Pub Date : 2025-11-13DOI: 10.1016/j.infpip.2025.100498
L. Amminou, H. Soualem, S. Boukssim, S. Chbicheb
Objective
Blood exposure accidents (BEAs) are a major occupational hazard for dental students. Limited data exist on their prevalence and risk factors in Morocco.
Methods
A cross-sectional survey was conducted among 236 clinical-year dental students (4th–6th year) at the Faculty of Dental Medicine, Rabat. A structured, self-administered questionnaire assessed demographics, BEA history, and clinical practices. Chi-square tests and multivariable logistic regression identified independent risk factors.
Results
45.3% of participants reported at least one BEA, primarily from sharp instrument injuries (55.1%) or splashes onto mucous membranes (25.2%). Multivariate analysis showed that male gender was independently associated with higher risk (∼3.3×), with female students having lower odds of BEA (OR = 0.3, 95% CI: 0.18–0.86). Advanced academic year significantly increased risk (5th year: OR = 2.7, 95% CI: 1.2–6.2; 6th year: OR = 7.0, 95% CI: 3.1–15.3), while absence of procedural assistance also increased risk (OR = 0.1, 95% CI: 0.05–0.43 for assisted vs. non-assisted). Needle recapping practices showed no significant association.
Conclusion
BEAs are frequent among Moroccan dental students in Rabat, particularly in senior years and when procedures are unassisted. Targeted infection-control education, structured supervision, and national guidelines are needed to reduce occupational risks.
{"title":"Blood exposure accidents and associated risk factors among dental students in Rabat, Morocco: A cross-sectional study","authors":"L. Amminou, H. Soualem, S. Boukssim, S. Chbicheb","doi":"10.1016/j.infpip.2025.100498","DOIUrl":"10.1016/j.infpip.2025.100498","url":null,"abstract":"<div><h3>Objective</h3><div>Blood exposure accidents (BEAs) are a major occupational hazard for dental students. Limited data exist on their prevalence and risk factors in Morocco.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among 236 clinical-year dental students (4th–6th year) at the Faculty of Dental Medicine, Rabat. A structured, self-administered questionnaire assessed demographics, BEA history, and clinical practices. Chi-square tests and multivariable logistic regression identified independent risk factors.</div></div><div><h3>Results</h3><div>45.3% of participants reported at least one BEA, primarily from sharp instrument injuries (55.1%) or splashes onto mucous membranes (25.2%). Multivariate analysis showed that male gender was independently associated with higher risk (∼3.3×), with female students having lower odds of BEA (OR = 0.3, 95% CI: 0.18–0.86). Advanced academic year significantly increased risk (5th year: OR = 2.7, 95% CI: 1.2–6.2; 6th year: OR = 7.0, 95% CI: 3.1–15.3), while absence of procedural assistance also increased risk (OR = 0.1, 95% CI: 0.05–0.43 for assisted vs. non-assisted). Needle recapping practices showed no significant association.</div></div><div><h3>Conclusion</h3><div>BEAs are frequent among Moroccan dental students in Rabat, particularly in senior years and when procedures are unassisted. Targeted infection-control education, structured supervision, and national guidelines are needed to reduce occupational risks.</div></div><div><h3>Trial registration</h3><div>CERB 122-24.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"8 1","pages":"Article 100498"},"PeriodicalIF":1.9,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145748451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-08DOI: 10.1016/j.infpip.2025.100497
S. Kenny , K. Kuan , A. Walsh , S.F. FitzGerald
{"title":"Comparison of bacterial contamination between disposable and cloth caps in an operating theatre setting","authors":"S. Kenny , K. Kuan , A. Walsh , S.F. FitzGerald","doi":"10.1016/j.infpip.2025.100497","DOIUrl":"10.1016/j.infpip.2025.100497","url":null,"abstract":"","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"8 1","pages":"Article 100497"},"PeriodicalIF":1.9,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-05DOI: 10.1016/j.infpip.2025.100488
A. Melaku , T. Admasu , A. Ambelu
Introduction
Hand hygiene is crucial for preventing hospital-acquired infections (HAIs), but compliance and resource availability still fall short in developing countries. This study examined hand hygiene compliance and its determinants among healthcare workers in selected hospitals in Addis Ababa, Ethiopia.
Methods
A mixed-methods, cross-sectional study was conducted in both public and private hospitals from December 2024 to January 2025, involving 506 healthcare workers across 19 hospitals. Twenty in-depth interviews were conducted with healthcare workers. Kobo Toolbox was used for quantitative data collection, and SPSS was used for analysis. Binary and multi-nomial logistic regression identified determinants of hand hygiene compliance (P<0.05). Thematic analysis was used to analyse qualitative data.
