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1.
Med Sci Monit ; 30: e943493, 2024 Mar 25.
Artigo em Inglês | MEDLINE | ID: mdl-38523334

RESUMO

BACKGROUND Care bundles for infection control consist of a set of evidence-based measures to prevent infections. This retrospective study aimed to compare surgical site infections (SSIs) from a single hospital surveillance system between 2017 and 2020, before and after implementing a standardized care bundle across specialties in 2019. It also aimed to assess whether bundle compliance affects the rate of SSIs. MATERIAL AND METHODS A care bundle consisting of 4 components (peri-operative antibiotics use, peri-operative glycemic control, pre-operative skin preparation, and maintaining intra-operative body temperature) was launched in 2019. We compared the incidence rates of SSIs, standardized infection ratio (SIR), and clinical outcomes of surgical procedures enrolled in the surveillance system before and after introducing the bundle care. The level of bundle compliance, defined as the number of fully implemented bundle components, was evaluated. RESULTS We included 6059 procedures, with 2010 in the pre-bundle group and 4049 in the post-bundle group. Incidence rates of SSIs (1.7% vs 1.0%, P=0.013) and SIR (0.8 vs 1.48, P<0.01) were significantly lower in the post-bundle group. The incidence of SSIs was significantly lower when all bundle components were fully adhered to, compared with when only half of the components were adhered to (0.3% vs 4.0%, P<0.01). CONCLUSIONS SSIs decreased significantly after the application of a standardized care bundle for surgical procedures across specialties. Full adherence to all bundle components was the key to effectively reducing the risk of surgical site infections.


Assuntos
Pacotes de Assistência ao Paciente , Infecção da Ferida Cirúrgica , Humanos , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/prevenção & controle , Infecção da Ferida Cirúrgica/etiologia , Estudos Retrospectivos , Antibacterianos , Pacotes de Assistência ao Paciente/efeitos adversos , Pacotes de Assistência ao Paciente/métodos , Controle de Infecções/métodos
3.
Int Wound J ; 21(3): e14583, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38453147

RESUMO

Previous studies show that both the frequency of surgeries and incidence of surgical site infections (SSIs) have been lower during the coronavirus disease 2019 (COVID-19) pandemic. This study's purpose is to analyse the possible association of the COVID-19 epidemic-related increased health measures, such as protective equipment and products, increased hand hygiene and restrictions imposed, on the incidence of SSIs in an academic medical centre. We designed a single-centre, retrospective cohort study and collected data on the frequency of surgeries and the incidence of SSIs, among patients who had surgeries pre- and post-COVID-19 pandemic. Besides the intervention and outcome variable, we sought information on patient gender, surgery type, body mass index (BMI), smoking, and type II diabetes mellitus. We used Wald 95% confidence interval (95% CI) and the p values of the odds ratio (OR) to report results. Of the N = 24 098 surgeries performed in this hospital, there were 269 patients who reported post-surgical SSIs in this hospital between March 2019 and March 2021. The OR of developing a post-surgical SSI was 0.40 (95% CI: 0.33-0.57, p < 0.05; adjusted for confounders 0.39 [95% CI: 0.30-0.52, p < 0.05]) among patients who had surgery under post-pandemic infection control measures, as compared to patients who had surgery under pre-pandemic usual care infection control measures. Our significant results conclude that an association may exist between the enhanced infection control measures used during the COVID-19 pandemic and lower incidence of SSIs we observed during this period.


Assuntos
COVID-19 , Diabetes Mellitus Tipo 2 , Humanos , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia , Estudos Retrospectivos , Diabetes Mellitus Tipo 2/complicações , Pandemias , COVID-19/epidemiologia , COVID-19/complicações , Controle de Infecções , Fatores de Risco
4.
Clin Plast Surg ; 51(2): 191-204, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38429043

RESUMO

Burn care evolved slowly from primitive treatments depicted in cave drawings 3500 years ago to a vibrant medical specialty which has made remarkable progress over the past 200 years. This evolution involved all areas of burn care including superficial dressings, wound assessment, fluid resuscitation, infection control, pathophysiology, nutritional support, burn surgery, and inhalation injury. Major advances that contributed to current standards of care and improved outcomes are highlighted in this article. New innovations are making possible a future where severe burn injuries will require less morbid interventions for acute care and outcomes will restore patients more closely to their pre-injury condition.


