Infection Prevention Procedures Research Articles

Do the prevention procedures work in reducing infections?

Abstract Introduction Healthcare-associated infections (HCAIs) pose significant challenges in healthcare settings. Poor environmental hygiene contributes to HCAI. This study aims to evaluate and to assess the effectiveness of HCAI containment practices in nursing homes (NH). Methods The study examined infection prevention procedures in eight NHs supervised by the Multidisciplinary Commission of the Tuscany South-East Local Health Authority of Italy. Infection frequencies were obtained from NHs management and compliance with preventive procedures was assessed by inspection reports. Infection prevention protocols, including cleaning and disinfection procedures, were referenced from ministerial guidelines for hospital and territorial facilities. Comparisons was done whit Mann-Whitney test, using STATA. Results In 2023 more frequent infections were SARS-CoV-2 (19.5%), urinary tract infections (17%), pharyngitis (15.7%), influenza-like syndromes (ILI) (15%), and pneumonia (9%). Compared to 2022, significant improvements were observed in legionellosis surveillance, laundry, sanitary procedures, instrument disinfection, and hairdressing services. Non-compliance to specific procedures revealed differences in infectious onset like cleaning process verification with fungal infections (P = 0.01; M = 2,5), gastrointestinal infections (P = 0.04; M = 1.5); cleaning sanitary pans with Clostridium Difficile gastrointestinal infections (P = 0.04; M = 2); instrument disinfection with gastrointestinal infections (P = 0.04; M = 1.5) conjunctivitis (P = 0.01; M = 8); laundry procedures with pneumonia (P = 0.04; M = 18) and ILI (P = 0.04; M = 35). Conclusions These findings emphasize the importance of well-defined procedures in reducing HCAIs. While preventive measures demonstrate efficacy, continuous efforts are necessary for their consistent implementation. Continuous monitoring and stakeholder engagement are essential for developing sustainable strategies in preventing healthcare-associated infections. Key messages • Healthcare-associated infections are a significant complication in the healthcare sector and require effective practices in nursing homes. • Prevention measures are effective, but continuous and collaborative effort is needed to ensure their uniform implementation and develop more effective strategies in preventing HCAI.

Risk factors for antimicrobial-resistant Enterobacterales in dogs: a systematic review.

Identifying risk factors associated with the carriage of antimicrobial-resistant (AMR) bacteria in dogs is crucial to understanding their epidemiology and for developing and refining targeted control measures. However, relevant data is scattered and conflicting findings have been reported. This systematic review aimed to compile risk factors associated with the carriage of AMR-Enterobacterales in dogs worldwide and to identify relevant knowledge gaps for directing future research. A systematic review was conducted according to PRISMA guidelines, searching PubMed, CABi, and Scopus databases for studies reporting risk factors for acquiring AMR-Enterobacterales in dogs. After screening peer-reviewed, English-language studies by title/abstract, eligible studies were subjected to a full-text assessment, data extraction, risk-of-bias assessment, and qualitative synthesis. In the initial search, 774 articles were identified, including 274 duplicates. After screening by title/abstract, 77 articles were subjected to full-text review, from which 40 were eventually selected for data extraction, including 29 cross-sectional, six cohort, and five case-control studies. The most frequently investigated risk factors for AMR-Enterobacterales carriage in dogs were antimicrobial use (28 of 40), age (24), sex (22), hospitalization (19), and feeding raw diet (14). Of these, antimicrobial use was the most common risk factor significantly associated with AMR-Enterobacterales (19/28), followed by raw diet (9/14) and hospitalization (8/19). Our synthesis emphasized the importance of increasing awareness regarding the prudent use of critically important antimicrobials (CIAs), such as fluoroquinolones, in companion animal practices, strengthening infection prevention and control procedures in veterinary clinics and hospitals and educating caregivers about the potential risks of feeding raw diets in order to reduce the burden of AMR-bacteria in dogs.

