Infection Control Department Research Articles

Infection control nursing competency model for nurses in intensive care units: A Delphi study

Intensive care unit (ICU) nurses require advanced expertise and skills in critical care and need infection control nursing competency (ICNC). Given the lack of research on it, this study aimed to develop a model of ICU nurses' ICNC. A Delphi panel consisting of experts in intensive care nursing and infection control was organized to provide discerning and professional perspective on ICNC. Approved by the Institutional Review Board, a 3-round Delphi survey was conducted via email from July to December 2023. The content validity ratio and the coefficient of variation were calculated for panel responses. Among 17, 15 nurses (88.2%) participated and completed the surveys. About80% were female, and the panel had an average working experience of 14.2years specifically in theICUs or infection control departments at hospitals. After the initial round, a preliminary model was developed, consisting of 10 main components and 59 subelements. After eliminating 5 elements with content validity ratio values below 0.49 in the second survey, the final model, consisting of 10 main components and 54 subelements, was confirmed in the third survey. ICU nurses' ICNC can be understood based on this study's results, and further research can be designed to improve this competency.

The Impact of COVID-19 on Healthcare-Associated Infections: A Survey of Acute Care Hospitals

Background: The COVID-19 pandemic has placed an enormous strain on the healthcare system, including infection prevention and control. The response to the COVID-19 pandemic required extraordinary resources, which were often diverted from routine infection prevention and control activities and may have contributed to increased rates of HAI in the acute care setting. However, the impact of the COVID-19 pandemic on infection prevention and control departments, including staffing and resources, and on routine infection prevention and control activities is not well-described. The objective of this study was to describe the impact of the COVID-19 pandemic on IPC departments and department response to the pandemic. Methods: Between August and December of 2023, we conducted an electronic survey of all acute care facilities participating in the National Healthcare Safety Network. Survey data were analyzed using descriptive statistics. Results: Over 594 infection control departments participated in the survey, representing 1,400 NHSN facilities (20% response rate based on number of eligible NHSN facilities). Half of the respondents reported that their hospital experienced increases in the following HAI rates during the first two years of the pandemic: central-line associated bloodstream infections (54%), catheter-associated urinary tract infections (46%) and ventilator associated pneumonia (45%). When asked to identify the top three contributors to increased HAI rates in their facility, respondents cited the following factors: staffing shortages (70%), patient acuity (69%), use of travel nurses (48%), increased device utilization (37%), and reduced bedside acuity (31%). Respondents reported that their department utilized the following actions to decrease these HAI rates: increased rounding and monitoring of IPC procedures (81%), reeducation of frontline staff on IPC policies and procedures (77%), environmental care rounds (69%), monitoring of isolation compliance (66%), HAI Task Force/Committee (57%), nurse-driven catheter removal protocols (53%), and insertion prevention protocols (53%). When asked if the department experienced applied pressure or attempts to influence HAI reporting due to the increase in HAI rates in the facility experienced in the wake of the pandemic, 19% of respondents reported increased pressure from management/C-suite and 7% reported increased pressure from providers. Conclusion: The COVID-19 pandemic had a substantial impact on IPC departments in acute care hospitals and had a profound effect on IPC staffing, resources and routine IPC activities. Future work needs to identify best practices and lessons learned from the pandemic to inform future pandemic preparedness.