Results
Hand hygiene compliance showed a disparity: self-reported compliance was 71% (54.7% in public hospitals vs 87.3% in private hospitals), while observed compliance was much lower at 20.4% (11% public vs 29.8% private). Infrastructural assessment found that 79.2% of hospitals had handwashing sinks (70.9% public vs 98.6% private), 16% of which were non-functional (24.7% public vs 1.3% private). Additionally, 49.4% of hospitals lacked running water (66.8% public vs 8.6% private), and 54.6% lacked soap (79.5% public vs 9.8% private). Compliance was significantly associated with availability of a functional sink [adjusted odds ratio (AOR) 2.29, 95% confidence interval (CI) 1.17–4.51], touch-free taps (AOR 3.39, 95% CI 1.6–7.17), soap (AOR 2.11, 95% CI 1.05–4.25), training (AOR 2.39, 95% CI 1.43–4.00), and a hand hygiene protocol (AOR 7.50, 95% CI 2.84–19.81). The main barriers to compliance were infrastructural deficits, glove dependency, low risk perception, and insufficient institutional prioritization.
Conclusion
Hand hygiene compliance and material provision in hospitals in Addis Ababa are low, with a notable disparity between public and private hospitals. As the presence of infrastructure alone does not ensure compliance, the availability of a functional sink with water and soap at the point of care (or alcohol-based hand rub), regular hygiene training, adequate WASH funding, and strong institutional commitment are essential.
手部卫生对于预防医院获得性感染至关重要，但在发展中国家，遵守卫生要求和资源供应仍然不足。本研究考察了埃塞俄比亚亚的斯亚贝巴选定医院的卫生保健工作者的手卫生依从性及其决定因素。方法采用混合方法，于2024年12月至2025年1月在公立和私立医院进行横断面研究，涉及19家医院的506名医护人员。对医护人员进行了20次深度访谈。采用Kobo Toolbox进行定量数据收集，采用SPSS进行分析。二元和多元逻辑回归确定了手卫生依从性的决定因素（P<0.05）。采用专题分析对定性数据进行分析。结果口腔卫生依从性存在差异：自我报告的依从性为71%（公立医院为54.7%，私立医院为87.3%），而观察到的依从性为20.4%（公立医院为11%，私立医院为29.8%）。基础设施评估发现，79.2%的医院有洗手槽（70.9%的公立医院对98.6%的私立医院），其中16%的医院没有功能（24.7%的公立医院对1.3%的私立医院）。此外，49.4%的医院没有自来水（66.8%的公立医院比8.6%的私立医院），54.6%的医院没有肥皂（79.5%的公立医院比9.8%的私立医院）。依从性与功能水槽的可用性显著相关[调整优势比（AOR） 2.29, 95%可信区间（CI） 1.17-4.51]、免触水龙头（AOR 3.39, 95% CI 1.6-7.17）、肥皂（AOR 2.11, 95% CI 1.05-4.25）、训练（AOR 2.39, 95% CI 1.43-4.00）和手卫生方案（AOR 7.50, 95% CI 2.84-19.81）。合规的主要障碍是基础设施缺陷、手套依赖、低风险认知和机构优先级不足。结论亚的斯亚贝巴市医院的手卫生依从性和用品供应较低，公立医院与私立医院之间存在显著差异。由于仅有基础设施并不能确保遵守规定，因此必须在护理点提供带水和肥皂（或含酒精的洗手液）的功能性洗涤槽、定期的卫生培训、充足的讲卫生资金以及强有力的机构承诺。
{"title":"Determinants of hand hygiene compliance among healthcare workers in public and private hospitals of Addis Ababa, Ethiopia","authors":"A. Melaku , T. Admasu , A. Ambelu","doi":"10.1016/j.infpip.2025.100488","DOIUrl":"10.1016/j.infpip.2025.100488","url":null,"abstract":"<div><h3>Introduction</h3><div>Hand hygiene is crucial for preventing hospital-acquired infections (HAIs), but compliance and resource availability still fall short in developing countries. This study examined hand hygiene compliance and its determinants among healthcare workers in selected hospitals in Addis Ababa, Ethiopia.</div></div><div><h3>Methods</h3><div>A mixed-methods, cross-sectional study was conducted in both public and private hospitals from December 2024 to January 2025, involving 506 healthcare workers across 19 hospitals. Twenty in-depth interviews were conducted with healthcare workers. Kobo Toolbox was used for quantitative data collection, and SPSS was used for analysis. Binary and multi-nomial logistic regression identified determinants of hand hygiene compliance (<em>P</em><0.05). Thematic analysis was used to analyse qualitative data.</div></div><div><h3>Results</h3><div>Hand hygiene compliance showed a disparity: self-reported compliance was 71% (54.7% in public hospitals vs 87.3% in private hospitals), while observed compliance was much lower at 20.4% (11% public vs 29.8% private). Infrastructural assessment found that 79.2% of hospitals had handwashing sinks (70.9% public vs 98.6% private), 16% of which were non-functional (24.7% public vs 1.3% private). Additionally, 49.4% of hospitals lacked running water (66.8% public vs 8.6% private), and 54.6% lacked soap (79.5% public vs 9.8% private). Compliance was significantly associated with availability of a functional sink [adjusted odds ratio (AOR) 2.29, 95% confidence interval (CI) 1.17–4.51], touch-free taps (AOR 3.39, 95% CI 1.6–7.17), soap (AOR 2.11, 95% CI 1.05–4.25), training (AOR 2.39, 95% CI 1.43–4.00), and a hand hygiene protocol (AOR 7.50, 95% CI 2.84–19.81). The main barriers to compliance were infrastructural deficits, glove dependency, low risk perception, and insufficient institutional prioritization.</div></div><div><h3>Conclusion</h3><div>Hand hygiene compliance and material provision in hospitals in Addis Ababa are low, with a notable disparity between public and private hospitals. As the presence of infrastructure alone does not ensure compliance, the availability of a functional sink with water and soap at the point of care (or alcohol-based hand rub), regular hygiene training, adequate WASH funding, and strong institutional commitment are essential.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"8 1","pages":"Article 100488"},"PeriodicalIF":1.9,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-31DOI: 10.1016/j.infpip.2025.100490
