Conocimiento en estudiantes de enfermería sobre desinfección terminal del área quirúrgica / Knowledge in nursing students about terminal disinfection of the surgical area

Determinar el nivel de conocimiento de los estudiantes de enfermería de la Universidad Técnica de Ambato sobre la desinfección terminal del área quirúrgica. Metodología: Esta investigación es cuantitativa, con enfoque descriptivo de cohorte transversal ya que el nivel de conocimiento se ha representado mediante tablas y gráficos para describir la problemática del periodo octubre 2023-febrero 2024. Resultados: Se evidencia el alto porcentaje de respuestas incorrectas por cada ítem por parte de los estudiantes. La categoría desinfección fue respondida de manera incorrecta con un porcentaje del 26%, la categoría proceso de desinfección con el 55,6%, la categoría aplicación del DAN con el 45.8%, la categoría desinfectante del DAN con el 36,2% y, por último, la categoría riesgo y prevención del DAN con el 29,2%. Conclusiones: El nivel de conocimiento de los estudiantes sobre desinfección es bajo, porque no están lo suficientemente motivados o interesados en el tema de desinfección[AU]

Determine the level of knowledge of nursing students at the Technical University of Ambato about terminal disinfection of the surgical area.Methodology:This research is quantitative, with a descriptive cross-sectional cohort approach and the level of knowledge has been represented through tables and graphs to describe the problems of the period October 2023-February 2024.Results:A high percentage of incorrect answers for each item by the students is evident. The disinfection category was answered incorrectly with a percentage of 26%, the disinfection process category with 55.6%, the DAN application category with 45.8%, the disinfectant category with 36.2% and, finally, the DAN risk and prevention category. with 29.2%. Conclusions:The level of knowledge of students about disinfection is low, because they are not sufficiently motivated or interested in the topic of disinfection[AU]

Determinar o nível de conhecimento dos estudantes de enfermagem da Universidade Técnica de Ambato sobre desinfecção terminal da área cirúrgica. Metodologia:Esta pesquisa é quantitativa, com abordagem descritiva de coorte transversal e o nível de conhecimento foi representado por meio de tabelas e gráficos para descrever os problemas do período outubro de 2023 a fevereiro de 2024.Resultados: Evidencia-se um alto percentual de respostas incorretas para cada item por parte dos alunos. A categoria desinfecção foi respondida incorretamente com um percentual de 26%, a categoria processo de desinfecção com 55,6%, a categoria aplicação DAN com 45,8%, a categoria desinfetante com 36,2% e, por último, a categoria risco e prevenção DAN. com 29,2%.Conclusões:O nível de conhecimento dos alunos sobre desinfecção é baixo, porque não estão suficientemente motivados ou interessados no tema da desinfecção[AU]

Enhancing laboratory biosafety management: a comprehensive strategy from theory to practice.

Objective: This study examines biosafety management practices in a psychiatric hospital's laboratory in China, focusing on how outdated information technology impacts the hospital's ability to respond to public health emergencies. The goal is to enhance the hospital's emergency response capabilities by updating risk assessments, biosafety manuals, and implementing a comprehensive quality management system alongside a specialized infection control system for significant respiratory diseases. Methods: We utilized an integrated research approach, expanding the scope of risk assessments, updating the biosafety manual according to the latest international standards, and implementing a quality management system. A specialized infection control system for significant respiratory diseases was introduced to improve emergency response capabilities. Results: Updated risk assessments and a new biosafety manual have significantly improved the identification and management of biosafety threats. Implementing new quality management and infection control systems has enhanced response efficiency and operational standardization. Conclusion: The measures taken have strengthened the biosafety management and emergency response capabilities of the laboratory department, highlighting the importance of information technology in biosafety management and recommending similar strategies for other institutions.

Can probiotics trigger a paradigm shift for cleaning healthcare environments? A narrative review.

