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MacEwan SR, Gaughan AA, Beal EW, Hebert C, DeLancey JO, McAlearney AS. Concerns and frustrations about the public reporting of device-related healthcare-associated infections: Perspectives of hospital leaders and staff. Am J Infect Control 2023; 51:633-637. [PMID: 35948123 PMCID: PMC10303069 DOI: 10.1016/j.ajic.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/02/2022] [Accepted: 08/03/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Public reporting of healthcare-associated infections (HAIs) aims to incentivize improvement in infection prevention. The motivation and mechanisms of public reporting have raised concerns about the reliability of this data, but little is known about the specific concerns of hospital leaders and staff. This study sought to better understand perspectives of individuals in these roles regarding the identification and public reporting of HAIs. METHODS We conducted interviews with 471 participants including hospitals leaders (eg, administrative and clinical leaders) and hospital staff (eg, physicians and nurses) between 2017 and 2019 across 18 US hospitals. A semistructured interview guide was used to explore perspectives about the use of HAI data within the context of management strategies used to support infection prevention. RESULTS Interviewees described concerns about public reporting of HAI data, including a lack of trust in the data and inadvertent consequences of its public reporting, as well as specific frustrations related to the identification and accountability for publicly-reported HAIs. CONCLUSION Concerns and frustrations related to public reporting of HAI data highlight the need for improved guidelines, transparency, and incentives. Efforts to build trust in publicly-reported HAI data can help ensure this information is used effectively to improve infection prevention practices.
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Affiliation(s)
- Sarah R MacEwan
- Division of General Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH; The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, OH.
| | - Alice A Gaughan
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, OH
| | - Eliza W Beal
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, OH; Department of Surgery, College of Medicine, The Ohio State University, Columbus, OH
| | - Courtney Hebert
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, OH; Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH; Division of Infectious Diseases, College of Medicine, The Ohio State University, Columbus, OH
| | - John Oliver DeLancey
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, OH; Department of Urology, College of Medicine, The Ohio State University, Columbus, OH
| | - Ann Scheck McAlearney
- The Center for the Advancement of Team Science, Analytics, and Systems Thinking (CATALYST), College of Medicine, The Ohio State University, Columbus, OH; Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH; Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH
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Infection prevention requirements for the medical care of immunosuppressed patients: recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute. GMS HYGIENE AND INFECTION CONTROL 2022; 17:Doc07. [PMID: 35707229 PMCID: PMC9174886 DOI: 10.3205/dgkh000410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In Germany, guidelines for hygiene in hospitals are given in form of recommendations by the Commission for Hospital Hygiene and Infection Prevention (Kommission für Krankenhaushygiene und Infektionsprävention, "KRINKO"). The KRINKO and its voluntary work are legitimized by the mandate according to § 23 of the Infection Protection Act (Infektionsschutzgesetz, "IfSG"). The original German version of this document was published in February 2021 and has now been made available to the international professional public in English. The guideline provides recommendations on infection prevention and control for immunocompromised individuals in health care facilities. This recommendation addresses not only measures related to direct medical care of immunocompromised patients, but also management aspects such as surveillance, screening, antibiotic stewardship, and technical/structural aspects such as patient rooms, air quality, and special measures during renovations.
