanical barrier in front of the patient's face blocked forward propagation of the exhaled airflow. Turning on a forceful and direct draft of air over the surgeon's working area dampened and diverted the exhaled airflow away from the surgeons' breathing area. This effect was particularly pronounced in the OR, with the overhead laminar airflow. Using high force airflow with the draft facing downward can dampen and divert the exhaled airflow away from healthcare providers. Using masks/mechanical barriers and taping the mask reduces potential dissemination of aerosols and, thereby, human and surface contamination.

A pre-systematic review on the use of masks as a protection material for SARS-COV-2 during the COVID-19 pandemic.

BackgroundCoronavirus disease 2019 (COVID‐19) was first reported in Wuhan, China on 31 December 2019. Aims: to review, analyse and discuss all works about the wearing and development of facemasks as potential protection against SARS‐COV‐2 during the COVID‐19 pandemic.Methods PubMed, SciELO, Google Scholar and DOAJ were browsed. Keywords: “mask and (SARS or Cov)” (1 August 2019 to 12 April 2020). Inclusion criteria: original research. PRISMA criteria were followed.ResultsTwenty‐one works were selected. Identified topics: effectiveness of protective equipment/devices (PE) (n = 3), universal wearing of facemasks plus other protective measures in the community (n = 3), impact of infection control measures on hospitals and epidemiological tracing (n = 3), development of new PE (n = 2), sanitisation of facemasks (n = 4), clinical guidance (n = 4) and questionnaires (n = 2).DiscussionIt seems that the effectiveness of PE, namely facemasks, is not fully known. Universal wearing of facemasks may be simultaneously recommended with other protective measures. Nosocomial and community infections seem to be preventable. New PE, methods of facemask sanitisation and clinical guidance are emerging, but caution is recommended regarding their adoption, revision and monitoring by international boards and institutions. Questionnaires are useful tools for collecting citizens’ opinions on implementing public health measures, and thus contribute to mitigating the COVID‐19 pandemic.ConclusionsUniversal wearing of facemasks in the community is likely to be recommended during the COVID‐19pandemic. Since SARS‐COV‐2 is highly contagious, a set of measures should be considered. Facemask sanitisation is possible, but standardised procedures are lacking. New PE is emerging and requires detailed regulatory approval. It is advisable to monitor public opinion.

162: Dying During the COVID-19 Pandemic: Impact of Infection Control Measures at the Bedside

INTRODUCTION: Infection control measures introduced during the COVID-19 pandemic present myriad challenges to end-of-life (EOL) care beyond restricted hospital visiting hours The objective of this analysis was to understand the effect of infection control measures on bedside care for dying patients in a study embedded in an evaluation of the 3 Wishes Project We hypothesized diverse effects from clinicians' perspectives METHODS: Using a mixed-methods design, we enrolled patients with a ≥95% probability of dying in hospital, or plans were to withdraw life support on 3 hospital wards Clinicians who cared for these patients were purposively sampled 2-10 weeks postmortem for an audio-recorded interview;data were analyzed by conventional content analysis RESULTS: In total, 45 patients were enrolled in the ICU (n=34);COVID-19 ward (n=7), or medical step-down unit (n=4) from March 16-July 1, 2020 Of 236 terminal wishes elicited, 99% were implemented During their hospital stay, 32 (71%) patients had ≥1 family member visit in the patient's room, outside the room, or at the outdoor window At the time of death, 20 (44%) patients had family members at the bedside (none had COVID-19) Perspectives from 45 clinicians (16 nurses, 10 physicians, 8 residents, and others) highlighted several changes to physical aspects of EOL care during the pandemic Patients with COVID-19 are cohort and/or isolated Care for patients with and without COVID-19 is clustered to preserve personal protective equipment (PPE), thereby modifying the number and nature of bedside conversations, and physical aspects of care by some healthcare professionals PPE, including gowns, masks, face shields, and gloves hinder visual and tactile aspects of care, precluding lip reading, covering facial expressions, interfering with natural tactile manifestations of concern Many wishes were targeted at reducing patient isolation Beyond task-oriented aspects of care, infection control strategies affect both verbal and non-verbal communication, including expressing and detecting emotion CONCLUSIONS: Care for patients with and without COVID-19 is affected by infection control measures necessary during the pandemic, which modify many aspects of end-of-life care

Impact of infection control measures on the related costs and the amount of broad-spectrum antimicrobial agents used in a hospital: A time-series analysis.