BACKGROUND: The environment of healthcare institutions plays a major role in the transmission of multidrug resistant organisms (MDRO) and likely in subsequent healthcare-associated infections (HAIs). Probiotic cleaning products are a novel option for environmental cleaning. They represent a sustainable and biodegradable alternative to conventional chemical disinfectants for controlling microbial bioburden, and preventing pathogen transmission in hospital environments. High-quality studies including randomized clinical trials (RCT) triggered a summary with expert recommendations until further studies allow a critical review and meta-analysis of the data. METHODS: Infection control experts from five European countries summarized available data as of June 2023. Authors presented their published RCTs, reviewed the existing literature on probiotic cleaning, summarized the results and identified knowledge gaps and subsequent research needs. RESULTS: Probiotic cleaning was similarly effective for reducing HAI-related pathogens, enveloped viruses such as SARS-CoV-2 and MDRO in environmental samples compared to conventional chemical disinfectants. More importantly, probiotic cleaning was non-inferior to disinfectants in terms of preventing HAI in a large RCT. In addition, probiotic cleaning has also been shown to reduce antimicrobial resistance genes (ARG), costs and antimicrobial consumption in other hospital trials. They are biodegradable, do not require any protection for chemical hazards, and are compliant with occupational health. A paradigm shift, however, requires a very strong evidence to justify for such a change. In the past, this evidence was limited by the heterogeneity of study design, products, protocols, and few studies on clinical outcomes used in the trials. Furthermore, the regulatory, safety, and quality aspects of probiotic cleaning products are not, yet, completely defined and require clearing by authorities. CONCLUSION: To date, probiotic cleaning is a breakthrough technology and a biological alternative for chemical disinfectant when treating hospital environment. It may also have a positive effect on MDRO transmission. However, the different compositions of probiotic products will require standardization, and more robust data should be generated to support these promising results on different compositions. This may trigger a paradigm shift in cleaning of healthcare institutions from chemical to biological control of the hospital environment.

The state of hand rub dispensers in healthcare settings - a multicenter assessment in 19 German healthcare facilities.

BACKGROUND: Hand hygiene is one of the most important hygiene measures to prevent healthcare-associated infections. Well-functioning hand rub dispensers are the foundation of hand hygiene but are often overlooked in research. As the point of origin for hand hygiene, dispensers not only promote compliance through ease of use, but also strongly influence the amount of hand rub used per disinfection. This work investigates how dispenser types and conditions affect dispensed volumes and usability. METHODS: Data from 5,014 wall-mounted or point-of-care dispensers was collected from 19 German healthcare facilities during installation of an electronic hand hygiene monitoring system, including dispenser type and dispensed hand rub volumes. Of these dispensers, 56.2% were metal dispensers, and the majority (89.5%) were wall-mounted. For one hospital, 946 wall-mounted dispensers were analyzed in detail regarding pump material, damages, functionality, cleanliness, and filling levels. RESULTS: Dispensed volumes varied across and within dispenser types, ranging from 0.4 mL to 4.4 mL per full actuation, with the largest volumes generally dispensed by plastic dispensers with a preset of 1.0 to 3.0 mL per actuation. In general, most dispensers dispense more hand rub per full actuation than specified by the manufacturer. When different types of dispensers are used within a healthcare facility, vastly different volumes can be dispensed, making reliable and reproducible disinfection difficult for healthcare workers. In the detailed analysis of 946 dispensers, 27.1% had cosmetic defects, reduced performance, or were unusable, with empty disinfectant being the most common reason. Only 19.7% of working dispensers delivered their maximum volume on the first full actuation. CONCLUSION: Even though several studies addressed the variability in dispensed volumes of hand hygiene dispensers, studies dealing with dispenser types and functionality are lacking, promoting the common but false assumption that different dispensers may be equivalent and interchangeable. Variability in dispensed volumes, coupled with frequent dispenser defects and maintenance issues, can be a major barrier to hand hygiene compliance. To support healthcare workers, more attention should be paid to 'dispenser compliance', selecting dispensers with similar volume ranges and proper maintenance.

Exploring barriers to and facilitators of infection prevention and control practices in the Pediatrics and Child Health Department of Tikur Anbessa Specialized Hospital, Ethiopia.

