The evaluation of electrolyzed water, sodium dichloroisocyanurate, and peracetic acid with hydrogen peroxide for the disinfection of patient room surfaces.

BACKGROUND: Sporicidal disinfectants are necessary to control Clostridioides difficile and Candida auris. Novel application methods such as electrostatic sprayers may increase disinfection effectiveness. We employed a standardized protocol to assess 3 sporicidal disinfectants: electrolyzed water (EW), sodium dichloroisocyanurate (NaDCC) and peracetic acid/hydrogen peroxide (PAA/H2O2). METHODS: The study was conducted at 2 New York City hospitals (1,082 total beds) over an 18-month period. The 3 chemicals were applied by housekeeping personnel following the hospital protocol; the use of electrostatic sprayers was incorporated into EW and NaDCC. In randomly selected rooms, 5 surfaces were sampled for microbial colony counts after cleaning. Data analyses were performed using negative binomial logistic regression. RESULTS: We collected 774 samples. NaDCC-disinfected surfaces had a lower mean colony count (14 colony forming units [CFU]) compared to PAA/H2O2 (18 CFU, P = .36) and EW (37 CFU, P < .001). PAA/H2O2 and EW had more samples with any growth (both P < .05) compared to NaDCC. NaDCC applied with wipes and an electrostatic sprayer had the lowest number of samples with no growth and <2.5 CFU/cm2 (difference not significant). CONCLUSIONS: The use of NaDCC for surface disinfection resulted in the lowest bacterial colony counts on patient room high touch surfaces in our study.

Effect of a multidisciplinary intervention on central line utilization in an acute care hospital.

BACKGROUND: Many institutions that have adopted evidence-based infection prevention practices have achieved reductions in the rate of central line-associated bloodstream infection (CLABSI) in their intensive care units (ICUs). Few studies have investigated the impact of CLABSI prevention strategies in non-ICU settings, however. This study was conducted to assess whether a multifaceted educational initiative significantly improved health care workers' adherence to clinical practices that have been demonstrated to reduce CLABSI rates. METHODS: This prospective interventional study compared central line utilization and other variables in medical ICU (MICU) and non-ICU settings at an inner city community teaching hospital. The study included 3 phases: preintervention, intervention, and postintervention. RESULTS: A total of 128 central venous catheter (CVC) placements were reviewed. After the intervention, the proportion of patients transferred out of the MICU with a CVC in place decreased significantly (P = .05), and the percentage of patients transitioned from a CVC to a peripherally inserted venous catheter increased (P = .004). The mean duration of CVC use decreased from 8.2 days to 5.7 days (P = .004), which was confirmed by linear regression (P = .003). CONCLUSIONS: Our data indicate that multidisciplinary, evidenced-based educational interventions can significantly improve targeted measures of CVC use. Our program was successfully implemented with limited resources and should be reproducible at other hospitals.

Spiritual perspectives of nurses in the United States relevant for education and practice.

The purpose of the current study was to describe nurses' spiritual perspectives as they relate to education and practice. A multiple triangulation research design encompassing a questionnaire and a descriptive qualitative content analysis were used with the purpose of capturing a more complete, holistic, and contextual description of nurses' spiritual perspectives. Multiple triangulation included two data sources, two methodological approaches, and nine investigators. Using survey methods, Reed's Spiritual Perspective Scale (SPS) was sent to 1,000 members of Sigma Theta Tau International Nursing Honor Society (STTI). Results support Reed's premise that spirituality permeates one's life. Regardless of gender, participants with a religious affiliation had significantly higher SPS scores than those without one. Nurses having a spiritual base use it in practice. Six themes emerged from the qualitative analysis: Nurses perceive spirituality as strength, guidance, connectedness, a belief system, as promoting health, and supporting practice. The integration of spirituality in nursing curriculums can facilitate spiritual care.

Spiritual care activities of nurses using Nursing Interventions Classification (NIC) labels.

PURPOSE: To describe the spiritual care activities of nurses as subsequently identified in the Nursing Interventions Classification (NIC) labels. METHODS: Data were taken from a larger study that used a multiple triangulation research design to describe spiritual perspectives, interventions, and attitudes of 1,000 Sigma Theta Tau International members. Data analysis included descriptive and multivariate statistics for quantitative items, and content analysis for responses to questions. FINDINGS: 97 respondents reported providing 32 spiritual care activities. Ten NIC labels actually mapped the nurses' spiritual care activities. CONCLUSIONS: Spiritual care activities involve a broad spectrum of interventions that may be unique to each patient. The 32 spiritual care activities described by the nurses provide new knowledge regarding core spiritual care activities. The use of NIC labels can facilitate documentation of spiritual care activities in diverse practice settings. PRACTICE IMPLICATIONS: This study supports greater specificity in describing spiritual care interventions to a level that allows replication and advancement of knowledge.