Nosocomial Transmission of Mycobacterium tuberculosis in an Oncological Setting

Objective: Mycobacterium tuberculosis (MTB) is a contagious airborne disease that is spread from person to person via particles in the air which are expelled when speaking or coughing1. This retrospective observational study aims to assess the nosocomial transmission of pulmonary MTB among inpatient roommates in a high-risk oncological population over a 14-year period. With limited studies on the transmissibility of MTB in such environments, the investigation focuses on evaluating the risk of nosocomial transmission and implementation of appropriate infection control measures. Design: A retrospective analysis from 2010 – April 2023 was conducted in an acute care, 500-bed oncological center. Following exposure workups performed by the Department of Infection Prevention and Control, 17 of 57 identified patients with active pulmonary MTB had inpatient stays with roommates. Source infectivity showed 7 AFB smear positive results, 4 MTB PCR positive results, and 14 MTB culture positive results. Some index patients had a combination of AFB, PCR and/or culture positivity. A high-risk exposure is defined as any patient who shared a room with an index patient for >4 cumulative hours during the infectious period. Infectious period was determined for each index patient based on the onset of symptoms and laboratory results. Workups identified 33 exposed roommates who were notified and advised to undergo testing, employing QuantifERON (QFT-GIT) serum test or Tuberculin skin (TST) PPD test at least 8 weeks following their last day of exposure. The overlap between inpatient roommates and index patients ranged from 1 to 4 days, averaging 1.5 days. Results: Of the 33 high-risk roommates, 14 (42%) patients were unable to provide follow-up testing for various reasons including: patient expiration prior to testing, patient transfer to hospice, and being lost to follow up. Nineteen (58%) patients completed post-exposure testing. 12 patients underwent PPD testing (63%) and 7 patients underwent QuantifERON testing (37%). Zero (0%) were found to have a positive QuantifERON or PPD following their exposure. 15.8% (N=3) of exposed patients had hematologic malignancies, and 84.2% (N=16) of exposed patients had solid tumor malignancies. Conclusion: The risk of active pulmonary MTB transmission in an oncological, inpatient setting was determined to be low. The absence of positive conversions among roommates of confirmed MTB patients underscores the effectiveness of infection control measures, emphasizing the importance of isolating confirmed or suspected cases promptly. Ongoing efforts should continue to focus on these preventive measures to mitigate the risk of MTB transmission in similar high-risk settings.

Academic-practice partnership: Exploring a model for collaborative nursing education in infection prevention and control

The academic-practice partnership has become increasingly important in nursing education. An academic-practice partnership between a health systems infection prevention and control (IPC) department and its academic affiliate may provide an opportunity to help advance undergraduate nursing student’s IPC knowledge and skills and provide IPC staff the opportunity to develop their clinical teaching skills as they teach and mentor students. We convened an exploratory workshop between our private university-based college of nursing and its affiliated health care system IPC department to brainstorm and identify areas for mutual collaboration and gauge interest in formalizing a partnership.

A nurse-led multifaceted intervention for the optimal use of indwelling urinary catheters at a tertiary care center: A before-after trial

BackgroundFew interventional studies of catheter-associated urinary tract infection (CAUTI) have been conducted to optimize indwelling urinary catheter (IUC) use in Japan. MethodsThe nurse-led, before-after study was conducted at a tertiary care center from June 2018 through May 2022. The intervention included 1) the provision of appropriate indications for IUC use, 2) prospective feedback to the primary care providers by ward nurses on unnecessary/inappropriate IUC use with two, separate interventional phases, the first involving intensive care units (ICU) only, the second involving ICU and general wards, and 3) proactive feedback by Infectious diseases physicians in the Infection Control department to the primary care providers regarding IUC discontinuation upon discharge from the ICU. ResultsDuring the first phase involving the implementation of the intervention only in the ICU, the indwelling urinary catheter-device utilization ratio (IUC-DUR) trend in the general wards decreased by 1.5 % (P = 0.01). However, the addition of the intervention to the general wards in the second phase led to a 2 % increase in the trend (P = 0.010). The CAUTI incidence in neither the ICU nor the general wards changed significantly. ConclusionsAlthough providing feedback on IUC removal at discharge from the ICU and appropriate indications for urinary catheter insertion can reduce inappropriate urinary catheter use, the nurse-led intervention alone was inadequate for reducing the CAUTI incidence.