BACKGROUND: Adherence to infection prevention and control (IPC) standards and guidelines by healthcare workers is essential for reducing the spread of healthcare-associated infections (HAIs). However, IPC practices among healthcare workers in low- and middle-income countries (LMICs), including Ethiopia, are generally inadequate. This research aims to identify the barriers to and facilitators of IPC practices in the Pediatrics and Child Health Department of Tikur Anbessa Specialized Hospital (TASH) in Ethiopia. METHODS: We employed a rapid ethnographic assessment (REA) approach for this study, using focus group discussions (FGDs), in-depth interviews (IDIs), and observations to collect data. Participants were selected from the Pediatrics and Child Health Department of TASH, and data collection took place in March and April 2022. Two FGDs and eight IDIs were conducted in the participants' workplace within the department. Unstructured guides were used to facilitate the FGDs and IDIs. Nvivo version 10 software was used for data organization and analysis. The data were coded deductively through thematic analysis to identify similar ideas and concepts, based on the Systems Engineering Initiative for Patient Safety (SEIPS) model. RESULT: A total of 23 healthcare workers participated, with 15 in FGDs and 8 in IDIs. The study identified several barriers to IPC practices, including nonadherence to IPC practice protocols, lack of pre-employment training, space constraints, insufficient maintenance and repair of equipment, limited management engagement and support, shortage of resources and budget, incidents of needle stick injuries and infections, high workloads for healthcare workers, shortages of personal protective equipment and water supply, and inadequate waste management. We also identified some facilitators, including the existence of an IPC team and committee, a health education schedule for patients and visitors, morning sessions for healthcare providers, and the presence of television screens in waiting areas. By addressing the identified barriers and leveraging the facilitators, department heads, IPC team leaders, and decision-makers can develop targeted strategies and interventions to improve infection control, reduce the spread of HAIs, and ultimately enhance the quality of healthcare services. CONCLUSION: This study explored several barriers that contribute to inappropriate and suboptimal IPC practices in the study area. These barriers create significant challenges for healthcare workers and hindering their ability to effectively implement IPC practices. The findings highlight the complex and multifaceted nature of the problems, which not only affect the current working environment but also compromise the overall quality of care. The hospital administrator should address these critical issues to improving IPC practices and ensuring a safer healthcare environment.

Impact of sterile gloving during proximal manipulation of central line catheter hub: the multicenter observational study CleanHandPROX.

BACKGROUND: Patients with central lines face an increased risk of developing bacteremia. Preventing late-onset catheter-related infections relies on implementing various measures during manipulations of the catheter hub of central lines (e.g., during connections, disconnections, blood withdrawals, pulsed rinses, or injections performed at the first connection after the central catheter). French guidelines include, among these measures, the requirement to put on sterile gloves immediately before proximal manipulation to help prevent contamination of the catheter hub during preparation. To our knowledge, no study has reported compliance with wearing sterile gloves during these manipulations, nor the impact of not wearing sterile gloves on the cleanliness of the fingers of healthcare workers (HCWs) just before manipulating the connectors. METHODS: We conducted a two-part study to assess compliance with sterile gloving and to provide direct microbiological evidence of bacterial contamination on HCWs' hands immediately before the manipulation of central lines when sterile gloving is not used. First, the use of sterile gloves was observed during proximal manipulations of central lines using a standardized grid. Second, we examined the microbial flora present on the fingers of each observed HCW just before proximal manipulation. RESULTS: A total of 260 HCWs from 35 healthcare institutions were observed during proximal manipulation. The HCWs were distributed into three groups: 188 used sterile gloves (72%), 23 used nonsterile gloves (9%), and 49 did not wear gloves (19%). The swabbing of the fingertips revealed microbial cultures from 72 samples (28%). A total of 97 microorganisms were identified, all of which are well-recognized agents responsible for catheter-related bacteremia, predominantly coagulase-negative staphylococci (n = 36) and Bacillus sp. (n = 31). Fingertip contamination was lower for HCWs wearing sterile gloves (27/188; 14%) than for those wearing nonsterile gloves (12/23; 52%) or not wearing gloves (33/49; 67%) (p < 0.001). The contaminants were similar across the three groups. CONCLUSIONS: Our data support the positive impact of sterile gloving in ensuring clean fingertips during proximal manipulation of central lines, a key measure in preventing late-onset catheter-related bacteremia. The contamination of sterile gloves in one out of seven HCWs highlights the need for a clean care environment and minimal contact with the patient's skin and surroundings during proximal manipulation.

