Infection Prevention in Practice最新文献

英文中文

Healthcare professionals' knowledge, attitudes, and practices in preventing catheter-associated urinary tract infections: a cross-sectional study in a rehabilitation facility 医疗保健专业人员在预防导尿管相关性尿路感染方面的知识、态度和实践：一项康复机构的横断面研究

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-18 DOI: 10.1016/j.infpip.2025.100438

D.C. Muscat , M. Sciortino , E. Tartari

Background

Catheter-associated urinary tract infections (CAUTIs) are prevalent yet preventable healthcare-associated infections. Effective prevention requires healthcare professionals (HCPs) to possess adequate knowledge, positive attitudes, and adherence to best practices.

Objective

To evaluate the knowledge, attitudes, and practices (KAPs) of HCPs regarding the prevention and management of CAUTI in a Maltese rehabilitation facility.

Methods

A cross-sectional survey was conducted with a self-administered online questionnaire from January to March 2023, using total population sampling of doctors, nurses, and nursing assistants (N = 315). Descriptive and inferential analyses were conducted using SPSS.

Results

Of the 315 HCPs invited, 215 responded (68.3%). KAP levels towards CAUTI prevention were moderate to adequate. The attitude scores of doctors and nurses varied significantly based on nationality (P = 0.011), professional designation (P = 0.010), and educational level (P<0.001). Positive correlations were identified between CAUTI knowledge and practices among doctors' and nurses' (P=0.002, r = 0.309). For nursing assistants, significant differences were observed across knowledge (P<0.001), attitude (P<0.001), and practice scores (P<0.001), based on age, educational level, job experience, and timing of their last infection prevention and control training. Positive correlations were observed between knowledge and attitudes (P<0.001, r = 0.471), knowledge and practice (P<0.001, r = 0.383), and attitudes and practice (P<0.001, r = 0.403) for nursing assistants.

Conclusions

HCP knowledge and attitudes directly influence CAUTI prevention practices. Continuous education and targeted training programmes are critical to improving practices and reducing CAUTI-related patient harm.

导尿管相关性尿路感染（CAUTIs）是一种普遍但可预防的卫生保健相关感染。有效的预防需要医疗保健专业人员（HCPs）拥有足够的知识、积极的态度和遵守最佳实践。目的了解马耳他某康复机构医护人员对CAUTI预防和管理的知识、态度和实践情况。方法采用横断面调查方法，于2023年1月至3月采用在线自填问卷进行调查，对医生、护士和护工进行总体抽样（N = 315）。采用SPSS进行描述性和推断性分析。结果被邀请的315名HCPs中，有215名回应，占68.3%。预防caui的KAP水平为中等至充分。不同国籍（P = 0.011）、不同职称（P = 0.010）、不同学历（P = 0.001）的医生、护士态度得分差异显著。医生和护士的CAUTI知识与实践呈正相关（P=0.002, r = 0.309）。护理助理的知识（P<0.001）、态度（P<0.001）和实践分数（P<0.001）在年龄、教育水平、工作经验和最后一次感染预防和控制培训时间的基础上存在显著差异。护理人员的知识与态度（P<0.001, r = 0.471）、知识与实践（P<0.001, r = 0.383）、态度与实践（P<0.001, r = 0.403）呈正相关。结论shcp知识和态度直接影响CAUTI的预防实践。持续教育和有针对性的培训规划对于改进做法和减少与冠状动脉感染相关的患者伤害至关重要。

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引用次数: 0

Surgical prophylaxis in Haydom Lutheran Hospital, Tanzania – learning from a point prevalence survey 手术预防在海多姆路德医院，坦桑尼亚-从点患病率调查学习

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-09 DOI: 10.1016/j.infpip.2024.100429

T.J. Schrama , K.J. Vliegenthart-Jongbloed , M. Gemuwang , E.Q. Nuwass

Background

Antimicrobial resistance (AMR) is a significant global health concern, with improper antibiotic use contributing to its rise. Tanzania initiated an AMR action plan in 2017, but comprehensive surveillance and stewardship efforts remain limited. This study focused on evaluating antibiotic use, particularly surgical prophylaxis, in a rural Tanzanian hospital.

Methods

The study was conducted at Haydom Lutheran Hospital in Tanzania in May 2023, using a cross-sectional point prevalence survey. Antibiotic use in all patients admitted for >24 h and those undergoing surgery was recorded, including type, dose, indication and duration. Quality indicators for surgical prophylaxis were assessed.

