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Bhan A, Green CV, Liang Philpotts L, Doherty M, Greenfield AS, Courtney A, Shenoy ES. Educational interventions to improve compliance with disinfection practices of noncritical portable medical equipment: A systematic review. Infect Control Hosp Epidemiol 2024; 45:360-366. [PMID: 37929604 DOI: 10.1017/ice.2023.234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
OBJECTIVE To describe educational interventions that have been implemented in healthcare settings to increase the compliance of healthcare personnel (HCP) with cleaning and disinfection of noncritical portable medical equipment (PME) requiring low-level disinfection (LLD). DESIGN Systematic review. METHODS Studies evaluating interventions for improving LLD practices in settings with HCP, including healthcare students and trainees, were eligible for inclusion. RESULTS In total, 1,493 abstracts were identified and 1,416 were excluded, resulting in 77 studies that underwent full text review. Among these, 68 were further excluded due to study design, setting, or intervention. Finally, 9 full-text studies were extracted; 1 study was excluded during the critical appraisal process, leaving 8 studies. Various forms of interventions were implemented in the studies, including luminescence, surveillance of contamination with feedback, visual signage, enhanced training, and improved accessibility of LLD supplies. Of the 8 included studies, 4 studies reported successes in improving LLD practices among HCP. CONCLUSIONS The available literature was limited, indicating the need for additional research on pedagogical methods to improve LLD practices. Use of visual indicators of contamination and multifaceted interventions improved LLD practice by HCP.
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Affiliation(s)
- Aarushi Bhan
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts
- Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Chloe V Green
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts
- Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Megan Doherty
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts
- Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Amy Courtney
- Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts
| | - Erica S Shenoy
- Division of Infectious Diseases, Massachusetts General Hospital, Boston, Massachusetts
- Infection Control Unit, Massachusetts General Hospital, Boston, Massachusetts
- Infection Control, Mass General Brigham, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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Chen X, Zhang P, Zhang R, Li S, Cao R, Hu F, Jin YH, Lin L, Cai L, Feng B, Zhang C, Wang X. Development and validation of the regarding infection prevention and control among environmental service workers on knowledge, attitudes, practise, and experience questionnaire. Front Public Health 2023; 10:1062199. [PMID: 36699941 PMCID: PMC9869485 DOI: 10.3389/fpubh.2022.1062199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
Purpose This study aimed to develop and test the validity and reliability of the Knowledge, Attitudes, Practise, and Experience regarding Infection Prevention and Control-associated Questionnaire for environmental service workers. Design This study was a development and validation study of a questionnaire using multiple methods, including literature review, questionnaire survey, and Delphi technique. Methods Phase I of the study entailed the development of items through an extensive literature review and two round Delphi process with 15 experts specialised in infection prevention and control, environmental service worker management, or scale construction to examine the content validity of the questionnaire. Phase II involved administering the questionnaire to a convenience sample of 1,176 environmental service workers from the public hospital from 13 provinces in China to evaluate its construct validity and reliability. Findings In the two rounds of Delphi consultation, the recovery rate were 93.75 and 100%. Moreover, the expert authority coefficient was 0.93, and the coordination coefficients of expert opinions in the first round were as follows: correlation of 0.204 and importance of 0.249 for the first-level index; correlation of 0.128 and importance of 0.142 for the secondary index. In round two, the coordination coefficients of expert opinions were as follows: correlation of 0.221 and importance of 0.221 for the first-level indicators; correlation of 0.096 and importance of 0.101 for the secondary index. The results for the index were P < 0.05 for the two rounds. The pilot survey shows the instrument was excellent content validity (S-CVI/Ave = 0.989). The overall internal consistency was excellent (Cronbach's α = 0.967). The questionnaire ultimately comprised four first-level indices (knowledge, attitudes, practise, and experience) and 49 second-level indices. Conclusion The Questionnaire demonstrated good reliability and validity and is effective in measuring levels of infection prevention and control-related knowledge, attitudes, practise, and experience among environmental service workers. It will provide a tool for future national investigations of the current infection prevention and control situation among environmental service workers. Future research should explore determinants of environmental service workers' knowledge, attitudes, practise, and experience and associations between infection prevention and control knowledge, attitudes, practises, and experience.
