Infection Control Competency Research Articles

Effectiveness of a Virtual Reality-based Infection Control Education Program

Purpose: This study evaluated the effect of virtual reality (VR)-based infection control (IC) education program on IC knowledge, awareness, performance confidence, and self-efficacy in nursing students.Methods: A single-group pretest-posttest design was employed. The study participants consisted of 86 nursing students. The VR-based IC education program was developed by applying the ADDIE (Analysis, Design, Development, Implementation, Evaluation) model. The subject of the VR-based IC education program was isolation precautions. The effects of the VR-based educational program were measured via a questionnaire.Results: There were no significant differences in IC knowledge before and after the VR-based IC education program. However, IC awareness (t=2.31, p=.023), IC performance confidence (t=2.19, p=.031), and self-efficacy (t=3.43, p=.001) exhibited statistically significant increases after the VR-based IC education program. Satisfaction with the VR-based IC education program was relatively high, at 4.71±0.59 points.Conclusion: IC education using VR effectively strengthened IC competency by improving IC awareness, performance confidence, and self-efficacy. Therefore, it is necessary to develop and utilize various VR-based IC education content for nursing students.

Development of an infection control competency scale for clinical nurses: an instrument design study.

Nurses work in close proximity to patients, and as such, they can have a direct impact on the control of infections; thus, it is important for nurses to be competent in infection control. However, the scales used to measure infection control performance in nurses are not suitable for measuring infection control competencies that reflect nurses' expertise, clinical environment, and work. Thus, this study aimed to develop a valid and reliable measure to assess infection control competency of clinical nurses. A concept analysis, using a hybrid model, was performed on the infection control competency of clinical nurses to confirm the components and develop 67 initial items. Ten experts evaluated the content validity of these items, and a Korean language expert and a Doctor of Nursing reviewed the questions to consolidate them into 59 items. Subsequently, 267 nurses working at a certified tertiary hospital in D City were surveyed to confirm the validity and reliability of the scale. As a result of the study, the final scale comprising seven factors and 33 questions was derived, and the cumulative explanatory power of these factors was 60.8%. To verify convergent and discriminant validity, confirmatory factor analysis was conducted, and the average variance extraction index, composite reliability values, and confidence interval of the correlation coefficient between factors were confirmed. Convergent and discriminant validities were verified by comparison with standard values. The Cronbach's α for the entire scale in this study was 0.93. Consequently, the validity and reliability of the clinical nurses' infection control competency measurement scale were verified. The validity and reliability of the infection control competency measurement scale for clinical nurses (ICCS-CN) developed in this study was verified, and the scale can be effectively used to measure the infection control competency of clinical nurses. Measuring the infection control competency of clinical nurses will help reduce the harm caused by infection and ensure patient safety by decreasing infection rates in medical institutions.

Barriers to Learning Healthcare-Associated Infections Prevention and Control during Clinical Practicum among Nursing Students in Korea: A Focus Group Study.

Healthcare-associated infections (HAI) refer to infections that patients may acquire from healthcare facilities through nursing activities. Nursing students involved in patient care are regularly exposed to an array of pathogens and clinical practicum is essential for them to appropriately practice HAI prevention and control. This study aimed to explore the barriers to learning HAI prevention and control experienced by nursing students during their clinical practicum. A qualitative study was performed using focus group interviews. A total of 12 nursing students from South Korea, consisting of six third-year students and six fourth-year students, were enrolled. Both groups had taken clinical practicum courses. Data were collected using semi-structured questions and analyzed with conventional content analysis. Barriers experienced by the participants when learning HAI prevention and control were limited learning opportunities, inadequate infection control-related knowledge, inadequate practicum experience, and passive learning attitudes. Addressing the identified barriers would allow nursing students to effectively acquire infection control competencies during their clinical practicum.

Carbapenem-Resistant Actinetobacter Baumannii Transmission Containment in a Ventilator Skilled Nursing Facility