Device associated healthcare associated infection (DA-HAI): a detailed analysis of risk factors and outcomes in a university hospital in Rome, Italy

This study investigates the impact of invasive procedures on healthcare-associated infections (HAI) at Policlinico Universitario Tor Vergata in Rome, Italy, aiming to understand their role in device-associated HAI and to inform prevention strategies. A retrospective cohort analysis was conducted, examining mandatory discharge records and microbiology data from 2018 across all departments. The study focused on adult patients, analysing the correlation between invasive procedures and HAI through univariate and multivariate logistic regression. Of the 12,066 patients reviewed, 1,214 (10.1%) experienced HAI. Univariate analysis indicated an association between invasive procedures and HAI (OR= 1.81, P < 0.001), which was not observed in multivariable analysis. Specific procedures significantly raised HAI risks: temporary tracheostomy (AOR= 22.69, P <0.001), central venous pressure monitoring (AOR= 6.74, P <0.001) prolonged invasive mechanical ventilation (AOR= 4.44, P <0.001), and venous catheterisation (AOR= 1.58, P <0.05). Aggregated high-risk procedures had an increased likelihood of HAI in multivariable analysis (OR= 2.51, P < 0.001). High-risk departments were also notably associated with HAI (OR= 6.13, P < 0.001). This study suggests that specific invasive procedures, such as temporary tracheostomy, significantly increase HAI risks. The results highlighting the need for targeted infection prevention and control procedures and supports the need for innovative methods such as record-linkage in policymaking to address HAI. These findings inform clinical practice and healthcare policy to improve patient safety and care quality.

A Review of COVID-19 Hotels in New York City During the Early 2020 Outbreak: An Alternative Care Model.

New York City (NYC) was the epicenter of the early USCOVID-19 pandemic. From March to May 2020, overburdened healthcare centers precipitated an emergent need for non-traditional facilities to meet patient care demands. Given travel restrictions and NYC's underutilized tourist infrastructure, hotels were available to support emergency response needs. This article describes the process by which NYC's non-medical COVID-19 hotel programs were selected, mobilized, and operated, including lessons learned. NYC agencies and organizations collaborated, creating an interagency initiative that activated hotels to provide safe isolation and quarantine spaces for those diagnosed with or exposed to COVID-19, aiming to reduce community spread, increase capacity for NYC's strained healthcare system, and mitigate interagency redundancy. Interagency groups addressed hotel challenges, including infection prevention and control; behavioral health, intellectual, and developmental disorders; social determinants of health; and coordination, operations, and planning. NYC's COVID-19 hotel program successfully supported overburdened hospitals by providing alternate locations for non-inpatient COVID-19 individuals. Community engagement required a methodical approach, balancing quality assurance with efficient access. An interagency coordinating body developed and shared clinical criteria for hotel admissions, infection prevention and control (IPC) procedures, and discharge plans, enhancing the program's ability to scale and address complex needs. Lessons learned from this program can be applied for smoother implementation of similar programs in the future.

A Label-Free Optical Flow Cytometry Based-Method for Rapid Assay of Disinfectants' Bactericidal Activity.

Selecting the appropriate disinfectant to control and prevent healthcare-associated infections (HAIs) is a challenging task for environmental health experts due to the large number of available disinfectant products. This study aimed to develop a label-free flow cytometry (FCM) method for the rapid evaluation of bactericidal activity and to compare its efficacy with that of standard qualitative/quantitative suspension tests. The bactericidal efficiency of eight commercial disinfectants containing quaternary ammonium compounds (QACs) was evaluated against four strains recommended by EN 13727 (Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus hirae) and four multidrug-resistant pathogens. The proposed FCM protocol measures changes in scattered light and counts following disinfectant exposure, neutralization, and culture steps. Unlike other available FCM-based methods, this approach does not rely on autofluorescence measurements, impedance cytometry, or fluorescent dyes. The FCM scattered light signals revealed both decreased count rates and morphological changes after treatment with minimum inhibitory concentrations (MICs) and higher concentrations for all tested bacteria. The results from the FCM measurements showed excellent correlation with those from standard assays, providing a rapid tool for monitoring the susceptibility profile of clinical, multidrug-resistant pathogens to chemical disinfectants, which could support infection prevention and control procedures for healthcare environments. This label-free FCM protocol offers a novel and rapid tool for environmental health experts, aiding in the optimization of disinfectant selection for the prevention and control of HAIs.

Adherence to Infection Prevention Practice Standard Protocol and Associated Factors Among Healthcare Workers.

