American journal of infection control最新文献

Background: Leadership competencies among infection preventionists (IPs) are essential to improving patient safety and reducing healthcare-associated infections. The Advanced Leadership Certification in Infection Prevention and Control (AL-CIP) recognizes IPs demonstrating advanced leadership, yet little is known about the experiences of certified professionals or how the credential supports leadership development.

Methods: The Leadership Evaluation and Development for Infection Preventionists (LEAD-IP) study used an observational nested cohort design. Secondary data from all AL-CIP applicants across two 2025 certification cycles were analyzed. A nested cohort representing 18% of certified professionals completed a structured 60-minute qualitative interview. Data were analyzed using Braun and Clarke's inductive thematic analysis.

Results: Thirty AL-CIP-certified leaders participated. Seven themes emerged: transition from task-based to systems-level leadership; use of data and structured improvement models; communication and psychological safety as core leadership tools; persistent structural barriers; intentional inclusivity of under-represented teams; proactive risk management; and strengthened leadership identity, confidence, and professional growth through AL-CIP.

Conclusions: AL-CIP-certified professionals described leadership roles requiring systems thinking, data literacy, inclusive engagement, and anticipatory risk management. AL-CIP reinforced leadership confidence and credibility and supported career advancement. These findings highlight the value of leadership-focused training and certification in strengthening the IPC workforce.

Background: Hospital-acquired infections (HAIs) impose a global burden, with hand hygiene (HH) a key preventive measure. Sustaining HH compliance requires behavioral change. Motivational interviewing (MI), promotes self-reflection and shows promise. This study evaluated MI's effectiveness on HH compliance among health care workers and its impact on HAI rates.

Methods: This prospective interventional study was conducted from June 2018 to February 2019 in a tertiary hospital MICU involving 29 doctors (8 consultants, 21 residents). Three-month pre-intervention phase recorded baseline HH compliance and HAI rates [central line-associated bloodstream infection (CLABSI), Ventilator-associated pneumonia (VAP), catheter-associated urinary tract infection (CAUTI)]. Intervention included educational, MI sessions, and promotional videos. Post-intervention, HH compliance, readiness to change, and HAI rates were reassessed. Compliance was analysed using multilevel mixed-effects linear regression, and product use was compared using Wilcoxon rank-sum test. P-value <.05 was considered statistically significant.

Results: Among 650 observed opportunities, HH compliance improved significantly post-intervention (~41% to ~65%-70%; P < .001). Residents improved more than consultants. Alcohol based handrubs and soap use showed no significant change. VAP and CAUTI decreased (P = .0495), while CLABSI remained unchanged.

Conclusions: Multimodal strategy combining education and MI improved HH compliance among doctors. Its impact on HAIs remains uncertain, warranting investigation.

Background: Nosocomial transmission of varicella zoster virus (VZV), with susceptible health care workers (HCWs) playing a crucial role, poses a significant challenge in health care settings. This study aimed to assess immunity to VZV among HCWs in transplantation units and to identify susceptibility-associated factors. It also examined the characteristics of staff who contracted varicella during their working lives and the workdays lost.

Methods: A cross-sectional study included HCWs (n = 180) in 3 transplantation units at Mansoura University Hospitals. Participants completed a questionnaire that included sociodemographic and occupational details, as well as medical and vaccination histories. Participants' serum samples were tested for VZV antibodies.

Results: Among the participants, 78.3% tested positive for antibodies, 21.7% tested negative, and none had received a vaccination. A lack of prior varicella infection history significantly predicted susceptibility. Those who had chickenpox or herpes zoster while working lost an average of 14 and 8.8 workdays and an estimated 24.6 and 11.4 annual full-day equivalents, respectively.

Conclusions: Nearly a quarter of HCWs caring for transplantation patients are susceptible to VZV, below the recommended immunity threshold for preventing nosocomial transmission. Implementing a strategy to document immune status and vaccinate susceptible workers is essential.

Background: Our hospital observed a significant increase in nosocomial methicillin-resistant Staphylococcus aureus bacteremia with half of these cases occurring in the adult intensive care units (ICUs). We tested a set of implementation strategies to improve the mupirocin ordering rate for universal decolonization within the adult ICUs.

Methods: There were 3 implementation phases followed by a washout phase and a final fourth phase. The desired goal was ≥ 85% of eligible patients ordered for mupirocin within 48 hours of admission; 2 consecutive weeks below this goal prompted movement to the next phase. The first phase utilized a top-down method of education. Educational outreach was conducted during phase two. Direct messaging was utilized in phase three. Following the washout, mupirocin was added to the daily ICU rounds checklist in phase four.

Results: Across all ICUs, we did not reach the desired goal during the first 2 phases. Phase three was well above the desired goal every week. During the washout, there were 3 consecutive weeks where all ICUs were below 85%. Phase four met the desired goal for all 16 weeks.