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Anforderungen an die Infektionsprävention bei der medizinischen Versorgung von immunsupprimierten Patienten. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:232-264. [PMID: 33394069 PMCID: PMC7780910 DOI: 10.1007/s00103-020-03265-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Consumer knowledge and attitudes toward public reporting of health care-associated infection data. Am J Infect Control 2019; 47:656-660. [PMID: 30639097 DOI: 10.1016/j.ajic.2018.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/08/2018] [Accepted: 11/08/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND There is little information regarding consumer knowledge of health care-associated infection (HAI). Furthermore, it is unclear how meaningful publicly reported HAI data is to consumers, how they may use it, and the most appropriate format for data presentation. The purpose of this study was to explore consumer knowledge and attitudes toward HAI and public reporting. METHODS A qualitative study design, characterized by a series of semistructured interviews, was undertaken with purposively selected, adult elective surgical inpatients at a large metropolitan acute hospital. Interviews were digitally recorded and transcribed verbatim. Analysis of the data were conducted using thematic analysis. RESULTS Twenty interviews were conducted. The 5 major themes identified were: (1) awareness through experience, (2) focus on current illness, (3) patient contribution to infection prevention, (4) sources and mode of information, and (5) influence on choice of hospital. DISCUSSION We found broad variation in knowledge, sources of information, and preferences for the type and delivery of information. A significant cohort of participants preferred not to be informed, whereas others were neutral or only mildly interested. CONCLUSIONS If public reporting of HAI data is to be aimed at consumers, further engagement with consumers is crucial to ensure the information provided is fit for purpose.
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Poster DL, Miller CC, Obeng Y, Postek MT, Cowan TE, Martinello RA. Innovative Approaches to Combat Healthcare-Associated Infections Using Efficacy Standards Developed Through Industry and Federal Collaboration. PROCEEDINGS OF SPIE--THE INTERNATIONAL SOCIETY FOR OPTICAL ENGINEERING 2018; 10730. [PMID: 31092964 DOI: 10.1117/12.2500431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Nation-wide, healthcare-associated infections (HAIs) infect one in every 25 hospital patients, account for more than 100,000 deaths and increase medical costs by around $96-147B, each year. Ultraviolet-C (UV-C) antimicrobial devices are shown to reduce the incidence of many of these HAIs by 35% or more, through the deactivation of the pathogen's DNA chain following irradiation with a wavelength of ~254 nm. This irradiation does not kill the cells, per se but effectively prevents the cells from multiplying. Clinical case reductions of 30-70% in Clostridium difficile (C. diff.) have been reported with similar results for methicillin-resistant Staphylococcus aureus (MRSA), and others. The methodology works, but, the adoption of UV-C technology by the healthcare industry has been sporadic. This is largely due to the lack of definitive knowledge and uniform performance standards or measures for efficacy to help healthcare managers make informed, credible investment decisions. The leveling of the playing field with scientifically certifiable data of the efficacy of antimicrobial devices will enhance acceptance by the healthcare industry and public, at large, as well as facilitate science-based decision making. The National Institute of Standards and Technology (NIST) has engaged with the International Ultra Violet Association (IUVA) and its member companies and affiliates to explore ways to develop needed standards, determine appropriate testing protocols, and transfer the technology to help to reduce these inharmonious market conditions. Collaborative efforts are underway to develop science-based answers to the healthcare industry's questions surrounding standards and measures of device disinfection efficacy, as well as reliability, operations and durability. These issues were recently discussed at the IUVA 2018 America's Conference in Redondo Beach, CA in several panel sessions. A major output of the sessions was the formation of a formal IUVA Working Group for the development of antimicrobial standards and initiatives for the healthcare industry. The goal of this working group is to provide global guidance, with specific programs and deliverables, on the use of UV technologies and standards to combat HAIs and to further the stated aims of the IUVA on its outreach to the healthcare industry. This paper reviews the strong collaboration between NIST and its industry partners pursuing the development of standards, guidelines and guidance documents related to healthcare applications that include standard methods for validating performance of UV devices and test guidelines for efficacy measurements. In addition, an overview of the issues, problems, and a summary of the needs confronting future growth and success of the UV industry in the Nation's healthcare application space is provided.
