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1.
Presse Med ; 48(12): 1528-1535, 2019 Dec.
Artículo en Francés | MEDLINE | ID: mdl-31767249

RESUMEN

The emergence of a viral disease most often results from an imbalance in the interaction between the infectious agent, the host and the environment. After the introduction phase of a viral disease in a territory or a given population and once the first chains of transmission occur, the spread of the disease or its sustainability are possible if the control measures are not implemented or are not sufficiently effective. If it is difficult to anticipate the occurrence and introduction of an emerging viral disease, the following three key elements must be strengthened to limit its impact: (1) anticipation and preparation; (2) research and (3) monitoring and surveillance. Finally, to guarantee that the measures taken are relevant and acceptable to the population, a multidisciplinary approach must be systematically relied upon and re-evaluated on a prospective basis.


Asunto(s)
Enfermedades Transmisibles Emergentes/epidemiología , Brotes de Enfermedades , Predicción , Virosis/epidemiología , Enfermedades Transmisibles Emergentes/prevención & control , Brotes de Enfermedades/prevención & control , Ambiente , Diseño de Investigaciones Epidemiológicas , Monitoreo Epidemiológico , Predicción/métodos , Humanos , Control de Infecciones/organización & administración , Control de Infecciones/normas , Control de Infecciones/tendencias , Prevención Primaria/métodos , Prevención Primaria/organización & administración , Virosis/prevención & control
3.
J Infus Nurs ; 42(2): 249-253, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31464833

RESUMEN

Every health care facility aims to achieve and maintain a zero central line-associated bloodstream infection (CLABSI) rate. Infections can be costly for institutions of any size and are often not covered by health insurance. The interventions put in place in this quality improvement project were implemented in 4 phases: (1) develop a new standard of care for central lines and give nurses full responsibility for the care and handling of these lines (including blood sampling); (2) revise policy and provide educational sessions to support nurses; (3) document compliance with the new policy; and (4) document CLABSI rates. The project took place during a 15-month period between January 1, 2016 and March 30, 2017, in 4 critical care units in a university medical center in Lebanon. The results revealed a reduction in CLABSI rates from a maximum rate of more than 17 per 1000 catheter days to zero per 1000 catheter days, which was sustained for 10 months. Nurse compliance with the new policy after 3 months ranged from 95% to 99%.


Asunto(s)
Infecciones Relacionadas con Catéteres/prevención & control , Cateterismo Venoso Central/normas , Enfermería de Cuidados Críticos/educación , Adhesión a Directriz/normas , Control de Infecciones/normas , Unidades de Cuidados Intensivos , Centros Médicos Académicos , Adulto , Adhesión a Directriz/estadística & datos numéricos , Humanos , Líbano , Mejoramiento de la Calidad
4.
Nurse Educ Today ; 81: 72-77, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31330405

RESUMEN

BACKGROUND: The risk of acquiring and spreading infection must be minimized in nursing students because they are exposed to healthcare-associated infections during clinical training. To achieve this goal, students should be knowledgeable and competent in infection control practice before proceeding to their training hospitals. OBJECTIVES: This study assessed the nursing students' perception of the infection prevention climate in training hospitals in Saudi Arabia. It also examined the predictors of the students' perceptions. DESIGN: A quantitative, cross-sectional design was used. METHODS: This investigation was part of a large study conducted in six Saudi universities. A total of 829 Saudi nursing students were included in this study. Data were collected using the Leading Culture of Quality in Infection Prevention scale and analyzed using descriptive and inferential statistics. Ethical approval was obtained from the King Saud University, and permission was given by the administration of each participating university. RESULTS: The overall perception of nursing students indicated a modest infection prevention climate. Prioritization of quality and improvement orientation was rated as the highest dimensions, whereas psychological safety and supportive environment were the lowest. The nursing students in University F had the poorest perceptions among the six universities. The predictors of nursing student perception of their training hospitals' infection prevention climates were the university where they studied, their age, and participation in infection prevention seminars. CONCLUSIONS: This article describes nursing students' perception of the infection prevention climate of their training hospitals in Saudi Arabia. Results may provide a unique theoretical underpinning on the perception and factors that effect an infection prevention climate. Thereby, previous knowledge and literature may be expanded. Results can be used as a guide in establishing clinical policies in efforts toward improving the infection prevention climate.


