Improving adherence to Standard Precautions for the control of health care-associated infections.
Ontology highlight
ABSTRACT:
SUBMITTER: Moralejo D
PROVIDER: S-EPMC6491237 | biostudies-literature | 2018 Feb
REPOSITORIES: biostudies-literature
Publications
Improving adherence to Standard Precautions for the control of health care-associated infections.
Moralejo Donna D El Dib Regina R Prata Rafaela A RA Barretti Pasqual P Corrêa Ione I
The Cochrane database of systematic reviews 20180226
<h4>Background</h4>'Standard Precautions' refers to a system of actions, such as using personal protective equipment or adhering to safe handling of needles, that healthcare workers take to reduce the spread of germs in healthcare settings such as hospitals and nursing homes.<h4>Objectives</h4>To assess the effectiveness of interventions that target healthcare workers to improve adherence to Standard Precautions in patient care.<h4>Search methods</h4>We searched CENTRAL, MEDLINE, Embase, CINAHL, ...[more]
Similar Datasets
Project description:BackgroundIt is essential to identify factors that affect adherence to standard precautions, which could increase risk of occupational exposure to pathogens.MethodsA descriptive cross-sectional study was conducted. Nurses (n = 241) in an acute care hospital completed the survey including the Factors Influencing Adherence to Standard Precautions Scale (FIASPS) (total possible scores in each domain ranged from 5 to 25) and the Compliance with Standard Precautions Scale (CSPS) (total possible scores ranged from 0 to 20).ResultsResults showed moderate influence of the judgement (mean = 14.04, SD = 4.04), leadership (M = 14.58, SD 3.78), and culture/practice (M = 12.61, SD = 3.18) factors; high score on contextual cues (M = 15.77, SD = 3.60); and low score on justification (M = 5.76, SD = 4.57). The overall mean CSPS score was 76.68% (SD 13.82). There was a significant negative relationship between justification for non-use of standard precautions and nurses' adherence with standard precautions (r = -0.24, p < 0.001). A significant positive relationship was reported between the leadership factor (r = 0.25, p < 0.001), cultural practice factor in FIASPS (r = 0.24, p < 0.001) and nurse' adherence with standard precautions.ConclusionNurses would benefit from regular training sessions to reiterate the infection control guidelines and the need to abide to them. Encouraging nurses to be role models serves to increase the adherence to SPs in their colleagues. Organization should continue with strict enforcement of policies with monitoring.
| S-EPMC7833319 | biostudies-literature
Project description:BackgroundOccupational exposure to blood and body fluids is a serious concern for health care workers, and presents a major risk for the transmission of infections such as HIV and hepatitis viruses. The objective of this study was to investigate occupational exposures and behavior of health care workers (HCWs) in eastern Ethiopia.MethodsWe surveyed 475 HCWs working in 10 hospitals and 20 health centers in eastern Ethiopia using a structured questionnaire with a response rate of 84.4%. Descriptive statistics and multivariate analysis using logistic regression were performed.ResultsLife time risks of needle stick (30.5%; 95% CI 26.4-34.6%) and sharps injuries (25.7%; 95% CI 21.8-29.6%) were high. The one year prevalence of needle stick and sharps injury were 17.5% (95% CI 14.1-20.9%) and 13.5% (95% CI 10.4-16.6%) respectively. There was a high prevalence of life time (28.8%; 95% CI = 24.7-32.9%) and one year (20.2%; 95% CI = 16.6-23.8%) exposures to blood and body fluids. Two hundred thirteen (44.8%) HCWs reported that they were dissatisfied by the supply of infection prevention materials. HCWs had sub-optimal practices and unfavorable attitudes related to standard precautions such as needle recapping (46.9%) and discriminatory attitudes (30.5%) toward HIV/AIDS patients.ConclusionThere was a high level of exposure to blood and body fluids among HCWs. We detected suboptimal practices and behavior that put both patients and HCWs at significant risk of acquiring occupational infections. Health authorities in the study area need to improve the training of HCWs and provision of infection prevention equipment. In addition, regular reporting and assessment of occupational exposures need to be implemented.