Disinfectants efficacy in reducing pathogens related to health-care infection associated in universities hospitals of Gorgan, North of Iran.

BACKGROUND: Disinfection has a fundamental role in the control of pathogens in the hospital environment. This study was designed to assess the efficacy and functional impact of disinfectants in reducing pathogens related to healthcare associated infections (HAIs) in hospitals. METHODS: This observation study was conducted at three university hospitals in Gorgan, Iran, from May to Oct 2023. The data including used disinfectants and microbiological examination were obtained from the infection control unit of each hospital. RESULTS: The results showed that a variety of disinfectants from intermediate to high levels were employed in accordance with the World Health Organization (WHO) protocols. The microbial result revealed that 31.6% (286 out of 906) of the sample had at least one microorganism. Among identified organisms, Bacillus spp. were the predominant species followed by Staphylococcus epidermis, fungus genera, Enterobacter spp., Enterococcus spp., Pseudomonas spp., Escherichia coli, Alcaligenes spp., Staphylococcus aureus, Citrobacter spp., Corynebacterium spp., Klebsiella spp., Acinetobacter spp., Micrococcus spp., Staphylococcus saprophyticus, and Serratias spp. The highest prevalence rates of microorganisms were observed in the wards of ICU, emergency, internal medicine, and women's ward. The chi-square test revealed a significant relationship between the presence of organisms and hospital wards (P < 0.05). CONCLUSION: The presence of pathogens indicates a defect in the disinfection process, probably due to both little attention to disinfection protocols and multidrug resistance. It is not yet possible to eliminate pathogens from the hospital environment, but it can be minimized by education intervention, standardizing disinfecting processes, and monitoring by the infection control committee.

Mitigation behaviour analysis to understand the effectiveness of COVID-19 infection control policies in Riau.

Objectives: To analyse mitigation behaviour in understanding the effectiveness of coronavirus disease-2019 infection control programme. METHODS: The quantitative, descriptive study was conducted in the Riau province of Indonesia from April to May 2020. After approval from the Faculty of Medicine, Riau University, and comprised individuals of either gender aged 15-69 years. Data was collected using a closed questionnaire generated on Google Forms and distributed through social media using WhatsApp. Data was analysed using SPSS 27. RESULTS: Of the 440 subjects, 304(69.1%) were women, 185(42%) were in the late adolescent age group, and 345(78.4%) had education up to the college level. The mitigation behaviour was appropriate in 263(59.8%) cases at the individual level and 233(53%) at the community level. CONCLUSIONS: The mitigation behaviour towards coronavirus disease-2019 infection prevention was appropriate in majority of the subjects at both individual and community levels.

Knowledge, attitude and practice of healthcare workers on infection prevention and control in Ethiopia: A systematic review and meta-analysis.