Results

Among 199 inpatients, 55% received antibiotics, with surgical prophylaxis accounting for 23% of prescriptions. Notably, none of the patients who received surgical prophylaxis received a single-dose regimen, and 67% exceeded the recommended 24-h duration. A combination of ampicillin-cloxacillin plus metronidazole was the most commonly prescribed combination for surgical prophylaxis (41% of prescriptions). Thirty-three percent of the antibiotics prescribed for surgical prophylaxis were classified as ‘Not recommended’ by the World Health Organization. Furthermore, 90% of surgical prophylaxis prescriptions lacked documented rationale, and 83% of prescriptions lacked stop/review dates in medical records.

Conclusion

This study reveals a high prevalence of prolonged antibiotic use for surgical prophylaxis, frequent use of antibiotics classified as ‘Not recommended’, and a lack of adequate documentation, which deviates from international standards. These practices highlight the urgent need for contextualized national guidelines, large-scale implementation projects of evidence-based interventions, and local initiatives in antibiotic stewardship, particularly in low-resource settings.

抗生素耐药性（AMR）是一个重大的全球健康问题，抗生素使用不当导致其上升。坦桑尼亚于2017年启动了一项抗菌素耐药性行动计划，但全面的监测和管理工作仍然有限。这项研究的重点是评估坦桑尼亚一家农村医院的抗生素使用情况，特别是手术预防。方法本研究于2023年5月在坦桑尼亚的Haydom Lutheran医院进行，采用横断面点患病率调查。记录所有住院24小时及手术患者的抗生素使用情况，包括类型、剂量、适应证和持续时间。评估手术预防的质量指标。结果199例住院患者中，55%的患者使用抗生素，其中手术预防处方占处方的23%。值得注意的是，没有接受手术预防的患者接受单剂量方案，67%超过推荐的24小时持续时间。氨苄西林-氯西林联合甲硝唑是外科预防最常用的处方组合（占处方的41%）。33%用于手术预防的抗生素被世界卫生组织列为“不推荐”。此外，90%的外科预防处方缺乏书面理由，83%的处方在医疗记录中缺乏停止/审查日期。结论：本研究揭示了外科预防长期使用抗生素的高发率，频繁使用被归类为“不推荐”的抗生素，以及缺乏足够的文件，这与国际标准不符。这些实践突出表明，迫切需要根据具体情况制定国家指南，大规模实施循证干预措施项目，并在抗生素管理方面采取地方行动，特别是在资源匮乏的环境中。

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引用次数: 0

Reducing waste and improving provider safety: a retrospective analysis with lessons from the COVID-19 Pandemic 减少浪费和提高提供者安全：基于COVID-19大流行经验教训的回顾性分析

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-08 DOI: 10.1016/j.infpip.2025.100437

Johannes Heymer, Stefani Fruchi, Anna Hein, Matthias Ott, Daniel Räpple

Background

Reducing waste is an important component in comprehensive efforts to create greener intensive care units (ICU). Personal protective equipment (PPE) constitutes a significant share of the waste produced during ICU care. During the COVID-19 pandemic, the availability and supply of PPE posed substantial challenges globally. We aimed to investigate the lessons learned from the use of PPE during the pandemic (regarding the reduction of PPE consumption) and impact on hospital-acquired infections in healthcare workers.

Methods

Conducting a retrospective analysis, we examined all newly issued standard operating procedures for the ICU related to the pandemic. We observed for a potential effect on the use of PPE and scrutinized PPE consumption and patient day data focusing on potential differences between 2020 and the following years until 2023. The primary objective was to evaluate the impact of the protocols and measures on PPE consumption.

Results

Our analysis revealed that the implementation of four key infection control measures (cohorting, limitation of visits, institutional protocols for PPE use, staff training) lead to a substantial reduction in the use of masks and isolation gowns during the initial stages of the COVID-19 pandemic with no recorded hospital-acquired infections among healthcare workers.

Conclusion

It is possible to reduce PPE consumption without compromising the safety of our healthcare professionals. Our observations may guide future policies to reduce PPE consumption with the intent of reducing the environmental impact.