Assessment of the FilmArray Gastrointestinal Pathogen PCR Panel at a Tertiary Cancer Center

Background: The FilmArray gastrointestinal (GI) pathogen panel (BioFire Diagnostics, Salt Lake City, UT) is a multiplex PCR assay for syndromic diagnosis of infectious gastroenteritis. This highly sensitive assay has been widely adopted as a preferred testing modality for infectious diarrhea among hospitalized patients. However, in the era of diagnostic stewardship, concerns have been raised that this approach risks unexpected findings of questionable significance. Following an increase in GI pathogen panel testing, the infection control department reviewed results among hospitalized patients at different stages of admission. Methods: From October 2022 to May 2023, we retrospectively reviewed all GI pathogen panels sent in a large tertiary cancer hospital. Count of tests ordered and positivity trends were studied by unit and organism among inpatients. We categorized an admission course into early (≤2 inpatient days) and late (≥3 inpatient days) stages and compared results across these stages. Finally, we compared reproducibility of multiple tests sent during a single admission. Results: From October 2022 to May 2023, a total of 2,763 tests were sent across the institution with 2,113 tests from inpatient units. Tests were most commonly sent on the Pediatrics and Hematology -Oncology inpatient units and together these units accounted for 60% of tests. These two units also had the highest rate of test positivity and together accounted for 60% of positive tests among hospitalized patients. The most frequently detected organisms were Norovirus (7%) and Enteropathogenic E. coli (3%) (Figure 1). Patients tested in the early stage of hospital admission were more likely to have a positive result for any target (93/509, 18.3%) compared to patients tested in the late stage (202/1604, 12.5%). Patients with a positive test in the early stage of admission were less likely to have a subsequent negative test (3/93, 3%) compared to patients who were positive in late stage of admission (39/202, 19.3% (Figure 2). Conclusions: Our findings suggest that the utility of the FilmArray GI PCR panel is highest in the early stages of a patient’s hospital admission. Testing of patients hospitalized ≥3 days is likely to be inappropriate. These findings support implementation of diagnostic stewardship standards on when syndromic testing for potentially infectious diarrhea is appropriate. Figure 1: FilmArray gastrointestinal pathogen PCR panel positivity by organism. Figure 2: FilmArray gastrointestinal pathogen PCR panel positivity by organism comparing early vs late stage of hospital admission.

Optimization and standardization of the work of a health care facility during a chemical accident

During the years of war, as a result of aviation and missile attacks, a significant number of health care facilities in various regions of Ukraine were destroyed, and the complexity and intensity of their work increased significantly. If the readiness of hospitals and their employees to treat gunshot and explosive injuries is established, in the case of mass destruction of chemically hazardous enterprises and the threat of the enemy using weapons of mass destruction, including chemical weapons, there is a need for special training of health care facilities to work in the in conditions of chemical threats. The aim of the work was justification of the development and set of measures for the implementation of standard operating procedures in the event of a chemical incident. The legal documents and recommendations of the Ministry of Health of Ukraine, management of the World Health Organization and the Red Cross on the topic of the study were used. The research methods: bibliosemantic, analytical, modeling were applied. It is established that the special management group, which includes representatives of various services, is of decisive impor­tance in the effective management of a health care facility during a chemical incident: administration; communication department; security department; management of nurses and the department of infection control; human resources department; pharmacy; intensive care unit; department of engineering maintenance and repair; laboratory; kitchen; laundry; cleaning service and waste management. The most important measures of response to a chemical incident that ensure the safety of medical personnel and patients are the organization of a triage zone and a decontamination area for chemically affected persons. Based on the above, to prepare a health care facility for work during a chemical incident, it is necessary to develop a response plan, which consists of special administrative and management decisions and provides for regular staff training.

