Influenza outbreak management on a locked behavioral health unit

Strategies for Promoting Hand Hygiene Compliance on Inpatient Psychiatric Units

To identify recommendations to improve staff and patient adherence to hand hygiene best practices on inpatient psychiatric units, a survey of the literature was conducted to distill the most effective recommendations. Several interventions have been identified that have met with success in previous outbreaks of infectious disease. These interventions require little more than basic nursing skills: education, time and attention, and knowledge of one's patients. The literature suggests that strict hand hygiene and infection control processes can be implemented to the benefit of an inpatient psychiatric ward, but only with significant adjustments for staff and patients. [Journal of Psychosocial Nursing and Mental Health Services, 59(5), 21-24.].

Preparedness Through Urban Resilience

This book explores the topic of resilience at the city level. The focus is more on outbreak events at the city level, or how cities should prepare and react in facing the larger events of epidemic and pandemic.

Use of ward closure to control outbreaks among hospitalized patients in acute care settings: a systematic review

BACKGROUND

Though often used to control outbreaks, the efficacy of ward closure is unclear. This systematic review sought to identify studies defining and describing ward closure in outbreak control and to determine impact of ward closure as an intervention on outbreak containment.

METHODS

We searched these databases with no language restrictions: MEDLINE, 1946 to 7 July 2014; EMBASE, 1974 to 7 July 2014; CINAHL, 1937 to 8 July 2014; and Cochrane Database of Systematic Reviews, 2005 to May 2014. We also searched the following: IndMED; LILACS; reference lists from retrieved articles; conference proceedings; and websites of the CDCP, the ICID, and the WHO. We included studies of patients hospitalized in acute care facilities; used ward closure as a control measure; used other control measures; and discussed control of the outbreak(s) under investigation. A component approach was used to assess study quality.

RESULTS

We included 97 English and non-English observational studies. None included a controlled comparison between ward closure and other interventions. We found that ward closure was often used as part of a bundle of interventions but could not determine its direct impact separate from all the other interventions whether used in parallel or in sequence with other interventions. We also found no universal definition of ward closure which was widely accepted.

CONCLUSIONS

With no published controlled studies identified, ward closure for control of outbreaks remains an intervention that is not evidence based and healthcare personnel will need to continue to balance the competing risks associated with its use, taking into consideration the nature of the outbreak, the type of pathogen and its virulence, mode of transmission, and the setting in which it occurs. Our review has identified a major research gap in this area.

Infections in psychiatric facilities, with an emphasis on outbreaks

Outbreaks of infectious diseases in psychiatric units are very different from those in intensive care units or acute medical-surgical units. Outbreaks in psychiatric units are most often caused by agents circulating in the community. Infection control in psychiatric units also faces unique challenges due to the characteristics of the patients and facilities.