American journal of infection control最新文献

The relationship between pathogens in the health care environment and health care-associated infection has been well-documented in the literature. No study has been published since 2012 regarding the contamination of reusable bath basins. This brief report aims to determine if basin contamination remains a reservoir for bacteria that may contribute to the risk of spreading microorganisms to vulnerable patients. We address this question with data from multiple sites over 10years.

Background: Limited information exists regarding health care workers' (HCWs) perceptions about infection prevention and control (IPC) in Latin America.

Methods: We conducted an electronic voluntary anonymous survey to assess HCWs' perceptions toward IPC in 30 hospitals in Latin America during August to September 2022. Nurses, physicians, and environmental cleaning (EVC) staff were prioritized for recruitment.

Results: Overall, 1,340 HCWs completed the survey. Of these, 28% were physicians, 49% nurses, 8% EVC staff, and 15% had "other" roles. Self-compliance with hand hygiene and prevention bundles was perceived to be high by 95% and 89% of respondents, respectively; however, ratings were lower when asked about compliance by their peers (reported as high by 81% and 75%, respectively). Regular training on IPC and access to health care-associated infections (HAI) rates were more limited among physicians than other HCWs (eg, 87% of EVC staff and 45% of physicians reported training upon hiring and thereafter, 60% of nurses and 51% of physicians reported regular access to HAI rate reports).

Conclusions: We identified several opportunities to strengthen IPC practices in Latin American hospitals, including improving HCW education and training on IPC and their awareness of HAI rates and compliance with prevention measures.

Background: Although several surveys of infection prevention and control (IPC) practices have been conducted in the United States, none have focused on the state of Florida, which has the fourth-largest number of certified nursing facilities in the country. A needs assessment survey was conducted to better understand the specific needs and practices of individuals responsible for IPC in long-term care facilities (LTCFs) in Florida.

Methods: In November and December of 2022, a 90-question online survey was distributed to individuals responsible for IPC activities at 3,690 LTCFs in Florida. After omitting incomplete responses, 304 survey responses were analyzed using descriptive statistics.

Results: Survey responses regarding hand hygiene, sharps safety, and staff training reflect compliance with recommended IPC practices. Staffing shortages for registered nurses, licensed practical nurses, and certified nursing assistants were high among respondents (30%), while few reported shortages of personal protective equipment (5%). Only 11% of respondents state their facility requires flu vaccines, despite the high-risk environment of LTCFs. Concerning the built environment, the results suggest infection preventionists have limited awareness of the scope of heating, ventilation, and air conditioning systems in their facilities.

Conclusions: Some areas of compliance with IPC best practices were noted, but multiple opportunities for education and training on IPC best practices were identified.

Background: Hand Hygiene (HH) monitoring is essential for patient and staff safety, but the optimal number of observations remains elusive. This project aimed to determine a statistically comparable number below the current standard of 100 to 200 per month per unit.

Methods: HH observations from various hospitals were grouped in strata by facility, unit, and month, then resampled into sets of 25, 50, 100, and 150 for comparison with 200. Significant comparisons and confidence interval width differences were calculated. A power analysis, accounting for adherence rates (50%-90%), identified sample sizes needed for significant differences from 200 at the 0.05 level.

Results: A total of 873,618 observations across 68 facilities, compared sample sizes (25, 50, 100, 150) to 200, showed 2.6% to 4.3% significant differences at P = .05, with median confidence interval width differences from 0.05% to 0.68%. The power analysis showed required percentage differences for significance at P = .05 ranged from 7.8% (150 vs 200 at 90% HH adherence) to 30% (25 vs 200 at 50% adherence).

Conclusions: The findings suggest hospitals could reduce HH observations to 50 per unit per month without affecting data quality even at lower adherence. It is recommended that standards shift focus from monitoring (with fewer observations) to training, education, culture, infrastructure, and feedback.

Background: Mass vaccination is crucial for achieving herd immunity and controlling pandemics. Simulation models predict vaccination outcomes. This study evaluates efficiency and designs a tailored vaccination plan for Thailand.

Methods: Data were derived from a coronavirus disease-19 mass vaccination hub in Chiang Mai, Thailand. It was taken between June 2021 and December 2021. The discreet event simulation model is developed in Arena Simulation Enterprise Suite version 14.0.

Results: The operational efficiency of Chiang Mai University Mass Vaccination Hub (CMU-MVH) was 1,073 vaccinations per 8 hours with 38 service staff. The average processing times were 2.5 minutes for the registration station, 12.2 minutes for the assessment station, 8.3 minutes for vaccination, and 28.2 minutes for observation. With 100% staff availability and staff utilization ranging from 0.5 to 0.7, the CMU-MVH could handle 180 to 230 vaccinees per hour or 1,227 to 1,527 vaccinees per day. Reduced staff availability leads to an increase in average processing time, especially when staff availability is lower or equal to 60%.

Conclusions: The CMU-MVH could handle approximately a thousand vaccinations within 8 working hours. This capability could assist policymakers in developing more effective strategies and planning for future mass vaccinations.