INTRODUCTION: Infectious diseases remain the leading causes of death in low and middle-income countries including Ethiopia. The existence of emerging, re-emerging, and drug-resistant infectious agents maximizes the importance of infection prevention and control. Healthcare workers are the key actors in the prevention and control of infection. As a result assessing the knowledge, attitude, and practice of healthcare workers toward infection prevention and control is very critical in the prevention and control of infectious diseases. Therefore, this systematic review and meta-analysis aimed to assess the knowledge, attitude, and practice of healthcare providers toward infection prevention in Ethiopia. METHOD: PubMed, Scopus, SEMANTIC SCHOLAR, Google Scholar, and Addis Ababa University Digital Library were systematically searched for relevant literature until November 18/2023. The quality of the included studies was assessed using the Joanna Briggs Institute quality appraisal tool. Data were abstracted using a Microsoft Excel spreadsheet and analyzed using STATA version 11. A random-effects model was used to estimate the pooled prevalence. Heterogeneity among reported studies was assessed by Forest plot, Cochran's Q-statistics, and I2 test. Publication bias was checked using funnel plots, and Egger's regression test. In addition, sub-group and sensitivity analyses were conducted. RESULT: A total of 7,681 articles were retrieved of which 19 studies with 5,650 healthcare workers were included in this systematic review and meta-analysis. About 74.5% (95% CI, 65.88, 83.12), 66.71% (95% CI 55.15, 78.28), and 55.2% (95% CI 48.22, 62.18) of healthcare workers were knowledgeable, had positive attitudes, and good standard of practice on infection prevention respectively. CONCLUSION: Despite acceptable knowledge and attitude, about half of the healthcare workers have unsafe infection prevention and control practices in Ethiopia. Hence, serious attention should be given to healthcare workers' application of infection prevention standards in their working environment.

Infection prevention and control status at public hospitals and factors associated with COVID-19 infection among healthcare workers in Myanmar: A cross-sectional study.

BACKGROUND: Hospitals should prepare for emerging diseases and protect healthcare workers (HCWs) from work-related infection. This study aims to assess public hospital preparedness for the coronavirus disease 2019 (COVID-19) a year after the Myanmar government began implementing COVID-19 prevention measures, and to identify factors associated with work-related COVID-19 infection among HCWs in Myanmar. METHODS: In January 2021, data were collected from 101 hospitals and 706 HCWs who had COVID-19 in Myanmar in 2020. Data from the hospitals included basic information, the status of infection prevention and control (IPC), the preparedness for COVID-19 (guidelines, checklists, fever screening, patient pathway, and training), handwashing facilities, and availability of personal protective equipment (PPE). Data of COVID-19 infected HCWs included age, occupation, workplace, severity and source of COVID-19 infection, knowledge and practice of handwashing, and working environment. Chi-square test was performed to compare the preparedness for COVID-19 among three hospital levels (primary, secondary and tertiary levels). Logistic regression analysis was performed to identify the associated factors of work-related infection of HCWs. RESULTS: The total number of beds, HCWs, and COVID-19 patients in 2020 at the 101 hospitals was 12,888, 14,421, and 19,835, respectively. The availability of PPE was high in hospitals at all levels. Approximately 80% of hospitals had functional status of IPC, set up fever screening and patient pathway, and provided training on IPC and COVID-19. However, only 39.6% of hospitals had developed COVID-19 guidelines and 55.4% had developed checklists. The percentage of hospitals that prepared each measurement was lowest at the primary level. The factors associated with work-related COVID-19 among HCWs were being 30-39 years old, working as a doctor, working at isolation wards, having disinfection technique training, and having enough PPE at the workplace. CONCLUSION: The preparedness for COVID-19 at public hospitals in Myanmar in January 2021 was insufficient, especially in the availability of the guidelines and checklists and at primary hospitals. A support system for hospital pandemic preparedness and monitoring of IPC implementation is needed. The government should prepare for emerging diseases and provide appropriate and adequate PPE and additional training to all HCWs, especially HCWs who work for isolation wards.

Enhancing infection control practices and biosecurity plans on Swedish pig farms: insights, challenges, and strategies.