Health care-associated infections (HAIs) worsen patient prognoses and increase medical costs. Antimicrobial stewardship (AMS), which involves appropriate use of antimicrobial agents and antiseptics, may be beneficial for addressing the issue of HAIs. In hospitals, an infection control team (ICT) plays an important role on the appropriate use of antimicrobial agents and antiseptics based on AMS. We aimed to conduct a time-series analysis of the efficacies of infection control measures in terms of related costs, amount of broad-spectrum antimicrobial agents used (carbapenems and quinolones), and methicillin-resistant Staphylococcus aureus (MRSA) detection rates. This retrospective cross-sectional study included in-hospital patients treated at a single institute between January 2012 and December 2015. The intervention start point (initiation of infection control measures) was January 2014. All survey items were subjected to segmented regression analysis using an autoregressive integrated moving average (ARIMA) model. Differences between pre-intervention and postintervention levels and their trends were assessed, using a statistical significance cutoff of P < .05. The infection control costs demonstrated a significantly increasing trend, despite significant decreases in the amount of carbapenems used. Accordingly, the implementation of infection control measures was associated with increased costs, whereas carbapenem use decreased immediately after intervention. Postintervention levels, trends of quinolone use, or MRSA detection rates did not reveal significant changes. Although implementation of infection control measures induced gradual increases in related costs, these measures led to immediate reductions in carbapenem use. Our study findings will support the establishment of more effective and economical infection control measures.

Healthcare Acquired Respiratory Infections-Considerations and Strategies for Prevention and Control

Abstract This paper provides a critical review of existing procedures and practices, including surveillance methods and systems for identifying patients’ risk of acquiring healthcare associated respiratory infections, in different settings. The burden of healthcare associated respiratory infections afflicting patients and healthcare workers is underappreciated. Infection control measures for TB control have been strictly applied in the United States and have decreased rates of disease acquisition below that of the general population. However, in most other countries healthcare workers are greater risk of acquiring TB and other infections. The principles of these TB and general infection control measures can be applied in resource scarce settings and should reduce the transmission of TB in particular but may provide protection from other respiratory infections as well. As facilities vary widely in the complexity of care they provide, a framework of risk assessment should be used to identify and apply engineering controls, work practice controls, administrative controls, personal protective equipment and finally education. Novel and creative solutions, including use of telemedicine and mHealth solutions should be further explored. As care becomes more complex in resource constrained settings, the necessary infrastructure related to water, energy, medical records, ability to do preventive maintenance and sterilize (reprocess) devices must be put into place so that the benefits of invasive care exceed the risks to the patients. The volume of water available per patient and family in hospitalized patients is a crude indicator of the quality and sophistication of care that can be provided. As we seek improve infection control as much as possible with simple interventions, it is important to realize that once again, limits are reached without a broader system infrastructure strengthening. Safe care does not harm the patient, the provider or the community. Implementation of safe care requires risk assessments and provision of appropriate ventilation and adequate volumes of water. Because the preconditions for a safe environment of care cannot be assumed in resource scarce settings, there may be limitations in the effective application of US infection control “bundles”. Infection control measures will have to be tested prior to implementation. Unlike in the United States, the impact of infection control measures may have to be extrapolated from studies done at sentinel sites. Measures can then be applied to facilities and evaluated with process control measures. Examples of process control measures include compliance with respiratory symptom screening, available volumes of water, hand hygiene monitoring, employee absenteeism, presence of crowds in areas with low air exchanges, ventilation, and indications for treatment among others. Keywords : Tuberculosis; Respiratory Infections; Healthcare settings; Infection Control

Impact of Infection Control Measures to Control an Outbreak of Multidrug-Resistant Tuberculosis in a Human Immunodeficiency Virus Ward, Peru.

Multidrug-resistant tuberculosis (MDRTB) rates in a human immunodeficiency virus (HIV) care facility increased by the year 2000—56% of TB cases, eight times the national MDRTB rate. We reported the effect of tuberculosis infection control measures that were introduced in 2001 and that consisted of 1) building a respiratory isolation ward with mechanical ventilation, 2) triage segregation of patients, 3) relocation of waiting room to outdoors, 4) rapid sputum smear microscopy, and 5) culture/drug–susceptibility testing with the microscopic-observation drug-susceptibility assay. Records pertaining to patients attending the study site between 1997 and 2004 were reviewed. Six hundred and fifty five HIV/TB–coinfected patients (mean age 33 years, 79% male) who attended the service during the study period were included. After the intervention, MDRTB rates declined to 20% of TB cases by the year 2004 (P = 0.01). Extremely limited access to antiretroviral therapy and specific MDRTB therapy did not change during this period, and concurrently, national MDRTB prevalence increased, implying that the infection control measures caused the fall in MDRTB rates. The infection control measures were estimated to have cost US$91,031 while preventing 97 MDRTB cases, potentially saving US$1,430,026. Thus, this intervention significantly reduced MDRTB within an HIV care facility in this resource-constrained setting and should be cost-effective.

Impact of Infection Control Measures During Construction and Renovation on the Incidence of Invasive Aspergillosis: A Quasi-experimental Study

Invasive aspergillosis is a well-known environmental airborne infectious disease related to the construction and renovation of healthcare facilities. Active infection control measures against invasive aspergillosis are therefore strongly recommended from the design phase for these activities. However, the impact of such measures on the incidence of invasive aspergillosis at the institutional level has not been adequately elucidated.

