Chiara Moreal , Stefania Chiappinotto , Ian Blackman , Luca Grassetti , Sara Scarsini , Barbara Narduzzi , Maura Mesaglio , Carlo Tascini , Alvisa Palese
{"title":"错过的感染预防和控制活动及其预测因素:大流行前后研究的启示。","authors":"Chiara Moreal , Stefania Chiappinotto , Ian Blackman , Luca Grassetti , Sara Scarsini , Barbara Narduzzi , Maura Mesaglio , Carlo Tascini , Alvisa Palese","doi":"10.1016/j.jhin.2024.10.015","DOIUrl":null,"url":null,"abstract":"<div><h3>Aim</h3><div>The primary aim was to compare differences, if any, in missed infection prevention and control (IPC) activities before and after the pandemic, along with the related predictors. The secondary aim was to identify relationships between missed IPC activities and unfinished nursing care.</div></div><div><h3>Methods</h3><div>A repeated cross-sectional design was conducted in 2019 (pre-pandemic, 184 nurses) and 2024 (post-pandemic, 240 nurses) in a large academic hospital following the Checklist for Reporting of Survey Studies guidelines. The Missed Nursing Care in Infection Prevention and Control Survey (MNC-IPC) (Part A: missed activities, Part B: reasons), the Unfinished Nursing Care Survey (UNCS), and professional data were collected homogeneously across both periods.</div></div><div><h3>Findings</h3><div>Self-reported missed IPC activities decreased from 2.15 out of 5 (95% CI, 2.05–2.25) to 1.51 (95% CI, 1.45–1.58) (p < 0.0005), as did the related reasons, which decreased from 2.35 out of 4 (95% CI, 2.24–2.46) to 2.20 (95% CI, 2.11–2.30) (p = 0.046). The total variance in the MNC-IPC overall scores was explained by 22.8% (pre-) and 20.7% (post-pandemic) by different predictors: system-level issues (estimated value 0.409, p = 0.008) and nurses’ intention to leave (0.107, p = 0.023) in the pre-pandemic and by the number of patients admitted in the last shift (0.015, p = 0.053), organisational issues (0.186, p < 0.0005) and priority-setting issues (0.092, p = 0.053) in the post-pandemic period. MNC-IPC and UNCS scores have reported significant correlations in both periods.</div></div><div><h3>Conclusion</h3><div>Missed IPC activities were less likely in the post-pandemic period possibly due to system efforts and lessons learned during the pandemic, which may have routinised IPC practices among nurses. Overall, predictors of missed IPC care changed after the pandemic, suggesting new patterns and the need for innovative interventions, particularly at the unit level and targeting younger nurses. The correlations between UNCS and MNC-IPC suggest that targeted improvements in one area are likely to yield positive outcomes in the other. However, despite their commonalities, these represent two distinct phenomena.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"155 ","pages":""},"PeriodicalIF":3.9000,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Missed Infection Prevention and Control Activities and Their Predictors: Insights from a Pre- and Post-Pandemic Study\",\"authors\":\"Chiara Moreal , Stefania Chiappinotto , Ian Blackman , Luca Grassetti , Sara Scarsini , Barbara Narduzzi , Maura Mesaglio , Carlo Tascini , Alvisa Palese\",\"doi\":\"10.1016/j.jhin.2024.10.015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aim</h3><div>The primary aim was to compare differences, if any, in missed infection prevention and control (IPC) activities before and after the pandemic, along with the related predictors. The secondary aim was to identify relationships between missed IPC activities and unfinished nursing care.</div></div><div><h3>Methods</h3><div>A repeated cross-sectional design was conducted in 2019 (pre-pandemic, 184 nurses) and 2024 (post-pandemic, 240 nurses) in a large academic hospital following the Checklist for Reporting of Survey Studies guidelines. The Missed Nursing Care in Infection Prevention and Control Survey (MNC-IPC) (Part A: missed activities, Part B: reasons), the Unfinished Nursing Care Survey (UNCS), and professional data were collected homogeneously across both periods.