Assuntos
Queimaduras , Humanos , Queimaduras/terapia , Bandagens , Hidratação , Controle de Infecções
5.
J Glob Health ; 14: 04042, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38426844

RESUMO

Background: Hundreds of millions of people become infected globally every year while seeking care in health facilities that lack basic needs like infection control measures and personal protective equipment (PPE). We aimed to evaluate the availability of infection control items and PPE in eight low- and middle-income countries and identify disparities in the availability of those items. Methods: In this study, we combined publicly available nationally representative cross-sectional health system surveys (Service Provision Assessments by the Demographic and Health Survey Programme) conducted in eight countries between 2013 and 2018: Afghanistan, Bangladesh, the Democratic Republic of the Congo, Haiti, Malawi, Nepal, Senegal, and Tanzania. The availability of infection control items was evaluated using a list of six items (a waste receptacle, a sharps container, disinfectant, single-use disposable or auto-disposable syringes, soap and running water, or an alcohol-based hand rub, and guidelines for standard precautions). PPE includes four items: gloves, medical masks, gowns, and eye protection. We considered these items available in a facility if they were observed in general outpatient areas or any service-specific area (i.e. delivery room). Results: We analysed data from 7948 health facilities (694 hospitals and 7254 health centres/clinics). Overall, among the infection control items and PPE, most surveyed facilities had high availability of single-use disposable or auto-disposable syringes (91.40%) and latex gloves (92.56%). Of infection control measures, guidelines for infection control were the least available during the survey, with the lowest (6.15%) in Nepal and the highest (68.18%) in Malawi. Of the PPE items, eye protection was the least available during the survey, with the lowest (5.4% in Senegal) and the highest (28.17%) in Haiti. Only 1567 (19.71%) facilities looked to have all the basic infection control materials, and 1023 (12.87%) of the analysed facilities possessed all of the PPE. Within the same country, the availability of items varied more between hospitals and health centres/clinics than between them. Conclusions: All eight of our study countries experience shortages of the most fundamental standard precaution items to avert infection. Steps must be taken in each of these countries to reduce inadequacies and disparities and enhance efficiency in the conversion of health-system inputs into the facility's availability of standard precaution items for infection control - to curb the risk of infectious disease transmission.


Assuntos
Países em Desenvolvimento , Equipamento de Proteção Individual , Humanos , Estudos Transversais , Instalações de Saúde , Controle de Infecções
6.
Int J Oral Sci ; 16(1): 23, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38429299

RESUMO

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment. However, irrigant selection or irrigation procedures are far from clear. The vapor lock effect in the apical region has yet to be solved, impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes. Additionally, ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified. Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes. Indeed, clinicians have been aware of these concerns for years. Based on the current evidence of studies, this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions. The evolution of different kinetic irrigation methods, their effects, limitations, the paradigm shift, current indications, and effective operational procedures regarding intracanal medication are also discussed. This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication, thus facilitating a better understanding of infection control, standardizing clinical practice, and ultimately improving the success of endodontic therapy.


Assuntos
Controle de Infecções , Tratamento do Canal Radicular , Consenso
7.
Antimicrob Resist Infect Control ; 13(1): 32, 2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38475931

RESUMO

BACKGROUND: Standard Precautions (SPs) are the minimal infection prevention and control (IPC) measures that apply to all patient care activities at all times, regardless of whether the patient has a suspected or proven disease, in any place where healthcare service is provided. These evidence-based practices protect healthcare workers (HCWs) from infection while preventing the spread of infectious agents among patients, visitors, and the environment. OBJECTIVES: Assessed compliance of HCWs working in public hospitals in Addis Ababa to infection prevention and control SPs, and factors associated with noncompliance. METHODS: In a hospital-based cross-sectional study, 422 HCWs were recruited from nine public hospitals in Addis Ababa using a stratified random sampling technique. Data were collected using self-administered questionnaires, entered into a computer using Epi data, and analyzed using SPSS version 25. The association between the independent and the outcome variables was investigated using logistic regression. Odd ratios with corresponding 95% confidence intervals (CI) were used as measures of the strength of the association between the outcome and the explanatory variables. A p-value below 5% was considered an indicator of statistical significance. RESULTS: The level of knowledge of HCWs about IPC and SPs was 51.9% and 36.49% of the respondents were compliant with SPs. Receiving IPC Training [Adjusted Odds Ratio (AOR) = 1.81, 95% CI 1.06, 3.09], knowing SPs [AOR = 3.46, 95% CI = 1.83, 6.54], presence of a mechanism in the hospital to enforce the IPC practices [AOR = 1.71 95% CI = 1.01, 2.89], and availability of cleaning and disinfection chemicals in the hospital [AOR = 2.18, 95%CI = 1.15, 4.13] were significantly associated with the HCWs' compliance with SPs. CONCLUSION: Compliance with IPC standard precautions of HCWs in public hospitals of Addis Ababa is suboptimal. Working in medical units, less work experience, lack of training, poor knowledge, absence of a mechanism to enforce adherence, and inadequate resources are independent predictors for non-compliance of the HCWs.