Healthcare-associated infection affects more than 100 million patients annually. Healthcare workers' poor adherence to standard infection prevention and control procedures can result in many negative consequences, ranging from disability to death. A facility-based, cross-sectional study was conducted in June 2021 among 379 healthcare workers selected using a stratified random sampling technique. All types of healthcare providers except pharmacy professionals were included in the study. Standardization and validation of the study tool were performed ahead of data collection. Multivariable regression was used to assess the variables associated with adherence. The study found that 60.2% of healthcare workers (95% CI, 55.1-65.2) had good adherence to infection prevention practices, and 68.7% and good knowledge of infection prevention practices. Training on infection prevention methods (adjusted odds ratio [AOR] = 1.68; 95% CI, 1.04-2.72), availability of water supply at hand washing station (AOR = 2.90; 95% CI, 1.62-5.31), and attitude toward infection prevention (AOR = 2.64; 95% CI, 1.65-4.24) were identified as predictors of adherence to infection prevention and control procedures. More than half of the participants had good adherence to infection prevention guideline practices. In-service infection prevention training, a consistent water supply at the hand washing station, and a positive attitude of participants were associated with good adherence to infection prevention practices.

Molecular characterization of carbapenemase and extended spectrum beta-lactamase producing Acinetobacter baumannii isolates causing surgical site infections in Ethiopia

BackgroundAcinetobacter baumannii is an opportunistic pathogen that can cause a variety of nosocomial infections in humans. This study aimed to molecularly characterize extended-spectrum beta-lactamase (ESBL) producing and carbapenem-resistant Acinetobacter species isolated from surgical site infections (SSI).MethodsA multicentre cross-sectional study was performed among SSI patients at four hospitals located in Northern, Southern, Southwest, and Central parts of Ethiopia. The isolates were identified by microbiological methods and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Antibiotic susceptibility was determined using disk diffusion. The presence of phenotypic ESBL and carbapenemase production was detected by employing standard microbiological tests, including combined disk diffusion (CDT). ESBL and carbapenem resistance determinants genes were studied by polymerase chain reaction (PCR) and sequencing.ResultsA total of 8.7% Acinetobacter species were identified from 493 culture-positive isolates out of 752 SSI wounds. The species identified by MALDI-TOF MS were 88.4% A. baumannii, 4.7% Acinetobacter pittii, 4.7% Acinetobacter soli, and 2.3% Acinetobacter lactucae. Of all isolates 93% were positive for ESBL enzymes according to the CDT. Using whole genome sequencing 62.8% of the A. baumannii harbored one or more beta-lactamase genes, and 46.5% harbored one or more carbapenemase producing genes. The distribution of beta-lactamases among Acinetobacter species by hospitals was 53.8%, 64.3%, 75%, and 75% at JUSH, TASH, DTCSH, and HUCSH respectively. Among ESBL genes, blaCTX−M alleles were detected in 21.4% of isolates; of these 83.3% were blaCTX−M−15. The predominant carbapenemase gene of blaOXA type was detected in 24 carbapenem-resistant A. baumannii followed by blaNDM alleles carried in 12 A. baumannii with blaNDM−1 as the most common.ConclusionsThe frequency of Acinetobacter species that produce metallobetalactamases (MBLs) and ESBLs that were found in this study is extremely scary and calls for strict infection prevention and control procedures in health facilities helps to set effective antibiotics stewardship.

Challenges of Compliance with Infection Prevention and Control (IPC) Standard Procedures among Healthcare Workers: A Hospital-Based Cross-Sectional Study

Introduction: This hospital-based cross-sectional study aimed to assess the compliance of 251 healthcare workers (HCWs) with Infective Prevention and Control (IPC) standard procedures. The study addresses the critical issue of IPC compliance among HCWs, as it plays a pivotal role in reducing the risk of infectious disease transmission within healthcare settings. Methodology: Analytical cross-sectional study was conducted at St. Francis Referral Hospital, involving 251 healthcare workers from different departments including Internal medicine, Surgery, and Emergency. The Compliance with Standard Precautions Scale (CSPS) tool developed by WHO was used. Descriptive and regression analysis was done. A P-value of less than 0.05 indicated statistical significance. Results: Overall average compliance with IPCSPs was 54% whereby only 24.7% (62/251) of healthcare workers had a good compliance. The majority of HCWs (85.3%) reported highest compliance on proper disposal of used sharp items into sharp boxes and low compliance rate (11.6%) was on the disposal of the sharp box, sharp box is only disposed when it is full. Statistically significant were found between IPCSPs and number of years of working experience, level of education, profession, IPC training and IPC meeting attendance. Conclusion: This cross-sectional study has shed light on the critical challenges faced by healthcare workers in complying with IPCSPs. Findings revealed a concerning compliance with IPCSPs which is below the WHO standard and national level standard as well. We therefore recommend enhancement of IPC training program, IPC awareness campaign, and more implementational research for IPCSPs compliance.