Background Actinetobacter baumannii are Gram-negative bacteria that can cause urinary, bloodstream, lung, wound, and other infections. In August 2020, the Louisiana Department of Health (LDH) was notified of three patients who were infected with carbapenem-resistant A. baumannii and were hospitalized at an acute care hospital within four weeks. They originated from the same ventilator skilled nursing facility (vSNF). LDH epidemiologists initiated a response consistent with CDC's national containment strategy to combat antibiotic resistant threats. Methods An in-person infection control assessment and response (ICAR) survey with rounding was conducted within five days of notification of the cluster. Interim infection control recommendations included implementing a policy for the removal of gel polish and acrylic nails, auditing of environmental cleaning practices, and reinforcing infection control competencies. Isolates were forwarded to the CDC Southeast Antibiotic Resistance Laboratory (ARLN) for pulse field gel electrophoresis and enhanced sensitivity testing. The facility agreed to colonization screening for the ventilator unit where all of the cases were previously housed. Swabs shipment was coordinated, and candidate screening patients were identified. Results Preliminary comparisons of antibiotic sensitivity results of cases showed similar resistance patterns for nine antibiotics, of which one was a carbapenem (meropenem). Two of the three index cases were confirmed for pan-resistant A. baumannii and positive for the OXA-23 gene on the CDC assay from respiratory and bronchiolar lavage specimens. Two rounds of colonization screenings were conducted greater than two weeks apart among four testing candidates each. No additional cases of A. baumannii, or any other multi drug-resistant pathogen, were identified. Conclusions Swift public health coordination is necessary for the containment of multi drug-resistant threats when introduced into congregate healthcare settings. While colonization screening results for this facility were encouraging, infection control recommendations and policy interventions were needed to prevent the spread of additional pathogens among vulnerable ventilated and non-ventilated patients. Actinetobacter baumannii are Gram-negative bacteria that can cause urinary, bloodstream, lung, wound, and other infections. In August 2020, the Louisiana Department of Health (LDH) was notified of three patients who were infected with carbapenem-resistant A. baumannii and were hospitalized at an acute care hospital within four weeks. They originated from the same ventilator skilled nursing facility (vSNF). LDH epidemiologists initiated a response consistent with CDC's national containment strategy to combat antibiotic resistant threats. An in-person infection control assessment and response (ICAR) survey with rounding was conducted within five days of notification of the cluster. Interim infection control recommendations included implementing a policy for the removal of gel polish and acrylic nails, auditing of environmental cleaning practices, and reinforcing infection control competencies. Isolates were forwarded to the CDC Southeast Antibiotic Resistance Laboratory (ARLN) for pulse field gel electrophoresis and enhanced sensitivity testing. The facility agreed to colonization screening for the ventilator unit where all of the cases were previously housed. Swabs shipment was coordinated, and candidate screening patients were identified. Preliminary comparisons of antibiotic sensitivity results of cases showed similar resistance patterns for nine antibiotics, of which one was a carbapenem (meropenem). Two of the three index cases were confirmed for pan-resistant A. baumannii and positive for the OXA-23 gene on the CDC assay from respiratory and bronchiolar lavage specimens. Two rounds of colonization screenings were conducted greater than two weeks apart among four testing candidates each. No additional cases of A. baumannii, or any other multi drug-resistant pathogen, were identified. Swift public health coordination is necessary for the containment of multi drug-resistant threats when introduced into congregate healthcare settings. While colonization screening results for this facility were encouraging, infection control recommendations and policy interventions were needed to prevent the spread of additional pathogens among vulnerable ventilated and non-ventilated patients.

SARS-CoV-2 antibody prevalence among healthcare workers: A cross-sectional study at a quaternary healthcare center in Saudi Arabia

BackgroundThe objective of this study was to determine the seroprevalence of SARS-CoV-2 antibodies among Healthcare Workers (HCWs). MethodsWe carried out a cross-sectional study among 3644 HCWs at King Saud Medical City (KSMC) during the last two weeks of December 2020. A Google form survey was used to collect data on demographics, underlying health conditions, job duties, infection control competencies, COVID-19 exposure history, symptoms, and confirmed infections. Findings26.5% demonstrated seropositivity to SARS-CoV-2 antibodies, 10-fold higher than the national seroprevalence (2.36) conducted in May 2020. Seropositivity was significantly higher among non-Saudi HCWs and participants who lived outside the hospital dormitory p < 0.0001 and 0.01, respectively). Seropositivity was significantly higher among HCWs who worked on clinical areas of high exposure level, and those who spent longer duration working with patients with COVID-19; p = 0.002 and 0.005, respectively). ConclusionSARS-CoV-2 infections among HCWs can go unrecognized, which magnifies the importance of complying with universal masking and social distancing directives. Detecting SARS-CoV-2 antibodies in HCWs can help healthcare leaders in considering staff allocations and assignments accordingly.