Akeza Awealom Asgedom , Bente Elisabeth Moen , Ana Lorena Ruano
Background
Healthcare-associated infections are a major cause of morbidity and mortality among health personnel worldwide. The World Health Organization's (WHO) multi-modal hand hygiene tool has shown inadequate hand hygiene levels in various sub-Saharan countries. We have applied it here to describe the hand hygiene level in public health facilities in Tigray, Ethiopia.
Methods
A cross-sectional study was conducted from June to July 2024 in all accessible public health facilities. An interview-based WHO hand hygiene self-assessment framework (HHSAF) tool was used for data collection. Descriptive analyses and independent t-test were used to analyse data.
Results
A total of 33 facilities (two referral, 10 general, and 21 primary hospitals) from six accessible zones of Tigray participated in the survey. The mean age of the respondents was 35 years (SD: 8) with a mean service duration of nine years (SD: 7). Most respondents were infection prevention and control (IPC) focal persons (66.7%), followed by chief executive officers (9.1%). The overall HHSAF score was 126 (range: 15–318), indicating a basic hand hygiene level. Seventeen facilities (51.5%) had inadequate hand hygiene levels, 13 (39.4%) had basic hand hygiene level, three (9.1%) had an intermediate hand hygiene level, and none had an advanced hand hygiene level.
Conclusions
Hand hygiene levels were unsatisfactory in post-war Tigray and were limited across all zones and types of facility, posing an increased risk of infection for healthcare personnel. Improvements in hand hygiene practices and IPC capacity building are essential to prevent healthcare-associated infections. Longitudinal research on hand hygiene level monitoring is recommended.
{"title":"Evaluation of hand hygiene implementation in hospitals in the post-war Tigray region of Ethiopia, using the WHO Hand Hygiene Self-Assessment Framework","authors":"Akeza Awealom Asgedom , Bente Elisabeth Moen , Ana Lorena Ruano","doi":"10.1016/j.infpip.2025.100490","DOIUrl":"10.1016/j.infpip.2025.100490","url":null,"abstract":"<div><h3>Background</h3><div>Healthcare-associated infections are a major cause of morbidity and mortality among health personnel worldwide. The World Health Organization's (WHO) multi-modal hand hygiene tool has shown inadequate hand hygiene levels in various sub-Saharan countries. We have applied it here to describe the hand hygiene level in public health facilities in Tigray, Ethiopia.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted from June to July 2024 in all accessible public health facilities. An interview-based WHO hand hygiene self-assessment framework (HHSAF) tool was used for data collection. Descriptive analyses and independent <em>t</em>-test were used to analyse data.</div></div><div><h3>Results</h3><div>A total of 33 facilities (two referral, 10 general, and 21 primary hospitals) from six accessible zones of Tigray participated in the survey. The mean age of the respondents was 35 years (SD: 8) with a mean service duration of nine years (SD: 7). Most respondents were infection prevention and control (IPC) focal persons (66.7%), followed by chief executive officers (9.1%). The overall HHSAF score was 126 (range: 15–318), indicating a basic hand hygiene level. Seventeen facilities (51.5%) had inadequate hand hygiene levels, 13 (39.4%) had basic hand hygiene level, three (9.1%) had an intermediate hand hygiene level, and none had an advanced hand hygiene level.</div></div><div><h3>Conclusions</h3><div>Hand hygiene levels were unsatisfactory in post-war Tigray and were limited across all zones and types of facility, posing an increased risk of infection for healthcare personnel. Improvements in hand hygiene practices and IPC capacity building are essential to prevent healthcare-associated infections. Longitudinal research on hand hygiene level monitoring is recommended.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 4","pages":"Article 100490"},"PeriodicalIF":1.9,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145568215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to evaluate the effectiveness of nudge-based messages on hand soap usage in a Japanese hospital setting.