ASSESSING KNOWLEDGE, ATTITUDE, AND PRACTICE OF HEALTHCARE WORKERS REGARDING MEDICAL WASTE MANAGEMENT AT DISTRICT JAMSHORO, SINDH

This study aimed to evaluate the waste management knowledge, attitudes, and practices of three groups of healthcare workers: doctors, nurses, and paramedical staff. A cross-sectional study involved doctors, nurses, and technicians at the National Institute of Cardiovascular Disease (NICVD) and the Syed Abdullah Shah Institute of Medical and Health Science (SASIMS) in Shahwan Sharif, District Jamshoro, Sindh. A convenient non-probability sampling technique was used to select the study participants. A total of 370 healthcare workers consented to be part of the study. The data was obtained through the administration of questionnaires. Data were collected and compiled using Microsoft Excel and analyzed using SPSS version 22.0. This study had 39 (63.2%) males and 34 (36.8 %%) females. The median age of participants was 30.5 years, with a mean of 33.12 ± 8.2 years. The majority of the participants were paramedics (42.7%). They were followed by doctors (34.3%) and nurses (23%). The knowledge of healthcare workers indicated that there was a significant association between the waste categories (p = 0.02), type of waste (p = 0.00), color coding differentiation (p = 0.01), hospital policies (p = 0.00), infection control department (p = 0.03), risk toward healthcare workers (p = 0.00), human anatomical waste (p = 0.01), color-coding container used for wasted sharps and infectious solid waste (p = 0.00), and type of color-coding container (p = 0.00) This study highlights the discrepancies and inadequacies of knowledge and practice of proper healthcare waste management among healthcare workers. Healthcare workers with adequate knowledge were paramedics, doctors, and nurses. All healthcare personnel should have medical waste management guidelines ready and easily accessible.

Healthcare-associated infection management in 62 ICUs for patients with congenital heart disease in China: a survey study.

All patients with congenital heart disease (CHD) receive postoperative management in ICUs. Infection prevention and control (IPC) has a significant impact on prognosis. This study provides a preliminary understanding of the fundamental aspects of IPC in ICUs following CHD surgery in China. From September to October 2023, we initiated a survey on healthcare-associated infection (HAI) management in hospitals that perform CHD surgeries independently. The questionnaires were jointly completed by the ICU physicians and IPC personnel. Duplicate or unqualified questionnaires were excluded from the study. The contents of our questionnaires covered hospital and ICU capacity, performance of the infection control department, HAI surveillance, implementation of IPC measures, and antimicrobial stewardship (AMS). Qualified questionnaires were compared according to the volume of annual CHD surgeries performed in different ICUs. Group 1 was defined as volume more than 300 cases and group 2 was defined as volume less than or equal to 300 cases. Sixty-two of the 118 questionnaires were completed, with a response rate of 53%. The CHD surgical volume in 2022 of the 62 hospitals was 36342, accounting for 52% of the annual CHD surgical volume (69672) across the country. The postoperative infection rates obtained from the 15 ICUs varied from 1.3 to 15%, with a median rate of 4.5%. A total of 16 ICUs provided data on drug-resistant bacteria, Klebsiella pneumoniae exhibiting the highest frequency. More than 95% of ICUs have established complete HAI management systems. Information-based HAI surveillance was conducted in 89% of ICUs. Approximately 67% of ICUs stopped prophylactic antibiotics within 48 hours after surgery. In complex cases, carbapenems were administered empirically in 89% of ICUs. Group 1 had an advantage over group 2 in preventing multi-drug-resistant organisms (all instruments should be used alone 100% vs. 86%, P =0.047; cleaning and disinfection of environmental surfaces, 100% vs. 81%, P =0.035; antibiotic consumption control 85% vs. 61%, P =0.044) and in preventing surgical site infections (perioperative blood glucose monitoring, 88% vs. 67%, P =0.048). However, Group 1 did not perform well in preventing catheter-related bloodstream infection (delayed catheter removal due to convenience of laboratory tests, 31% vs. 6%, P =0.021) and catheter-associated urinary tract infection (delayed catheter removal due to muscle relaxant administration, 88% vs. 58%, P =0.022). A relatively complete HAI management system has been established throughout the country in ICUs for CHD patients. Information-based surveillance of HAI needs to be promoted, and actions should be taken to facilitate the implementation of IPC measures and AMS bundles. Training and feedback are critical for implementing IPC measures.