General infection prevention, mitigation, and control procedures implemented in the university education during the COVID-19 pandemic to achieve classroom attendance: a successful community case study.

The COVID-19 pandemic entailed confinement and elimination of face-to-face university classes in Spain. The Francisco de Vitoria University in Madrid (UFV by its Spanish acronym) implemented risk management systems to enable on-campus university activity to avoid a negative impact on students, teachers, and faculties. A tracking/registry system was implemented to collect data, identify COVID-19-related cases, implement containment measures, and do follow-up in the UFV community (administration/services personnel [ASP], teaching/research personnel [TRP], and students), from September 2020 to April 2022. In addition, a prevention plan was implemented on campus to avoid COVID-19 spreading. Satisfaction with these measures was assessed through an online questionnaire. A total of 7,165 suspected COVID-19 cases (84.7% students, 7.7% ASP, 6.5% TRP) were tracked (62.5% female cases, mean age (±SD) 24.8 years (±9.2 years)), and 45% of them confirmed (82% symptomatic/16% asymptomatic), being the student group that with the highest percentage (38.3% total tracked cases). The source of infection was identified in 50.6% of the confirmed cases (90.2% located off-campus). Nineteen COVID-19 outbreaks were registered (inside-10/outside-9). COVID-19 incidence rates were similar or lower than those reported in the Community of Madrid, except in the last wave, corresponding to Omicron variant. The degree of satisfaction (scale 1-6) with the implemented measures was high (scores 4.48-5.44). During the COVID-19 pandemic, UFV control measures, periodic monitoring, and the effectiveness of the tracking system have contributed to maintaining classroom teaching, guaranteeing health and safety. UFV has adapted to a new reality as an example of good practice for future pandemics or emergency situations.

Practice- and System-Based Interventions to Reduce COVID-19 Transmission in Primary Care Settings: A Qualitative Study.

Using qualitative interviews with 68 family physicians (FPs) in Canada, we describe practice- and system-based approaches that were used to mitigate COVID-19 exposure in primary care settings across Canada to ensure the continuation of primary care delivery. Participants described how they applied infection prevention and control procedures (risk assessment, hand hygiene, control of environment, administrative control, personal protective equipment) and relied on centralized services that directed patients with COVID-19 to settings outside of primary care, such as testing centres. The multi-layered approach mitigated the risk of COVID-19 exposure while also conserving resources, preserving capacity and supporting supply chains.

Mapping of infection prevention and control education and training in some countries of the World Health Organization’s Eastern Mediterranean Region: current situation and future needs

BackgroundA strong understanding of infection prevention and control (IPC) procedures and comprehensive training among healthcare workers is essential for effective IPC programs. These elements play a crucial role in breaking the chain of nosocomial infections by preventing the transmission of resistant organisms to patients and staff members. This study mapped the components of IPC education and training across various member states of the World Health Organization (WHO) in the Eastern Mediterranean Region (EMR) at national, academic, and healthcare institutional levels.MethodsA self-administered structured online questionnaire based on the WHO “Core Component 3” of IPC programs at the national and acute healthcare facility levels (IPC education and training) was given to national IPC focal persons in each of the WHO’s EMR countries between February and March 2023.ResultsFrom 14 of the 22 countries,15 IPC persons participated in the survey. Most countries have scattered nonhomogeneous IPC education programs in human health undergraduate majors without considering it a standalone module. Academic institutions are rarely involved, and elaborate and predefined undergraduate IPC education programs provided by universities are present in 21.4% of the countries. In 71.4% of these countries, postgraduate training targeting IPC professionals is provided by national IPC teams, primarily based on national IPC guidelines developed with the aid of the WHO. Generally, healthcare worker training relies heavily on healthcare facilities in 92.9% of the countries, rather than on a national training program. In 42.9% of the countries, practicing IPC physicians are not necessarily specialists of infectious disease or medical microbiologists and IPC nurses are not required to specialize in IPC. However, nonspecialized IPC professionals are expected to undergo training upon employment and before beginning practice. Nongovernmental organizations such as the WHO play a significant role in IPC education and in supporting national IPC authorities in establishing national IPC guidelines, as it is the case in 78.6% of these countries.ConclusionClear disparities exist in IPC education and training across different countries in the WHO’s EMR. Establishing a regional scientific network specializing in IPC would help bridge the existing gaps and standardize this education within individual countries and across countries in the region. This region needs to establish IPC certification standards and standardized education curricula.