Assuntos
Pessoal de Saúde , Controle de Infecções , Humanos , Etiópia , Estudos Transversais , Hospitais Públicos
8.
Emergencias (Sant Vicenç dels Horts) ; 36(1): 9-16, feb. 2024. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-EMG-462

RESUMO

Objetivo. Investigar si la combinación de biomarcadores de respuesta inflamatoria (BMRI) y escalas clínicas mejora la estratificación pronóstica de pacientes atendidos en servicios de urgencias hospitalarios (SUH) por sospecha de infección. Método. Estudio analítico, observacional y prospectivo que incluyó pacientes con sospecha de infección atendidos en un SUH. Se recogieron variables demográficas, comorbilidades, datos clínicos a la llegada al SUH, foco de infección y los siguientes BMRI: leucocitos, proteína C reactiva, procalcitonina, lactato y región medial de la proadrenomodulina (MR-proADM). Se calcularon los valores de las escalas SIRS (síndrome de respuesta inflamatoria sistémica), qSOFA (quick Sequential Organ Failure Assessment) y NEWS (National Early Warning Score). La variable de resultado principal fue una compuesta que incluía mortalidad a 30 días o necesidad de ingreso en la unidad de cuidados intensivos (UCI). Resultados. Se incluyeron 473 pacientes, con una edad media de 70 (DE 19) años y el 54,3% (257). Hubo 31 fallecimientos (6,6%) y 16 (3,4%) ingresos en UCI. La variable de resultado se produjo en 45 (9,5%) pacientes. La MR-proADM mostró la mejor área bajo la curva de la característica operativa del receptor (ABC-COR) en comparación con el resto de biomarcadores y escalas clínicas [0,739 (IC 95% 0,671-0,809)], aunque sin diferencias respecto a lactato (p = 0,144) ni a la escala NEWS (p = 0,064). Al combinar MR-proADM con los diferentes biomarcadores y escalas clínicas, no se obtuvo ninguna combinación que mejore significativamente la precisión pronóstica individual del MR-proADM. Conclusiones. La estratificación del riesgo de los pacientes con infección es una cuestión clave para la toma de decisiones en los SUH. La determinación de MR-proADM supera a otros BMRI y escalas clínicas para la estratificación pronóstica de los pacientes a corto plazo en los SUH... (AU)


Objective. To determine whether combining biomarkers of inflammatory response and clinical scales can improve risk stratification of patients with suspected infection in a hospital emergency department (ED). Methods. Prospective observational study of ED patients treated for infections. We collected the following information on arrival: demographic and baseline clinical data, comorbidities, the focus of infection, and values for the following inflammatory biomarkers: leukocyte counts, and C-reactive protein, procalcitonin, and midregional proadrenomedullin (MR-proADM) concentrations. Scores on the following clinical scales were recorded based on the variables gathered: the SIRS (Systemic Inflammatory Response Syndrome) criteria, the qSOFA (Quick Sequential Organ Failure Assessment), and the NEWS (National Early Warning Score). The main outcome was a composite measure that included 30-day death or need for intensive care unit (ICU) admission. Results. A total of 473 patients with a mean (SD) age of 70.3 (19.2) years were included. The majority were men (257, 54.3%). Thirty-one (6.6%) died within 30 days and 16 (3.4%) were admitted to the ICU. The composite outcome (death or ICU admission) occurred in 45 patients (9.5%). The MR-proADM concentration, with an area under the receiver operating characteristic curve of 0.739 (95% CI, 0671-0.809) was a better predictor than the other biomarkers or clinical scales, although the differences between MR-proADM and either lactate concentration or the NEWS were not significant in the comparisons (P = .064). Combining the MR-proADM concentration with any of the scales did not significantly improve risk prediction. Conclusions. Risk stratification of patients with infection is a key part of ED decision-making. MR-proADM concentration is superior to other biomarkers and clinical prediction scales for predicting short-term prognosis in the ED... (AU)


