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Lateral effects of infection prevention measures during COVID-19 pandemic on hospital-acquired Clostridioides difficile infection. COVID-19 大流行期间的感染预防措施对医院获得性艰难梭菌感染的侧向影响。
IF 1 Q4 INFECTIOUS DISEASES Pub Date : 2024-11-01 Epub Date: 2024-04-26 DOI: 10.1177/17571774241251662
Eleni Mylona, Sofia Kostourou, Fani Veini, Chrysoula Kolokotroni, Eleni Belesiotou, Katerina Kaziani, Athina Argyropoulou, Vasileios Papastamopoulos

Background: Systematic surveillance of Clostridioides difficile infection (CDI) in our institution showed a reduction in the incidence of healthcare associated CDI (HA-CDI) during COVID-19 pandemic. Aim: Our objective was to search for factors related to this reduction. Methods: We retrospectively studied the trend of the incidences of HA-CDI, Multidrug Resistant (MDR) organisms, total antibiotic and chlorine consumptions as well as the influence of the last two on the incidence of HA-CDI. Results: During COVID-19 pandemic, the HA-CDI incidence was reduced with respect to the previous years, although total antibiotic consumption was found to increase (p < .01). MDR organisms' incidence was found to increase (p < .01), as well as the chlorine consumption (p = .04) which was the only factor to be related to the decreased rates of HA-CDI (r = -0.786, p < .05). Discussion: In our institution, COVID-19 epidemic overlapped with the reduction in the HA-CDI's incidence. This could be due to faithful compliance with the contact precaution measures but then, we would expect the incidence of MDR organisms to decrease as well. Chlorine usage for environmental cleaning was generalized during pandemic. It was the only factor to be related to the decreased rates of HA-CDI, highlighting the importance of environmental cleaning as a measure for HA-CDI prevention.

背景:我院对艰难梭菌感染(CDI)进行的系统监测显示,在 COVID-19 大流行期间,与医疗相关的艰难梭菌感染(HA-CDI)发病率有所下降。目的:我们的目标是寻找与发病率下降相关的因素。方法我们回顾性地研究了 HA-CDI、耐多药(MDR)菌、抗生素和氯的总消耗量的发病趋势,以及后两者对 HA-CDI 发病率的影响。研究结果在 COVID-19 大流行期间,HA-CDI 发病率与前几年相比有所下降,但抗生素总用量有所增加(p < .01)。多重耐药菌发病率增加(p < .01),氯消耗量增加(p = .04),而氯消耗量是唯一与 HA-CDI 发病率下降相关的因素(r = -0.786,p < .05)。讨论在我院,COVID-19 的流行与 HA-CDI 发病率的下降相重叠。这可能是由于我们严格遵守了接触预防措施,但我们预计 MDR 微生物的发病率也会随之下降。大流行期间,环境清洁普遍使用氯气。这是与HA-CDI发病率下降有关的唯一因素,突出了环境清洁作为预防HA-CDI措施的重要性。
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引用次数: 0
Diary. 日记
IF 0.9 Q4 INFECTIOUS DISEASES Pub Date : 2024-09-01 Epub Date: 2024-09-18 DOI: 10.1177/17571774241285251
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引用次数: 0
Factors responsible for student nurses' use of non-sterile gloves: An exploratory qualitative study. 学生护士使用无菌手套的因素:一项探索性定性研究。
IF 0.9 Q4 INFECTIOUS DISEASES Pub Date : 2024-07-01 Epub Date: 2024-03-07 DOI: 10.1177/17571774241238686
Jennifer Bate

Background: Disposable non-sterile gloves are part of the personal protective equipment (PPE) to be considered to protect oneself from the risk of infection. They have subsequently become the topic of concern related to increased use, inappropriate use, and potentially increasing the risk of cross-infection and environmental impact of plastic waste.

Aim/objective: This study aimed to explore the views of pre-registration student nurses about non-sterile glove use in clinical practice and to identify the factors that impact student nurses' decision on whether to wear non- sterile gloves.

Methods: Using a social constructivist approach, the study was organised in a higher education institution. Semi-structured interviews were conducted with second year student nurses, utilising a theoretical domains framework (TDF).

Findings/results: The key findings showed that students had limited awareness of the national infection prevention and control best practice procedures. The primary influential factors for non-sterile gloves use behaviour were personal protection, the type of care interventions required and the observations of peers and role models.