Clinical Pharmacology and Infection Control Department in a Multidisciplinary Health Care Organization: Peculiarities of Work Organization

Clinical Pharmacology and Infection Control Department in a Multidisciplinary Health Care Organization: Peculiarities of Work Organization

Needlestick and Sharps Injuries Among Healthcare Workers at a Tertiary Care Hospital: A Retrospective Single-Center Study.

Healthcare workers are still at risk from needlesticks and sharps injuries, which can expose them to blood-borne diseases like hepatitis B, hepatitis C, and HIV. We aimed to investigate the proportion of needlesticks and sharps injuries among healthcare workers in a tertiary care hospital in Somalia and also evaluate associated risk factors. This retrospective study was conducted at the Mogadishu Somalia Turkey Recep Tayyip Erdogan Training and Research Hospital. The data was retrieved from the hospital record of the infection prevention and control department over a six-year period between 2017 and 2022. There were a total of 233 needlestick and sharps injury incidents. The highest number of needlestick and sharps injury cases were reported among nurses (52.4%), followed by cleaners (22.3%), physicians (18.5%), and technicians (6.9%) during the six-year period. Operation theaters were the most frequent place (21.9%) where injuries happened, followed by inpatient care (17.6%) and emergency rooms (16.7%). The most commonly reported instrument that resulted in injuries was a hypodermic needle (81.1%). About 24.9% of the needles or sharps devices that caused needlestick and sharps injury cases were contaminated with hepatitis B. There was a significant difference between gender and place of injury for needlestick and sharps injuries (P=0.001). Healthcare professionals around the world continue to face major health risks from needle stick and sharps injuries. The present study found that 8.6%of healthcare workers sustained a needle stick and sharps injuries incident in the past year. According to our findings, healthcare institutions need to regularly teach healthcare professionals, especially nurses and cleaners about the significance of needle stick and sharps injuries.

Investigation of Acinetobacter baumannii Outbreak in a Burn Unit Revealed a Surprising Environmental Source.

We describe an outbreak of Acinetobacter baumannii in a 15-bed regional burn unit in an academic tertiary care medical center, and the investigations and control measures used to halt the outbreak are described.Nine cases of A. baumannii were reported in our burn unit in a one-year period, which was higher than our expected number of two-three cases per year. Our burn unit director requested an outbreak investigation, and our hospital's infection control department investigated thoroughly and found a source for that outbreak, which was never reported as a source in the previous literature. We identified table fans as the source of this outbreak. We then developed a strict fan policy, and after implementation of the policy, and terminal cleaning of rooms, only two cases per year of A. baumannii were reported in the next three-year period. We concluded that the table fans were colonized with A. baumannii and since they were used interchangeably in all patient rooms, caused this outbreak. There are no specific joint commission guidelines for the use of fans in hospitals. While fans can be used for the comfort of the patient, we should be cautious not to spread infections.

The role of online marketing to engage healthcare workers with infection prevention and control information and resources: A pilot study.

The successful adoption and application of infection prevention and control (IPC) principles in all healthcare settings is dependent on the degree to which healthcare workers (HCWs) are aware of the requirements, have access to program resources and information, and engage with the IPC program. This study investigates the impact of redesigning the Infection Control Department (ICD) intranet site based on user feedback followed by a targeted marketing campaign to improve website usability, awareness, and access. In this systematic study, we used a survey plus two focus group interviews to elicit user requirements for the content and look of the ICD intranet page and identify the best communication platforms to use for the marketing campaign to launch the redesigned intranet page. The information was used to redesign the intranet page and develop the marketing campaign. The survey was repeated post-intervention and these results, along with a comparison of website analytics monitoring traffic, were used to determine the success of the intervention. The ICD intranet page redesign increased the information and resources. Post-intervention survey results demonstrated a significant improvement in user satisfaction including ease of navigation and access to IPC information and resources. The marketing campaign resulted in a significant increase in website traffic to the ICD intranet page, demonstrating enhanced engagement with HCWs. This study demonstrated that website redesign based on user feedback, combined with a marketing campaign, can increase the traffic to the website and improve the user experience when accessing and navigating the site making the information and resources more accessible to HCWs.