Virtual Vs In-Personal Teaching of Infection Control Essentials: A Quasi-Experimental Multi-Center Nonequivalent Groups Design

BACKGROUND In setting of the current COVID-19 pandemic, it is crucial to endorse infection control competencies. However, whether virtual training is equivalent to in-person teaching to develop such competencies requires further elucidation. AIM We aim to explore the effect of a brief, three-to-five-minute training session on infection control competencies in the major area of emergency department infection control, using virtual versus in-person training. METHODS Two hospitals were chosen, and the study design was a quasi-experimental multi-centre nonequivalent groups design. RESULT The learning score increased from 39.06%, SD=17.18 (95% CI 32.39-45.72) to 52.48%, SD=26.48 (95% CI 44.01-60.95) in the virtual training group, and from 47.86%, SD=22.51 (95% CI 41.47-54.26) to 79.65%, SD=21.45 (95% CI 70.14-89.16) after the in-person teaching. The mean difference between the two groups revealed a higher learning score using in-person teaching: 27.16%; t(60)=-4.12, p = 0.0001. CONCLUSION Infection control competencies are better acquired via in-person teaching than by virtual education.

Clinical placements for undergraduate diagnostic radiography students amidst the COVID-19 pandemic in Singapore: Preparation, challenges and strategies for safe resumption

IntroductionThe COVID-19 pandemic resulted in the suspension of clinical training for undergraduate radiography students in Singapore. Coordinated preparation plans and strategies between the university and hospitals were needed to safely resume clinical placements within national and hospitals’ risk control measures against COVID-19 transmission. MethodsSingapore Institute of Technology (SIT) and the Radiology Department of Singapore General Hospital (SGH) had collaborated to meet requirements for safe resumption of clinical placements. SIT prepared students by emphasising compliance to all risk measures, addressing concerns of risk transmission, meeting learning objectives, and reassessing infection control competencies. In tandem, SGH prepared an orientation programme and used technology for open communication among faculty, clinical educators and students which included monitoring of well-being and rapid dissemination of updates. Of note, SGH reorganised operating procedures and physical spaces to meet national standards of safe physical distancing, restricted movement between treatment areas and teams, and rosters to remain committed to the supervision and education of students. ResultsClinical placements resumed 3 months following suspension. Clinical educators faced the challenge of the need for balance between increasing clinical load and student supervision. A solution was frequent engagement and support by faculty, with educators and students via video conferencing platforms. Students’ well-being was frequently checked. There was less variation in cases which simulation training made up for some of the learning objectives. ConclusionAdaptation and commitment to continue active and quality clinical education while ensuring students' safety were vital during a pandemic. Clinical training within stringent precautionary measures may shape the era of the new norm.

Development of a high-risk neonatal infection control competency scale.

The purpose of this study was to develop a scale to measure high-risk neonatal infection control competency among nurses in neonatal intensive care units (NICUs). The study participants included 251 nurses working in NICUs at seven hospitals in South Korea. The scale was designed to measure high-risk neonatal infection control competency in terms of performance (HirNICCS_P) and knowledge (HirNICCS_K), which were addressed by 42 and 54 items, respectively, and was initially subjected to content validity testing by a panel of experts in neonatal nursing. The items were divided into five factors: (1) basic care, (2) skin care, (3) feeding management, (4) medication and invasive procedures, and (5) environment management. After participant completion of the scale, construct validity was examined using exploratory and confirmatory factor analyses, and internal reliability tests were also performed. The total variance of validity was 53.7% for HirNICCS_P, and the Cronbach's alpha values for reliability were .95 for HirNICCS_P and .67 for HirNICCS_K based on a Kuder-Richardson-20 test. We concluded that this scale can be used to assess the performance and knowledge with regard to infection control competency among neonatal nurses and that its application can support strengthening of infection control education for nurses who score low on performance and knowledge competency.

Transferring knowledge into practice: a multi-modal, multi-centre intervention for enhancing nurses' infection control competency in Bangladesh

Nurses are considered as the key to infection prevention as they play a major role in treatment as well as taking care of patients. To assess the role of a multi-modal intervention (MMI) in improving nurses' competency and adherence to standard infection control practices in Bangladesh. The study adopted a pretest-post-test intervention approach, in three different periods (from 2012 to 2017) in five hospitals (two public, two private, and one autonomous) in Bangladesh. Each study period was divided into three phases: pretest, MMI, and post-test. Data were collected on 642 nurses using direct observation method through a structured checklist. After implementing the MMI, overall hand hygiene compliance significantly increased before patient contact (from 1.3% to 50.2%; P<0.000) and after patient contact (from 2.8% to 59.6%; P<0.000). Remarkable improvements were also achieved in adherence to use of gloves (from 14.6% to 57.6%; P<0.000), maintaining sterility of equipment during aseptic techniques (from 34.9% to 86%; P<0.000), biomedical waste segregation (from 1.8% to 81.3%; P<0.000) and labelling of procedural sites (from 0% to 85.7%; P<0.000). Moreover, needlestick injury rate notably decreased (from 6.2% to 0.6%; P<0.000). MMI can play a vital role in improving nurses' compliance with the standard infection control practices. Such context-specific interventions, which are crucial for preventing healthcare-associated infections and for decreasing occupational hazards, should be replicated in resource-poor countries for achieving universal health coverage by 2030.