Discussion: The study found limited awareness on the importance of infection prevention and control precautions, including the correct procedure for donning, and doffing of personal protection equipment, along with a lack of confidence to challenge non-compliance.

背景:一次性非无菌手套是个人防护设备(PPE)的一部分,用于保护自己免受感染。随后,非无菌手套的使用量增加、使用不当、可能增加交叉感染的风险以及塑料垃圾对环境的影响等问题引起了人们的关注:本研究旨在探讨注册前学生护士对在临床实践中使用非无菌手套的看法,并确定影响学生护士决定是否佩戴非无菌手套的因素:研究采用社会建构主义方法,在一所高等教育机构内进行。采用理论领域框架(TDF),对二年级护士学生进行了半结构式访谈:主要调查结果显示,学生对国家感染预防与控制最佳实践程序的认识有限。使用非无菌手套行为的主要影响因素是个人防护、所需护理干预的类型以及同伴和榜样的观察:讨论:研究发现,学生对感染预防和控制预防措施(包括穿戴和脱下个人防护设备的正确程序)的重要性认识有限,而且缺乏挑战违规行为的信心。
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引用次数: 0
World Health Organization World Hand Hygiene Day, 5 May 2024. SAVE LIVES: Clean Your Hands campaign: Promoting knowledge and capacity building on infection prevention and control, including hand hygiene, among health and care workers. 世界卫生组织世界手卫生日,2024 年 5 月 5 日。拯救生命:清洁双手运动:在卫生和护理工作者中推广有关感染预防和控制(包括手部卫生)的知识和能力建设。
IF 0.9 Q4 INFECTIOUS DISEASES Pub Date : 2024-05-01 Epub Date: 2024-03-19 DOI: 10.1177/17571774241239044
Claire Kilpatrick, Ermira Tartari, Miranda Deeves, Didier Pittet, Benedetta Allegranzi

The World Health Organization's (WHO) World Hand Hygiene Day continues to "bring people together and accelerate hand hygiene action at the point of care in health care to contribute to a reduction in health care-associated infections and the achievement of safer, quality health care for all."