Asunto(s)
Infección Hospitalaria/enfermería , Infección Hospitalaria/prevención & control , Control de Infecciones/normas , Estudiantes de Enfermería/psicología , Universidades , Estudios Transversales , Curriculum , Bachillerato en Enfermería , Femenino , Adhesión a Directriz/normas , Hospitales , Humanos , Masculino , Arabia Saudita , Estudiantes de Enfermería/estadística & datos numéricos , Encuestas y Cuestionarios
5.
Int J Health Care Qual Assur ; 32(6): 991-1003, 2019 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-31282260

RESUMEN

PURPOSE: The purpose of this paper, a point prevalence study, is to quantify the incidence of isolation and identify the type of communicable diseases in isolation. The paper evaluates isolation precaution communication, availability of personal protective equipment (PPE) as well as other equipment necessary for maintaining isolation precautions. DESIGN/METHODOLOGY/APPROACH: A standardised audit tool was developed in accordance with the National Standards for the Prevention and Control of Healthcare Associated Infections (May 2009). Data were collected from 14 March 2017 to 16 March 2017, through observation of occupied isolation rooms in an academic hospital in Dublin, Ireland. The data were subsequently used for additional analysis and discussion. FINDINGS: In total, 14 per cent (125/869) of the total inpatient population was isolated at the time of the study. The most common isolation precaution was contact precautions (96.0 per cent). In all, 88 per cent of known contact precautions were due to multi-drug resistant organisms. Furthermore, 96 per cent of patients requiring isolation were isolated, 92.0 per cent of rooms had signage, 90.8 per cent had appropriate signs and 93.0 per cent of rooms had PPE available. Finally, 31 per cent of rooms had patient-dedicated and single-use equipment and 2.4 per cent had alcohol wipes available. PRACTICAL IMPLICATIONS: The audit tool can be used to identify key areas of noncompliance associated with isolation and inform continuous improvement and education. ORIGINALITY/VALUE: Currently, the rate of isolation is unknown in Ireland and standard guidelines are not established for the evaluation of isolation rooms. This audit tool can be used as an assessment for isolation room compliance.


Asunto(s)
Infección Hospitalaria/prevención & control , Guías como Asunto , Hospitales de Aislamiento/organización & administración , Control de Infecciones/normas , Auditoría Médica , Centros Médicos Académicos , Bases de Datos Factuales , Femenino , Adhesión a Directriz/estadística & datos numéricos , Recursos en Salud , Humanos , Irlanda , Masculino
6.
Rev Bras Enferm ; 72(3): 774-779, 2019 Jun 27.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31269145

RESUMEN

OBJECTIVE: To evaluate the compliance of the care process involving insertion of central vascular catheter (CVC) in hemodialysis. METHOD: Cross-sectional quantitative approach developed at the hemodialysis service of a reference hospital in Sergipe, Brazil. Sample consisting of 1,342 actions evaluated, corresponding to 122 forms for monitoring and control of CVC insertion. Data collection was held from July to December 2016. RESULTS: The adherence rate to the use of the insertion form was 54.9%. The procedure evaluated achieved 93% overall compliance. Of the 11 specific actions observed, seven (64%) presented 100% compliance. The density of the overall incidence of primary bloodstream infections reduced from 10.6 to 3.1 infections per 1,000 patients/day. CONCLUSION: Although the observed actions reached specific desired conformities, the use of the checklist was lower than expected. Strategies for monitoring, coaching and educational and organizational actions can contribute to safe care.


Asunto(s)
Catéteres Venosos Centrales/efectos adversos , Adhesión a Directriz/normas , Control de Infecciones/normas , Adulto , Brasil , Cateterismo Venoso Central/efectos adversos , Cateterismo Venoso Central/métodos , Catéteres Venosos Centrales/estadística & datos numéricos , Estudios Transversales , Femenino , Adhesión a Directriz/estadística & datos numéricos , Humanos , Control de Infecciones/estadística & datos numéricos , Masculino , Garantía de la Calidad de Atención de Salud/métodos , Diálisis Renal/instrumentación , Diálisis Renal/métodos
7.
Hosp Pract (1995) ; 47(4): 203-210, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31359809