Conclusions: Direct messaging and adding mupirocin to the ICU rounds checklist proved to be the most effective strategies for sustainable implementation.

Background: The COVID-19 pandemic highlighted gaps in infection prevention and control (IPC) practices and workforce support. This study assessed Infection Preventionists' (IPs) training needs, challenges, and resources to inform strategies supporting the IPC workforce through initiatives like CDC Project Firstline.

Methods: An anonymous survey was distributed June-August 2023 through national and state professional networks and public health programs. Participants included 267 IPs across 31 states and all 10 U.S. HHS regions.

Results: Respondents were experienced (>10 years: 70%; ≤3 years: 30%); 48% were the only IP in their facility. Leadership support varied by facility size (critical access: 75% strong engagement vs large facilities: 45%). Welch's ANOVA with Games-Howell post-hoc tests showed higher support perceptions in smaller hospitals than mid-sized facilities. Onboarding was structured for 46%, yet only 14% rated it highly effective; mid-sized facilities reported lower onboarding adequacy than smaller hospitals. Continuing education was difficult to access for 62% of IPs, and 59% reported a lack of protected time for training; no significant facility size differences were found.

Conclusions: Three key findings emerged: inconsistent leadership engagement/collaboration, inadequate onboarding/mentorship, and limited continuing education/professional development. Targeted workforce supports and system-level engagement are needed to strengthen IPC programs and sustainability.

A 7-year institutional commitment to catheter-associated urinary tract infection (CAUTI) risk mitigation was associated with a sustained reduction from baseline in indwelling urinary catheter (IUC) utilization, CAUTI events below 1 per 1,000 IUC days, and annual CAUTI Standardized Infection Ratios below national benchmarking standards. Multidisciplinary data-driven assessments of IUC utilization and CAUTI events prompted a series of targeted, feasible, and pragmatic multicomponent interventions.

The necessity and duration of contact precautions for multidrug-resistant organisms (MDROs) in pediatrics is unknown. We compared the incidence rate, level, and trend of healthcare-associated MDROs before and after implementation of revised deisolation criteria allowing for shorter duration of contact isolation for select MDROs. We found that shortening duration of contact isolation was not associated with a statistically significant change in healthcare-associated MDROs in our pediatric hospital.

Objective: Evaluate adherence using the antimicrobial-resistant organism (ARO) admission screening tool in the provincial clinical information system (CIS) in Alberta and its relationship with hospital ARO rates.

Methods: A population-based, serial cross-sectional study examined admissions to acute care facilities using the CIS and where ARO screening for methicillin-resistant Staphylococcus aureus (MRSA) and carbapenemase-producing organisms was completed by healthcare providers (January 1, 2020-March 31, 2024). Adherence was the proportion of admissions with a completed ARO screening tool in the CIS. MRSA and carbapenemase-producing organisms colonization or infection rates were incident cases per 1,000 admissions or 10,000 patient-days, respectively. Generalized linear models assessed factors associated with adherence. Spearman rank correlations and generalized linear models assessed the relationship between adherence and ARO rates.

Results: Ninety-two percent of eligible facilities were included. Overall adherence ranged from 43% to 65%. After adjustment for bed size and health zone, adherence declined with increasing months of CIS use (aIRR 0.987, 95% CI 0.986-0.987). Higher adherence was associated with lower overall MRSA infection rates (r_s = -0.68) and remained in adjusted models (aIRR 0.99, 95% CI 0.986-0.994).

Conclusions: Greater adherence to ARO admission screening was associated with lower MRSA infection rates, although the effect size was small. Further work is needed to clarify the relationship between ARO screening and ARO transmission in hospitals.

Introduction: The recent history of viral global epidemics highlights the importance of teaching the proper use of personal protective equipment (PPE) for personal safety and infection prevention. The present study evaluated long-term retention of knowledge for proper donning and doffing of PPE following face-to-face and video instruction.

Methods: Three cohorts of residents were examined, with long-term retention assessment occurring in subsets of each cohort at least 7 months following initial training. Without instruction, the anesthesiology residents donned appropriate PPE and then sprayed with Glo Germ® before doffing to identify areas of contamination. Following instruction, the process was repeated both immediately posttraining and at long-term follow-up.

Results: 23 participants completed long-term assessment. Overall donning compliance from posttraining to long-term retention did not change significantly (mean difference = -4.5%; 95% CIs: -10.7%, 1.7%; P = 0.105); however, doffing compliance decreased significantly (mean difference = -20.7%; 95% CIs: -28.1%, -13.4%; P < 0.001). Contamination rates of multiple sites increased by 17.4% (P = 0.248), though did not reach statistical significance.

Discussion: At long-term follow-up, there was a higher retention of proper donning with a decay of knowledge with doffing. It is important to implement educational maintenance programs, not single courses, for healthcare workers to prevent contamination during these common highly virulent epidemics.