BACKGROUND: African swine fever (ASF) poses a threat to the global pig industry, leading to significant economic losses and widespread disruptions in pig farming and associated sectors. In September 2023, the first case of ASF in Swedish wild boar triggered immediate responses from authorities, including the establishment of restricted zones and culling measures. A new ASF certification programme for pig herds was initiated to improve biosecurity and proactive disease management. This survey aimed to assess the sentiments and actions of Swedish pig farmers six months post-outbreak, particularly regarding biosecurity measures. Such information is important to improve preparedness for future disease threats. A questionnaire was distributed to members of the Swedish pig producers' organisation. RESULTS: A total of 113 farmers responded (response rate 27%), with the majority considering the risk of ASF reappearing in Sweden as high. The estimated cost for connecting the farms to the ASF certification programme varied greatly, with a majority identifying cost as a substantial hurdle. While many farmers sought biosecurity advice from veterinarians, 43% had not implemented suggested measures. Over one third had not received concrete measures that would fit their farms, and 14% had not received any biosecurity advice from veterinarians at all. Discussions among farmers emphasized concerns about ASF outbreaks, transmission mechanisms, and regulatory compliance, highlighting the importance of ongoing communication and knowledge exchange to address the challenges posed by ASF effectively. Additionally, participants also mentioned the role of dense wild boar populations and shortcomings in municipal food waste management as important risk factors. CONCLUSIONS: The responding farmers expressed widespread concern about new ASF outbreaks. A majority identified cost as a substantial hurdle for joining the ASF certification programme. While many farmers consulted veterinarians for advice on biosecurity, a significant number had yet to implement suggested measures and one third had not received specific guidance suitable for their farms. Stakeholder conversations highlighted concerns about ASF outbreaks, transmission, and compliance. They also discussed the role of dense wild boar populations and issues with municipal food waste management as significant risk factors for ASF.

Comparative study of infection control practices in DOTS/sputum microscopy centre in two different districts of state of Uttarakhand and Uttar Pradesh of India.

BACKGROUND & OBJECTIVE: Tuberculosis (TB) is endemic in India. TB is transmitted through droplet infection and the transmission occurs when a person inhales droplet nuclei containing of Mycobacterium tuberculosis. Infection control practices play a major role in controlling the TB infection in healthcare settings and further prevents TB infection in the HCWs. The aim of the study is to conduct the cross sectional study for infection control practices in DOTS cum Sputum Microscopy Centre's under NTEP in Ghaziabad (Uttar Pradesh) & Dehradun (Uttarakhand) districts with the objective to assess the compliance of infection control measures by HCWs in DOTS cum Sputum Microscopy Centre's and to suggest the suitable measures and/or model to reduce the transmission of infection to the HCWs and to the community at large. MATERIALS & METHODS: The cross sectional study is conducted for two years in two districts of different state having high burden of TB disease in UP and low burden of disease in UK state. All DOTS cum Sputum Microscopy centres of both selected districts i.e. 100% sample size are covered in the study. RESULTS: Hand washing is the most efficient and cost-effective practice for prevention and control of infection. In Dehradun district 66.66% (12) centers and in Ghaziabad district 57.14% (16) centers have adequate hand washing facility available at DOTS and sputum microscopy lab. Unavailability of adequate PPE will lead to the infection. In Dehradun district, 55.56% (10) centers have adequate PPE available whereas in Ghaziabad District 21.43% (6) centers have adequate PPE available. Training on infection prevention and control for HCWs are provided in 27.78% (5) DOTS/sputum microscopy center in Dehradun whereas none of the DOTS/sputum microscopy center in Ghaziabad district are given training on infection prevention & control for HCWs in last one year. Adequate ventilation plays an important role in transmission of TB/MDR TB or any respiratory infection. HCWs working in DOTS/Sputum microscopy center are at risk to contact the TB/MDR TB infection if there is no proper ventilation in their working places. In 33.33% (6) DOTS/sputum microscopy center in Dehradun & 28.57% (8) in Ghaziabad district have adequate ventilation. Layout of DOTS room and for sputum microscopy center are suggested to reduce the risk of transmission of TB/MDR-TB and other respiratory pathogens amongst HCWs who are working in DOTS cum sputum microscopy center. CONCLUSION: DOTS cum Sputum Microscopy Centers of both districts in different states are having deficient infection control practices. Staff is not adequately trained in infection prevention and control practices.

Assessing infection prevention and control structures in German hospitals after the COVID-19 pandemic using the WHO infection prevention and control assessment framework (IPCAF): results from 660 hospitals and comparison with a pre-pandemic survey.

