Journal of Infection Prevention最新文献

Background: Healthcare-associated infections are strictly related to healthcare practices. A head nurse stimulates and motivates nurses, boosts nurses' job performance and satisfaction, and can influence adverse event development.

Aim: To explore the relationship between healthcare-associated infections and head nurse leadership style.

Methods: A systematic review was conducted. The search was conducted from 1973 until March 2022 on PubMed, Cochrane Library, Scopus, CINAHL, Web of Science, Embase, and APA PsycInfo databases. The review followed the Joanna Briggs Institute Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A thematic synthesis and critical appraisal of the included studies have been conducted.

Results: Eight articles were included in this review. Head nurses' leadership, supported by the organization, can positively influence the job performance and job satisfaction of nurses by reducing infection rates associated with vascular access and urinary catheters.

Discussion: Authentic and transformational nurse leadership styles can foster targeted interventions and improvements tailored to preventing and controlling healthcare-associated infections. Even if there is limited evidence, the results support that the occurrence of infections can be reduced by leadership strategies implemented by head nurses.

Background: After an increase of central line-associated bloodstream infections (CLABSIs) at our community hospital in 2021, a case-control study suggested that patients with CLABSIs were 3.0 times more likely to have missed daily chlorhexidine gluconate (CHG) bathing than patients without CLABSIs.

Objective: To increase the rate of daily CHG bathing in hospitalized patients with central lines and subsequently reduce the number of CLABSIs.

Methods: Our pre-post intervention was launched on September 2022 and consisted of enhancements to the electronic health record (EHR) to simplify the identification of overdue CHG bathing instances to increase compliance, and therefore decrease the CLABSI rate at our hospital. A workflow was implemented Monday-Friday utilizing these EHR enhancements for active surveillance to engage frontline nursing staff and address gaps in care in real time.

Results: After the initiative was implemented, adherence to daily CHG bathing increased from 94.9% to 95.3%, with a considerable disparity between weekdays (97.6%) and weekends (89.3%). After weekend data were excluded, the post-intervention increase in the adherence rate was statistically significant (p = .003).

Discussion: This initiative underscored the importance of involving health care informatics partners and showed how technology can bridge gaps in health care quality. Outreach and reminders effectively improved CHG bathing adherence by emphasizing the importance of consistent communication and follow-up.

Background: It is very important for healthcare professionals to know the isolation precautions and apply the isolation rules correctly in COVID-19 process.

Aim: This study was conducted to determine the COVID-19 fear levels and isolation compliance levels of nurses.

Method: This descriptive, cross-sectional, and correlational study was conducted between December 2020-February 2021 with 217 nurses working in a public hospital in Istanbul/Turkey. Data were collected using the Sociodemographic-Form, the COVID-19 Fear Scale, and the Compliance with Isolation Measures Scale.

Results: Statistically significant difference was found between the level of compliance with the isolation measures and the education level of the nurses (p = .011), as well as their professional position (p = .026) (p < .05). A positive, low-level significant relationship was determined between the COVID-19 fear of nurses and their compliance with isolation measures (r = 0.168; p = .015).

Conclusions: It was determined that nurses' compliance with Isolation Precautions and their level of fear were high during the COVID-19 pandemic. It was observed that nurses' fear levels and isolation adaptation levels were related.

Background: Healthcare-associated infections are a global concern and can be dependent on the infection prevention behaviours of nursing staff, which in turn can be influenced by working conditions. Qualitative studies are scarce, and a greater understanding of the relationship between working conditions and nursing staff behaviour is needed.

Aim: The aim was to describe nursing staff's experiences and reflections on working conditions and infection prevention behaviours.

Methods: A qualitative study with semi-structured focus group interviews at four surgical units and two orthopaedic hospital units. Twenty-seven nursing staff (12 registered nurses and 15 assistant nurses) participated. Data was analysed using qualitative content analysis.

Results: We generated one theme: Navigating in a complex and shifting context. The result indicates that working conditions are sometimes inadequate, which can hinder the nursing staff's infection prevention behaviours. Even when working conditions seemed to be sufficient, hygiene routines could fail, since situations constantly arise in a hospital unit that are difficult to predict and regulate.

Discussion: This study highlights the complexities faced by nursing staff in maintaining infection prevention behaviours within the dynamic hospital work environment. While nursing staff are professionally obliged to comply with hygiene routines, organisational support is essential for fostering sustainable working conditions. A multi-tiered approach is needed, from first-line managers to decision-makers, to promote a supportive environment that sustains safe practices.

Background: The Center for Disease Control's National Healthcare Safety Network (NHSN) reported increased Standardized Infection Ratios (SIRs) for hysterectomy at a large community hospital.

Objective: To promote a surgical site infection (SSI) prevention bundle implemented to reduce hysterectomy-associated SSI.

Methods: A multidisciplinary Workgroup implemented the Hysterectomy SSI Prevention Bundle in 2020 to enforce standardization of perioperative techniques. This study included all benign hysterectomies pre-implementation (n = 857) and post-implementation (n = 772). Per NHSN categorization guidelines, "abdominal hysterectomy" includes both open and laparoscopic routes. "Inpatient surgery" is date of discharge different from date of surgery; "outpatient surgery" is same date of discharge. "SSI" includes superficial, deep, and organ/space; "complex SSI" includes deep and organ/space. Patient demographics were categorized and evaluated for statistical significance.

Results: After implementation of the SSI bundle, SIRs for hysterectomy were reduced to <1.0, indicating infection prevention. Reductions in SIR were significant for outpatient abdominal hysterectomy (0.868 [p = .007]), inpatient vaginal hysterectomy (0 [p < .001]), inpatient complex abdominal hysterectomy (0 [p = .040]), and inpatient complex vaginal hysterectomy (0 [p < .001]). Differences between groups were significant for increased laparoscopic and decreased vaginal hysterectomies (p < .001), increased outpatient surgeries (p < .001), and longer procedure duration (p < .001).

Conclusion: Implementation of an SSI prevention bundle at a large community hospital has significantly reduced SIR for inpatient vaginal hysterectomies, outpatient abdominal hysterectomies, and all inpatient complex hysterectomies.

Background: Approximately 25% of hospitalised adults require an indwelling urinary catheter (IDC) during their hospital stay. IDCs expose patients to risks of infectious and non-infectious complications.

Aims: To identify IDC prevalence, assess adherence to clinical practice guidelines and patient-reported involvement in IDC care for adult hospital inpatients.

Methods: This point prevalence study was conducted in 22 wards in a single quaternary hospital. Data was collected by clinical and research nurses working in pairs on a single day. Study outcomes were reported descriptively as frequencies and percentages.

Results: Of 502 patients included, 77 (15.3%) had an IDC (median duration 99.6 h). The median age of patients with an IDC was 64 years (interquartile range 22-88 years), 54 (70%) were male and one-quarter (n = 19; 25%) of IDCs were inserted at another hospital. More than half (n = 44; 57%) of the 77 IDCs had no documented removal plan. Three patients were unavailable for review for observed clinical practices, and it was found 43% (n = 32/74) lacked a securement device. Of 77 people with IDCs, there were 44 patient responses, and 27 (61.4%) patients did not know the reason for their catheter.

Discussion: Areas for improvement included securement device use, timely removal plans and patient education for the reason for the device. Regular point prevalence studies to assess use and adherence to clinical practical guidelines can improve safety outcomes for patients requiring IDCs.