Comparing infection control and ward nurses' views of the omission of infection control activities using the Missed Nursing Care Infection Prevention and Control (MNCIPC) Survey

Aim

To compare the perceptions of nurses with infection control expertise and ward nurses as to what infection control activities are missed and the reasons why these activities are omitted.

Background

Infection prevention activities are viewed as important for reducing health care‐acquired infections (HAIs) but are often poorly performed.

Methods

Data were collected through the Missed Nursing Care Infection Prevention and Control (MNCIPC) Survey delivered to 500 Australian nurses prior to COVID‐19.

Results

Significant differences were found on the mean scores between infection control and other nurses on ten items. In eight cases, five relating to hand hygiene, infection control specialists viewed the activity as more likely to be missed. Factors viewed as having greater contribution to omission of infection control prevention were as follows: 'Patients have to share bathrooms', 'Urgent patient situation' and 'Unexpected rise in patient volume and/or acuity on the ward/unit'. Infection control nurses were more likely to highlight the role of organisational and management factors in preventing effective infection control.

Conclusions

Differences in response between nurses suggest that the extent of omission of infection control precautions may be under‐estimated by ward nurses.

Implications for Nursing Management

Infection control specialists are more likely to identify organisational barriers to effective infection control than other nurses. Work demands arising from pandemic management may contribute to infection control precautions being missed.

Survey of isolation room equipment and resources in an academic hospital

PURPOSE

The purpose of this paper, a point prevalence study, is to quantify the incidence of isolation and identify the type of communicable diseases in isolation. The paper evaluates isolation precaution communication, availability of personal protective equipment (PPE) as well as other equipment necessary for maintaining isolation precautions.

DESIGN/METHODOLOGY/APPROACH

A standardised audit tool was developed in accordance with the National Standards for the Prevention and Control of Healthcare Associated Infections (May 2009). Data were collected from 14 March 2017 to 16 March 2017, through observation of occupied isolation rooms in an academic hospital in Dublin, Ireland. The data were subsequently used for additional analysis and discussion.

FINDINGS

In total, 14 per cent (125/869) of the total inpatient population was isolated at the time of the study. The most common isolation precaution was contact precautions (96.0 per cent). In all, 88 per cent of known contact precautions were due to multi-drug resistant organisms. Furthermore, 96 per cent of patients requiring isolation were isolated, 92.0 per cent of rooms had signage, 90.8 per cent had appropriate signs and 93.0 per cent of rooms had PPE available. Finally, 31 per cent of rooms had patient-dedicated and single-use equipment and 2.4 per cent had alcohol wipes available.

PRACTICAL IMPLICATIONS

The audit tool can be used to identify key areas of noncompliance associated with isolation and inform continuous improvement and education.

ORIGINALITY/VALUE

Currently, the rate of isolation is unknown in Ireland and standard guidelines are not established for the evaluation of isolation rooms. This audit tool can be used as an assessment for isolation room compliance.

Exploiting interprofessional learning to reduce avoidable healthcare associated infections: project development and outcomes of the pilot event in an acute NHS foundation trust

This paper reflects upon the development of an interprofessional education project and the learning derived from the pilot event, which focused upon interprofessional learning in action and its potential to enable collaborative working to reduce avoidable healthcare associated infections in an acute NHS foundation trust.

Infection control nurses’ perceptions of managing MRSA in the community

In the United Kingdom (UK), the majority of hospitalised patients colonised with meticillin resistant Staphylococcus aureus (MRSA) prior to or on admission to hospital are prescribed decolonisation treatment and isolated with appropriate precautions to reduce the risk of cross-transmission. However, MRSA colonisation in patients who have not completed decolonisation therapy does not prevent discharge or transfer to community healthcare facilities and current guidelines do not recommend routine community treatment and follow-up of patients. This qualitative study examines the perceptions of six senior infection prevention and control nurses in relation to the management of MRSA colonisation in the community. Data were collected using semi-structured interviews, and findings suggest that gaps exist in current service provision for patients colonised with MRSA who are discharged to community healthcare settings. Respondents perceived that this was due to a number of

factors including: practice being shaped by targets, compliance with guidelines, and the split in hospital and community providers. We suggest that current guidelines should be modified to provide follow-up for patients colonised with MRSA who are discharged to community healthcare settings.