世界卫生组织(WHO)的 "世界手卫生日 "继续 "将人们聚集在一起,加快医疗保健护理点的手卫生行动,为减少与医疗保健相关的感染和为所有人实现更安全、更优质的医疗保健做出贡献"。
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引用次数: 0
‘Family members screaming for help makes it very difficult to don PPE’. A qualitative study on UK ambulance staff experiences of infection prevention and control practices during the COVID-19 pandemic 家人的呼救让穿戴个人防护设备变得非常困难"。英国救护车工作人员在 COVID-19 大流行期间的感染预防和控制实践经验定性研究
IF 1.2 Q4 INFECTIOUS DISEASES Pub Date : 2024-01-08 DOI: 10.1177/17571774231209494
P. Eaton-Williams, Julia Williams
During the first wave of the COVID-19 pandemic in the UK, ambulance staff continued to deliver direct patient care whilst simultaneously adapting to a considerable escalation in evolving infection prevention and control (IPC) practices. To enable learning to benefit future planning, this qualitative article aims to describe ambulance staff’s experiences of this rapid escalation of IPC practices. Three online surveys were presented during the acceleration, peak, and deceleration phases of the pandemic’s first wave in the UK (2020). Overall, 18 questions contributed 14,237 free text responses that were examined using inductive thematic analysis at both descriptive and interpretive levels. Many participants lacked confidence in policies related to the use of personal protective equipment (PPE) because of perceived inadequate supporting evidence, confusing communication, and low familiarity with items. Compliance with policy and confidence in PPE use were further influenced by discomfort, urgency, and perceptions of risk. Various suggestions were made to improve IPC practices within the work environment, including reducing unnecessary exposure through public education and remote triage improvements. Some participants’ poor experiences of escalating IPC practices were shared with health care workers studied in other environments and in previous epidemics, emphasising the need for lessons to be learnt. PPE should be developed with consideration of ambulance staff’s unique working environment and regular familiarisation training could be beneficial. Pragmatic, evidence-based, clearly communicated policies implemented with sufficient resources may protect staff and facilitate them to maintain standards of care delivery during a pandemic.
在英国 COVID-19 大流行的第一波期间,救护人员在继续提供直接病人护理的同时,还要适应不断发展的感染预防和控制 (IPC) 实践的大幅升级。为了使学习有利于未来规划,这篇定性文章旨在描述救护人员在这种快速升级的 IPC 实践中的经历。在英国第一波大流行(2020 年)的加速、高峰和减速阶段,共进行了三次在线调查。总体而言,18 个问题共收集了 14,237 条自由文本回复,我们采用归纳式主题分析法对这些回复进行了描述性和解释性研究。许多参与者对与使用个人防护设备 (PPE) 相关的政策缺乏信心,因为他们认为这些政策缺乏足够的支持证据、沟通混乱以及对相关项目不太熟悉。对政策的遵守和使用个人防护设备的信心还受到不适感、紧迫感和风险感的影响。与会者就如何改进工作环境中的 IPC 实践提出了各种建议,包括通过公众教育和远程分流来减少不必要的接触。一些与会者与在其他环境和以往流行病中学习过的医护人员分享了升级 IPC 实践的不良经验,强调需要吸取教训。在开发个人防护设备时应考虑到救护人员独特的工作环境,定期开展熟悉情况的培训可能会有所帮助。务实、以证据为基础、明确传达的政策以及充足的资源可以保护工作人员,并帮助他们在大流行期间保持护理服务的标准。
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引用次数: 0
Impact of an educational intervention on hand hygiene practice among nursing students, with a focus on hand drying efficacy 教育干预对护理专业学生手部卫生实践的影响,重点关注手部干燥效果
IF 1.2 Q4 INFECTIOUS DISEASES Pub Date : 2023-12-28 DOI: 10.1177/17571774231224695
John Gammon, Julian Hunt, Lisa Duffy, Ioan Humphreys, Jon Hinkin, Alan Watkins
Hand hygiene and its significance for reducing the spread of infection is well evidenced and has been brought into sharp focus following the COVID-19 pandemic. Although a crucial clinical skill in ensuring safe healthcare, little is known regarding nursing students’ effectiveness of hand hygiene practice. The aim of this study was to evaluate the impact of an educational intervention on hand hygiene practice, designed by the research team for first year pre-registration nursing students. Particular emphasis was placed upon hand drying technique and time. 825 nursing students were observed and assessed for their hand hygiene practice in a clinical suite at a university setting. Nursing students were observed for compliance against set outcome measures involving hand hygiene preparation, hand and wrist washing technique, hand drying technique and time. Data were analysed quantitatively using SPSS. The educational intervention had a significant impact on the clinical skills learning of nursing students. 