Methods
Interrupted time series analysis was conducted using monthly hand soap usage data from April 2022 to March 2024. The following nudge messages were placed in restrooms: “Are your neighbors washing their hands with soap?” (men) and “Water does not disinfect; soap works!” (women). A generalized least squares model with harmonic terms was used to analyze the data, accounting for seasonality and autocorrelation.
Results
The intervention was associated with an immediate increase of 147.85 units/month in hand soap usage (95% confidence interval [CI]: 61.87–233.83; P = 0.003). However, usage gradually decreased by 11.47 units/month thereafter (95% CI: –27.10 to 4.15; P = 0.166). Sensitivity analysis using Poisson regression confirmed the robustness of these findings. The intervention was associated with a 38.5% increase in hand soap usage (incidence rate ratio [IRR] = 1.385, 95% CI: 1.265–1.515, P < 0.001), but there was a subsequent 1.9% monthly decrease (IRR = 0.981, 95% CI: 0.965–0.997, P = 0.019).
Conclusions
These findings suggest that nudge-based interventions can be effective in promoting hand hygiene in Japanese health-care settings, but the effect may wane over time.
本研究旨在评估日本医院环境中轻推信息对洗手液使用的有效性。方法对2022年4月至2024年3月每月洗手液使用数据进行中断时间序列分析。洗手间里贴着这样的提示信息：“你的邻居用肥皂洗手吗？”（男人）和“水不消毒；soap工作!”(女性)。采用调和项广义最小二乘模型对数据进行分析，考虑了季节性和自相关性。结果干预与立即增加147.85单位/月的洗手液使用量相关（95%可信区间[CI]: 61.87-233.83; P = 0.003）。然而，此后使用量逐渐减少11.47个单位/月（95% CI: -27.10至4.15;P = 0.166）。使用泊松回归的敏感性分析证实了这些发现的稳健性。干预与洗手液使用率增加38.5%相关（发病率比[IRR] = 1.385, 95% CI: 1.265-1.515, P < 0.001），但随后每月下降1.9% （IRR = 0.981, 95% CI: 0.965-0.997, P = 0.019）。这些发现表明，在日本卫生保健机构中，以轻推为基础的干预措施可以有效地促进手卫生，但效果可能会随着时间的推移而减弱。
{"title":"Impact of a nudge-based intervention on hand soap usage in a Japanese Hospital: interrupted time series analysis","authors":"Tetsuji Morishita , Masayoshi Monji , Masao Kuwabara , Shin Lee , Makoto Hayashi , Hisashi Tsurumi , Hidetoshi Matsunami","doi":"10.1016/j.infpip.2025.100494","DOIUrl":"10.1016/j.infpip.2025.100494","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to evaluate the effectiveness of nudge-based messages on hand soap usage in a Japanese hospital setting.</div></div><div><h3>Methods</h3><div>Interrupted time series analysis was conducted using monthly hand soap usage data from April 2022 to March 2024. The following nudge messages were placed in restrooms: “Are your neighbors washing their hands with soap?” (men) and “Water does not disinfect; soap works!” (women). A generalized least squares model with harmonic terms was used to analyze the data, accounting for seasonality and autocorrelation.</div></div><div><h3>Results</h3><div>The intervention was associated with an immediate increase of 147.85 units/month in hand soap usage (95% confidence interval [CI]: 61.87–233.83; <em>P</em> = 0.003). However, usage gradually decreased by 11.47 units/month thereafter (95% CI: –27.10 to 4.15; <em>P</em> = 0.166). Sensitivity analysis using Poisson regression confirmed the robustness of these findings. The intervention was associated with a 38.5% increase in hand soap usage (incidence rate ratio [IRR] = 1.385, 95% CI: 1.265–1.515, <em>P</em> < 0.001), but there was a subsequent 1.9% monthly decrease (IRR = 0.981, 95% CI: 0.965–0.997, <em>P</em> = 0.019).</div></div><div><h3>Conclusions</h3><div>These findings suggest that nudge-based interventions can be effective in promoting hand hygiene in Japanese health-care settings, but the effect may wane over time.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 4","pages":"Article 100494"},"PeriodicalIF":1.9,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-27DOI: 10.1016/j.infpip.2025.100495
Jie Li , Maria Theresa Cabahug , Tuodi Wu , Hairu Chai , Rongyan An , Nicole Shu Ning Teoh , Liang Fang Yu , Zaleha binte Alias , Shi Yun Foo , Suhailah binte Nasir , Wenyi Seow , Philomena Liew , Thean Yen Tan
Background
Peripheral intravenous catheters (PIVCs) are widely used in hospitals and account for up to one-third of hospital-onset Staphylococcus aureus bacteremia (HO-SAB) cases.
Local Problem
In response to increasing HO-SAB, a quality improvement initiative was launched to reduce PIVC-related phlebitis and HO-SAB.
