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Evaluating the accuracy of an automatic counting system to detect dispensing of hand hygiene product. 评估自动计数系统检测手部卫生用品分配的准确性。
Pub Date : 2024-11-23 DOI: 10.1016/j.idh.2024.11.001
Georgia Matterson, Katrina Browne, Philip L Russo, Sonja Dawson, Hannah Kent, Brett G Mitchell

Background: Hand hygiene (HH) is an essential element of infection prevention and control programs. Direct observation of adherence to the 5 moments for HH is considered the gold standard in compliance monitoring. However, as direct observation introduces potential bias, other strategies have been proposed to supplement HH compliance data in healthcare facilities. This study evaluated the accuracy of an automatic counting system (MEZRIT™) to detect when a HH product (soap or alcohol-based hand rub) was dispensed, and thus measure product usage as opposed to compliance with the 5 moments for HH.

Methods: A quasi-experimental study was conducted in a nursing simulation lab where seven participants undertook basic nursing tasks which included performing HH. Sensors were attached to soap and alcohol-based hand rub dispensers to record the time at which a product was dispensed. HH events were video recorded (time-stamped) and validated against timestamps from the automatic counting system.

Results: 260 HH events were detected by the automatic counting system and confirmed by video recordings. 5182 non-HH events were calculated from analysis of the video recordings. The automatic counting system had 90 % sensitivity (95%CI 85.8-93.1 %), and 100 % specificity (95%CI 99.9-100 %). This model generated a positive predictive value of 100 % (95%Cl 98.4-100 %), and a negative predictive value of 99.5 % (95%CI 99.3-99.7 %).

Conclusion: The MEZRIT™ system accurately identified 90 % of HH events and excluded 100 % of non-HH events. The real-time monitoring of HH product usage may be beneficial in responding quickly to changes in product usage.

背景:手部卫生 (HH) 是感染预防和控制计划的基本要素。直接观察是否遵守手卫生的 5 个时刻被认为是监测手卫生依从性的黄金标准。然而,由于直接观察可能会产生偏差,因此有人提出了其他策略来补充医疗机构的手卫生依从性数据。本研究评估了自动计数系统(MEZRIT™)在检测保健用品(肥皂或酒精擦手液)配发时间方面的准确性,从而衡量产品使用情况,而不是保健5时刻的依从性:在护理模拟实验室中进行了一项准实验研究,七名参与者执行了基本护理任务,其中包括进行 HH。在肥皂和酒精擦手纸分配器上安装了传感器,以记录分配产品的时间。结果:自动计数系统检测到 260 次 HH 事件,并通过视频记录予以确认。通过对视频记录的分析,计算出 5182 个非 HH 事件。自动计数系统的灵敏度为 90%(95%CI 85.8-93.1%),特异度为 100%(95%CI 99.9-100%)。该模型的阳性预测值为 100 %(95%Cl 98.4-100%),阴性预测值为 99.5 %(95%CI 99.3-99.7%):MEZRIT™系统能准确识别90%的HH事件,并排除100%的非HH事件。对 HH 产品使用情况的实时监控有助于快速应对产品使用的变化。
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引用次数: 0
Exploring challenges and policy considerations in point-of-care testing for hospital preparedness ahead of infectious disease emergencies: A qualitative study. 探索在传染病突发事件发生前医院准备工作中进行床旁检测所面临的挑战和政策考虑因素:定性研究。
Pub Date : 2024-11-21 DOI: 10.1016/j.idh.2024.10.001
Oluremilekun Oyefolu, Gigi Kwik Gronvall

Background: Despite the uncertainty raised by several studies regarding the practicality of Point-of-Care Testing (POCT) in hospital settings, the urgency prompted by the COVID-19 pandemic led many hospitals to invest in these rapid diagnostics. As the COVID-19 pandemic showcased the potential of POCT in emergency situations, an urgent call arises to leverage the successes and lessons learned for the long-term benefit of healthcare systems, particularly in preparation for the next pandemic of viral respiratory nature.

Methods: We conducted semi-structured interviews with nine emergency care and hospital laboratory stakeholders with expertise and responsibility over POCT operations within hospital systems during the COVID-19 pandemic in Maryland, USA. The grounded theory approach was utilized, and the transcripts were thematically analyzed through an iterative process.

Results: Three distinct themes were identified as barriers to POCT implementation: Regulatory barriers encompassed inconsistencies between the federal and state regulations and a regulatory structure that lags technological advancements. Staffing and operational barriers comprised a shortage of POCT workforce including nurses and Point of Care coordinators. Economic barriers were linked to the overall cost of integrating new POCT devices into the existing testing menu at emergency departments.