779 students passed the assessment at the first attempt (94.4%). Of the 46 students that failed to meet the necessary criteria, 45 satisfied the criteria at the second attempt; giving an overall optimal compliance of 99.9%. 99.6% of students complied with recommended hand drying standards. This study offers an important contribution to the development and delivery of nursing education programmes. The educational intervention improved compliance with recommended hand hygiene technique and practice. Lack of attention to hand drying may negate effective hand hygiene in healthcare.
手部卫生及其对减少感染传播的重要意义已得到充分证明,在 COVID-19 大流行之后,手部卫生更成为人们关注的焦点。尽管手部卫生是确保医疗安全的一项重要临床技能,但人们对护理专业学生的手部卫生实践效果却知之甚少。本研究旨在评估由研究小组为注册前护理专业一年级学生设计的手部卫生实践教育干预措施的影响。其中特别强调了手部干燥的技术和时间。在一所大学的临床病房中,对 825 名护理专业学生的手部卫生实践进行了观察和评估。根据手部卫生准备、洗手和手腕清洗技术、手部干燥技术和时间等设定的结果衡量标准,对护理专业学生的依从性进行了观察。数据采用 SPSS 进行定量分析。教育干预对护理专业学生的临床技能学习产生了重大影响。779 名学生在首次尝试时通过了评估(94.4%)。在未达到必要标准的 46 名学生中,有 45 名学生在第二次尝试时达到了标准;总体最佳达标率为 99.9%。99.6%的学生符合推荐的干手标准。这项研究为护理教育课程的开发和实施做出了重要贡献。教育干预提高了学生对推荐的手部卫生技术和做法的依从性。不注意手部干燥可能会影响医疗保健中手部卫生的效果。
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引用次数: 0
Efficacy of facemasks in preventing transmission of COVID-19 in non-healthcare settings: A scoping review 口罩在非卫生保健环境中预防COVID-19传播的有效性:范围审查
Q4 INFECTIOUS DISEASES Pub Date : 2023-11-06 DOI: 10.1177/17571774231203387
Chloe Enright, Claire Gilbourne, Rachel Kiersey, Randal Parlour, Paula Flanagan, Emer McGowan, Mairin Boland, Deirdre Mulholland
Background During the COVID-19 pandemic, an abundance of literature relating to the efficacy of face masks on reducing transmission of COVID-19 in non-healthcare settings emerged. Aim/objective The aim of this scoping review was to allow the identification of: types of evidence conducted in this area; knowledge gaps and common concepts relating to mask efficacy in non-healthcare settings. Methods A comprehensive literature search was conducted in PubMed, CINAHL, MEDLINE, Embase and the Irish Management Institute bibliographic database on December 15th, 2021. All types of face masks were included. Of 722 records, 16 were included after full text screening. Findings/results Themes from an adapted model of Howard et al. framework were used to group results and identify common concepts. The grouped thematic results were then applied to the socio-ecological model. This illustrated the multifactorial elements determining the efficacy of masks themselves while also illustrating how other factors such as individual behaviours, social interactions, settings and national policy can influence the degree of the protective effect. Discussion The findings from this scoping review indicate that an abundance of experimental literature is available indicating that masks are effective at preventing COVID-19 transmission but their degree of efficacy is impacted by external factors. This review highlights that the quality of the evidence available is low.
背景在2019冠状病毒病大流行期间,出现了大量有关口罩在非卫生保健环境中减少COVID-19传播功效的文献。目的/目的本次范围审查的目的是允许确定:在该领域进行的证据类型;与非卫生保健环境中口罩功效相关的知识差距和常见概念。方法于2021年12月15日在PubMed、CINAHL、MEDLINE、Embase和Irish Management Institute书目数据库中进行综合文献检索。所有类型的口罩都包括在内。在722条记录中,有16条在全文筛选后被纳入。发现/结果采用Howard等人改编的框架模型中的主题对结果进行分组并确定共同概念。然后将分组主题结果应用于社会生态模型。这说明了决定口罩本身功效的多因素因素,同时也说明了个人行为、社会互动、环境和国家政策等其他因素如何影响防护效果的程度。本次综述的结果表明,大量实验文献表明,口罩在预防新冠肺炎传播方面是有效的,但其有效性受外部因素的影响。本综述强调现有证据的质量较低。
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引用次数: 0
Diary 日记
Q4 INFECTIOUS DISEASES Pub Date : 2023-11-01 DOI: 10.1177/17571774231214663
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引用次数: 0
The effectiveness of interventions to improve the seasonal influenza vaccination uptake among nurses: A systematic review. 改善护士季节性流感疫苗接种的干预措施的有效性:一项系统综述。
IF 0.9 Q4 INFECTIOUS DISEASES Pub Date : 2023-11-01 Epub Date: 2023-10-20 DOI: 10.1177/17571774231208115
Paula Flanagan, Maura Dowling, Duygu Sezgin, Jolita Mereckiene, Louise Murphy, Martina Giltenane, Peter Carr, Georgina Gethin