Methods
An evidence-based bundle for peripheral intravenous catheter (PIVC) insertion and care was developed, focusing on four key components: hand hygiene, aseptic technique during insertion, daily monitoring and timely removal of PIVCs, and optimization of maintenance care. The bundle was piloted in two wards using the Model for Improvement, which led to a reduction in phlebitis rates. The same PIVC bundle was subsequently implemented in a phased manner across the hospital, with the implementation process guided by Kotter's 8-step model of change to ensure effective and sustainable adoption.
Interventions
Interventions involved staff education, daily PIVC checks, process and outcome monitoring with feedback, ongoing ward engagement, and hospital-wide awareness campaigns. Key implementation measures included bundle compliance, phlebitis rates, and PIVC-related HO-SAB.
Results
Phlebitis rates in pilot wards declined from 7% to 1–2%, with comparable reductions observed after hospital-wide implementation. PIVC-related HO-SAB rates decreased from 0.61 (pre-implementation) to 0.26 episodes per 10,000 patient-days.
Conclusions
Overall, the structured care bundle significantly reduced phlebitis and was associated with lower PIVC-related HO-SAB rates.
{"title":"Implementation of a peripheral intravenous catheter bundle to reduce phlebitis and hospital-onset Staphylococcus aureus bacteremia: A quality improvement project","authors":"Jie Li , Maria Theresa Cabahug , Tuodi Wu , Hairu Chai , Rongyan An , Nicole Shu Ning Teoh , Liang Fang Yu , Zaleha binte Alias , Shi Yun Foo , Suhailah binte Nasir , Wenyi Seow , Philomena Liew , Thean Yen Tan","doi":"10.1016/j.infpip.2025.100495","DOIUrl":"10.1016/j.infpip.2025.100495","url":null,"abstract":"<div><h3>Background</h3><div>Peripheral intravenous catheters (PIVCs) are widely used in hospitals and account for up to one-third of hospital-onset <em>Staphylococcus aureus</em> bacteremia (HO-SAB) cases.</div></div><div><h3>Local Problem</h3><div>In response to increasing HO-SAB, a quality improvement initiative was launched to reduce PIVC-related phlebitis and HO-SAB.</div></div><div><h3>Methods</h3><div>An evidence-based bundle for peripheral intravenous catheter (PIVC) insertion and care was developed, focusing on four key components: hand hygiene, aseptic technique during insertion, daily monitoring and timely removal of PIVCs, and optimization of maintenance care. The bundle was piloted in two wards using the Model for Improvement, which led to a reduction in phlebitis rates. The same PIVC bundle was subsequently implemented in a phased manner across the hospital, with the implementation process guided by Kotter's 8-step model of change to ensure effective and sustainable adoption.</div></div><div><h3>Interventions</h3><div>Interventions involved staff education, daily PIVC checks, process and outcome monitoring with feedback, ongoing ward engagement, and hospital-wide awareness campaigns. Key implementation measures included bundle compliance, phlebitis rates, and PIVC-related HO-SAB.</div></div><div><h3>Results</h3><div>Phlebitis rates in pilot wards declined from 7% to 1–2%, with comparable reductions observed after hospital-wide implementation. PIVC-related HO-SAB rates decreased from 0.61 (pre-implementation) to 0.26 episodes per 10,000 patient-days.</div></div><div><h3>Conclusions</h3><div>Overall, the structured care bundle significantly reduced phlebitis and was associated with lower PIVC-related HO-SAB rates.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 4","pages":"Article 100495"},"PeriodicalIF":1.9,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-21DOI: 10.1016/j.infpip.2025.100493
Yuying Pang , Yan Hu , Jiaoyang Zhu , Zhaoxia Liu , Youquan Zhou , Xiumei Yang , Yifan Peng , Min Zhao
Background
We describe an outbreak of carbapenem-resistant Klebsiella pneumoniae (CRKP) nosocomial infection in the intensive care unit (ICU) of a cancer hospital. We evaluate the containment measures implemented and provide evidence-based recommendations for improving CRKP infection prevention and control strategies.
Methods
Between June and July 2023, a comprehensive epidemiological investigation was conducted, including environmental hygiene surveillance and targeted infection control interventions. These measures focused on patients with CRKP nosocomial infections in the ICU, and their effectiveness was systematically evaluated.
Results
A total of 22 CRKP strains were identified in 14 patients(including one transferred from another hospital), with 13 nosocomial infections. Five patients had infections at multiple sites. The nosocomial infection rate was 8.1%, representing a statistically significant increase compared to the same period in previous years. Environmental surveillance detected CRKP contamination on the hands of two doctors (8.7% detection rate) and on various surfaces (8% detection rate), particularly shared equipment, bed unit surfaces, and sanitary ware. Following the implementation of control measures, the spread was effectively contained.
Conclusions
Key factors contributing to transmission likely included delayed identification of infected patients, inadequate enforcement of isolation protocols, and suboptimal environmental cleaning and disinfection. Early detection, strict isolation measures, and thorough environmental cleaning are essential for effective prevention and control of CRKP in the ICU setting.
