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Kopuit P, Bier L, Abu-Gush S, Smadga H, David R, Shraga T, Dery I, Ezagui BS, Yinnon AM, Benenson S. How effective are monthly departmental tracer surveys? A 5-year retrospective study of 138 surveys in 96 departments. Am J Infect Control 2024; 52:872-877. [PMID: 38583776 DOI: 10.1016/j.ajic.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Repeat department-wide surveys are commonly employed for infection control. There remains debate concerning their cost-effectivess. The aim of the study was to measure the impact of repeat department-wide surveys in major in-patient departments (IPDs) and ambulatory facilities (AFs) in a tertiary care hospital. This was a retrospective study of 138 surveys condcuted in 96 departments over a 5-year period. METHODS Two itemized questionnaires were designed to assess the most frequently inadequately adhered to infection control measures: one for IPD (with 21 items) and the other for AF (with 17 items). RESULTS A total of 72 surveys were conducted in 49 IPDs, of which 39 (54%) were repeat surveys, and 66 surveys in 47 AFs, of which 33 (50%) were repeat surveys. The baseline rate of adherence/department was 71% ± 14 for the IPD, with an increase from the first to the last survey to 82% ± 13 (P = .037). In 15/21 measured infection control items, adherence improved. Adherence to infection control items was lower at baseline in the AFs than in the IPDs (63 ± 27), with an increase to 76 ± 20 (non significant). Although adherence improved for 9 items, it deteriorated in another 8, producing an overall statistically unchanged outcome. CONCLUSION Repeat whole-department surveys contribute moderately to increased adherence to infection control guidelines. AFs demonstrate lower rates of adherence to infection control guidelines and are less receptive to educational measures.
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Affiliation(s)
- Puah Kopuit
- Infection Control and Prevention Unit, The Eisenberg R&D Authority, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Liora Bier
- Infection Control and Prevention Unit, The Eisenberg R&D Authority, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Samar Abu-Gush
- Infection Control and Prevention Unit, The Eisenberg R&D Authority, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Hanna Smadga
- Infection Control and Prevention Unit, The Eisenberg R&D Authority, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Ruth David
- Infection Control and Prevention Unit, The Eisenberg R&D Authority, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Tova Shraga
- Infection Control and Prevention Unit, The Eisenberg R&D Authority, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Ilana Dery
- Infection Control and Prevention Unit, The Eisenberg R&D Authority, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Bath Sheva Ezagui
- Infection Control and Prevention Unit, The Eisenberg R&D Authority, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Amos M Yinnon
- Infection Control and Prevention Unit, The Eisenberg R&D Authority, Shaare Zedek Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew-University Hadassah Medical School, Jerusalem, Israel.
| | - Shmuel Benenson
- Infection Control and Prevention Unit, The Eisenberg R&D Authority, Shaare Zedek Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew-University Hadassah Medical School, Jerusalem, Israel
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Arnold L, Bimczok S, Schütt H, Lisak-Wahl S, Buchberger B, Stratil JM. How to protect long-term care facilities from pandemic-like events? - A systematic review on the effectiveness of non-pharmacological measures to prevent viral respiratory infections. BMC Infect Dis 2024; 24:589. [PMID: 38880893 PMCID: PMC11181531 DOI: 10.1186/s12879-024-09271-7] [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: 11/01/2023] [Accepted: 03/28/2024] [Indexed: 06/18/2024] Open
Abstract
BACKGROUND The SARS-CoV-2 pandemic underscored the need for pandemic preparedness, with respiratory-transmitted viruses considered as a substantial risk. In pandemics, long-term care facilities (LTCFs) are a high-risk setting with severe outbreaks and burden of disease. Non-pharmacological interventions (NPIs) constitute the primary defence mechanism when pharmacological interventions are not available. However, evidence on the effectiveness of NPIs implemented in LTCFs remains unclear. METHODS We conducted a systematic review assessing the effectiveness of NPIs implemented in LTCFs to protect residents and staff from viral respiratory pathogens with pandemic potential. We searched Medline, Embase, CINAHL, and two COVID-19 registries in 09/2022. Screening and data extraction was conducted independently by two experienced researchers. We included randomized controlled