Conclusion: We conclude with strategies, including policy considerations, to enable and sustain decentralized POCT programs within hospitals. Some of these strategies include expanding the workforce trained in the regulatory procedures required to support POCT; harmonizing state and federal regulations for diagnostic testing, especially for FDA-waived POCT; and sustained funding for POCT development and use for public health preparedness.

背景:尽管一些研究对医院环境中的床旁检测(POCT)的实用性提出了不确定性,但 COVID-19 大流行所引发的紧迫感促使许多医院投资于这些快速诊断技术。由于 COVID-19 大流行展示了 POCT 在紧急情况下的潜力,人们迫切要求利用成功经验和教训为医疗系统带来长期利益,特别是为下一次病毒性呼吸道疾病大流行做准备:方法:在美国马里兰州 COVID-19 大流行期间,我们对九名急诊护理和医院实验室的相关人员进行了半结构化访谈,他们都具有专业知识并负责医院系统内的 POCT 操作。我们采用了基础理论方法,并通过迭代过程对访谈记录进行了主题分析:结果:确定了三个不同的主题作为实施 POCT 的障碍:监管障碍包括联邦和州法规之间的不一致,以及监管结构滞后于技术进步。人员和操作障碍包括 POCT 劳动力短缺,包括护士和护理点协调员。经济障碍与将新的 POCT 设备整合到急诊科现有检测菜单中的总体成本有关:最后,我们提出了一些策略,包括政策考虑因素,以促进和维持医院内的分散式 POCT 项目。其中一些策略包括:扩大接受过支持 POCT 所需的监管程序培训的员工队伍;协调各州和联邦的诊断检测法规,尤其是美国食品及药物管理局豁免的 POCT;持续资助 POCT 的开发和使用,以做好公共卫生准备。
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引用次数: 0
Moral distress among infection prevention and control professionals: A scoping review. 感染预防与控制专业人员的精神压力:范围审查。
Pub Date : 2024-11-21 DOI: 10.1016/j.idh.2024.10.002
Matt Mason, Byeonghun Im, Jocelyne M Basseal, Peta-Anne Zimmerman

Background: The COVID-19 pandemic highlighted the vital role of Infection Prevention and Control Professionals (IPCPs) in safeguarding public health. Amid rapidly evolving guidelines, critical personal protective equipment shortages, and surging workloads, IPCPs encountered unprecedented moral and ethical dilemmas. However, their experiences, ethical challenges, and the resulting moral distress remain understudied.

Methods: A scoping review following Arksey and O'Malley's methodology was conducted to examine current research on ethical challenges and moral distress among IPCPs. Searches in CINAHL, MEDLINE via OVID, Emcare, Scopus, and Korea Citation Index yielded two extracted articles.

Results: Common themes included high workload, increased recognition, pressure to deliver accurate and timely information, need for peer support, and evidence-based practice. Differences in nationality, role discretion, and administrative systems led to varied experiences. District Medical Officers in Norway experienced more decision-making responsibilities and resulting ethical dilemmas in the context of broader communities and municipalities. The experiences of IPCPs were confined to their respective healthcare facilities.

Conclusion: There is a dearth of available research reporting the moral distress experienced by IPCPs whilst there is a plethora for those seen as "frontline" workers. Given the integral decision-making and implementation roles of these health professionals, and the burdens of ethical dilemmas they experienced in pandemic preparedness and response, further research is imperative to inform strategies to build moral resilience in the future.

背景:COVID-19 大流行凸显了感染预防与控制专业人员 (IPCP) 在保障公共卫生方面的重要作用。在指导方针迅速演变、个人防护设备严重短缺和工作量激增的情况下,IPCPs 遇到了前所未有的道德和伦理困境。然而,他们的经历、伦理挑战以及由此产生的道德困扰仍未得到充分研究:方法:我们按照 Arksey 和 O'Malley 的方法进行了一次范围界定研究,以考察当前有关 IPCPs 所面临的伦理挑战和道德困扰的研究。在 CINAHL、MEDLINE via OVID、Emcare、Scopus 和韩国引文索引中进行了检索,共摘录了两篇文章:共同的主题包括工作量大、认可度提高、提供准确及时信息的压力、需要同行支持以及循证实践。国籍、角色自由裁量权和行政制度的不同导致了不同的经验。挪威的地区医务官员在更广泛的社区和市政范围内承担了更多的决策责任,并因此遇到了道德难题。IPP的经验则局限于各自的医疗机构:有关 IPCPs 所经历的道德困境的研究报告很少,而有关被视为 "一线 "工作者的研究报告却很多。鉴于这些卫生专业人员在决策和执行方面的重要作用,以及他们在大流行病防备和应对过程中所经历的道德困境的负担,进一步的研究势在必行,以便为未来建立道德复原力的战略提供信息。
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引用次数: 0
Infection prevention and control professionals: Stress, resilience, personality traits and views about their workforce and profession. 感染预防与控制专业人员:压力、复原力、个性特征以及对其工作队伍和职业的看法。
Pub Date : 2024-10-29 DOI: 10.1016/j.idh.2024.09.038
Brett G Mitchell, Philip L Russo