BACKGROUND: The WHO Infection Prevention and Control Assessment Framework (IPCAF) is a standardized tool to assess infection prevention and control (IPC) structures in healthcare facilities. The IPCAF reflects the eight WHO core components (CC) of IPC. Besides facility self-assessment, the IPCAF can be used for national surveys, and repeated usage can aid in describing trends concerning IPC structures. A previous survey in over 700 German hospitals conducted in 2018, yielded an overall high IPC level in participating hospitals, albeit with potentials for improvement. In 2023, the survey was repeated to describe once again the state of IPC implementation in German hospitals and compare findings to data from 2018. METHODS: The German National Reference Center for the Surveillance of Nosocomial Infections (NRC) invited 1,530 German acute care hospitals participating in the national surveillance network "KISS", to complete a translated online version of the IPCAF between October 2023 and January 2024. The questionnaire-like nature of the IPCAF, where each answer corresponds to a number of points, allows for calculating an overall IPC score. Based on the overall score, hospitals were allocated to four different IPC levels: inadequate (0-200), basic (201-400), intermediate (401-600), and advanced (601-800). Aggregated scores were calculated and compared with results from 2018. RESULTS: Complete datasets from 660 hospitals were received and analyzed. The median overall IPCAF score was 692.5 (interquartile range: 642.5-737.5), with 572 hospitals (86.6%) classified as advanced, and 87 hospitals (13.2%) as intermediate. One hospital (0.2%) fell into the basic category. The overall median score was virtually unchanged when compared to 2018 (690; data from 736 hospitals). The median score for the CC on workload, staffing and bed occupancy was markedly higher (85 vs. 75), whereas the median score for the CC on multimodal strategies was slightly lower than in 2018 (75 vs. 80). CONCLUSIONS: Repeated assessments of IPC structures at the national level with the IPCAF are feasible and a means to gain insights into the evolution of IPC structures. When comparing aggregated scores, a stable and high level of IPC key aspects in Germany was observed, with improvements over time in IPC indicators related to workload and staffing.

Harnessing computational tools of the digital era for enhanced infection control.

This paper explores the potential of artificial intelligence, machine learning, and big data analytics in revolutionizing infection control. It addresses the challenges and innovative approaches in combating infectious diseases and antimicrobial resistance, emphasizing the critical role of interdisciplinary collaboration, ethical data practices, and integration of advanced computational tools in modern healthcare.

Assessing the impact of enhanced hygiene precautions during the COVID-19 pandemic on surgical site infection risk in abdominal surgeries.

BACKGROUND: A surgical site infection (SSI) is a postoperative infection that occurs at or near the surgical incision. SSIs significantly increase morbidity, mortality, length of hospital stay, and healthcare costs. The World Health Organization (WHO) has established hospital hygiene precaution guidelines for the prevention of SSIs, which were enhanced during the COVID-19 pandemic. The current study aims to explore the effect of the COVID-19 pandemic on SSI incidence among initially uninfected postoperative patients. We hypothesize that these enhanced precautions would reduce the incidence of SSIs. MATERIALS AND METHODS: A retrospective study comparing surgical outcomes before and during the pandemic. Patients who had abdominal surgery between June and December 2019 (Non-COVID-19) or between February and June 2020 (COVID-19) were included. The two groups were matched in a 1:1 ratio based on age, Sex, acuity (elective or emergent), surgical approach, and comorbidities. Electronic medical records were reviewed to identify SSIs and hospital readmissions within 30 days after surgery. Pearson's chi-square test and Fisher's exact test were used. RESULTS: Data was collected and analyzed from 976 patients who had surgery before the COVID-19 pandemic (non-COVID group) and 377 patients who had surgery during the pandemic (COVID group). After matching, there were 377 patients in each group. In our study, we found 23 surgical site infections (SSIs) in both laparoscopic and open surgeries. The incidence of SSIs was significantly higher in the non-COVID period compared to the COVID period [17 cases (4.5%) vs. 6 cases (1.6%), respectively, p = 0.032], especially in non-COVID open surgeries. The incidence of SSIs in laparoscopic surgeries was also higher during the non-COVID period, but not statistically significant. CONCLUSIONS: Enhanced hygiene precautions during the COVID -19 pandemic may have reduced SSIs rates following abdominal surgery.