| S-EPMC3009714 | biostudies-literature
Project description:Health care-associated infections (HCAIs) are infections that occur while receiving health care, developed in a hospital or other health care facility that first appear 48 hours or more after hospital admission, or within 30 days after having received health care. Multiple studies indicate that the common types of adverse events affecting hospitalized patients are adverse drug events, HCAIs, and surgical complications. The US Center for Disease Control and Prevention identifies that nearly 1.7 million hospitalized patients annually acquire HCAIs while being treated for other health issues and that more than 98,000 patients (one in 17) die due to these. Several studies suggest that simple infection-control procedures such as cleaning hands with an alcohol-based hand rub can help prevent HCAIs and save lives, reduce morbidity, and minimize health care costs. Routine educational interventions for health care professionals can help change their hand-washing practices to prevent the spread of infection. In support of this, the WHO has produced guidelines to promote hand-washing practices among member countries.
| S-EPMC6245375 | biostudies-other
Project description:OBJECTIVE:Our objective was to determine the impact of the Health Literacy Universal Precautions Toolkit, adapted for rheumatology, on medication adherence, patient satisfaction, and feasibility in all patients; its effect on the clinical disease activity index (CDAI) was studied in a rheumatoid arthritis (RA) subpopulation. METHODS:Data collected during a 6-month prospective quality assurance intervention was compared with data from a prior 6-month period. Interventions included 1) encouraging questions, 2) teach-back communication, and 3) brown-bag medication review. Analysis was performed using linear regression or generalized estimating equation (GEE) regression. RESULTS:During the intervention period, 46 physicians completed 1737 patient visits. Questions were encouraged, and teach-back communication was performed in more than 90% of visits. Brown-bag medication reviews were performed in 47% of visits overall and 69% of visits in a subgroup that received additional reminder calls. Visit duration and patient satisfaction were not significantly increased. Adherence for rheumatology-related medications that were prescribed both before and during the intervention increased by 22% (P ≤ 0.001; by GEE). Teach-back communication predicted a statistically significant improvement in medication adherence in this subpopulation (by linear regression). The mean CDAI did not improve; however, African American race and Hispanic ethnicity were associated with a decreased CDAI (by GEE). CONCLUSION:Implementation of the Health Literacy Universal Precautions Toolkit, adapted for rheumatology, improved medication adherence in our safety-net clinic, with particularly strong effects seen with teach-back communication. In certain populations, use of the toolkit may also improve RA disease activity. This is the first study to document improved medication adherence with this intervention in a real-world setting.
| S-EPMC7011426 | biostudies-literature
Project description:BACKGROUND: Ineffective communication of infection control requirements during transitions of care is a potential cause of non-compliance with infection control precautions by healthcare personnel. In this study, interventions to enhance communication during inpatient transfers between wards and radiology were implemented, in the attempt to improve adherence to precautions during transfers. METHODS: Two interventions were implemented, comprising (i) a pre-transfer checklist used by radiology porters to confirm a patient's infectious status; (ii) a coloured cue to highlight written infectious status information in the transfer form. The effectiveness of the interventions in promoting adherence to standard precautions by radiology porters when transporting infectious patients was evaluated using a randomised crossover trial at a teaching hospital in Australia. RESULTS: 300 transfers were observed over a period of 4 months. Compliance with infection control precautions in the intervention groups was significantly improved relative to the control group (p?<?0.01). Adherence rate in the control group was 38%. Applying the coloured cue resulted in a compliance rate of 73%. The pre-transfer checklist intervention achieved a comparable compliance rate of 71%. When both interventions were applied, a compliance rate of 74% was attained. Acceptability of the coloured cue was high, but adherence to the checklist was low (40%). CONCLUSIONS: Simple measures to enhance communication through the provision of a checklist and the use a coloured cue brought about significant improvement in compliance with infection control precautions by transport personnel during inpatient transfers. The study underscores the importance of effective communication in ensuring compliance with infection control precautions during transitions of care.