{"title":"Carbapenem-Resistant Klebsiella pneumoniae outbreak in the Intensive Care Unit of a cancer centre","authors":"Yuying Pang , Yan Hu , Jiaoyang Zhu , Zhaoxia Liu , Youquan Zhou , Xiumei Yang , Yifan Peng , Min Zhao","doi":"10.1016/j.infpip.2025.100493","DOIUrl":"10.1016/j.infpip.2025.100493","url":null,"abstract":"<div><h3>Background</h3><div>We describe an outbreak of carbapenem-resistant <em>Klebsiella pneumoniae</em> (CRKP) nosocomial infection in the intensive care unit (ICU) of a cancer hospital. We evaluate the containment measures implemented and provide evidence-based recommendations for improving CRKP infection prevention and control strategies.</div></div><div><h3>Methods</h3><div>Between June and July 2023, a comprehensive epidemiological investigation was conducted, including environmental hygiene surveillance and targeted infection control interventions. These measures focused on patients with CRKP nosocomial infections in the ICU, and their effectiveness was systematically evaluated.</div></div><div><h3>Results</h3><div>A total of 22 CRKP strains were identified in 14 patients(including one transferred from another hospital), with 13 nosocomial infections. Five patients had infections at multiple sites. The nosocomial infection rate was 8.1%, representing a statistically significant increase compared to the same period in previous years. Environmental surveillance detected CRKP contamination on the hands of two doctors (8.7% detection rate) and on various surfaces (8% detection rate), particularly shared equipment, bed unit surfaces, and sanitary ware. Following the implementation of control measures, the spread was effectively contained.</div></div><div><h3>Conclusions</h3><div>Key factors contributing to transmission likely included delayed identification of infected patients, inadequate enforcement of isolation protocols, and suboptimal environmental cleaning and disinfection. Early detection, strict isolation measures, and thorough environmental cleaning are essential for effective prevention and control of CRKP in the ICU setting.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 4","pages":"Article 100493"},"PeriodicalIF":1.9,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-20DOI: 10.1016/j.infpip.2025.100492
Rachel Bousfield , Ruth Kappeler , Sumita Pai , Olly Allen , Kathy Randall , Jacqueline Keane , Stephen Baker
Background
The National incidence of bloodstream infection (BSI) caused by Klebsiella Pneumoniae increased during the Covid-19 pandemic in the United Kingdom, whilst we observed an increase in BSI caused by Gram-negative bacteria in our adult Intensive Care Unit (ICU).
Methods
We audited all Gram-negative bacterial BSIs between 13th April 2020 and 25th December 2021 in our ICU. In total, 41 organisms underwent antimicrobial susceptibility testing and genome sequencing. Notable organisms isolated included 16 Klebsiella spp., 4 E. coli, and 4 Pseudomonas spp.
Results
Overall, we observed a low prevalence of multi-drug resistant (MDR) organisms causing BSI on our unit. A fifth (4/20) of E. coli and Klebsiella spp. isolates carried ESBL or AmpC genes and a single P. monteilli carried the IMP-1 gene. At least 3/16 (19%) BSI with Klebsiella spp. were likely associated with transmission between patients in nearby beds. These transmission events were associated with two hypervirulent K. pneumoniae (ST412 and ST86) and a K. aerogenes ∗002b. Half of all K. pneumoniae associated with BSI were hypervirulent, having K2 or K57 capsule type and the presence of iuc, iro, Rmp genes.
Discussion
Hypervirulent K. pneumoniae is an emerging problem, capable of causing a severe, disseminated infection. We suggest risk factors for transmission may include shared equipment, environmental and PPE contamination, and failure of effective hand hygiene. With COVID-19 infection endemic, if SARS-CoV-2 patients require cohort nursing in bays with sessional use gowns, we recommend these are short-sleeved, to facilitate effective hand hygiene. We argue strict Infection Control policy, including enhanced cleaning, is critical to reduce transmission of hypervirulent K. pneumoniae and advocate for enhanced national surveillance systems.