Background: The COVID-19 pandemic placed considerable strain on the infection control professional workforce, who were at the forefront of pandemic response in their organisations and beyond. In order to support infection control professionals and inform future initiatives, it is important to further understand the infection control workforce. The objective of this study was to determine stress and resilience levels, personality traits and workforce intentions of infection control professionals in Australia and New Zealand.

Methods: We undertook an anonymous, cross-sectional online survey of infection control professionals in Australia and New Zealand. Validated tools, the brief resilience tool, workforce stressor tool and the Big Five personality test, were used to evaluate levels of stress, resilience and personality traits.

Results: Three hundred and fifty-six infection control professionals started the survey, with representation from all Australian jurisdictions and New Zealand. The mean stress score was 4.28 (SD 3.39) and 3.34 (SD 0.65) for resilience. Younger participants and those with less experience in infection control had higher levels of stress and lower levels of resilience. Individual personality traits vary by age, level of education and credentialing status. Approximately one-fifth of participants indicated that they planned to leave the IC workforce in the next three years.

Conclusions: Our study was the largest published study involving infection control professionals in Australia and New Zealand. Findings highlight the need for mentoring, peer support and wellbeing initiatives to support the profession. Understanding personality traits may also be beneficial for further enhancing communication and interpersonal relationships.

背景:COVID-19 大流行给感染控制专业人员队伍带来了巨大压力,他们在各自组织内外都处于大流行应对工作的最前沿。为了支持感染控制专业人员并为未来的举措提供信息,进一步了解感染控制专业人员非常重要。本研究旨在确定澳大利亚和新西兰感染控制专业人员的压力和复原力水平、个性特征和工作意向:我们对澳大利亚和新西兰的感染控制专业人员进行了匿名、横断面在线调查。我们使用了经过验证的工具,即简短复原力工具、劳动力压力工具和大五人格测试,来评估压力水平、复原力和人格特质:356 名感染控制专业人员参与了调查,他们来自澳大利亚所有辖区和新西兰。平均压力得分为 4.28(标准差为 3.39),抗压能力得分为 3.34(标准差为 0.65)。较年轻的参与者和感染控制经验较少的参与者压力较大,抗压能力较低。个人性格特征因年龄、教育水平和资格认证状况而异。约五分之一的参与者表示,他们计划在未来三年内离开感染控制工作岗位:我们的研究是涉及澳大利亚和新西兰感染控制专业人员的最大规模的公开研究。研究结果突出表明,有必要采取指导、同伴支持和福利措施来支持这一行业。了解个性特征也有利于进一步加强沟通和人际关系。
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引用次数: 0
Microbial laden mobile phones from international conference attendees pose potential risks to public health and biosecurity. 国际会议与会者携带微生物的手机对公共卫生和生物安全构成潜在风险。
Pub Date : 2024-09-26 DOI: 10.1016/j.idh.2024.08.004
Matthew Olsen, Adrian Goldsworthy, Mark Morgan, John Leggett, Thibaut Demaneuf, Natalia Van Der Bruggen, Gobinddeep Singh, Rose Ghemrawi, Abiola Senok, Reem Almheiri, Simon McKirdy, Rashed Alghafri, Lotti Tajouri

Introduction: Mobile phones, contaminated with pathogenic microorganisms, have the potential to act as "trojan horses". The microbial signatures present on their surfaces most probably vary across different geographical regions. As a result, mobile phones belonging to international conference attendees may serve as a model for global microbial dissemination, posing potential risks to public health and biosecurity.

Aim: This study aimed to profile the microbes present on mobile phones belonging to delegates attending an international scientific conference through use of metagenomic shotgun DNA sequencing.