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Affiliation(s)
- Dianne L Poster
- National Institute of Standards and Technology, Gaithersburg, Maryland, USA
| | - C Cameron Miller
- National Institute of Standards and Technology, Gaithersburg, Maryland, USA
| | - Yaw Obeng
- National Institute of Standards and Technology, Gaithersburg, Maryland, USA
| | - Michael T Postek
- National Institute of Standards and Technology, Gaithersburg, Maryland, USA
| | - Troy E Cowan
- Vision Based Consulting, Bethesda, Maryland, USA
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Wright MO, Allen-Bridson K, Hebden JN. Assessment of the accuracy and consistency in the application of standardized surveillance definitions: A summary of the American Journal of Infection Control and National Healthcare Safety Network case studies, 2010-2016. Am J Infect Control 2017; 45:607-611. [PMID: 28549513 DOI: 10.1016/j.ajic.2017.03.035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 03/30/2017] [Accepted: 03/31/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) surveillance definitions are the most widely used criteria for health care-associated infection (HAI) surveillance. NHSN participants agree to conduct surveillance in accordance with the NHSN protocol and criteria. To assess the application of these standardized surveillance specifications and offer infection preventionists (IPs) opportunities for ongoing education, a series of case studies, with questions related to NHSN definitions and criteria were published. METHODS Beginning in 2010, case studies with multiple-choice questions based on standard surveillance criteria and protocols were written and published in the American Journal of Infection Control with a link to an online survey. Participants anonymously submitted their responses before receiving the correct answers. RESULTS The 22 case studies had 7,950 respondents who provided 27,790 responses to 75 questions during the first 6 years. Correct responses were selected 62.5% of the time (17,376 out of 27,290), but ranged widely (16%-87%). In a subset analysis, 93% of participants self-identified as IPs (3,387 out of 3,640), 4.5% were public health professionals (163 out of 3,640), and 2.5% were physicians (90 out of 3,640). IPs responded correctly (62%) more often than physicians (55%) (P = .006). CONCLUSIONS Among a cohort of voluntary participants, accurate application of surveillance criteria to case studies was suboptimal, highlighting the need for continuing education, competency development, and auditing.
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Russo PL, Havers SM, Cheng AC, Richards M, Graves N, Hall L. Characteristics of national and statewide health care-associated infection surveillance programs: A qualitative study. Am J Infect Control 2016; 44:1505-1510. [PMID: 27665032 DOI: 10.1016/j.ajic.2016.06.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 06/24/2016] [Accepted: 06/24/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND There are many well-established national health care-associated infection surveillance programs (HAISPs). Although validation studies have described data quality, there is little research describing important characteristics of large HAISPs. The aim of this study was to broaden our understanding and identify key characteristics of large HAISPs. METHODS Semi-structured interviews were conducted with purposively selected leaders from national and state-based HAISPs. Interview data were analyzed following an interpretive description process. RESULTS Seven semi-structured interviews were conducted over a 6-month period during 2014-2015. Analysis of the data generated 5 distinct characteristics of large HAISPs: (1) triggers: surveillance was initiated by government or a cooperative of like-minded people, (2) purpose: a clear purpose is needed and determines other surveillance mechanisms, (3) data measures: consistency is more important than accuracy, (4) processes: a balance exists between the volume of data collected and resources, and (5) implementation and maintenance: a central coordinating body is crucial for uniformity and support. CONCLUSIONS National HAISPs are complex and affect a broad range of stakeholders. Although the overall goal of health care-associated infection surveillance is to reduce the incidence of health care-associated infection, there are many crucial factors to be considered in attaining this goal. The findings from this study will assist the development of new HAISPs and could be used as an adjunct to evaluate existing programs.
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Horowitz HW. Infection control II: A practical guide to getting to zero. Am J Infect Control 2016; 44:1075-7. [PMID: 27158090 DOI: 10.1016/j.ajic.2016.02.032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 01/22/2016] [Accepted: 02/26/2016] [Indexed: 11/25/2022]
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Otter JA. Reflections from Infection Prevention 2015: beating the bugs, improving the systems and thinking outside the box. J Infect Prev 2016; 17:37-41. [PMID: 28989452 DOI: 10.1177/1757177415617244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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