Reevaluating the Significance of Infection Preventionists and Infection Prevention and Control Departments in the Post-COVID-19 Era.

Infection preventionists are specialized health care professionals tasked with developing and implementing infection control policies, educating staff and patients on prevention practices, and investigating outbreaks. Infection preventionists role in developing effective measures for infection prevention and control and ensuring public health and safety became even more vital given the emergence of the COVID-19 pandemic. It is important for health care systems and institutions to incorporate lessons learned, enhance infection prevention and control resources, and grow the infection preventionists workforce to prepare for future pandemic events.

Incidence Rate, Pathogens and Economic Burden of Catheter-Related Bloodstream Infection: A Single-Center, Retrospective Case-Control Study.

Indwelling central venous catheters (CVCs) can cause catheter related bloodstream infection (CRBSI). CRBSI occurring in intensive care unit (ICU) patients may lead to the worse outcomes and extra medical costs. The present study aimed to assess the incidence and incidence density, pathogens and economic burden of CRBSI in ICU patients. A case-control study was retrospectively carried out in six ICUs of one hospital between July 2013 and June 2018. The Department of Infection Control performed routinely surveillance for CRBSI on these different ICUs. Data of the clinical and microbiological characteristics of patients with CRBSI, the incidence and incidence density of CRBSI in ICUs, the attributable length of stay (LOS), and the costs among patients with CRBSI in ICU were collected and assessed. A total of 82 ICU patients with CRBSI were included into the study. The CRBSI incidence density was 1.27 per 1000 CVC-days in all ICUs, in which the highest was 3.52 per 1000 CVC-days in hematology ICU and the lowest was 0.14 per 1000 CVC-days in SpecialProcurement ICU. The most common pathogen causing CRBSI was Klebsiella pneumoniae (15/82, 16.67%), in which 12 (80%) were carbapenem resistant. Fifty-one patients were successfully matched with control patients. The average costs in the CRBSI group were $ 67,923, which were significantly higher (P < 0.001) than the average costs in the control group. The total average costs attributable to CRBSI were $33, 696. The medical costs of ICU patients were closely related to the incidence of CRBSI. Imperative measures are needed to reduce CRBSI in ICU patients.

Risk factors for SARS-CoV-2 infection among health workers in India: a case control study.

COVID-19 was declared as a Public Health Emergency of International Concern on 30th January 2020. Compared to the general population, healthcare workers and their families have been identified to be at a higher risk of getting infected with COVID-19. Therefore, it is crucial to understand the risk factors responsible for the transmission of SARS-CoV-2 infection among health workers in different hospital settings and to describe the range of clinical presentations of SARS-CoV-2 infection among them. A nested case-control study was conducted among healthcare workers who were involved in the care of COVID-19 cases for assessing the risk factors associated with it. To get a holistic perspective, the study was conducted in 19 different hospitals from across 7 states (Kerala, Tamil Nadu, Andhra Pradesh, Karnataka, Maharashtra, Gujarat, and Rajasthan) of India covering the major government and private hospitals that were actively involved in COVID-19 patient care. The study participants who were not vaccinated were enrolled using the incidence density sampling technique from December 2020 to December 2021. A total of 973 health workers consisting of 345 cases and 628 controls were recruited for the study. The mean age of the participants was observed to be 31.17 ± 8.5 years, with 56.3% of them being females. On multivariate analysis, the factors that were found to be significantly associated with SARS-CoV-2 were age of more than 31 years (adjusted odds ratio [aOR] 1.407 [95% CI 1.53-1.880]; p = 0.021), male gender (aOR 1.342 [95% CI 1.019-1.768]; p = 0.036), practical mode of IPC training on personal protective equipment (aOR 1. 1.935 [95% CI 1.148-3.260]; p = 0.013), direct exposure to COVID-19 patient (aOR 1.413 [95% CI 1.006-1.985]; p = 0.046), presence of diabetes mellitus (aOR 2.895 [95% CI 1.079-7.770]; p = 0.035) and those received prophylactic treatment for COVID-19 in the last 14 days (aOR 1.866 [95% CI 0.201-2.901]; p = 0.006). The study was able to highlight the need for having a separate hospital infection control department that implements IPC programs regularly. The study also emphasizes the need for developing policies that address the occupational hazards faced by health workers.