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Affiliation(s)
- Xiaohang Chen
- Institute of Hepatobiliary Diseases of Wuhan University, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Pan Zhang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ruhan Zhang
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Shuting Li
- Department of Endocrinology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Rui Cao
- Department of Nursing, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Fen Hu
- Department of Nursing, Zhongnan Hospital of Wuhan University, Wuhan, China,Hubei Engineering Center for Infectious Disease Prevention, Control, and Treatment, Wuhan, China
| | - Ying-Hui Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Likai Lin
- Institute of Hospital Management, Wuhan University, Wuhan, China
| | - Lin Cai
- Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Bilong Feng
- Department of Nursing, Zhongnan Hospital of Wuhan University, Wuhan, China,Hubei Engineering Center for Infectious Disease Prevention, Control, and Treatment, Wuhan, China,Bilong Feng ✉
| | - Chunhua Zhang
- Department of Nursing, Zhongnan Hospital of Wuhan University, Wuhan, China,Chunhua Zhang ✉
| | - Xinghuan Wang
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China,Research Center of Wuhan for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan, China,Department of Urology, Zhongnan Hospital of Wuhan University, Wuhan, China,*Correspondence: Xinghuan Wang ✉
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Hewage SN, Makawita P, Gibson KE, Lee JA, Fraser AM. Relationship between ATP Bioluminescence Measurements and Microbial Assessments in Studies Conducted in Food Establishments: A Systematic Literature Review and Meta-Analysis. J Food Prot 2022; 85:1855-1864. [PMID: 36173898 DOI: 10.4315/jfp-22-187] [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: 06/15/2022] [Accepted: 09/25/2022] [Indexed: 11/11/2022]
Abstract
ABSTRACT Adherence to proper environmental cleaning practices is critical in food establishments. To validate cleanliness, cleaning practices should be routinely monitored, preferably by a rapid, reliable, and cost-effective method. The aim of this study was to determine whether a correlation exists between ATP bioluminescence measurements and selected microbial assessments in studies conducted in food establishments. A systematic literature review and meta-analysis was conducted using the principles of preferred reporting items for systematic reviews and meta-analyses. Twelve online databases and search engines were selected for the review. Peer-reviewed articles published in English between January 2000 and July 2020 were included in the search. From a total of 19 eligible studies, 3 that included Pearson correlation coefficients (r) between ATP bioluminescence measurements and microbial assessments were used for the meta-analysis calculations. Only the fixed-effect model produced a strong correlation because one value dominated the estimates: r = 0.9339 (0.9278, 0.9399). In contrast, both the random effects model, 0.2978 (0.24, 0.3471), and the mixed effects model, r = 0.3162 (-0.0387, 0.6711), indicated a weak relationship between ATP bioluminescence and microbial assessments, with no evidence of a strong correlation. The meta-analysis results indicated no sufficient evidence of a strong correlation between ATP bioluminescence measurements and microbial assessments when applied within food establishments. This lack of evidence for a strong correlation between the results of these two monitoring tools suggests that food establishments cannot depend on only one method. Yet, with immediate feedback and quantification of organic soiling, ATP bioluminescence could be an effective monitoring tool to use in food establishments. HIGHLIGHTS
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Affiliation(s)
- Supun Nabadawa Hewage
- Department of Food, Nutrition, and Packaging Sciences, Clemson University, 223 Poole Agricultural Center, Box 340316, Clemson, South Carolina 29634-0316
| | - P Makawita
- Department of Food, Nutrition, and Packaging Sciences, Clemson University, 223 Poole Agricultural Center, Box 340316, Clemson, South Carolina 29634-0316
| | - Kristen E Gibson
- Department of Food Science, System Division of Agriculture, University of Arkansas, 2650 North Young Avenue, Fayetteville, Arkansas 72704
| | - Jung-Ae Lee
- Department of Population and Quantitative Health Sciences, Chan Medical School, University of Massachusetts, 368 Plantation Street, Worcester, Massachusetts 01605, USA
| | - Angela M Fraser
- Department of Food, Nutrition, and Packaging Sciences, Clemson University, 223 Poole Agricultural Center, Box 340316, Clemson, South Carolina 29634-0316
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Ma H, Di D, Li L, Zhang W, Wang J. Environmental decentralization, environmental public service, and public health: evidence from 289 cities in China. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2022; 44:2905-2918. [PMID: 34613559 DOI: 10.1007/s10653-021-01112-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/22/2021] [Indexed: 06/13/2023]
Abstract
Effective supply of environmental public services (EPS) is important to guarantee the mitigation of residential pollution exposure risk. This study analyzes the impact of the supply efficiency of EPS on residential health through the sample of 289 cities in China by fixed-effect model and threshold regression model. The results show that: (1) Improving the efficiency of EPS can significantly increase the efficiency of pollution control, and improve the environmental quality and health level of residents. (2) Improving the efficiency of EPS can have a greater positive effect on residents' health in areas with high-level population aging, poor medical condition, and low population density. (3) Environmental decentralization weakens the positive effect of EPS on residential health. Giving more power of environmental management to local governments may be detrimental to pollution control. Therefore, differentiated strategies of EPS should be developed to realize the equalization of basic public services with healthcare and environmental protection. It is necessary to strengthen central environmental supervision and establish resident offices for environmental supervision.