Assuntos
Humanos , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Controle de Infecções , Serviços Médicos de Emergência , Estudos Prospectivos
9.
Arch Microbiol ; 206(3): 124, 2024 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-38409503

RESUMO

Quorum sensing (QS) is a communication mechanism employed by many bacteria to regulate gene expression in a population density-dependent manner. It plays a crucial role in coordinating various bacterial behaviors, including biofilm formation, virulence factor production, and antibiotic resistance. However, the dysregulation of QS can lead to detrimental effects, making it an attractive target for developing novel therapeutic strategies. Anti-QS approaches aim to interfere with QS signaling pathways, inhibiting the communication between bacteria, and disrupting their coordinated activities. Various strategies have been explored to achieve this goal. Advances in understanding QS mechanisms and the discovery of new targets have paved the way for the development of innovative anti-QS approaches. Combining multiple anti-QS strategies or utilizing them in combination with traditional antibiotics holds great promise for combating bacterial infections and addressing the challenges posed by antibiotic resistance. Anti-QS approaches offer a diverse range of strategies including natural compounds, antibody-mediated quorum quenching (QQ), computer-aided drug design for QQ, repurposing of Drugs approved by FDA as anti-QS agents and modulating quorum-sensing molecules which were discussed in detail in this review. This review, comprehensively and for the first time, sheds light on the significance of diverse anti-QS strategies in solving antimicrobial resistance problem in Gram-negative microbial infection.


Assuntos
Infecções Bacterianas , Percepção de Quorum , Humanos , Bactérias/metabolismo , Infecções Bacterianas/microbiologia , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Antibacterianos/metabolismo , Bactérias Gram-Negativas , Controle de Infecções , Biofilmes
10.
NEJM Evid ; 3(2): EVIDtt2300302, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38320491

RESUMO

Are Contact Precautions for Patients with MRSA Useful?MRSA infections lead to substantial morbidity and mortality. Hospitals commonly implement "contact precautions" to reduce MRSA transmission; however, recent studies have challenged the effectiveness of this strategy, and the use of contact precautions has been associated with certain adverse events. This article reviews the existing evidence and proposes a randomized trial to assess the efficacy of contact precautions in preventing MRSA transmission.


Assuntos
Infecção Hospitalar , Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas , Humanos , Infecção Hospitalar/prevenção & controle , Infecções Estafilocócicas/prevenção & controle , Controle de Infecções , Hospitais
12.
PLoS Biol ; 22(2): e3002465, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38300945

RESUMO

The breadth of pathogens to which T cells can respond is determined by the T cell receptors (TCRs) present in an individual's repertoire. Although more than 90% of the sequence diversity among TCRs is generated by terminal deoxynucleotidyl transferase (TdT)-mediated N-nucleotide addition during V(D)J recombination, the benefit of TdT-altered TCRs remains unclear. Here, we computationally and experimentally investigated whether TCRs with higher N-nucleotide diversity via TdT make distinct contributions to acute or chronic pathogen control specifically through the inclusion of TCRs with lower antigen binding strengths (i.e., lower reactivity to peptide-major histocompatibility complex (pMHC)). When T cells with high pMHC reactivity have a greater propensity to become functionally exhausted than those of low pMHC reactivity, our computational model predicts a shift toward T cells with low pMHC reactivity over time during chronic, but not acute, infections. This TCR-affinity shift is critical, as the elimination of T cells with lower pMHC reactivity in silico substantially increased the time to clear a chronic infection, while acute infection control remained largely unchanged. Corroborating an affinity-centric benefit for TCR diversification via TdT, we found evidence that TdT-deficient TCR repertoires possess fewer T cells with weaker pMHC binding strengths in vivo and showed that TdT-deficient mice infected with a chronic, but not an acute, viral pathogen led to protracted viral clearance. In contrast, in the case of a chronic fungal pathogen where T cells fail to clear the infection, both our computational model and experimental data showed that TdT-diversified TCR repertoires conferred no additional protection to the hosts. Taken together, our in silico and in vivo data suggest that TdT-mediated TCR diversity is of particular benefit for the eventual resolution of prolonged pathogen replication through the inclusion of TCRs with lower foreign antigen binding strengths.