Alarming case of avian influenza A (H5) in humans: call for urgent action in Ecuador

Alarming case of avian influenza A (H5) in humans: call for urgent action in Ecuador

Adherence to infection prevention and control measures and risk of exposure among health‐care workers: A cross‐sectional study from the early period of COVID‐19 pandemic in Addis Ababa, Ethiopia

AbstractBackground and AimHealthcare workers (HCWs) are considered a high‐risk group for severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) exposure, ascribed to the amount of time they spend in health‐care facilities (HCFs). This study aimed to assess HCWs' compliance with Infection Prevention and Control (IPC) procedures and the risk of exposure during the early period of the pandemic in Addis Ababa, Ethiopia.MethodsA descriptive cross‐sectional survey was conducted from June to September 2020. With a response rate of 79.2%, a standardized questionnaire was administered among 247 HCWs, working in eight HCFs. Descriptive and multivariate regression analysis was carried out in STATA version 16.ResultsAbout 22.5% (55) of the HCWs had proper adherence to IPC procedures. Of the total participants, 28.2% (69) had proper use of Personal Protective Equipment (PPE), 40% (98) had proper hand hygiene practices, and 33.1% (81) had frequently cleaned their working environment. HCWs who received training on IPC protocols were four times more likely to follow IPC standards than those with no training (adjusted odds ratio [AOR] = 3.93; 95% confidence interval [CI]: 1.46, 10.58). Besides, HCWs working in treatment centers were four times more likely to follow IPC standards than those working in conventional hospitals (AOR = 3.61; 95% CI:1.63, 8.02). Nurses were four times more likely to have adherence to IPC measures than cleaners and runners (AOR = 4.37; 95% CI: 1.38–13.88).ConclusionThe nature and magnitude of the pandemic did not introduce the required degree of adherence to IPC procedures, per se does not match the level of diligence needed to halt SARS‐CoV‐2 transmission. Our finding suggested that providing periodic training of HCWs with particular emphasis on nonclinical staff is commendable. Furthermore, it is necessary to maintain resilent IPC in HCF through continous follow up and safety drills, to assess the readiness of HFCs' adherance to IPC measures under normal circumstances, which could improve prepardeness for an effective response during epidemics.

Change of Plans: Overview of Bacterial Taxonomy, Recent Changes of Medical Importance, and Potential Areas of Impact.

The process of bacterial nomenclature change has evolved in complexity over time and continues to be an iterative process that is not without challenges. The importance and feasibility of such changes vary among basic researchers, clinical microbiologists, and clinicians. In recent years, clinically relevant changes have been made across Gram-positive and Gram-negative organism groups, as well as the mycobacteria. Updated clinical laboratory accreditation requirements state that clinical laboratories must update their reporting practices in the case of clinically relevant nomenclature changes. These updates may significantly affect various sectors of health care, including antimicrobial stewardship, laboratory protocols, and infection prevention procedures and policies. While regularly updating bacterial nomenclature aims to improve the accuracy and consistency of our microbial language, the potential impact of such changes must be considered.

Trends in hospital acquired New Delhi metallo-beta-lactamase-producing Enterobacterales in Tuscany (Italy) from 2019 to 2021: impact of the COVID-19 pandemic

In Tuscany, Italy, New Delhi metallo-beta-lactamase-producing carbapenem-resistant Enterobacterales (NDM-CRE) in hospitalized patients has increasingly been observed since 2018, leading in 2019 to the implementation of enhanced control measures successfully reducing transmission. We describe the NDM-CRE epidemiology during the COVID-19 pandemic in Tuscany. Data on NDM-CRE patients hospitalized in five Tuscan hospitals were collected from January 2019 to December 2021. Weekly rates of NDM-CRE cases on hospital days in medical and critical-care wards were calculated. In March-December 2020, NDM-CRE rates were stratified by COVID-19 diagnosis. Multi-variate regression analysis was performed to assess outcomes' differences among two periods analysed and between COVID-19 populations. Since March 2020, an increase in NDM-CRE cases was observed, associated with COVID-19 admissions. COVID-19 patients differed significantly from non-COVID-19 ones by several variables, including patient features (age, Charlson index) and clinical history and outcomes (NDM-CRE infection/colonization, intensive care unit stay, length of stay, mortality). During the pandemic, we observed a higher rate of NDM-CRE cases per hospital day in both non-COVID-19 patients (273/100,000) and COVID-19 patients (370/100,00) when compared with pre-pandemic period cases (187/100,00). Our data suggest a resurgence in NDM-CRE spread among hospitalized patients in Tuscany during the COVID-19 pandemic, as well as a change in patients' case-mix. The observed increase in hospital transmission of NDM-CRE could be related to changes in infection prevention and control procedures, aimed mainly at COVID-19 management, leading to new challenges in hospital preparedness and crisis management planning.