背景减少浪费是创建更环保的重症监护室（ICU）的重要组成部分。个人防护装备（PPE）在ICU护理期间产生的废物中占很大比例。在2019冠状病毒病大流行期间，个人防护装备的可用性和供应给全球带来了重大挑战。我们的目的是调查大流行期间使用个人防护装备的经验教训（关于减少个人防护装备的消耗）以及对卫生保健工作者医院获得性感染的影响。方法进行回顾性分析，我们检查了所有新发布的与大流行相关的ICU标准操作程序。我们观察了对个人防护用品使用的潜在影响，并仔细检查了个人防护用品消费量和患者日数据，重点关注2020年与2023年之间的潜在差异。主要目标是评估方案和措施对个人防护装备消费的影响。结果我们的分析显示，在COVID-19大流行的初始阶段，实施了四项关键感染控制措施（分组、限制出诊、机构使用个人防护装备的方案、工作人员培训），导致口罩和隔离服的使用大幅减少，卫生保健工作者中没有记录到医院获得性感染。结论在不影响卫生专业人员安全的情况下减少个人防护用品的使用是可能的。我们的观察结果可以指导未来减少PPE消费的政策，以减少对环境的影响。

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引用次数: 0

Understanding healthcare workers' experiences of face mask use in healthcare settings during the COVID-19 pandemic: an interview study 了解COVID-19大流行期间卫生保健机构医护人员使用口罩的经历：一项访谈研究

IF 1.8 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-06 DOI: 10.1016/j.infpip.2024.100434

H. Carter , A. Sharp , L. Davidson , C. Foster , E. McGuire , C. Brown , D. Weston

Background

Whilst healthcare workers (HCWs) are at high risk of contracting infectious viral diseases, such as COVID-19, measures can be put in place to reduce the spread of diseases in healthcare settings. These currently include the use of different types of masks: fluid-resistant surgical masks (FRSM) and filtering facepiece (FFP3) respirators. However, for mask policies to be effective, compliance with their use must be high.

Aim

To understand any barriers to face mask use, and to promote compliance with face mask policy.

Methods

Twelve HCWs from a variety of backgrounds were interviewed during the COVID-19 pandemic in England in 2022 to understand their experiences of mask use. We explored factors associated with compliance with mask use and potential impacts on HCW wellbeing.

Findings

Overall, participants reported good understanding of the benefits of masks and high compliance levels with policy. However, factors that reduced their compliance with mask policy and impacted their ability to carry out their role were highlighted. These included wearing masks for longer durations, policy being perceived as out of proportion with risk, communication challenges, and discomfort.

Conclusion

This study highlights the importance of clear communication of guidance, particularly when it has changed, ensuring staff are familiar with up-to-date research on efficacy of masks, and ensuring guidance aligns with risk. Furthermore, this study highlights the importance of masks being required for an appropriate duration (based on risk).

背景：虽然卫生保健工作者（HCWs）感染COVID-19等传染性病毒性疾病的风险很高，但可以采取措施减少疾病在卫生保健环境中的传播。这些措施目前包括使用不同类型的口罩：耐液体外科口罩（FRSM）和过滤式面罩（FFP3）呼吸器。然而，要使口罩政策有效，必须高度遵守其使用规定。目的：了解使用口罩的任何障碍，并促进遵守口罩政策。方法：对2022年英国COVID-19大流行期间12名不同背景的医护人员进行访谈，了解其口罩使用情况。我们探索了与口罩使用依从性相关的因素以及对HCW健康的潜在影响。调查结果：总体而言，参与者对口罩的好处有很好的理解，对政策的遵守程度也很高。然而，报告强调了降低他们遵守口罩政策和影响他们履行职责能力的因素。其中包括戴口罩的时间更长、政策被认为与风险不成比例、沟通困难和不适。结论：本研究强调了明确沟通指导的重要性，特别是在指导发生变化时，确保工作人员熟悉有关口罩功效的最新研究，并确保指导与风险保持一致。此外，这项研究强调了口罩需要适当持续时间（基于风险）的重要性。

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IF 1.9 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-01

引用次数: 0

IF 1.9 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-01

引用次数: 0

IF 1.9 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-01

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IF 1.9 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-01

引用次数: 0

IF 1.9 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-01

引用次数: 0

IF 1.9 Q3 INFECTIOUS DISEASES

Infection Prevention in Practice

Pub Date : 2025-01-01

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Infection Prevention in Practice

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