Assuntos
Infecção Persistente , Linfócitos T , Animais , Camundongos , Nucleotídeos , Receptores de Antígenos de Linfócitos T , Peptídeos , Controle de Infecções
13.
Disaster Med Public Health Prep ; 18: e19, 2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38329113

RESUMO

OBJECTIVE: The goal of this study is to explore the risk factors associated with self-contamination points during personal protective equipment (PPE) donning and doffing among health care workers (HCWs). METHODS: In total, 116 HCWs were randomly sampled and trained to don and doff the whole PPE set. We smeared the whole PPE set with the fluorescent powder. After each participant finished PPE doffing, the whole body was irradiated with ultraviolet light in order to detect contamination points and record the position and quantity. Sociodemographic characteristics and previous infection prevention control (IPC) training experience, among others, were collected by using electronic questionnaires. Poisson regression was used in identifying risk factors that are associated with the number of contamination points, and the relative risk (RR) and its 95% confidence interval (CI) were calculated. RESULTS: About 78.5% of participants were contaminated. Ever training experience (RR = 0.37; 0.26, 0.52), clinical departments (RR = 0.67; 0.49, 0.93), body mass index (BMI) (RR = 1.09; 1.01, 1.18), and shoulder width (RR = 1.07; 1.01, 1.13) were associated with the number of contamination points. CONCLUSIONS: Previous IPC training experience, department types, BMI, and shoulder width were associated with self-contamination points after the PPE was removed.


Assuntos
Controle de Infecções , Equipamento de Proteção Individual , Humanos , Pessoal de Saúde/educação , Fatores de Risco
14.
BMJ Open ; 14(2): e083806, 2024 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-38346888

RESUMO

INTRODUCTION: Infection prevention and control (IPC) teams are routinely confronted with intense emotions in their daily work, as they are involved in many change processes with front-line medical staff, for example, when promoting compliance with basic IPC measures. In addition, they are confronted with challenges due to their role as intermediaries. Based on former research, this study aims to empower IPC teams to promote clinicians' compliance through interventions focusing on the IPC teams' leadership skills. METHODS AND ANALYSIS: The IP-POWER study (Infection Prevention with head and heart: Psychological empowerment of IPC teams), a multicentre, two-arm, non-blinded, cluster-randomised controlled trial with a parallel waiting control group, is planned to be conducted in Germany as of February to November 2024. A group of 10 voluntary hospitals is going to participate in a multistage intervention programme, including 2 days of intense psychological training; 5 hospitals will be randomly assigned to the waiting control group. After the workshops, there will be a 12-week follow-up period during which the contents learnt within the workshops can be applied and internalised into IPC practice. The proposed outcomes (both self-assessed and other-assessed leadership competencies of IPC team members and their task profiles, perceived workload, motivation to act in order to implement IP measures and goal attainment) are going to be collected with an online questionnaire, followed by an analysis with IBM SPSS (Statistics 29 (or later)) using descriptive analyses and multiple linear regressions. Additionally, as external data sources, hand hygiene compliance rates from the study hospitals' monitoring systems will be analysed using χ² tests. ETHICS AND DISSEMINATION: This study was reviewed and approved by the ethics committee of the University of Leipzig (184/23-ek; vote from 4 July 2023). Findings will be disseminated via peer-review publications, and national and international conference presentations. TRIAL REGISTRATION NUMBER: DRKS00031879.


