Journal of Infection Prevention最新文献

Introduction: The World Health Organization (WHO) advocates for the strengthening of education and training in infection prevention and control (IPC) in higher educational institutions (HEIs). This is fundamental to ensure health science students are confident and competent in clinical practice.

Aim: To explore the existing evidence on undergraduate health science students' preparedness for IPC practice.

Methods: A systematic search was conducted in PubMed, CINAHL, Ovid, MEDLINE Complete, ProQuest, Scopus, Google Scholar, and gray literature. Quantitative and mixed-methods studies on teaching, learning, and technological approaches to Infection Prevention and Control (IPC) in undergraduate health science curricula were included. Participants were undergraduate students in medical, nursing, pharmacy, dental, physiotherapy, radiology, medical imaging, and paramedic programs. Studies published in English between 2010 and 2023 were considered.

Results: Twenty studies were identified for this review. Most of the studies 11 (55%) reported improved knowledge, practice, attitudes, and confidence in IPC after implementation of technological approaches. The most reported technological approaches were didactic instruction 12 (65%) followed by virtual simulation.

Discussion: There is considerable variation in the scope, content, and delivery methods for IPC in undergraduate programs. The use of traditional face-to-face teaching methods remains widespread despite its lack of interactive or practical aspects. It is important to incorporate technological methods that promote experiential learning in IPC and to develop standardized curricula for IPC at national, regional, and international levels.

Introduction: Antimicrobial Stewardship Programs (ASPs) are critical in addressing Antimicrobial Resistance (AMR). Surgical Antibiotic Prophylaxis (SAP) guidelines provide essential guidance on antibiotic selection, administration, and duration for surgical procedures. This study evaluates the impact of department-level audit and feedback interventions within an ASP on compliance with SAP guidelines.

Objective: To assess the effect of a biannual audit and feedback initiative by the Antimicrobial Stewardship Committee over 2 years on compliance with SAP guidelines regarding antibiotic selection, timing, and duration at a secondary care hospital in the UAE.

Material & methods: A quasi-experimental study was conducted at a secondary care hospital in Ras Al Khaimah, UAE, comparing data from the year before (2021) and 2 years after (2022-2023) the intervention. Statistical analysis was performed using the Open Epi system. All clean and clean-contaminated surgeries meeting SAP criteria were included; contaminated and dirty surgeries were excluded.

Results: The intervention significantly improved compliance with SAP guidelines. Appropriate antibiotic duration increased from 17% to 50%, and correct timing improved from 42% to 87%, both with a statistically significant p-value of 0.0001.

Conclusions: The audit and feedback intervention significantly enhanced compliance with SAP guidelines, particularly in timing and duration, contributing to reduced surgical site infections and costs. Implementing institute-wide SAP guidelines based on local antibiogram data is recommended to support clinicians and improve compliance.

Background: COVID-19 has claimed millions of lives, with severe economic impacts, particularly in resource-limited developing nations. Despite vaccines, face masks remain vital to curb transmission. However, variable adherence poses risks amid emerging variants.

Objectives: To identify mask-wearing determinants and associations with demographics, knowledge, perceived laws/enforcement, and concerns about disadvantages.

Study design and methods: Using survey data from 1200 respondents in the Philippines, Vietnam, and Indonesia (July-September 2021), binary logistic regression determined factors influencing individuals' face mask-wearing behaviour.

Results: Socio-demographic factors significantly predicted mask-wearing. Compliance increased with better knowledge of the virus and pandemic. Positive perceptions of relevant laws and enforcement improved behaviour, while individuals unconcerned about the disadvantages of masks were more likely to adopt recommended practices.

Conclusions: While mask-wearing is strongly recommended to prevent COVID-19, adherence varies significantly with socio-demographics, knowledge, perceptions of law enforcement, and personal concerns.

Background: Clinical students, like healthcare workers, are at risk of sharp or needlestick injuries and potential percutaneous exposure to blood and body fluids. They can acquire infections such as HIV and hepatitis B virus (HBV) through these injuries. This study determined the prevalence and factors associated with sharp injuries among clinical students at Mbale Regional Referral Hospital.

Methods: A cross-sectional study was carried out at Mbale Regional Referral Hospital among randomly selected clinical students. Data was entered in Microsoft Excel, cleaned, and exported to STATA version 14 for analysis.

Results: One hundred sixty (55.2%) clinical students had sustained a sharp injury in their clinical practice, with a self-reported prevalence of 46.6% in the last year. A significant proportion of these students, 93 (68.9%), experienced multiple sharp injuries. The common cause and site of injury were solid needles (72; 45%) and fingers (83.1%), respectively. Most students, 197 (67.9%), reported ward procedures not being supervised, and 124 (42%) students worked on ≥ 15 patients daily. Students who worked on ≥15 patients were more likely to sustain a sharp injury than those who attended to <15 patients daily (P = .000, OR: 6.3, 95% CI: 3.7%-10.8%).

Conclusion: This study showed a high prevalence of needlestick injuries among clinical students. The risk factors were the year of study, having not learned about infection control, and the number of patients attended to daily.

Background: Preventing multidrug-resistant organism (MDRO) transmission in inpatient settings remains challenging due to gaps in infection control practices which facilitate their transmission and compromise patient safety.

Purpose: This project evaluated the impact of implementing two Centers for Disease Control and Prevention (CDC) guidelines-Management of Multidrug-Resistant Organisms in Healthcare Settings and Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Setting-on time to initiation of transmission-based precautions (TBPs) for inpatients who were, or had a history of being, colonized or infected with one or more targeted MDROs.

Methods: Using a quantitative methodology and quasi-experimental design, pre- and post-implementation data were analyzed via independent samples t-test to assess TBPs initiation times.