Assessment of Staff Nurses’ Competencies Related to Safety Measure for Specific Practices

Background: Nursing competency and safety of nursing practice are major concerns in nursing educational and clinical practice settings that decrease errors made by nurses. The National Council of State Boards of Nursing (NCSBN) report in 2005 indicated that 25% of sentinel events in healthcare were related to nursing errors and the majority of these errors related to incompetence of health care workers. Aim of the study: to assess staff nurses’ competencies related to safety measure for specific practices. Research design: Descriptive research design was used in this study. Sample: Sixty nurses. Setting: Medical and Surgical Department at Minia University Hospital and Matai District Hospital. Tool of data collection: one tool, divided into two parts, part (1) included socio-demographic data sheet and part (2) included check list performance. Results: it was noted that two-third (63.3%) of nurses at Minia University Hospital didn’t do the infection control measures compared to only one-third (33.3%) among Matai Hospital. There was statistical significant positive correlation between infection control competency, medication administration safety and environmental safety in both hospitals (p=0.001). Also, this study revealed that there is low competency level of staff nurses due to the lack of nursing competency assessment for nurses. Conclusion: this study revealed that there is low competency level of staff nurses, also it is important for integrating a structured nursing competency assessment that measures nursing competence in the nursing care delivery systems and determining the competency levels of nurses to ensure safe nursing practice. Recommendation: Provide self-competency assessment checklist which assists nurses to identify, maintain, and improve their nursing practice

Microbiology Education and Infection Control Competency: Offering a New Perspective.

Healthcare-associated infections (HAIs) have become a significant and costly problem for healthcare institutions worldwide. Despite the crucial role of infection prevention and control (IC) procedures, there is a substantial body of evidence to indicate that IC knowledge and practices of health professional graduates is, however, sub-optimal. This paper presents a discussion of the critical role microbiology plays in infection control education and practice, arguing that without an ability to apply microbiology knowledge to IC decision-making, there is an inherent risk of incorrect application of IC practices and thus a risk to patient (and nurse) safety. The authors propose a re-conceptualization of infection control competency, using nursing as an exemplar profession, to reflect practice that is not based on simple memorization of protocols but rather on a sound understanding of microbiology and informed decision-making. The proposal for re-conceptualizing the definition and assessment of IC competence, if adopted, would potentially enhance students’ understanding and synthesis of microbiology knowledge and help build students’ capacity to apply that knowledge to practice.

Interventions for enhancing an online infection control course for Latin American countries

In 2010, St Jude began a 12-week infection control (IC) course using e-learning & face-to-face methodologies to train Latin-American infection preventionists in IC competencies. In 2014, we added a weekly hands-on practicum for reinforcing learned course elements. It consisted of using the Infection Control Assessment Tool (ICAT) developed by USAID and Management Sciences for Health, and the WHO Hand Hygiene Self-Assessment Framework (HHSAF); these validated tools aligned with course competencies.

Identifying essential infection control competencies for newly graduated nurses: a three-phase study in Australia and Taiwan

Healthcare- and hospital-acquired infection increases patients' morbidity and mortality and increases healthcare costs. Infection prevention and control is a high priority for medical professionals in healthcare settings. To identify essential infection prevention and control competencies for newly graduated nurses. Three phases of research were designed: phase I, Instrument development, which was undertaken from January to May 2008; phase II, Expert panel identification, for which 122 experts were recruited, each nominated by presidents of infection control bodies and heads of nursing schools in Australia (N = 60) and Taiwan (N = 62); and phase III, Delphi surveys, which were conducted in three rounds simultaneously in Australia and Taiwan between July 2008 and May 2009. Ninety-three experts returned the first questionnaire. Response rates of 76.2%, 91.4% and 94.1% were achieved in rounds I, II and III, respectively. Eighty experts participated in all three rounds. Overall, 81 items reached consensus, including seven in the competency area of basic microbiology, 12 in hand hygiene, 30 in standard precautions and additional precautions, 12 in personal protective equipment, nine in cleaning, disinfection and sterilization and 11 in critical assessment skills. The majority of experts (N = 49; 75.4%) agreed that infection control competency levels of newly graduated nurses were inadequate. Eighty-one items of infection prevention and control specific to newly graduated nurses were identified by consensus between expert panellists from Taiwan and Australia. Baseline data from this study may help to develop undergraduate nursing curricula to facilitate nurses' clinical application of infection control principles.