Assuntos
Higiene das Mãos , Liderança , Humanos , Motivação , Controle de Infecções , Empoderamento , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Multicêntricos como Assunto
15.
BMC Infect Dis ; 24(1): 214, 2024 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-38369460

RESUMO

BACKGROUND: Application of accumulated experience and management measures in the prevention and control of coronavirus disease 2019 (COVID-19) has generally depended on the subjective judgment of epidemic intensity, with the quality of prevention and control management being uneven. The present study was designed to develop a novel risk management system for COVID-19 infection in outpatients, with the ability to provide accurate and hierarchical control based on estimated risk of infection. METHODS: Infection risk was estimated using an auto regressive integrated moving average model (ARIMA). Weekly surveillance data on influenza-like-illness (ILI) among outpatients at Xuanwu Hospital Capital Medical University and Baidu search data downloaded from the Baidu Index in 2021 and 22 were used to fit the ARIMA model. The ability of this model to estimate infection risk was evaluated by determining the mean absolute percentage error (MAPE), with a Delphi process used to build consensus on hierarchical infection control measures. COVID-19 control measures were selected by reviewing published regulations, papers and guidelines. Recommendations for surface sterilization and personal protection were determined for low and high risk periods, with these recommendations implemented based on predicted results. RESULTS: The ARIMA model produced exact estimates for both the ILI and search engine data. The MAPEs of 20-week rolling forecasts for these datasets were 13.65% and 8.04%, respectively. Based on these two risk levels, the hierarchical infection prevention methods provided guidelines for personal protection and disinfection. Criteria were also established for upgrading or downgrading infection prevention strategies based on ARIMA results. CONCLUSION: These innovative methods, along with the ARIMA model, showed efficient infection protection for healthcare workers in close contact with COVID-19 infected patients, saving nearly 41% of the cost of maintaining high-level infection prevention measures and enhancing control of respiratory infections.


Assuntos
COVID-19 , Infecção Hospitalar , Viroses , Humanos , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/prevenção & controle , Pacientes Ambulatoriais , Controle de Infecções
16.
Antimicrob Resist Infect Control ; 13(1): 16, 2024 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-38331974

RESUMO

The 5th edition of the Global Ministerial Summit on Patient Safety was held in Montreux, Switzerland, in February 2023, delayed by three years due to the COVID-19 pandemic. The overarching theme of the summit was "Less Harm, Better Care - from Resolution to Implementation", focusing on the challenges of implementation of infection prevention and control (IPC) strategies as well as antimicrobial stewardship programs (ASP) around the world. IPC strategies and ASP are of increasing importance due to the substantial burden of healthcare-associated infections and antimicrobial resistance threatening patient safety. Here, we summarize countries' and regional experiences and activities related to the implementation of IPC strategies and ASP shared at the meeting. Full implementation of effective programs remains a major challenge in all settings due to limited support by political and healthcare leaders, and human and financial constraints. In addition, the COVID-19 pandemic challenged already well-established programs. By enforcing sustained implementation by dedicated, cross-disciplinary healthcare personnel with a broad skill set, a reduction in healthcare-associated infections and multidrug-resistant pathogens can be achieved, leading ultimately to improved patient safety.


Assuntos
Gestão de Antimicrobianos , COVID-19 , Infecção Hospitalar , Humanos , Segurança do Paciente , Pandemias/prevenção & controle , Antibacterianos/uso terapêutico , Controle de Infecções , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/tratamento farmacológico , COVID-19/prevenção & controle
17.
Natl Health Stat Report ; (200): 1-8, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38411549

RESUMO

Objectives-Emergency operations plans that are specific to or include response to pandemics, approaches to implement the plans, and related infection control policies and practices vary among residential care communities (RCCs). This report presents nationally representative percentages of RCCs with infection control programs by selected characteristics. Methods-Data are from the RCC component of the 2020 National Post-acute and Long-term Care Study, conducted biennially by the National Center for Health Statistics. The study asked four binary questions, including whether the RCC had a written Emergency Operations Plan that was specific to or included pandemic response, had a designated staff member or consultant responsible for coordinating the infection control program, offered annual influenza vaccination to residents, and offered annual influenza vaccination to all employees or contract staff. RCC characteristics presented in this report are bed size, chain affiliation, ownership status, and provision of dementia-specific care (RCCs that only served residents with dementia or had a dementia wing). Metropolitan statistical area (MSA) was used to characterize geographic location. Results-Most RCCs reported having a written Emergency Operations Plan that was specific to or included pandemic response. A higher percentage of RCCs with more than 26 beds and those with a designated space for dementia care reported having a written Emergency Operations Plan and a designated staff to coordinate an infection control program. The largest differences were observed in the provision of annual influenza vaccination to residents and to all employees or contract staff by MSA status, bed size, and presence of a designated space for dementia care. A higher percentage of RCCs in non-MSAs (83.4%), RCCs with a designated space for dementia care (95.0%), those with more than 50 beds (93.9%), those with 26-50 beds (93.3%), and those with nonprofit ownership (85.8%) offered annual influenza vaccination to all employees or contract staff.