RESUMEN

Background: Healthcare-associated infections (HAIs) increase morbidity, mortality, length of hospital stay and costs, and should be prevented where possible. In addition, up to 71% of neonates are prone to bloodstream infections (BSI) during intensive care due to a variety of factors. Consequently, the objectives of this study were to estimate the burden of HAIs and possible risk factors in a tertiary hospital in Botswana as well as describe current trends in bacterial isolates from neonatal blood specimen and their antibiotic resistance patterns.Methods: Point Prevalence Survey (PPS) in all hospital wards and a retrospective cross-sectional review of neonatal blood culture and sensitivity test results, with data abstracted from the hospital laboratory database.Results: 13.54% (n = 47) of patients had HAIs, with 48.9% (n = 23) of them lab-confirmed. The highest prevalence of HAIs was in the adult intensive care unit (100% - n = 5), the nephrology unit (50% - n = 4), and the neonatal intensive care unit (41.9% - n = 13). One-fourth of HAIs were site unspecific, 19.1% (n = 9) had surgical site infections (SSIs), 17% (n = 8) ventilator-associated pneumonia/complications, and 10.6% (n = 5) were decubitus ulcer infections. There were concerns with overcrowding in some wards and the lack of aseptic practices and hygiene. These issues are now being addressed through a number of initiatives. Coagulase Negative Staphylococci (CoNS) was the commonest organism (31.97%) isolated followed by Enterococci spp. (18.03%) among neonates. Prescribing of third-generation cephalosporins is being monitored to reduce Enterococci, Pseudomonas and Acinetobacter spp. infections.Conclusions: There were concerns with the rate of HAIs and BSIs. A number of initiatives are now in place in the hospital to reduce these including promoting improved infection prevention and control (IPC) practices and use of antibiotics via focal persons of the multidisciplinary IPC committee. These will be followed up and reported on.


Asunto(s)
Bacteriemia/epidemiología , Infección Hospitalaria/epidemiología , Control de Infecciones/normas , Unidades de Cuidado Intensivo Neonatal/organización & administración , Centros de Atención Terciaria/estadística & datos numéricos , Antibacterianos/uso terapéutico , Bacteriemia/tratamiento farmacológico , Cultivo de Sangre , Botswana/epidemiología , Infección Hospitalaria/tratamiento farmacológico , Estudios Transversales , Aglomeración , Femenino , Humanos , Higiene , Recién Nacido , Unidades de Cuidado Intensivo Neonatal/normas , Masculino , Prevalencia , Estudios Retrospectivos , Factores de Riesgo
8.
J Clin Nurs ; 28(19-20): 3538-3546, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31162881

RESUMEN

AIM AND OBJECTIVE: To describe and compare the Knowledge, Attitudes and Practices (KAP) pertaining to standard precautions (SPs) among nurses in China and Ethiopia. BACKGROUND: SPs are guidelines for reducing the risk of transmission of blood-borne and other pathogens in hospital settings. SPs have been widely promoted to protect healthcare workers (HCW); however, these are not fully practised worldwide, especially in resource-constrained countries like China and Ethiopia. DESIGN: A descriptive, cross-sectional, comparative study was performed between February-April 2018. The study followed the "Strengthening the Reporting of Observational Studies in Epidemiology" (STROBE) guideline. METHODS: Self-administered questionnaire survey of a convenience sample of 357 nurses (237 Chinese and 120 Ethiopian nurses) from one teaching hospital each in China and Ethiopia. KAP pertaining to SPs were measured. RESULTS: Nurses of both countries were found to have a good understanding of the concept of SPs; however, the acceptance to organisation of policies for prevention of hospital-acquired infections (HAI) was lower in Ethiopia. Fewer medical resources in Ethiopia resulted in poorer adherence to use of personal protective equipment (PPE). The usage rate of PPE (except apron and goggles) among Ethiopian nurses was significantly lower than that among Chinese nurses. CONCLUSIONS: Both Ethiopian and Chinese nurses showed favourable attitudes towards SPs; however, Chinese nurses reported better knowledge and practices. The organisation should strengthen formal and on-the-job training, implement targeted infection prevention strategies and provide adequate medical supplies to improve infection control in Ethiopia. RELEVANCE TO CLINICAL PRACTICE: Our findings highlight some of the reasons for low compliance to SPs in both countries and potentially other similar settings. The information provided here can help develop infection prevention and control strategies for resource-constrained countries.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Control de Infecciones/normas , Personal de Enfermería en Hospital/normas , Adulto , China , Infección Hospitalaria/prevención & control , Estudios Transversales , Etiopía , Femenino , Hospitales de Enseñanza , Humanos , Masculino , Encuestas y Cuestionarios
9.
Future Microbiol ; 14: 21-25, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31210535