trials and non-randomized observational studies of intervention effects. Quality appraisal was conducted using ROBINS-I and RoB2. Primary outcomes encompassed number of outbreaks, infections, hospitalizations, and deaths. We synthesized findings narratively, focusing on the direction of effect. Certainty of evidence (CoE) was assessed using GRADE. RESULTS We analysed 13 observational studies and three (cluster) randomized controlled trials. All studies were conducted in high-income countries, all but three focused on SARS-CoV-2 with the rest focusing on influenza or upper-respiratory tract infections. The evidence indicates that a combination of different measures and hand hygiene interventions can be effective in protecting residents and staff from infection-related outcomes (moderate CoE). Self-confinement of staff with residents, compartmentalization of staff in the LTCF, and the routine testing of residents and/or staff in LTCFs, among others, may be effective (low CoE). Other measures, such as restricting shared spaces, serving meals in room, cohorting infected and non-infected residents may be effective (very low CoE). An evidence gap map highlights the lack of evidence on important interventions, encompassing visiting restrictions, pre-entry testing, and air filtration systems. CONCLUSIONS Although CoE of interventions was low or very low for most outcomes, the implementation of NPIs identified as potentially effective in this review often constitutes the sole viable option, particularly prior to the availability of vaccinations. Our evidence-gap map underscores the imperative for further research on several interventions. These gaps need to be addressed to prepare LTCFs for future pandemics. TRIAL REGISTRATION CRD42022344149.
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Affiliation(s)
- Laura Arnold
- Academy of Public Health Services, Kanzlerstraße 4, Duesseldorf, 40472, Germany
- Department of International Health, Care and Public Health Research Institute-CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Simon Bimczok
- Academy of Public Health Services, Kanzlerstraße 4, Duesseldorf, 40472, Germany
| | - Hannah Schütt
- Academy of Public Health Services, Kanzlerstraße 4, Duesseldorf, 40472, Germany
| | - Stefanie Lisak-Wahl
- Academy of Public Health Services, Kanzlerstraße 4, Duesseldorf, 40472, Germany
| | - Barbara Buchberger
- Robert Koch Institute, Berlin, Germany
- University of Duisburg-Essen, Institute for Health Care Management and Research, Essen, Germany
| | - Jan M Stratil
- Robert Koch Institute, Berlin, Germany.
- Department of Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany.
- Postgraduate Training for Applied Epidemiology (PAE), Robert Koch Institute, Berlin, Germany.
- Field Epidemiology Path (EPIET), European Centre for Disease Prevention and Control (ECDC), ECDC Fellowship Programme, Stockholm, Sweden.
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Merrill K, Cervantes D, Hebden JN, Pogorzelska-Maziarz M, Piatek D, Monsees E, Hessels A. Infection preventionists in public health, consultant and academic roles: Results from the 2020 APIC MegaSurvey. Am J Infect Control 2024; 52:261-266. [PMID: 37689123 DOI: 10.1016/j.ajic.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND Infection preventionists (IPs) work and practice in a variety of roles across many practice settings. While the health care-based IP role has been well studied, less is known about IPs who work in public health, consultant, and academic roles. METHODS Data were collected as a subset of the Association for Professionals in Infection Prevention and Control and Epidemiology 2020 MegaSurvey. Descriptive and bivariate analyses were performed to compare the responses of 147 IPs working in public health, consulting, or academic roles. RESULTS Respondents identified their primary IP role as public health (40%), consulting (39%), or academic (21%). Most were White and non-Hispanic females working in long-term care, acute care, and outpatient settings. Most had over 11 years of experience in health care before IP, with nursing being the most common. More consultants were certified in infection control (74%). While half of the respondents in public health reported being certified in infection control, and a third had 6 or more years of experience in infection prevention and control, they reported the lowest annual salary and satisfaction with total compensation. DISCUSSION These findings highlight the characteristics and contributions of infection prevention and control in nontraditional roles and settings. Certification and fair compensation are crucial factors for professional development and job satisfaction. CONCLUSIONS These insights can guide future education, recruitment, and retention strategies for IPs in public health, consulting, and academic roles.