Assuntos
Carcinoma de Células Renais , Demência , Influenza Humana , Neoplasias Renais , Estados Unidos , Animais , Humanos , Influenza Humana/prevenção & controle , Controle de Infecções , Políticas
18.
Tidsskr Nor Laegeforen ; 144(3)2024 Feb 27.
Artigo em Inglês, Norueguês | MEDLINE | ID: mdl-38415574

RESUMO

Background: Healthcare workers colonised with methicillin-resistant Staphylococcus aureus (MRSA) experience negative consequences due to work restrictions, long-term sick leave, stigmatisation, eradication failures and psychosocial stress. Throat colonisation is associated with prolonged carriage and non-successful treatment. Case presentation: We describe two Norwegian healthcare students with persistent MRSA throat carriage. After several eradication failures, MRSA eradication was successful only after tonsillectomy. Interpretation: Tonsillectomy is not the solution for persistent MRSA throat carriage in healthcare workers. However, their stories illustrate the challenges they faced during repeated eradication attempts. They suffered considerable psychological stress due to the risk of study disruption and limited career options. The impact of laws and strict guidelines for MRSA-colonised healthcare workers, needs to be re-assessed in order to reduce transmission. We argue that healthcare workers without individual risk factors should be able to work in units considered to pose no risk as long as they undergo individual training in basic infection control measures.


Assuntos
Staphylococcus aureus Resistente à Meticilina , Infecções Estafilocócicas , Humanos , Faringe , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/prevenção & controle , Pessoal de Saúde , Controle de Infecções , Portador Sadio
19.
BMC Prim Care ; 25(1): 72, 2024 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-38418938

RESUMO

BACKGROUND: Since the Coronavirus Disease 2019 (COVID-19) pandemic, awareness of infection prevention and control (IPC) has increased in primary care settings. This study aimed to examine behavioural determinants shaping IPC behaviour pre-, during, and post-pandemic among healthcare workers (HCWs) in general practices, to inform optimised IPC in primary care. METHODS: For this qualitative study, semi-structured in-depth interviews were conducted during two study periods: (1) pre-COVID-19 pandemic: July 2019-February 2020, with 14 general practitioners (GPs) and medical assistants, and (2) during the COVID-19 pandemic: July 2022-February 2023, with 22 GPs and medical assistants. The design was informed by behaviour change theories. Data were analysed using thematic analysis. RESULTS: Main themes were: (1) risk perception and IPC awareness, (2) attitudes towards IPC and professional responsibility, (3) decision-making process and risk considerations for IPC adherence, (4) social norm and social influence in GP practice team, and (5) environmental context and resource availability in GP practice. During the pandemic, risk perception and awareness of the importance of IPC increased compared to the pre-pandemic period. A consistent belief emerged that IPC is part of professional responsibility, while needing to be balanced with other aspects of patient care. Decision-making is dependent on the individual GP and mainly influenced by risk assessments and sustainability considerations. The social context in the practice team can reinforce IPC behaviours. GP practice building and layout, and limited IPC resource and material availability were reported as main barriers. CONCLUSIONS: The theory-informed insights of this study can be used for targeted interventions to optimise IPC behaviour in general practices. Adopting multifaceted strategies to target the various determinants is recommended to sustain IPC, by implementing continuous education using tailored communication, integrating IPC in work routines and organisational workflows, refining existing IPC protocols by incorporating decision-making tools for HCWs, fostering a culture of IPC through knowledge-sharing and teamwork, and addressing GP practice physical environment and IPC resource barriers.


Assuntos
COVID-19 , Medicina Geral , Clínicos Gerais , Humanos , COVID-19/prevenção & controle , Pandemias/prevenção & controle , Controle de Infecções/métodos
20.
Am J Nurs ; 124(3): 33, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38386832

RESUMO

These nurses prevent patients from contracting avoidable infections.


Assuntos
Enfermeiras Clínicas , Humanos , Controle de Infecções
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