{"title":"Retrospective cohort study of Gram-negative bacteraemia shows transmission of hypervirulent Klebsiella pneumoniae in a UK Intensive Care Unit during the Covid-19 pandemic","authors":"Rachel Bousfield , Ruth Kappeler , Sumita Pai , Olly Allen , Kathy Randall , Jacqueline Keane , Stephen Baker","doi":"10.1016/j.infpip.2025.100492","DOIUrl":"10.1016/j.infpip.2025.100492","url":null,"abstract":"<div><h3>Background</h3><div>The National incidence of bloodstream infection (BSI) caused by <em>Klebsiella Pneumoniae</em> increased during the Covid-19 pandemic in the United Kingdom, whilst we observed an increase in BSI caused by Gram-negative bacteria in our adult Intensive Care Unit (ICU).</div></div><div><h3>Methods</h3><div>We audited all Gram-negative bacterial BSIs between 13<sup>th</sup> April 2020 and 25<sup>th</sup> December 2021 in our ICU. In total, 41 organisms underwent antimicrobial susceptibility testing and genome sequencing. Notable organisms isolated included 16 <em>Klebsiella</em> spp., 4 <em>E. coli</em>, and 4 <em>Pseudomonas</em> spp.</div></div><div><h3>Results</h3><div>Overall, we observed a low prevalence of multi-drug resistant (MDR) organisms causing BSI on our unit. A fifth (4/20) of <em>E. coli</em> and <em>Klebsiella</em> spp. isolates carried ESBL or AmpC genes and a single <em>P. monteilli</em> carried the IMP-1 gene. At least 3/16 (19%) BSI with <em>Klebsiella</em> spp. were likely associated with transmission between patients in nearby beds. These transmission events were associated with two hypervirulent <em>K. pneumoniae</em> (ST412 and ST86) and a <em>K. aerogenes</em> ∗002b. Half of all <em>K. pneumoniae</em> associated with BSI were hypervirulent, having K2 or K57 capsule type and the presence of <em>iuc, iro, Rmp</em> genes.</div></div><div><h3>Discussion</h3><div>Hypervirulent <em>K. pneumoniae</em> is an emerging problem, capable of causing a severe, disseminated infection. We suggest risk factors for transmission may include shared equipment, environmental and PPE contamination, and failure of effective hand hygiene. With COVID-19 infection endemic, if SARS-CoV-2 patients require cohort nursing in bays with sessional use gowns, we recommend these are short-sleeved, to facilitate effective hand hygiene. We argue strict Infection Control policy, including enhanced cleaning, is critical to reduce transmission of hypervirulent <em>K. pneumoniae</em> and advocate for enhanced national surveillance systems.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 4","pages":"Article 100492"},"PeriodicalIF":1.9,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Effective infection prevention and control (IPC) and antimicrobial stewardship programs (ASPs) are essential components of hospitals. This study aims to evaluate the status of IPC and ASPs at Jimma University Medical Center (JUMC), a tertiary care hospital, in Southwest Oromia, Ethiopia.
Methods
A facility-based cross-sectional study was conducted in two parts. In part one, data on the core components of IPC were collected using the WHO Infection Prevention and Control Assessment Framework (IPCAF) tool. The hospital's IPC level was determined based on the total scores for the core components. In part two, ASP assessment tool was used to gather data on the core elements of ASPs, and the hospital's ASP status was determined based on the total scores.
Results
The overall IPC scores of JUMC was 455, corresponding to an intermediate level. The highest scores were observed for the IPC program (70), monitoring and feedback of IPC practices (67.5), and multimodal strategies (65). The lowest scores were for hospital-acquired infections (HAIs) surveillance (25) and IPC education and training (50). Regarding ASPs, the overall score was 51.2%, indicating a moderate level of ASP. Significant gaps were found in ASP core elements; education (0%), tracking antibiotic use (27.3%) and hospital leadership commitment (42.9%).
Conclusions
The IPC and ASP programs at JUMC are performing at intermediate and moderate levels, respectively. Attention is required to strengthen HAIs surveillance, tracking of antibiotic uses, and education and training. The overlap between IPC and ASPs presents an opportunity for future collaborative efforts to enhance both programs.
{"title":"Evaluation of infection prevention and antibiotic stewardship programs at a tertiary-care hospital in Southwest Ethiopia: An opportunity to leverage the synergy","authors":"Mulualem Tadesse , Selam Tesfaye , Abebe Dukessa , Belay Zawdie , Birhanu Yenealem , Kisi Chemeda , Addisalem Gebre , Daniel Dana , Henok Gulilat , Tadele Akeba Diriba , Amare Assefa , Diriba Fufa , Gemeda Abebe","doi":"10.1016/j.infpip.2025.100489","DOIUrl":"10.1016/j.infpip.2025.100489","url":null,"abstract":"<div><h3>Background</h3><div>Effective infection prevention and control (IPC) and antimicrobial stewardship programs (ASPs) are essential components of hospitals. This study aims to evaluate the status of IPC and ASPs at Jimma University Medical Center (JUMC), a tertiary care hospital, in Southwest Oromia, Ethiopia.</div></div><div><h3>Methods</h3><div>A facility-based cross-sectional study was conducted in two parts. In part one, data on the core components of IPC were collected using the WHO Infection Prevention and Control Assessment Framework (IPCAF) tool. The hospital's IPC level was determined based on the total scores for the core components. In part two, ASP assessment tool was used to gather data on the core elements of ASPs, and the hospital's ASP status was determined based on the total scores.</div></div><div><h3>Results</h3><div>The overall IPC scores of JUMC was 455, corresponding to an intermediate level. The highest scores were observed for the IPC program (70), monitoring and feedback of IPC practices (67.5), and multimodal strategies (65). The lowest scores were for hospital-acquired infections (HAIs) surveillance (25) and IPC education and training (50). Regarding ASPs, the overall score was 51.2%, indicating a moderate level of ASP. Significant gaps were found in ASP core elements; education (0%), tracking antibiotic use (27.3%) and hospital leadership commitment (42.9%).</div></div><div><h3>Conclusions</h3><div>The IPC and ASP programs at JUMC are performing at intermediate and moderate levels, respectively. Attention is required to strengthen HAIs surveillance, tracking of antibiotic uses, and education and training. The overlap between IPC and ASPs presents an opportunity for future collaborative efforts to enhance both programs.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 4","pages":"Article 100489"},"PeriodicalIF":1.9,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-16DOI: 10.1016/j.infpip.2025.100491
Melissa Rochon , Angila Jawarchan , Jamie Croker , Anna Thompson , Glorea P. Rajakumar , Nnadiebere Ayogu , Karen Cariaga , Ana Alves , Judith Tanner
Background
Surgical site infections (SSIs) are a leading cause of postoperative morbidity, contributing to significant healthcare resource utilisation and economic burden. This study evaluates the impact of smartphone-based remote monitoring of surgical wounds on reducing healthcare visits for cardiothoracic patients with SSIs within the National Health Service (NHS).