Background: The COVID-19 pandemic underscored the need to provide schools with support for implementing infection prevention and control (IPC) measures. The Missouri Department of Health and Senior Services engaged the Association for Professionals in Infection Control and Epidemiology to develop the IPC Toolkit for Missouri Schools to train school-based IPC teams.

Methods: A needs assessment was conducted with Missouri school staff and IPC professionals, among other partners. Once the IPC Toolkit was developed, 8 school districts were selected to participate in a pilot program. Pre-/post-surveys and qualitative interviews were conducted to evaluate participants' experience with the IPC Toolkit.

Results: More than half of respondents to the presurvey reported that funding, clear guidance or guidelines, and training are needed to implement IPC practices more efficiently and effectively in schools. Participants in the pilot program agreed that the toolkit was engaging (98.94%), clear (100%), easy to navigate (97.87%), and supported learning (100%).

Discussion: The IPC Toolkit helped to increase self-reported knowledge about IPC practices, the confidence to implement IPC practices, the level of importance participants attributed to IPC, and the extent to which participants embraced IPC as a responsibility of their role.

Conclusions: This study could help inform the implementation of IPC educational materials for other elementary, middle, and high schools.

A certified nursing assistant (CNA) at a long-term care-facility (LTCF) worked 3 shifts while infectious with monkeypox virus providing direct care to most or all 56 LTCF residents. Despite exposures and a delay of 16 days from symptom onset to diagnosis and public health notification, there is no evidence that transmission occurred. We describe details of this healthcare-associated exposure, public health response, situational risk factors for transmission, and discuss factors that might have contributed to the lack of transmission.

Background: This study aimed to determine the frequency of compliance with surgical prophylaxis in Turkey and to identify the causes and risk factors for non-compliance.

Methods: This multi-center, prospective, point prevalence study was conducted in eight hospitals from different regions of Turkey. Patients over 18 years who underwent surgical antimicrobial prophylaxis (SAP) in all hospital surgical units were included in the study. The SAP compliance assessment was carried out under five headings; unnecessary prophylaxis, inappropriate drug choice, prolonged prophylaxis, inappropriate dose interval, and inappropriate dosage.

Results: The study included 541 patients from 8 centers. 52.7% (n=285) were female and the median age was 54 years (min-max: 18-94). Orthopedics (23.7%, n=128), general surgery (22.2%, n=120), and obstetrics and gynecology (14.6%, n=79) were the most common specialties. SAP compliance was 14%. The specialty with the highest rate of inappropriate SAP was orthopedics (97%, n=124/128) and the lowest rate was in ophthalmology (25%, n=2). The most common causes of inappropriate surgical prophylaxis were prolonged prophylaxis (92.0%, n=299) and inappropriate dose interval (84.6%, n=275). Multivariate logistic regression analysis revealed that prolonged surgical time, American Society of Anaesthesiologists (ASA) score 3, and some specialties increased the risk of non-compliance with surgical prophylaxis.

Conclusion: Our study showed that SAP compliance is low in Turkey and that inappropriateness is caused mostly by prolonged and inappropriate antimicrobial use.

Background: Twelve bacterial families were identified as global priority pathogens by the World Health Organization in 2017, recognizing the greatest threat they pose to human health and the declining antibiotic efficacy. Robotics has emerged as a swift and contactless tool for disinfecting bacterial surface contamination in healthcare facilities, however, head-to-head comparison of disinfection efficacy of robotic versus manual disinfections is limited. This study aimed at comparing how robotic disinfection performs over manual disinfection against the global priority pathogens in the healthcare setting.

Methods: A spraying disinfection robot was developed, and its disinfection efficacy was compared against manual disinfection during July 2020-December 2020. Disinfections were performed on the clinical surfaces and inanimate objects at two hospitals in Nepal using robotic or manual application of a disinfectant (NaOCl). Swab samples from floor, bed, doorknob, and medical devices at both hospitals were collected before and after disinfection and examined for total heterotrophic plate count and bacterial pathogens were identified based on Gram's staining and biochemical characteristics. Disinfection outcomes were reported as log reduction (log₁₀ CFU/inch²) of heterotrophic count and presence or absence of target bacteria. A total of 76 samples were collected from two study sites including major pathogens: Staphylococcus aureus, Escherichia coli, Acinetobacter spp., and Klebsiella pneumoniae, among others.

Results: Both robotic and manual disinfection significantly reduced microbial load (log 2.3 to log 5.8) in the hospitals. No pathogens were detected post-disinfection using the robot. The use of robotic disinfection was more effective, significantly reducing more bacterial load (log 5.8) compared to manual disinfection (log 3.95).

Conclusions: Our results showed better efficacy of robotic disinfection compared to manual disinfection of hospital surfaces, and thus contactless robotic disinfection is recommended for disinfecting bacterial contamination of surfaces in the hospital and clinical settings as it favors patient safety against global priority pathogens.