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Nomoto H, Saito H, Ishikane M, Gu Y, Ohmagari N, Pittet D, Kunishima H, Allegranzi B, Yoshida M. First nationwide survey of infection prevention and control among healthcare facilities in Japan: impact of the national regulatory system. Antimicrob Resist Infect Control 2022; 11:135. [PMID: 36352429 PMCID: PMC9647990 DOI: 10.1186/s13756-022-01175-y] [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: 03/26/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Infection prevention and control (IPC) measures in Japan are facilitated by a financial incentive process at the national level, where facilities are categorized into three groups (Tier 1, Tier 2, or no financial incentive). However, its impact on IPC at the facility level using a validated tool has not been measured. METHODS A nationwide cross-sectional study was conducted from August 2019 to January 2020 to evaluate the situation of IPC programs in Japan, using the global IPC Assessment Framework (IPCAF) developed by the World Health Organization. Combined with the information on the national financial incentive system, the demographics of facilities and each IPCAF item were descriptively analyzed. IPCAF scores were analyzed according to the facility level of care and the national financial incentive system for IPC facility status, using Dunn-Bonferroni and Mann-Whitney U tests. RESULTS Fifty-nine facilities in Japan responded to the IPCAF survey: 34 private facilities (57.6%) and 25 public facilities (42.4%). Of these, 11 (18.6%), 29 (49.2%), and 19 (32.3%) were primary, secondary, and tertiary care facilities, respectively. According to the national financial incentive system for IPC, 45 (76.3%), 11 (18.6%), and three (5.1%) facilities were categorized as Tier 1, Tier 2, and no financial incentive system, respectively. Based on the IPCAF total score, more than half of the facilities were categorized as "Advanced" (n = 31, 55.3%), followed by "Intermediate" (n = 21, 37.5%). The IPCAF total score increased as the facility level of care increased, while no statistically significant difference was identified between the secondary and tertiary care facilities (p = 0.79). There was a significant difference between Tier 1 and Tier 2 for all core components and total scores. Core components 5 (multimodal strategies for implementation of IPC interventions) and 6 (monitoring/audit of IPC and feedback) were characteristically low in Japan with a median score of 65.0 (interquartile range 40.0-85.0) and 67.5 (interquartile range 52.5-87.5), respectively. CONCLUSIONS The national financial incentive system was associated with IPC programs at facility level in Japan. The current financial incentive system does not emphasize the multimodal strategy or cover monitoring/audit, and an additional systematic approach may be required to further promote IPC for more practical healthcare-associated infection prevention.
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Affiliation(s)
- Hidetoshi Nomoto
- grid.45203.300000 0004 0489 0290Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan ,grid.69566.3a0000 0001 2248 6943Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Miyagi, Japan
| | - Hiroki Saito
- grid.8591.50000 0001 2322 4988Faculty of Medicine, Institute of Global Health, University of Geneva, Geneva, Switzerland ,grid.412764.20000 0004 0372 3116Department of Emergency and Critical Care Medicine, St. Marianna University School of Medicine Yokohama Seibu Hospital, Kanagawa, Japan ,grid.45203.300000 0004 0489 0290AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masahiro Ishikane
- grid.45203.300000 0004 0489 0290Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan ,grid.45203.300000 0004 0489 0290AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshiaki Gu
- grid.265073.50000 0001 1014 9130Department of Infectious Diseases, Tokyo Medical and Dental University, Tokyo, Japan
| | - Norio Ohmagari
- grid.45203.300000 0004 0489 0290Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan ,grid.69566.3a0000 0001 2248 6943Emerging and Re-emerging Infectious Diseases, Graduate School of Medicine, Tohoku University, Miyagi, Japan ,grid.45203.300000 0004 0489 0290AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Didier Pittet
- grid.150338.c0000 0001 0721 9812Infection Control Programme, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Hiroyuki Kunishima
- grid.412764.20000 0004 0372 3116Department of Infectious Diseases, St Marianna University School of Medicine, Kanagawa, Japan
| | - Benedetta Allegranzi
- grid.3575.40000000121633745Infection Prevention and Control Hub, Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Masaki Yoshida
- grid.411898.d0000 0001 0661 2073Department of Infectious Diseases and Infection Control, The Jikei University School of Medicine, Tokyo, Japan
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Eng TY, Eng NL, Jenkins CA, Grota PG. "Did you wash your hands?": a prospective study of patient empowerment to prompt hand washing by healthcare providers. J Infect Prev 2021; 22:195-202. [PMID: 34659457 DOI: 10.1177/17571774211012767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 04/06/2021] [Indexed: 11/17/2022] Open
Abstract
Background Hand hygiene is paramount in preventing the spread of healthcare-associated infections especially during disease epidemics. Compliance rates with hand hygiene policies remain below 50% internationally and may be lower in the outpatient care setting. This study assessed the impact of the patient empowerment model on hand hygiene compliance among healthcare providers. Methods From October 2016 to May 2017, patients from a large ambulatory oncology centre were prospectively enrolled. Patients were instructed to observe healthcare providers for hand hygiene compliance and to remind healthcare providers where it was not observed during at least three consecutive encounters. Healthcare provider reactions to this intervention were rated by patients. Patients' hand hygiene knowledge and beliefs were objectively elicited pre and post-study. Results Thirty patients with a median age of 52 years (range 5-91) completed the study for a total of 190 healthcare provider encounters. When initial hand hygiene was not observed, patients offered a reminder in 71 (37.4%) encounters, did not offer a reminder in 73 (38.4%) encounters and forgot to offer a reminder in 24 (14.2%) encounters. Patients perceived positive or neutral reactions in 76.8% of encounters and negative or surprised reactions in 23.2% of encounters. Healthcare provider compliance improved from 11.6% to 48.9% with intervention. Patient hand hygiene knowledge improved by 16% following the study. Conclusions Patient-empowered hand hygiene may be a useful adjunct for improving hand hygiene compliance among healthcare providers and improving patient hand hygiene knowledge, although it may confer an emotional burden on patients.