Background: Seasonal influenza is a significant cause of mortality and morbidity worldwide. Despite annual recommendations, influenza vaccination uptake rates are disproportionately lower among nurses compared to other health care professionals, especially when compared to physicians. Nurses have an additional risk of exposure to influenza infection due to the nature of their work.

Aim: To determine the effectiveness of interventions in increasing seasonal influenza vaccination uptake among nurses.

Methods: Evidence on the effectiveness of interventions to improve seasonal influenza vaccination uptake among nurses was systematically reviewed. A comprehensive search of six electronic databases and grey literature was undertaken. A minimum of two reviewers completed study selection, data extraction and risk of bias assessment independently.

Results: One hundred and thirty-four studies were identified of which one cluster randomised trial met the inclusion criteria. The results of the included study found the implementation of an intervention with multiple components increased nurses' seasonal influenza vaccination rates during a single influenza season in geriatric healthcare settings in France. As the evidence in this review was very limited, it was not possible to make recommendations regarding which interventions were effective at increasing the seasonal influenza vaccination rate for nurses.

Conclusion: This systematic review highlights a lack of high-quality studies that assessed interventions to improve the seasonal influenza vaccination of nurses. In view of the likelihood of influenza and the coronavirus (COVID-19) pandemic occurring together, it is imperative to have evidence on effective interventions for the nursing workforce and for policy decision makers.

背景:季节性流感是世界范围内死亡率和发病率的重要原因。尽管有年度建议,但与其他卫生保健专业人员相比,护士的流感疫苗接种率不成比例地低,特别是与医生相比。由于护士的工作性质,他们有接触流感感染的额外风险。目的:确定提高护士季节性流感疫苗接种率的干预措施的有效性。方法:对提高护士季节性流感疫苗接种率的干预措施有效性的证据进行系统回顾。对六个电子数据库和灰色文献进行了全面检索。至少有两名审稿人独立完成研究选择、数据提取和偏倚风险评估。结果:确定了134项研究,其中1项聚类随机试验符合纳入标准。纳入的研究结果发现,在法国的老年保健机构中,实施多组分干预措施可提高护士在单一流感季节的季节性流感疫苗接种率。由于本综述的证据非常有限,因此不可能就哪些干预措施对提高护士的季节性流感疫苗接种率有效提出建议。结论:本系统综述强调缺乏高质量的研究来评估改善护士季节性流感疫苗接种的干预措施。鉴于流感和冠状病毒(COVID-19)大流行同时发生的可能性,必须为护理人员和政策制定者提供有效干预措施的证据。
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引用次数: 0
Personal protection equipment: Preliminary evidence of effectiveness from a three-phase simulation program. 个人防护装备:来自三相模拟程序的有效性初步证据。
IF 1.2 Q4 INFECTIOUS DISEASES Pub Date : 2023-11-01 Epub Date: 2023-10-18 DOI: 10.1177/17571774231208118
Ghazwan Altabbaa, Corrinne Pidhorney, Tanya Beran, Joseph Kim, Donna Ledgerwood, Michèle Cowan, Elizabeth Oddone Paolucci

Background: Healthcare providers carry the occupational risk of being exposed to pathogens. Personal Protection Equipment (PPE) requires proficiency whenever used. Yet, evidence shows significant errors and variation in competency when applying PPE.

Objective: In this study, we developed a three-phase intervention to promote PPE proficiency.

Methods: Education and assessment of participants' PPE knowledge and skills occurred at a large academic university in Western Canada. Participants first completed an online module; second, they experienced one-on-one coaching and deliberate practice with infection control professionals; and third, participants managed a COVID-19 clinical simulation scenario. The measured outcomes include a 15-item pre- and post-knowledge test and a pre- and post-skills assessment of donning and doffing behaviors. These behaviors were observed from video recordings and were assessed using two standardized checklists.

Results: Knowledge and donning/doffing post-test scores (11.73, 0.95, and 0.96, respectively) were significantly higher after completing all three phases of the educational intervention, p < .001.

Conclusions: An online module alone is insufficient for PPE knowledge and skill development. Rather, a module followed by practice and simulation allows learners to gain proficiency.

背景:医疗保健提供者承担暴露于病原体的职业风险。个人防护装备(PPE)要求熟练使用。然而,有证据表明,在使用个人防护装备时,存在显著的错误和能力差异。目的:在本研究中,我们开发了一种三阶段干预来提高个人防护装备的熟练程度。方法:在加拿大西部一所大型学术大学对参与者的PPE知识和技能进行教育和评估。参与者首先完成一个在线模块;其次,他们在感染控制专业人员的指导下进行了一对一的训练和刻意练习;第三,参与者管理COVID-19临床模拟场景。测量结果包括15项知识前和知识后测试,以及穿戴和脱衣行为的技能前和技能后评估。这些行为从录像中观察到,并使用两个标准化清单进行评估。结果:完成三个阶段的教育干预后,知识和穿戴后测试分数(分别为11.73、0.95和0.96)显著提高,p < 0.001。结论:对于PPE知识和技能的发展,仅通过在线模块是不够的。相反,一个模块之后的实践和模拟,使学习者获得熟练程度。
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引用次数: 0
期刊
Journal of Infection Prevention
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