Methods
A retrospective, multi-site service evaluation was conducted at Guy's and St Thomas' NHS Foundation Trust (GSTT), encompassing three specialised cardiac hospitals in London. Adult patients having cardiothoracic surgery were monitored for SSI using the Isla digital platform. SSI rates and associated NHS visits were analysed and compared against national cardiothoracic data.
Results
1,248 patients enrolled onto the Isla wound monitoring platform over a six-month period, showed an SSI rate of 6.7% and an overall response rate to Isla of 88%. 77 patients with an SSI at GSTT used 295 NHS visits, significantly fewer healthcare resources across nearly all visit types compared to national cardiothoracic SSI patients, including general practitioner (GP), nurse, outpatient and Accident and Emergency attendances (P< 0.05). The only exception was readmissions for SSIs that developed after hospital discharge, where there was no significant difference between GSTT and national patients (P = 0.9197). The median wound healing time for patients with digital monitoring was 19 days (range 2–156 days), while the national data reports a mean time to heal of 91.7 days ±67.5.
Conclusion
Smartphone-based remote wound monitoring significantly reduced healthcare visits while maintaining effective SSI management, aligning with NHS objectives to enhance resource efficiency and patient convenience. These findings underscore the potential of remote monitoring in postoperative care and warrant further studies to assess its broader applicability.
{"title":"The impact of smartphone-based monitoring on reducing National Health Service visits for cardiothoracic patients with surgical site infections","authors":"Melissa Rochon , Angila Jawarchan , Jamie Croker , Anna Thompson , Glorea P. Rajakumar , Nnadiebere Ayogu , Karen Cariaga , Ana Alves , Judith Tanner","doi":"10.1016/j.infpip.2025.100491","DOIUrl":"10.1016/j.infpip.2025.100491","url":null,"abstract":"<div><h3>Background</h3><div>Surgical site infections (SSIs) are a leading cause of postoperative morbidity, contributing to significant healthcare resource utilisation and economic burden. This study evaluates the impact of smartphone-based remote monitoring of surgical wounds on reducing healthcare visits for cardiothoracic patients with SSIs within the National Health Service (NHS).</div></div><div><h3>Methods</h3><div>A retrospective, multi-site service evaluation was conducted at Guy's and St Thomas' NHS Foundation Trust (GSTT), encompassing three specialised cardiac hospitals in London. Adult patients having cardiothoracic surgery were monitored for SSI using the Isla digital platform. SSI rates and associated NHS visits were analysed and compared against national cardiothoracic data.</div></div><div><h3>Results</h3><div>1,248 patients enrolled onto the Isla wound monitoring platform over a six-month period, showed an SSI rate of 6.7% and an overall response rate to Isla of 88%. 77 patients with an SSI at GSTT used 295 NHS visits, significantly fewer healthcare resources across nearly all visit types compared to national cardiothoracic SSI patients, including general practitioner (GP), nurse, outpatient and Accident and Emergency attendances (<em>P</em>< 0.05). The only exception was readmissions for SSIs that developed after hospital discharge, where there was no significant difference between GSTT and national patients (<em>P</em> = 0.9197). The median wound healing time for patients with digital monitoring was 19 days (range 2–156 days), while the national data reports a mean time to heal of 91.7 days ±67.5.</div></div><div><h3>Conclusion</h3><div>Smartphone-based remote wound monitoring significantly reduced healthcare visits while maintaining effective SSI management, aligning with NHS objectives to enhance resource efficiency and patient convenience. These findings underscore the potential of remote monitoring in postoperative care and warrant further studies to assess its broader applicability.</div></div>","PeriodicalId":33492,"journal":{"name":"Infection Prevention in Practice","volume":"7 4","pages":"Article 100491"},"PeriodicalIF":1.9,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145416748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号