524 Traveling Pediatric Burn Care on Wheels

Abstract Introduction Many burn patients initially seek treatment at a community hospital after suffering a burn injury and are then transferred to various hospitals before being evaluated by a burn specialist. Due to the increased volume of patients in the emergency department, pediatric burn patients in the past have waited on average 90 minutes to be assessed by a burn provider. A new process was implemented to decrease wait times and increase overall patient and family satisfaction. A breakdown in the process, noted by burn care staff, was the availability of burn care supplies located in the emergency department. Methods • A process developed for burn unit nurses to respond to the emergency department to evaluate all pediatric burn patients was implemented. • A survey was sent to burn nurses looking for the most used supplies while caring for a pediatric burn patient. • Collaborative efforts with the pharmacy department to obtain space in the medication pyxis for the most used ointments in burn care. • Collaborative efforts with the Child Life Specialist to stock the cart with stickers, small toys, and distraction items for pediatric patients. • Collaborative efforts with the attending burn surgeon to develop and implement a protocol for burn team response. • Collaborative efforts with infection control department to ensure proper regulation standards of the cart. Cart Contents: • Gauze • Securement wraps • Wound cleansers • Silver impregnated foam dressing • Non-stick petroleum gauze • Staplers • IV start supplies • Paper tracking tool • Discharge &amp; dressing change instructions • Stickers, small toys, &amp; distraction items Results The Hydro on Wheels cart was implemented in January 2022. A retrospective study of data including pediatric burn patients seen in 2021 was completed. The average wait time to be seen by a burn provider in the emergency department decreased from 90 minutes in 2021 to 34 minutes in the first 6 months of 2022. A follow up survey was sent to hydrotherapy burn nurses to assess the satisfaction of the new process and equipment available. Conclusions Overall decreased wait time for pediatric burn patients to be evaluated by a burn care provider. Burn care nurses felt prepared when responding to a pediatric burn patient in the emergency department. Applicability of Research to Practice The burn unit plans to continue this approach to improve patient and family satisfaction &amp; patient outcomes Future considerations to further improve the process would be to include a patient and family follow up satisfaction survey.

The Incidence of Needlestick and Sharps Injuries Among Healthcare Workers in a Tertiary Care Hospital: A Cross-Sectional Study.

Background Needlestickinjuries (NSIs) and sharps injuries (SIs) remain significant hazards in most healthcare facilities that expose healthcare workers (HCWs) to blood-borne pathogens (e.g., HIV, hepatitis B, and hepatitis C). This study aims to review the incidence of NSIs and SIs in King Fahad Medical City (KFMC) and correlate this incidence with several parameters related to the event, including age, sex, length of work experience,type of injury, type of instrument causing the injury, type of activity during which the injury happened, nature of the job of the HCWs, and location within the hospital where the injury happened. Methodology This cross-sectional study involves all self-reported documents related to needlestick and sharp injuries among HCWs at King Fahad Medical City (KFMC) in Riyadh, Kingdom of Saudi Arabia, from January 2017 to December 2020. The data of 389reports of needlestick and sharp injuries detailingincidence and site, shift, type, and instrument related to the incidents were reported to the infection control department for coding and analysis using the Statistical Package for the Social Sciences (SPSS)version 22 (IBM SPSS Statistics, Armonk, NY, USA). Results Our data showed that NSIs/SIs could be caused by a wide range of objects used by healthcare workers, including needles, suture needles, scalpels, and sharp devices. Remarkably, the most common cause of NSIs was handling the sharp object (38.8%), followed by disposing of the sharp object (19.3%).Furthermore, nurses were found to be the highest at-risk category of HCWs experiencing NSIs (49.9%), while medical waste handlers (1.5%) and dentists (1.3%) were least likely to incur injuries. Conclusion This study sheds some light on the incidence rates of NCIs and SIs at KFMCand correlates these rates with several demographical, occupational, and experiential parameters related to these events.