Methods: Twenty mobile phones, representing ten different geographical zones from around the world, were swabbed and pooled together into ten geographical-specific samples for high definition next-generation DNA sequencing. WONCA council members were invited to participate and provided verbal consent. Following DNA extraction, next generation sequencing, to a depth of approximately 10Gbp per sample, was undertaken on a v1.5 Illumina NovaSeq6000 system. Bioinformatic analysis was performed via the CosmosID platform.

Results: A total of 2204 microbial hits were accumulated across 20 mobile phones inclusive of 882 bacteria, 1229 viruses, 88 fungi and 5 protozoa. Of particular concern was the identification of 65 distinct antibiotic resistance genes and 86 virulence genes. Plant, animal and human pathogens, including ESKAPE and HACEK bacteria were found on mobile phones.

Discussion/conclusion: Mobile phones of international attendees are contaminated with many & varied microorganisms. Further research is required to characterize the risks these devices pose for biosecurity and public health. Development of new policies which appropriately address and prevent such risks maybe warranted.

导言:受到病原微生物污染的手机有可能成为 "特洛伊木马"。在不同的地理区域,手机表面的微生物特征很可能各不相同。因此,国际会议与会者的手机可能成为全球微生物传播的典范,给公共卫生和生物安全带来潜在风险。目的:本研究旨在通过使用元基因组枪式 DNA 测序,对参加国际科学会议的代表手机上的微生物进行分析:方法:对代表全球 10 个不同地理区域的 20 部手机进行拭抹,并将其汇集成 10 个特定地理区域的样本,用于高清下一代 DNA 测序。WONCA理事会成员应邀参加并口头表示同意。提取DNA后,在Illumina NovaSeq6000系统v1.5版本上进行下一代测序,每个样本的测序深度约为10Gbp。生物信息分析通过 CosmosID 平台进行:结果:在 20 部手机上共发现了 2204 种微生物,包括 882 种细菌、1229 种病毒、88 种真菌和 5 种原生动物。其中特别值得关注的是鉴定出了 65 个不同的抗生素抗性基因和 86 个毒力基因。在手机上发现了植物、动物和人类病原体,包括 ESKAPE 和 HACEK 细菌:讨论/结论:国际与会者的手机受到多种微生物的污染。需要进一步研究这些设备对生物安全和公共卫生造成的风险。也许有必要制定新的政策来适当处理和预防这些风险。
{"title":"Microbial laden mobile phones from international conference attendees pose potential risks to public health and biosecurity.","authors":"Matthew Olsen, Adrian Goldsworthy, Mark Morgan, John Leggett, Thibaut Demaneuf, Natalia Van Der Bruggen, Gobinddeep Singh, Rose Ghemrawi, Abiola Senok, Reem Almheiri, Simon McKirdy, Rashed Alghafri, Lotti Tajouri","doi":"10.1016/j.idh.2024.08.004","DOIUrl":"https://doi.org/10.1016/j.idh.2024.08.004","url":null,"abstract":"<p><strong>Introduction: </strong>Mobile phones, contaminated with pathogenic microorganisms, have the potential to act as \"trojan horses\". The microbial signatures present on their surfaces most probably vary across different geographical regions. As a result, mobile phones belonging to international conference attendees may serve as a model for global microbial dissemination, posing potential risks to public health and biosecurity.</p><p><strong>Aim: </strong>This study aimed to profile the microbes present on mobile phones belonging to delegates attending an international scientific conference through use of metagenomic shotgun DNA sequencing.</p><p><strong>Methods: </strong>Twenty mobile phones, representing ten different geographical zones from around the world, were swabbed and pooled together into ten geographical-specific samples for high definition next-generation DNA sequencing. WONCA council members were invited to participate and provided verbal consent. Following DNA extraction, next generation sequencing, to a depth of approximately 10Gbp per sample, was undertaken on a v1.5 Illumina NovaSeq6000 system. Bioinformatic analysis was performed via the CosmosID platform.</p><p><strong>Results: </strong>A total of 2204 microbial hits were accumulated across 20 mobile phones inclusive of 882 bacteria, 1229 viruses, 88 fungi and 5 protozoa. Of particular concern was the identification of 65 distinct antibiotic resistance genes and 86 virulence genes. Plant, animal and human pathogens, including ESKAPE and HACEK bacteria were found on mobile phones.</p><p><strong>Discussion/conclusion: </strong>Mobile phones of international attendees are contaminated with many & varied microorganisms. Further research is required to characterize the risks these devices pose for biosecurity and public health. Development of new policies which appropriately address and prevent such risks maybe warranted.</p>","PeriodicalId":94040,"journal":{"name":"Infection, disease & health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335195","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}
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Infection, disease & health
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