| S-EPMC3599084 | biostudies-other
Project description:BackgroundHealthcare-associated infections (HAIs) are preventable complications that overwhelm the healthcare system. The implementation of multifaceted control intervention actions in the intensive care setting modifies clinical outcomes, but its effectiveness has not been specifically investigated for high-risk patients, such as kidney transplant recipients (KTRs).MethodsThis observational retrospective natural experiment evaluated the effectiveness of multifaceted control interventions (bundles) in reducing HAIs in a KTR intensive care unit. We also measured the bundle adherence rate during 16 mo in the after era.ResultsWe included 1257 KTRs, 684 before and 573 in the postintervention period. After the bundle implementation, the incidence density of device-associated HAIs decreased from 8.5 to 3.9 per 1000 patient-days (relative risk [RR] = 0.46; 95% confidence interval [CI], 0.25-0.85; P = 0.01), primarily because of the reduction in central line-associated bloodstream infection from 8.0 to 3.4 events per 1000 catheter-days (RR = 0.43; 95% CI, 0.22-0.83; P = 0.012). Reductions in catheter-associated urinary tract infection (2.5 versus 0.6 per 1000 catheter-days; RR = 0.22; 95% CI, 0.03-1.92; P = 0.17) and ventilator-associated pneumonia (3.4 versus 1.0 per 1000 ventilator-days; RR = 0.29; 95% CI, 0.03-2.63; P = 0.27) were not significant. Central venous (P = 0.53) and urinary catheter (P = 0.47) insertion adherence were stable during 16 mo, whereas central venous (P < 0.001) and urinary catheter (P = 0.004) maintenance gradually increased. Finally, ventilator-associated pneumonia prevention bundle adherence slightly decreased over time (P = 0.06).ConclusionsThe implementation of comprehensive multifaceted control intervention actions in an intensive care unit dedicated to KTR care was effective in significantly reducing device-associated infections. The impact was in line with the reductions observed in populations that have not undergone transplantation, underscoring the effectiveness of these interventions across different patient groups.
| S-EPMC11521075 | biostudies-literature
Project description:BACKGROUND:Only one study has been conducted in Saudi Arabia to assess medical students' knowledge of standard precautions (SPs) and infection control (IC). In this study, we examined knowledge of SPs and IC among clinical students attending the King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. METHODS:In this cross-sectional study, we targeted clinical students from the following five colleges: Medicine (fifth and sixth years); Dentistry (second semester of the third, fourth, fifth, and sixth years); Applied Medical Sciences (third and fourth years); Nursing (third and fourth years); and Pharmacy (third, fourth, and fifth years). The data collection instrument was an adopted 41-item questionnaire that measured knowledge of SPs and IC in five domains. A score of??24 (60%) indicated sufficient knowledge. RESULTS:The participants comprised 129 students (67 men). The proportions of participants from each college were: Medicine, 58.1% (n=75); Dentistry, 14% (n=18); Applied Medical Sciences, 13.2% (n=17); Nursing, 10.9% (n=14); and Pharmacy, 3.9% (n=5). Most students (73.6%) demonstrated sufficient knowledge (men, 67.2% and women, 80.6%). The highest scores were obtained for the domains "general concept of SPs", "hand hygiene", and "personal protective equipment", whereas the lowest scores were obtained for "disposal of and injuries from sharp objects" and "health-care providers' care". The main information source was formal curricular teaching. CONCLUSIONS:In Saudi Arabia, students' knowledge of SPs and IC is satisfactory, with no significant differences between the sexes or between colleges. Thus, formal curricular teaching is an effective way to increase students' knowledge of SPs and IC.
| S-EPMC7102774 | biostudies-literature
Project description:ObjectivesTo evaluate a training program for non-specialist health care providers in a brief coaching intervention to improve positive airway pressure (PAP) usage in Veterans with sleep apnea.MethodsWe conducted a national webinar training designed for non-specialist providers to implement a brief telephone coaching intervention to improve PAP adherence. The curriculum was crafted by experts in sleep medicine and behavioral sleep medicine based on principles of PAP desensitization. Providers who participated in this training were asked to complete evaluations at 30 days and 1 year.ResultsProvider surveys indicated that most respondents had incorporated the intervention into their clinical practice and felt comfortable counseling patients about sleep apnea and adherence to PAP. Provider feedback suggested that future training programs should include refresher trainings, more training on PAP equipment specifics, and facilitated collaboration with local sleep medicine staff.ConclusionsThis pilot training program demonstrated that a webinar format was a feasible method to increase training in PAP adherence among non-specialist health care providers.InnovationNon-specialists can be trained as PAP coaches in webinar format, improving patients' access to effective strategies and support to be successful with PAP therapy.