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Affiliation(s)
- Huimin Ma
- School Hospital, China University of Geosciences, Wuhan, 430074, Hubei, China
| | - Danyang Di
- School of Economics, Shanghai University of Finance and Economics, Shanghai, 200433, China.
| | - Lin Li
- School of Economics and Management, China University of Geosciences, Wuhan, 430074, Hubei, China
- Research Centre of Resource and Environmental Economics, China University of Geosciences, Wuhan, 430074, Hubei, China
| | - Wei Zhang
- School of Economics and Management, China University of Geosciences, Wuhan, 430074, Hubei, China
| | - Jianmei Wang
- School of Public Economics and Administration, Shanghai University of Finance and Economics, Shanghai, 200433, China
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Goedken CC, McKinley L, Balkenende E, Hockett Sherlock S, Knobloch MJ, Perencevich EN, Safdar N, Reisinger HS. "Our job is to break that chain of infection": Challenges environmental management services (EMS) staff face in accomplishing their critical role in infection prevention. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e129. [PMID: 36483342 PMCID: PMC9726543 DOI: 10.1017/ash.2022.261] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES Contaminated surfaces in healthcare settings contribute to the transmission of nosocomial pathogens. Adequate environmental cleaning is important for preventing the transmission of important pathogens and reducing healthcare-associated infections. However, effective cleaning practices vary considerably. We examined environmental management services (EMS) staff experiences and perceptions surrounding environmental cleaning to describe perceived challenges and ideas to promote an effective environmental services program. DESIGN Qualitative study. PARTICIPANTS Frontline EMS staff. METHODS From January to June 2019, we conducted individual semistructured interviews with key stakeholders (ie, EMS staff) at 3 facilities within the Veterans' Affairs Healthcare System. We used the Systems Engineering Initiative for Patient Safety (SEIPS) framework (ie, people, environment, organization, tasks, tools) to guide this study. Interviews were audio-recorded, transcribed, and analyzed for thematic content. RESULTS In total, 13 EMS staff and supervisors were interviewed. A predominant theme that emerged were the challenges EMS staff saw as hindering their ability to be effective at their jobs. EMS staff interviewed felt they understand their job requirements and are dedicated to their work; however, they described challenges related to feeling undervalued and staffing issues. CONCLUSIONS EMS staff play a critical role in infection prevention in healthcare settings. However, some do not believe their role is recognized or valued by the larger healthcare team and leadership. EMS staff provided ideas for improving feelings of value and job satisfaction, including higher pay, opportunities for certifications and advancement, as well as collaboration or integration with the larger healthcare team. Healthcare organizations should focus on utilizing these suggestions to improve the EMS work climate.
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Affiliation(s)
- Cassie Cunningham Goedken
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa
| | - Linda McKinley
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | - Erin Balkenende
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa
- Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Stacey Hockett Sherlock
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa
- Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Mary Jo Knobloch
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
- University of Wisconsin–Madison, Madison, Wisconsin
| | - Eli N. Perencevich
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa
- Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Nasia Safdar
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
- University of Wisconsin–Madison, Madison, Wisconsin
| | - Heather Schacht Reisinger
- Center for Access & Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa
- Carver College of Medicine, University of Iowa, Iowa City, Iowa
- Institute for Clinical and Translational Science, Iowa City, Iowa
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Overbey KN, Hamra GB, Nachman KE, Rock C, Schwab KJ. Quantitative microbial risk assessment of human norovirus infection in environmental service workers due to healthcare-associated fomites. J Hosp Infect 2021; 117:52-64. [PMID: 34403766 PMCID: PMC8978295 DOI: 10.1016/j.jhin.2021.08.006] [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: 06/01/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Healthcare-associated norovirus outbreaks place a large burden on healthcare staff. Environmental service workers (ESWs), however, remain understudied despite high contact with potentially contaminated surfaces. Understanding the magnitude of the risk of norovirus infection in healthcare ESWs can protect workers and improve infection control. AIM This study simulated the risk of norovirus infection for unprotected ESWs after a single fomite contact, assuming no disinfection or protective equipment, in norovirus-positive patient rooms. In addition, the risk of secondary surface transmission from norovirus-exposed ESWs was simulated. METHODS A quantitative microbial risk assessment employing two-dimensional Monte Carlo simulation with parameters extracted from the literature was used to estimate norovirus infection from multiple fomite contact scenarios defined by: norovirus source (patient vomit/diarrhoea), location (bathroom/patient room) and target outcome (ESW/secondary illness). FINDINGS Unprotected ESWs have a maximum estimated risk of norovirus infection of 33% (1:3) for a single fomite contact in a room where a norovirus-positive patient had a diarrhoeal event. Patient vomit events lead to fomite contact risk estimates that are four orders of magnitude lower than those for diarrhoeal events. The estimated risk of secondary illness from touching a common surface is as high as 25% (1:4) after single fomite exposure following a diarrhoeal event. CONCLUSIONS A single fomite contact may lead to sizable risk of norovirus infection in ESWs if personal protective equipment and disinfection are not used appropriately. ESWs can also transfer virus to secondary surfaces, initiating further infections. Interventions are needed to reduce fomite transfer of norovirus, and protect patients and staff from nosocomial infections.
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Affiliation(s)
- K N Overbey
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - G B Hamra
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - K E Nachman
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Risk Sciences and Public Policy Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - C Rock
- Division of Infectious Diseases, Johns Hopkins Medicine, Baltimore, MD, USA
| | - K J Schwab
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Risk Sciences and Public Policy Institute, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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