</div></div><div><h3>Findings</h3><div>Self-reported missed IPC activities decreased from 2.15 out of 5 (95% CI, 2.05–2.25) to 1.51 (95% CI, 1.45–1.58) (p < 0.0005), as did the related reasons, which decreased from 2.35 out of 4 (95% CI, 2.24–2.46) to 2.20 (95% CI, 2.11–2.30) (p = 0.046). The total variance in the MNC-IPC overall scores was explained by 22.8% (pre-) and 20.7% (post-pandemic) by different predictors: system-level issues (estimated value 0.409, p = 0.008) and nurses’ intention to leave (0.107, p = 0.023) in the pre-pandemic and by the number of patients admitted in the last shift (0.015, p = 0.053), organisational issues (0.186, p < 0.0005) and priority-setting issues (0.092, p = 0.053) in the post-pandemic period. MNC-IPC and UNCS scores have reported significant correlations in both periods.</div></div><div><h3>Conclusion</h3><div>Missed IPC activities were less likely in the post-pandemic period possibly due to system efforts and lessons learned during the pandemic, which may have routinised IPC practices among nurses. Overall, predictors of missed IPC care changed after the pandemic, suggesting new patterns and the need for innovative interventions, particularly at the unit level and targeting younger nurses. The correlations between UNCS and MNC-IPC suggest that targeted improvements in one area are likely to yield positive outcomes in the other. However, despite their commonalities, these represent two distinct phenomena.</div></div>\",\"PeriodicalId\":54806,\"journal\":{\"name\":\"Journal of Hospital Infection\",\"volume\":\"155 \",\"pages\":\"\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2024-11-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hospital Infection\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0195670124003633\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hospital Infection","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0195670124003633","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Missed Infection Prevention and Control Activities and Their Predictors: Insights from a Pre- and Post-Pandemic Study
Aim
The primary aim was to compare differences, if any, in missed infection prevention and control (IPC) activities before and after the pandemic, along with the related predictors. The secondary aim was to identify relationships between missed IPC activities and unfinished nursing care.
Methods
A repeated cross-sectional design was conducted in 2019 (pre-pandemic, 184 nurses) and 2024 (post-pandemic, 240 nurses) in a large academic hospital following the Checklist for Reporting of Survey Studies guidelines. The Missed Nursing Care in Infection Prevention and Control Survey (MNC-IPC) (Part A: missed activities, Part B: reasons), the Unfinished Nursing Care Survey (UNCS), and professional data were collected homogeneously across both periods.
Findings
Self-reported missed IPC activities decreased from 2.15 out of 5 (95% CI, 2.05–2.25) to 1.51 (95% CI, 1.45–1.58) (p < 0.0005), as did the related reasons, which decreased from 2.35 out of 4 (95% CI, 2.24–2.46) to 2.20 (95% CI, 2.11–2.30) (p = 0.046). The total variance in the MNC-IPC overall scores was explained by 22.8% (pre-) and 20.7% (post-pandemic) by different predictors: system-level issues (estimated value 0.409, p = 0.008) and nurses’ intention to leave (0.107, p = 0.023) in the pre-pandemic and by the number of patients admitted in the last shift (0.015, p = 0.053), organisational issues (0.186, p < 0.0005) and priority-setting issues (0.092, p = 0.053) in the post-pandemic period. MNC-IPC and UNCS scores have reported significant correlations in both periods.
Conclusion
Missed IPC activities were less likely in the post-pandemic period possibly due to system efforts and lessons learned during the pandemic, which may have routinised IPC practices among nurses. Overall, predictors of missed IPC care changed after the pandemic, suggesting new patterns and the need for innovative interventions, particularly at the unit level and targeting younger nurses. The correlations between UNCS and MNC-IPC suggest that targeted improvements in one area are likely to yield positive outcomes in the other. However, despite their commonalities, these represent two distinct phenomena.
期刊介绍:
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.