Results: Implementation of the CDC guidelines significantly reduced TBPs initiation times by a mean of 16.32 hours (t (23.21) = 2.91, p = .008). This change reflects both statistical and clinical significance in reducing transmission risk.

Conclusions: The intervention had a positive impact on time to TBPs initiation. Translation of the CDC guidelines into nursing practice may facilitate timelier identification of patients with MDROs and reduce time to initiation of TBPs, thereby reducing the risk of transmission in the hospital setting.

Infection prevention and control (IPC) education is critical in reducing healthcare-associated infections, yet traditional teaching methods often lack engagement and practical relevance. Simulation-based education, particularly game-based learning, offers an innovative approach to improve knowledge retention and learner motivation. This study explores the use of a simulation game, Microbe Hunters, designed to enhance IPC awareness and practice among IPC link practitioners through an immersive escape room format. Microbe hunters is an escape-room style simulation that creates a more immersive educational experience. The simulation tasked participants with identifying an outbreak organism, completing the chain of infection, and recommending appropriate transmission-based precautions, PPE, and terminal cleaning. The activity concluded with team presentations and a structured debrief. A qualitative evaluation was conducted to assess learning experiences. Participants reported high levels of engagement, enjoyment, and improved understanding of IPC principles. They valued the hands-on problem-solving, teamwork, and realistic scenario design. The experience promoted critical thinking and practical application of knowledge. Microbe Hunters demonstrated that simulation-based, game-style learning is an effective and enjoyable method for IPC education. Grounded in experiential and constructivist learning theories, the approach supports active engagement and knowledge construction. Future research should investigate broader implementation, long-term outcomes, and scalability across healthcare teams.

Background: Healthcare-associated infections (HAIs) are a risk to patient safety and health. Several initiatives have been studied to reduce surface contamination; however, there is lack of work investigating emerging technologies such as 3D gestural human-computer interaction (HCI).

Aim/objective: This study investigates a touchless 3D gestural display and traditional HCI to quantify the differences in surface contamination.

Methods: A between-subjects experimental study was performed to study the spread of surface contamination in a simulated primary care clinic. Participants (N = 30) wore gloves with a blacklight-sensitive powder that would identify what surfaces were contaminated. The number of surfaces of contamination was collected for all participants as well as overall process times.

Findings/results: The findings showed that participants who used gestural technology spread contamination to significantly less surfaces that the traditional HCI group (p < .05). However, the gestural group took a significantly longer time to complete the process than the HCI group (p < .05).

Discussion: The implementation of 3D gestural HCI has the opportunity to reduce surface contamination and potentially reduce the risk of HAIs. Because the process was found to take longer with the 3D gestural technology, this technology could affect overall healthcare processes. Future work should investigate how the technology should be developed for use in healthcare systems as well as explore other high-risk areas in healthcare.

Purpose: Approximately 50%-60% of adult women experience at least one episode of urinary tract infection (UTI) during their lifetime, with 20%-24% of them experiencing recurrence within a year. Several randomized controlled trials have explored the efficacy and safety of D-mannose for the prevention of UTI in adult women but reported conflicting results.

Objective: We performed a meta-analysis comparing D-mannose with placebo or no treatment for the prevention of UTI in adult women.

Methods: We systematically searched PubMed, Scopus, and Cochrane Central databases for studies comparing D-mannose with placebo or no treatment for the prevention of UTI in adult women. The outcomes of interest were recurrent UTIs during follow-up and adverse events. Heterogeneity was assessed using I² statistics. Analysis followed the PRISMA guideline and was registered in the PROSPERO database.

Results: The systematic review identified 4 randomized controlled trials (RCTs) including 890 participants (D-mannose n = 447, 50.22%). Recurrent UTI (RR 0.44; 95% CI 0.18-1.11; p = .082; I² = 90%) and adverse events (RR 2.19; 95% CI 0.68-7.05; p = .190; I² = 79%) did not differ significantly between the groups at the end of follow-up.

Conclusion: Prophylaxis with D-mannose did not cause any difference in the risk of recurrent UTI during follow-up and adverse events in adult women. Fewer number of studies and heterogeneity in the results make it difficult to draw conclusions about the efficacy of D-mannose in preventing recurrent UTI. More placebo-controlled RCTs are required to confirm the efficacy and safety.

Background: In early spring 2020, the spread of SARS-CoV-2, began which developed into a global pandemic of the disease COVID-19. Nursing homes (NHs) for older adults in Sweden experienced a significant spread of the virus resulting in many deaths among the residents and cases of illness among the employees.

Aim: To explore how supply and use of products for protection of residents and staff against infection as well as IPC (infection prevention and control) training changed in Swedish NHs for older adults between the years 2019 and 2023.

Methods: A web-based survey form with questions concerning supply and use of products as well as training of employees in IPC and use of governing and supporting documents concerning IPC in 2019 and 2023 was sent out to 300 NHs in Stockholm County in January 2024. This was the total number of NHs which were in operation both in 2019 and 2023.

Results: Answers were obtained from 130 NHs with a total of 7377 residents. The response rate was 43.3%. Supply of all products was improved in 2023. There was a significant association between improved supply and improved use for all products (p < .01) except for single use gloves. The number of employees who received training on IPC had risen significantly from 2019 to 2023 (p < .01). In 2023, all respondents used guiding documents on IPC.

Discussion: The COVID-19-pandemic resulted in several improvements concerning IPC in NHs for older adults in Sweden. After the pandemic staff got better training, managers used governing and supporting documents to a higher degree and the supply and use of protective products was improved, except for the use of single use gloves. The difficulties in correct use of gloves were found in 2019 and remained in 2023.