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Affiliation(s)
- Katreena Merrill
- Brigham Young University, College of Nursing, Provo, UT; Intermountain Health - St. George Regional Hospital, Nursing Administration, St. George, UT.
| | - Diana Cervantes
- School of Public Health, Department of Biostatistics and Epidemiology, The University of North Texas Health Science Center, Fort Worth, TX
| | - Joan N Hebden
- University of Maryland School of Medicine Department of Epidemiology and Public Health, Baltimore, MD
| | | | - Dana Piatek
- Pennsylvania Department of Health, Harrisburg, PA
| | - Elizabeth Monsees
- Children's Mercy, Infection Prevention & Antimicrobial/Diagnostic Stewardship Integration, Service & Performance, University of Missouri-Kansas City School of Medicine, Kansas City, MO
| | - Amanda Hessels
- Columbia University, School of Nursing, New York, NY; Hackensack Meridian Health, Department of Nursing Research, Edison, NJ; Consulting Professionals, Inc., Bradenton, FL
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Nakayama A, Yamaguchi I, Okamoto K, Maesaki S. Public Health Centers' Training Session Programs to Develop Programs on Infection Control Practices for Multidrug-Resistant Organisms in Hospitals in Kawaguchi City, Japan. Cureus 2023; 15:e48178. [PMID: 38046751 PMCID: PMC10693389 DOI: 10.7759/cureus.48178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction The Kawaguchi City Public Health Center (PHC) conducted training sessions focusing on infection control practices on multidrug-resistant organisms (MDROs) for 19 hospitals and eight affiliated clinics (AFs) with beds in June 2022. Issues with infection control programs were identified via a survey implemented following the training sessions. These included providing feedback on infection control policies for MDROs, hand hygiene compliance programs (HHCPs), environmental cleaning (EC), and training sessions programs that hospitals or AFs with beds (hospitals) intended to implement in the future or develop (to be developed). We planned to examine whether the PHC training sessions programs have an effect on the development of hospital infection control programs designed to address these issues. The purpose of this study is to clarify the training session program provided by the Kawaguchi City PHC, which was effective in developing hospital infection control programs based on the results of the survey conducted after the training session. Methods In June 2023, a second training session that offered information on infection control practices was completed for 30 hospitals. This was followed by sending a questionnaire. We examined infection control programs to be developed and analyzed associations with the first learned information by training session (the first learned information). Results Twenty-four hospitals responded to the survey with a response rate of 80.0%. Half the respondents (12, 50.0%) had prepared for the infection control policy on carbapenem-resistant Enterobacteriaceae (CRE), 11 hospitals (45.8%) had provided feedback on HHC, and four (16.7%) planned to conduct feedback on HHC. HHCPs were planned to be developed by 19 hospitals (79.2%), EC by five hospitals (20.8%), training session by 12 hospitals (50.0%), and screening of MDROs upon hospital admission (AS) by nine hospitals (37.5%). The first learned information, "the prevention of healthcare-associated infections and cost savings by implementing cleaning bundles (the effects of cleaning bundles)," was identified by 10 hospitals (41.7%), and "specific programs on providing feedback effective for developing hand hygiene compliance (specific feedback)" was learned by eight hospitals (33.3%). The first learned information regarding specific feedback was significantly associated with HHCPs to be developed (p = 0.044). The first learned information on the effects of cleaning bundles was significantly associated with HHCPs and HHC feedback to be developed (p = 0.023, 0.034). The training session programs were not significantly connected to EC, training session, or AS to be developed. Conclusions Infection control programs to be developed were linked to the provision of information on numerical effects by implementing specific feedback and cleaning bundles. We suggest that the PHC should develop infection control programs for the hospitals and provide training sessions, including numerical effects.