Improving patient outcomes in the intensive care unit: The impact of infection control measures

Improving patient outcomes in the intensive care unit: The impact of infection control measures

Transmission Dynamics of Carbapenemase-Producing Klebsiella Pneumoniae and Anticipated Impact of Infection Control Strategies in a Surgical Unit

BackgroundCarbapenemase-producing Klebsiella pneumoniae (CPKP) has been established as important nosocomial pathogen in many geographic regions. Transmission from patient to patient via the hands of healthcare workers is the main route of spread in the acute-care setting.Methodology/Principal FindingsEpidemiological and infection control data were recorded during a prospective observational study conducted in a surgical unit of a tertiary-care hospital in Greece. Surveillance culture for CPKP were obtained from all patients upon admission and weekly thereafter. The Ross-Macdonald model for vector-borne diseases was applied to obtain estimates for the basic reproduction number R0 (average number of secondary cases per primary case in the absence of infection control) and assess the impact of infection control measures on CPKP containment in endemic and hyperendemic settings. Eighteen of 850 patients were colonized with CPKP on admission and 51 acquired CPKP during hospilazation. R0 reached 2 and exceeded unity for long periods of time under the observed hand hygiene compliance (21%). The minimum hand hygiene compliance level necessary to control transmission was 50%. Reduction of 60% to 90% in colonized patients on admission, through active surveillance culture, contact precautions and isolation/cohorting, in combination with 60% compliance in hand hygiene would result in rapid decline in CPKP prevalence within 8–12 weeks. Antibiotics restrictions did not have a substantial benefit when an aggressive control strategy was implemented.Conclusions/SignificanceSurveillance culture on admission and isolation/cohorting of colonized patients coupled with moderate hand hygiene compliance and contact precautions may lead to rapid control of CPKP in endemic and hyperendemic healthcare settings.

Prevalence of Methicillin-Resistant Staphylococcus aureus Colonization and Infection in Hospitalized Palliative Care Patients With Cancer

Little is known about the pattern of methicillin-resistant Staphylococcus aureus (MRSA) colonization and infection in hospitalized palliative care (PC) patients. We reviewed 854 admissions for 289 patients with advanced cancer managed by a PC service in a tertiary care hospital. The MRSA screening was performed at least once in 228 (79%) patients, and 21 (9%) of them were MRSA positive. Other cultures were done in 251 (86.8%) patients, and 8 (3%) patients were MRSA positive. The total number of MRSA-positive admissions was 28 (3%), with a median admission duration of 8 days. A substantial proportion of hospitalized PC patients with cancer are MRSA positive. Research is required to study the impact of infection control measures on the quality of PC delivered to MRSA-positive terminally ill patients in hospitals.

Respiratory syncytial virus outbreak in neonatal intensive care unit: Impact of infection control measures plus palivizumab use.

BackgroundThe occurrence of a respiratory syncytial virus (RSV) outbreak in a Neonatal Intensive Care Unit (NICU) is related to unfavorable outcomes, as this infection can lead to respiratory distress and death in premature in infants. Report the successful control of an outbreak that occurred in April 2010 in a NICU.MethodsAfter the index case, of 18 premature infants placed in the same room 10 infants were infected. Of those 10, 6 developed mild to moderate respiratory symptoms, 4 persisted asymptomatic and no death occurred. Contact and respiratory precautions were rapidly initiated, the infants were cohorted in 3 different rooms and palivizumab was administered to all contacts.ResultsThe outbreak was controlled and no new cases were subsequently indentified.ConclusionStandard infection control measures plus palivizumab prophylaxis were efficient in rapid control of the outbreak.

Waves of trouble: MRSA strain dynamics and assessment of the impact of infection control

There has been a sustained decline in bloodstream infections due to methicillin-resistant Staphylococcus aureus (MRSA) throughout the UK. The UK MRSA epidemic, which began in the 1990s, has been dominated by two epidemic MRSA (EMRSA) clones {EMRSA-15, of clonal complex (CC) 22 [sequence type (ST) 22], and EMRSA-16, of CC30 (ST36)}. It appears that both these clones followed a wave trajectory (initial expansion, relative stasis, then decline). Three recent studies have shown that ST36 has declined faster than ST22, a change that appears to have begun before the recent intensification of intensive control measures in the UK. The biological basis of infectious disease waves, including those of MRSA, is discussed, as are the implications of such waves for the assessment of the impact of infection control measures.

Modelling the impact of infection control measures on the incidence of vancomycin-resistance enterococci: a time-series analysis

Vancomycin-resistant enterococci (VRE), an important pathogen causing healthcare associated infection emerged and increased rapidly worldwide. Several measures have been implemented to control the spread of VRE. This study aimed to evaluate the impacts of the annual hand hygiene promotion program (HHPP) and the active VRE surveillance (AS) on VRE infection/colonization incidence in a 2300-bed teaching hospital in Taiwan.

Impact of infection control measures on psychosocial health: a study on the post‐stroke elders

Impact of infection control measures on psychosocial health: a study on the post‐stroke elders