ASSESSMENT OF KNOWLEDGE, ATTITUDES, AND PRACTICES IN INFECTION PREVENTION AND CONTROL AMONG HEALTH-CARE WORKERS AT THE GOVERNMENT TEACHING HOSPITAL, VISAKHAPATNAM

Objectives: The purpose of this questionnaire-based study is to assess frontline healthcare professionals’ knowledge and awareness of infection prevention and control policies and procedures. Methods: This is a cross-sectional study in which the knowledge and practices of the study group (Doctors, Nurses, and Laboratory Technicians) were assessed using an electronic Google form questionnaire. Data were collected and statistically analyzed. Results: There were 67 doctors, 18 laboratory technicians, and 35 nurses among the 120 responses analyzed. The majority of respondents (67%) were females and majority (50%) were between the ages of 21 and 30 years, with a mean age of 28. Among the respondents, 67% participated in training programs and 28% completed a certified course in infection prevention control. The majority (95%) were aware of all the standard precautions. Knowledge levels on hand washing, respiratory hygiene, and biomedical waste management were 85%, 77%, and 62% respectively. In comparison to knowledge, their attitudes toward infection control were lower (81%). In this study, only 70% of participants followed WHO guidelines for hand washing. More than 74% are familiar with the single-handed scoop technique for recapping needles. Only 50% know correct sequence of donning and doffing of PPE. Conclusion: The study participants have gaps in their knowledge and application of infection control. It would be beneficial for all HCW to receive formal and refresher training periodically.

Factors associated with burnout among hospital-based healthcare workers during the COVID-19 pandemic: A cross-sectional CRACoV-HHS study.

To assess the prevalence of burnout and associated factors among healthcare workers (HCWs) working in a hospital admitting patients with COVID-19. Burnout among HCWs is related to age, gender and occupation. However, little is known about organisational factors associated with burnout during the COVID-19 pandemic. A cross-sectional study of 1412 hospital HCWs (748 nurses) was carried out via online survey during the COVID-19 pandemic between 4 and 19 January 2021. The Maslach Burnout Inventory-Human Services Survey, the Checklist Individual Strength questionnaire, the interRAI items covering mental health, the WHO questionnaire items assessing HCWs' preparedness and exposure to SARS-CoV-2 were used. Univariable and multivariable linear regression analyses were conducted to clarify factors associated with emotional exhaustion (EE), depersonalisation (DP) and personal accomplishment (PA). This study adheres to the STROBE guidelines. Burnout prevalence varied from 10.0% to 22.0%. Most respondents (83.6%) reported low PA, 22.9% high EE and 18.7% high DP. Nurses and physicians had the highest levels of EE and DP. Staff exposed or uncertain if exposed to contaminated patients' body fluids and materials had higher levels of burnout. Preparedness (training) (b=1.15; 95%CI 0.26 to 2.05) and adherence to infection prevention and control procedures (b=1.57; 95%CI 0.67 to 2.47) were associated with higher PA, and accessibility of personal protective equipment (PPE) (b=-1.37; 95%CI -2.17 to -0.47) was related to lower EE. HCWs working in wards for patients with COVID-19 reported lower EE (b=-1.39; 95%CI -2.45 to -0.32). HCWs who contracted COVID-19 reported lower DP (b=-0.71, 95%CI -1.30 to -0.12). Organisational factors such as better access to PPE, training, and adherence to infection prevention and control procedures were associated with a lower level of burnout. Healthcare managers should promote strategies to reduce burnout among HCWs with regard to preparedness of all staff.