Integration of IPC/WASH critical conditions into quality of care and quality improvement tools and processes: Bangladesh case study.

Unsafe patient care in hospitals, especially in low- and middle-income countries, is often caused by poor infection prevention and control (IPC) practices; insufficient support for water, sanitation, and hygiene (WASH); and inadequate waste management. We looked at the intersection of IPC, WASH, and the global initiative of improving health care quality, specifically around maternal and newborn care in Bangladesh health facilities. We identified 8 primary quality improvement and IPC/WASH policy and guideline documents in Bangladesh and analyzed their incorporation of 30 subconditions under 5 critical conditions: water; sanitation; hygiene; waste management/cleaning; and IPC supplies, guidelines, training, surveillance, and monitoring. To determine how Bangladesh health care workers implemented the policies, we interviewed 33 informants from 16 public and private facilities and the national level. Bangladesh's 8 primary guidance documents covered 55% of the 30 subconditions. Interviews showed that Bangladesh health facility staff generally rely on eight tools related to quality improvement (five); IPC (two); and supportive supervision (one) plus a robust supervision mechanism. The stakeholders identified a lack of human resources and environmental hygiene infrastructure and supplies as the main gaps in providing IPC/WASH services. We concluded that the Bangladesh government had produced substantial guidance on using quality improvement methods to improve health services. Our recommendations can help identify strategies to better integrate IPC/WASH in resources including standardizing guidelines and tools within one toolkit. Strategizing with stakeholders working on initiatives such as universal health coverage and patient safety to integrate IPC/WASH into quality improvement documents is a mutually reinforcing approach.

Knowledge, attitudes, and readiness about critical antimicrobial resistant organisms among healthcare workers at colonial war memorial hospital in Fiji: a pre and post intervention study.

BACKGROUND: Gram-negative bacteria resistant to carbapenems are also known as critical antimicrobial resistant organisms. Their emergence at Colonial War Memorial Hospital (CWMH), the largest hospital in Fiji, is a major clinical concern. This study was conducted to determine the knowledge, attitudes, and readiness of healthcare workers (HCW) at CWMH regarding management of patients with infections caused by critical antimicrobial resistant organisms. METHODS: A questionnaire was designed using a Likert scale to assess knowledge, attitudes, and readiness. Two cross-sectional studies were conducted, before and after the implementation of targeted educational activities which were informed by the pre-intervention study findings. RESULTS: A total of 393 and 420 HCW participated in the pre- and post-intervention studies, respectively. The majority of respondents were female (77.3%) and 18-34 years of age (67%). HCW professional roles included nurses (56.3%), doctors (31.6%), and laboratory personnel (12.2%). In the post-intervention study, significantly more HCW reported having received infection prevention and control (IPC) and antimicrobial resistance education and training (26.8% in pre to 45.5% in post intervention, p < 0.001). The majority of nurses and doctors (> 85% to ≥ 95%) were aware of how AMR organisms spread in healthcare settings and knew the IPC measures to prevent transmission of AMR infections including hand hygiene, standard and transmission-based precautions. Attitudes towards AMR were positive, with 84.2% pre intervention and 84.8% of HCW post intervention expressing their willingness to change their work environment to assist with AMR prevention. Perceived readiness to address the problem showed mixed results. Improvements in laboratory AMR surveillance data availability were noted (29.4-52.4%, p < 0001). Modest improvement in the hospital's capacity for outbreak response (44-51.9%, p = 0.01), and treatment of AMR infections (38.9-44.4%, p = 0.01) was reported. CONCLUSIONS: Our data revealed high levels of staff awareness and knowledge about AMR and IPC. However, readiness for outbreak response and treatment of critical AMR infections requires more attention. Improving AMR prevention and containment in CWMH will likely require sustained and multisectoral interventions with strong administrative commitment.