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Affiliation(s)
- Tony Y Eng
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, USA
| | - Nina L Eng
- School of Medicine, Emory University, Atlanta, USA
| | - Carol A Jenkins
- Department of Radiation Oncology, UT Health San Antonio MD Anderson Cancer Center, San Antonio, USA
| | - Patti G Grota
- Office of Faculty Excellence, School of Nursing, UT Health San Antonio, San Antonio, USA
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Ahmed J, Malik F, Memon ZA, Bin Arif T, Ali A, Nasim S, Ahmad J, Khan MA. Compliance and Knowledge of Healthcare Workers Regarding Hand Hygiene and Use of Disinfectants: A Study Based in Karachi. Cureus 2020; 12:e7036. [PMID: 32211269 PMCID: PMC7082788 DOI: 10.7759/cureus.7036] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Hand hygiene is the cardinal step in combating various healthcare-associated infections. These infections are a cause of 37,000 deaths in Europe and 100,000 deaths in the United States annually. Thus, prevention of their spread is of utmost importance today. A study conducted in a tertiary care center in Karachi found that 17% of the medical professionals were aware of the World Health Organization (WHO) guidelines on hand hygiene while only 4.9% followed these hand-washing techniques. Lack of hand hygiene practice and awareness has raised a need to reassess infection control in hospitals. There is currently undisputed proof that adherence to hand cleanliness diminishes the danger of transmission of various infections. Methods A questionnaire-based cross-sectional study was conducted at Dr. Ruth K.M. Pfau Civil Hospital, Karachi in January 2019. Data from 212 participants who met the inclusion criteria were analyzed. A three-part questionnaire was used for the hospital staff who had been present at the hospital for at least six hours and had attended to the patients during the last three continuous working days. Staff members who visited the hospital but did not attend to any patients or those who had been present at the hospital for less than six hours were excluded. Collected data were analyzed using Statistical Package for Social Science (SPSS) version 23.0 (IBM, Armonk, NY). Results A total of 212 individuals (74 doctors, 66 nurses, 52 technicians, and 20 ward assistants) agreed to participate in our study, of which 124 were females. The compliance with hand disinfectant use before and after every patient contact was found to be 12.3%. The use of disinfectant was found to be more among males than females (mean 7.88 times for males vs. 6.20 for females) and the younger individuals were more compliant with hand hygiene practices; 62.73% of participants were aware of the WHO guidelines regarding hand hygiene and 65.56% were aware of hospital-acquired infections. However, nearly half of the participants (45.75%) had never attended a formal lecture on the subject and more than half (62.26%) of the participants were unenlightened about the complications of hospital-acquired infections. Conclusions Hand hygiene is a basic requirement for every medic and paramedic in a hospital setting today. Keeping in mind the drastic consequences of the spread of hospital-associated infections, it is evident that hand hygiene should be stressed upon. The rising incidence of nosocomial infections and their complications can be prevented by raising awareness about hand hygiene practices. There is a need to further investigate the application of and adherence to the basic guidelines on hand hygiene. Our results indicate that this issue should be tackled through a multidimensional approach.
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Affiliation(s)
- Jawad Ahmed
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Farheen Malik
- Pediatrics, Dow University of Health Sciences, Karachi, PAK
| | - Zahid Ali Memon
- Surgery, Dow University of Health Sciences, Karachi, PAK.,Surgery, Civil Hospital, Karachi, PAK
| | - Taha Bin Arif
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Aiman Ali
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Sundus Nasim
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
| | - Junaid Ahmad
- Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK
| | - Muhammad A Khan
- Internal Medicine, Dow University of Health Sciences, Karachi, PAK
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