| S-EPMC10624969 | biostudies-literature
Project description:Colonization with health care-associated pathogens such as Staphylococcus aureus, enterococci, Gram-negative organisms, and Clostridium difficile is associated with increased risk of infection. Decolonization is an evidence-based intervention that can be used to prevent health care-associated infections (HAIs). This review evaluates agents used for nasal topical decolonization, topical (e.g., skin) decolonization, oral decolonization, and selective digestive or oropharyngeal decontamination. Although the majority of studies performed to date have focused on S. aureus decolonization, there is increasing interest in how to apply decolonization strategies to reduce infections due to Gram-negative organisms, especially those that are multidrug resistant. Nasal topical decolonization agents reviewed include mupirocin, bacitracin, retapamulin, povidone-iodine, alcohol-based nasal antiseptic, tea tree oil, photodynamic therapy, omiganan pentahydrochloride, and lysostaphin. Mupirocin is still the gold standard agent for S. aureus nasal decolonization, but there is concern about mupirocin resistance, and alternative agents are needed. Of the other nasal decolonization agents, large clinical trials are still needed to evaluate the effectiveness of retapamulin, povidone-iodine, alcohol-based nasal antiseptic, tea tree oil, omiganan pentahydrochloride, and lysostaphin. Given inferior outcomes and increased risk of allergic dermatitis, the use of bacitracin-containing compounds cannot be recommended as a decolonization strategy. Topical decolonization agents reviewed included chlorhexidine gluconate (CHG), hexachlorophane, povidone-iodine, triclosan, and sodium hypochlorite. Of these, CHG is the skin decolonization agent that has the strongest evidence base, and sodium hypochlorite can also be recommended. CHG is associated with prevention of infections due to Gram-positive and Gram-negative organisms as well as Candida. Conversely, triclosan use is discouraged, and topical decolonization with hexachlorophane and povidone-iodine cannot be recommended at this time. There is also evidence to support use of selective digestive decontamination and selective oropharyngeal decontamination, but additional studies are needed to assess resistance to these agents, especially selection for resistance among Gram-negative organisms. The strongest evidence for decolonization is for use among surgical patients as a strategy to prevent surgical site infections.
| S-EPMC4786886 | biostudies-literature
Project description:BackgroundHealth care-associated infections (HAIs) are the most common noncardiac complications after cardiac surgery and are associated with increased morbidity and mortality. Current information about their economic burden is limited.ObjectivesThis research was designed to determine the cost associated with major types of HAIs during the first 2 months after cardiac surgery.MethodsProspectively collected data from a multicenter, observational study of the Cardiothoracic Surgery Clinical Trials Network, in which patients were monitored for infections for 65 days after surgery, were merged with related financial data routinely collected by the University HealthSystem Consortium. Incremental length of stay (LOS) and cost associated with HAIs were estimated using generalized linear models, with adjustments for patient demographics, clinical history, baseline laboratory values, and surgery type.ResultsAmong 4,320 cardiac surgery patients (mean age: 64 ± 13 years), 119 (2.8%) experienced a major HAI during the index hospitalization. The most common HAIs were pneumonia (48%), sepsis (20%), and Clostridium difficile colitis (18%). On average, the estimated incremental cost associated with a major HAI was nearly $38,000, of which 47% was related to intensive care unit services. The incremental LOS was 14 days. Overall, there were 849 readmissions; among these, 8.7% were attributed to major HAIs. The cost of readmissions due to major HAIs was, on average, nearly threefold that of readmissions not related to HAIs.ConclusionsHospital cost, LOS, and readmissions are strongly associated with HAIs. These associations suggest the potential for large reductions in costs if HAIs following cardiac surgery can be reduced. (Management Practices and the Risk of Infections Following Cardiac Surgery; NCT01089712).
| S-EPMC4293042 | biostudies-literature