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Affiliation(s)
- Ayako Nakayama
- Administration Department, Kawaguchi Public Health Center, Saitama, JPN
| | - Ichiro Yamaguchi
- Department of Environmental Health, National Institute of Public Health, Saitama, JPN
| | - Koji Okamoto
- Administration Department, Kawaguchi Public Health Center, Saitama, JPN
| | - Shigefumi Maesaki
- Department of Infectious Disease and Infection Control, Saitama Medical University, Saitama, JPN
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Giannopoulos G, Cronin K. Utilizing application scenarios to enhance a competency-based infection prevention orientation program. Am J Infect Control 2023; 51:1077-1079. [PMID: 36905987 DOI: 10.1016/j.ajic.2023.02.016] [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: 01/27/2023] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/11/2023]
Abstract
Infection Preventionists (IPs) are expected to be well-rounded and competent in their role, necessitating a robust orientation program. Feedback from IPs identified that orientation is task-based and lacks opportunities for meaningful application to the field. This team sought to enhance onboarding through focused interventions, including standardized resources and scenario-based applications. This department has engaged in an iterative process to refine and implement a robust orientation program, resulting in improvement in the department.
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Garcia R. Moving Beyond Central Line-Associated Bloodstream Infections: Enhancement of the Prevention Process. JOURNAL OF INFUSION NURSING 2023; 46:217-222. [PMID: 37406336 DOI: 10.1097/nan.0000000000000509] [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: 07/07/2023]
Abstract
The provision of medications and other treatments via intravenous (IV) therapy has provided millions of health care patients with extended benefits. IV therapy, however, is also associated with complications, such as associated bloodstream infections. Understanding the mechanisms of development and the factors that have contributed to the recent increases in such health care-acquired infections assists in formulating new preventive strategies that include the implementation of hospital-onset bacteremia, an innovative model that requires surveillance and prevention of bloodstream infections associated with all types of vascular access devices, expansion of vascular access service teams (VAST), and use of advanced antimicrobial dressings designed to reduce bacterial proliferation over the currently recommended time periods for maintenance of IV catheters.
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Affiliation(s)
- Robert Garcia
- Infection Prevention Consultant, Enhanced Epidemiology, Valley Stream, New York
- Robert Garcia, BS, MT(ASCP), CIC, FAPIC, has been an infection preventionist/consultant for 43 years and a member of the Association for Professionals in Infection Control & Epidemiology (APIC). He received a Bachelor of Science in Community Health from St. Joseph's College in 1982 and has been certified in infection control since 1984 by the Certification Board in Infection Control. Mr Garcia was elected in 2016 as a fellow in APIC 2016, a designation for experienced infection preventionists who have had significant contributions to the field of infection prevention. In addition, Mr Garcia has been an infection preventionist/director at 9 hospitals in New York, most recently as a senior instructional support specialist at the Healthcare Epidemiology Department, Stony Brook University Hospital (Stony Brook, NY). He is a principal national researcher on the effectiveness of silver-hydrogel urinary catheters, chlorhexidine skin antisepsis, and comprehensive oral care to prevent ventilator-associated pneumonia. Mr Garcia is an international speaker on infection prevention issues, such as health care-associated infections, microbiology, diagnostic and antibiotic stewardship, and environmental contamination
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McKay VR, Kwon JH. Identifying, deconstructing, and deimplementing low-value infection control and prevention interventions. Infect Control Hosp Epidemiol 2023:1-2. [PMID: 37183993 DOI: 10.1017/ice.2023.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- Virginia R McKay
- Brown School, Washington University in St. Louis, St. Louis, Missouri
| | - Jennie H Kwon
- Department of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri
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