SG-APSIC1064: The role of infection control activities on healthcare-associated infections during 2017-2021 at intensive care units in Cho Ray Hospital

Objectives: Healthcare-associated infections (HAIs) are one of the greatest challenges and concerns in Vietnam and around the world. Many studies have shown that HAIs may result in an increase in hospital length of stay, antibiotic use, multidrug-resistant organism (MDROs) infections, treatment costs, and mortality. Therefore, in the past 5 years, the Department of Infection Control of Cho Ray Hospital has carried out many infection and prevention control (IPC) activities to reduce the rates of HAI and MDRO infection. We evaluated IPC activities and results achieved in these efforts at Cho Ray Hospital during 2017–2021. Methods: We described the implemented IPC activities and retrospectively collected data from HAIs surveillance reports during 2017–2021 for 3 intensive care units (ICUs): ICU-B, ICU-D, and the NICU. Results: In the past 5 years, we implemented synchronous IPC activities, including promoting hand hygiene training and surveillance, environmental cleaning surveillance, carrying out improvement projects such as a ventilator-associated pneumonia (VAP) prevention bundle, an MDRO prevention bundle, and an environmental cleaning quality improvement project. Many positive results were achieved, although a slight increase in the HAI incidence occurred in 2021 due to the COVID-19 pandemic. Overall, the hand hygiene compliance rate increased from 49.7% to 83.8%. The rate of HAIs per 1,000 patient days decreased steadily from 5.4 to 2.4. The VAP rate fell from 30.5 to 17.2 per 1,000 patient days, and the central-line–associated bloodstream infection (CLABSI) rate decreased gradually from 5.4 to 2.4 per 1,000 patient days. The catheter-associated urinary tract infection (CAUTI) rate decreased from 2.9 to 0.9 per 1,000 patient days, and the MDRO infection rate decreased significantly from 32.7 to 11.3 per 1,000 patient days. Conclusions: The synchronous implementation of HAI prevention bundles promoting hand hygiene and environmental cleaning achieved significant effects in the efforts to decrease HAIs and MDROs in the ICUs of Cho Ray Hospital.

Design, Implementation, and Evaluation of an N95 Respirator Decontamination and Reuse Program for Healthcare Workers During the COVID-19 Pandemic

Early in the COVID-19 pandemic, substantial disruptions in personal protective equipment (PPE) supply chains forced healthcare systems to become resourceful to ensure PPE availability for healthcare workers. Most worrisome was the global shortage of N95 respirators. In response, a collaboration between the Department of Infection Control and Healthcare Epidemiology and the Department of Biosafety at the University of Texas Medical Branch developed a PPE recycling program guaranteeing an adequate supply of respirators for frontline staff. The team successfully developed and implemented a novel workflow that included validated decontamination procedures, education, and training programs as well as transportation, labeling, and storage logistics. In total, 15,995 respirators of various types and sizes were received for recycling. Of these, 12,752 (80%) were recycled. Following the program's implementation, we surveyed 134 frontline healthcare workers who overwhelmingly graded our institution's culture of safety positively. Overall impressions of the N95 respirator recycling program were mixed, although interpretation of those results was limited by a lower survey response rate. In an era of increasing health security threats, innovative recycling programs like this one may serve as a model for other health systems to respond to future PPE supply chain disruptions.