American journal of infection control最新文献

Background: The catheter-associated urinary tract infection (CAUTI) rate started to rise in October 2020 in our medical intensive care unit (ICU) during the early months of COVID-19 pandemic. A multidisciplinary taskforce therefore took the initiative in developing the CAUTI reduction process.

Methods: In this quality improvement initiative, the effectiveness of the CAUTI reduction process was examined retrospectively during the 25-month period from October 2020 to October 2022 in the medical ICU. The processes utilized a multifaceted approach, incorporating nurse-driven protocol for the removal of indwelling urinary catheters (IUCs). The urinary catheter device utilization ratios (DURs) and CAUTI rates from pre-intervention and post-intervention were monitored and compared.

Results: The DUR decreased significantly from 0.59 in the pre-intervention period to 0.39 in the post-intervention phase 1 (33.9% reduction, P =.002). The significant reduction continued through the post-intervention phase 2. In association with decline in DUR, the CAUTI rates reduced significantly from 3.14 in the pre-intervention period to 0.57 CAUTI per 1,000 catheter days in the post-intervention phase 2 (81.8% reduction, P =.029).

Conclusions: The CAUTI reduction process effectively decreased the DURs, and in turn, the CAUTI rates. Our effort highlights the success achieved through sustained multidisciplinary team participation.

Background: Bloodborne pathogen exposures (BBPEs) are an ongoing health hazard among healthcare employees and are often underreported. Prior studies have revealed that BBPEs may be underreported due to challenges related to the reporting process.

Methods: This quasi-experimental study was completed using data from the Denver Health and Hospital Authority (DHHA). BBPE reporting incidence was compared before and after implementation of a self-reported secure electronic form (SELF) reporting system. The primary outcome was the incidence of monthly BBPE reports. The secondary outcomes were nurse triage line call volume and proportion of cases referred for urgent healthcare evaluation.

Results: The mean number of BBPE reports increased by 9.5 reports per month (p = 0.001, 95% CI 6.23, 12.54), the mean number of nurse triage line calls decreased from 23 to 7 per month (p < 0.001, 95% CI 14.39, 19.22), and referral for urgent healthcare evaluation decreased by 61.8% (p < 0.001, df = 1) between the pre-intervention and post-intervention periods.

Conclusion: Implementing a SELF may help capture a greater number of BBPE reports in large healthcare systems compared to a nurse triage system alone. Additionally, SELFs allow for acquisition of additional descriptive information about BBPEs that can be used to inform future BBPE prevention on a programmatic level.

Objective: We evaluated the effectiveness of an "agents of change" intervention in enhancing hand hygiene compliance (HHC) with an electronic hand hygiene monitoring system (EHHMS), and improving perceptions of the EHHMS among healthcare workers.

Intervention: Two intervention units and one control unit were selected. Thirteen agents received training, then worked independently on the intervention units to improve their colleagues' perceptions and behaviors toward the EHHMS. Agents and unit healthcare workers were surveyed before and after the intervention to measure perceptions of the EHHMS and impact of the intervention. HHC was electronically monitored across all units 8 weeks before, 5 weeks during, and 8 weeks after the intervention.

Results: Post-intervention, 70% of agents believed they influenced their colleagues' behaviors, but 50% felt they changed attitudes. Unit level surveys confirmed minimal change in attitudes and culture. Average HHC rates increased by 6.8% and 5% in the intervention units during the intervention (both p <0.01), whereas the control did not. One intervention unit maintained improvement in the post-period, whereas the other returned to baseline. Compliance rates for all units were similar in the post-period.

Conclusion: Implementing an agents of change program to target EHHMS compliance is feasible, but sustained improvement is less certain.

Background: Current infection preventionist (IP) staffing ratio recommendations are inadequate to address the increasing demands and complexities of the role. This study sought to characterize current staffing levels and workloads for IPs, while investigating the relationships between these factors and the number of licensed inpatient beds, the complexity of acute care hospital services, and the geographical location of the facility.

Methods: A cross-sectional, web-based survey questionnaire was administered to 91 acute care facilities to assess staffing and resource allocation strategies for infection prevention departments from August to September 2023.

Results: The analysis revealed associations between IP full time equivalents and the number of in-patient licensed beds (p <.001) and geographical regions (p <.001). The average work hours of an infection preventionist (IP) exceeded the traditional 40-hour work week, participants (n=91) reported working an average of 43.6 hours per week. Cross-sharing of IP FTEs increased with the complexity of the healthcare delivery services, with IPs most frequently supporting the Quality department.

Conclusions: This study highlights that Infection Prevention departments are persistently understaffed, and IPs are consistently working excessive hours across healthcare settings. Factors such as geographic location and interdepartmental collaboration significantly influence staffing needs and workload demands.

Background: Automated room disinfection systems (ARDSs) have been increasingly adopted worldwide to address emerging infectious diseases and antibiotic-resistant bacteria.

Aim: This study aims to assess the current use of ARDSs in acute healthcare settings across South Korea.

Methods: A nationwide online survey was conducted in 150 tertiary general hospitals. It evaluated the use of ARDSs, prior experiences, barriers to adoption, and reasons for satisfaction and dissatisfaction.

Findings: Among the hospitals surveyed, 32.7% used ultraviolet C (UV-C), 26.0% used aerosolized hydrogen peroxide (aHP), and 15.3% used vaporized hydrogen peroxide (vHP). The majority of systems were implemented following the Middle East Respiratory Syndrome outbreak. UV-C systems were predominantly used in examination and isolation rooms, while aHP and vHP systems were used in isolation rooms. Satisfaction rates were 81.6% for UV-C, 76.9% for aHP, and 78.3% for vHP, with 91.3% to 94.9% of respondents expressing intent for continued use. Barriers to adoption included high maintenance costs, uncertainty regarding UV-C efficacy, challenges in operating aHP systems, and high purchase costs for vHP systems.

Conclusion: To increase the adoption of ARDSs, addressing high maintenance costs and confirming the disinfection efficacy of these systems is crucial. Enhancing convenience, cost-effectiveness, operational efficiency, and developing user guidelines and educational programs will be essential for the effective utilization of ARDSs.