1889. Knowledge, beliefs and practices about COVID-19 infection and vaccination in healthcare personnel at non-acute care facilities

Abstract Background The objective of this study is to characterize the experiences, knowledge, beliefs, and perceptions of risk related to COVID-19, infection prevention practices, and COVID-19 vaccination among healthcare personnel (HCP) at three non-acute care facilities. Methods The study protocol was approved by the Washington University IRB. Between April-May 2021, anonymous surveys were distributed to HCP at three non-acute care facilities in St. Louis, MO. Data was collected on demographics, experience working in healthcare, COVID-19 exposures, knowledge and beliefs about infection prevention policies and procedures, PPE use, perception of risk of acquiring COVID-19, and COVID-19 vaccination status. Results There were 156 respondents; 78% were female, and 53% reported &amp;gt;10 years of healthcare experience. The largest proportion (32%) were in direct patient care as nurses or nurses’ aides. A majority (97%) reported adequate knowledge of how to protect themselves from COVID-19 at work, and most (95%) reported access to adequate PPE supplies. HCP (58.7%) reported that wearing a mask or face shield made communication difficult, 56% stated they had taken on additional responsibilities due to staff shortages, and 53% indicated that their job became more stressful because of COVID-19. More than a quarter (28%) had considered quitting their job due to COVID-19. HCPs were more concerned about acquiring COVID-19 in the community than at work (47 vs 33%). When asked about the COVID-19 vaccine, 78% of respondents reported receiving at least one dose of vaccine and 72% had completed a primary vaccine series. The most common reasons given for deciding to get vaccinated were a desire to protect family and friends (84%) and wanting to help stop the spread of COVID-19 (82%). For unvaccinated respondents (29%), the most common reasons for not receiving vaccination were concern for side effects (53%) and belief that the vaccine was not tested well enough (50%). Conclusion A significant proportion of HCP reported stress and increased responsibilities at work due to COVID-19, and 1 in 4 considered leaving their job. A majority were vaccinated, with concerns about side effects or inadequate vaccine testing cited as the most common concerns by unvaccinated HCPs. Disclosures All Authors: No reported disclosures.

Institutional Factors Associated with Infection Prevention and Control Practices Globally during the Infectious Pandemics in Resource-Limited Settings.

Healthcare-associated infections lead to considerable morbidity, a prolonged hospital stay, antibiotic resistance, long-term disability, mortality and increased healthcare costs. Based on the literature, some individual and socio-demographic factors including knowledge, age and length of service or work experience, gender and type of profession influence compliance with infection prevention and control procedures. In addition, organizational culture, which refers to the assumptions, values, and norms shared among colleagues, can influence an individual's thinking and healthcare workers' behavior, either positively or negatively. Infection control practices based on the perspective of patients, hospital management and healthcare workers may help develop a better understanding of the factors influencing compliance with infection prevention and control policies and guidelines.

Anesthetists knowledge, practices, and associated factors towards infection prevention in Addis Ababa public hospitals, Addis Ababa, Ethiopia

BackgroundEvery year, hundreds of millions of individuals are afflicted by preventable illnesses in the health care system. In surgical patients in Sub-Saharan Africa, the rate of nosocomial infection ranges from 2.5 to 30.9%. Anesthesia doctors have a direct impact on the risk of perioperative infection. In the operating theater, 7% of surgical patients have a healthcare-associated infection. According to a study, bacterial transmission in the OR anesthesia work area was linked to 30-day postoperative illnesses in as many as 16% of surgical patients. ObjectiveThis study aims to assess anesthetists knowledge, practices, and associated factors towards infection prevention in xxx public hospitals. Methodology: A cross-sectional survey of 220 anesthetists working in xxx hospitals was undertaken using standardized pretested and self-administered questionnaires. The information gathered was double-checked for accuracy before being entered into the EPI INFO7 software and then exported to SPSS version 24 for analysis. For bivariate and multivariable analysis, descriptive statistical analysis was done, and a logistic regression model was built. A 95% confidence level and an alpha of 0.05 were employed to determine the existence of a relationship between variables. ResultA total of 220 anesthetists took part. 82.7% (95% of CL: 77.7–87.7) and 48.2% (95% of CL: 41.4–55.4) of respondents were rated as knowledgeable about infection prevention and safe procedures, respectively. The presence of an infection prevention committee and recommendations is significantly linked to both knowledge and practice in infection prevention. ConclusionAccording to the findings of this study, the majority of anesthetists have a good understanding of infection prevention and nearly half of anesthetists have inadequate infection prevention practice. Infection prevention guidelines should be developed, enough supplies of personal protective equipment should be available, and an infection prevention committee should be strengthened.