RESUMEN

The assessment and management of biological risk has always been a primary goal toward which occupational medicine has focused its efforts, in particular in healthcare workplaces. Healthcare professionals represent a category of workers at high risk for infections, many of which are vaccine-preventable diseases. There are various reasons for vaccinating healthcare workers, including to prevent illness among them so as to reduce absenteeism, to ensure an effective health service to users and to reduce social costs. Recently, the issue of vaccinations has been the subject of many debates. Vaccination is not always appreciated by health operators, and the reasons for low vaccination coverage are several and heterogeneous. This paper focuses on current Italian law and vaccination policies, along with the international background, evaluating the effectiveness of current policies and the consequences on public health. Overall, preventing infectious diseases means reducing costs, cases and outbreaks, shows responsibility toward third parties, and improves general welfare.


Asunto(s)
Personal de Salud , Política de Salud , Vacunación/legislación & jurisprudencia , Vacunación/normas , Política de Salud/tendencias , Humanos , Control de Infecciones/legislación & jurisprudencia , Control de Infecciones/normas , Italia , Salud Laboral/legislación & jurisprudencia , Salud Laboral/normas , Salud Pública , Medición de Riesgo , Vacunación/estadística & datos numéricos , Vacunas/administración & dosificación
10.
Glob Health Action ; 12(1): 1480085, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31154993

RESUMEN

Hospital cleaning has been shown to impact on rates of healthcare-associated infections (HCAIs) and good environmental hygiene is critical to quality care, yet those tasked with the role of ensuring a safe and clean environment often go unrecognised as members of the healthcare workforce. Sepsis is a leading cause of maternal and newborn death, a significant proportion of these cases are estimated to be due to HCAIs. Deliveries in health institutions have now reached 75% globally, and in low and middle income countries the corresponding increased pressure on facilities  has impacted both quality of care provided and quality of the birth environment in terms of infection prevention and control (IPC) and HCAIs. The paper discusses the neglected role of health facility cleaners, providing evidence from the literature and from needs assessments conducted by The Soapbox Collaborative and partners in Bangladesh, India, The Gambia and Zanzibar. While not the primary focus of the assessments, common themes emerged consistently pointing to institutional neglect of cleaning and cleaners. The paper argues that low status within facilities, wider societal marginalisation, lack of training, and poor pay and working conditions contribute to the lack of prioritisation placed on health facility environmental hygiene. With increased international attention focused towards health facility water, sanitation and hygiene and a growing focus on IPC, now is the time to address the neglect of this frontline healthcare workforce. We propose that provision of and improved training can enable the recognition of the valuable role cleaning staff play, as well as equipping these staff with the tools required to perform their job to the highest standard. In addition to training, wider systems changes are necessary to establish improvements in environmental hygiene and the role of cleaning staff, including addressing resource availability, supportive supervision, and an increased emphasis on preventative healthcare.


Asunto(s)
Infección Hospitalaria/prevención & control , Maternidades/normas , Servicio de Limpieza en Hospital/normas , Higiene/normas , Control de Infecciones/normas , Seguridad del Paciente/normas , Saneamiento/normas , Adulto , Bangladesh , Femenino , Gambia , Humanos , India , Recién Nacido , Persona de Mediana Edad , Evaluación de Necesidades , Embarazo , Tanzanía
11.
Zoonoses Public Health ; 66(5): 439-457, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31152501

RESUMEN

Effective infection control (IC) provides a safe environment for staff, clients and animals of veterinary practices by reducing the risk of nosocomial and zoonotic infections, which are associated with increased hospital stays, costs, morbidity and mortality. An equally important issue arising from nosocomial infection is the loss of trust between the client and the veterinary practice that has potential negative impacts on the veterinary practice in terms of economic risk and the well-being of staff. Furthermore, an emerging and significant threat, in this context, is antimicrobial resistance. The aim of this systematic review was to critically review published reports that documented current IC practices and evaluated interventions to improve IC practices. A systematic literature search using ten databases to identify papers published over a 20-year period (February 1996 to February 2016) was conducted for studies that met the inclusion criteria. Included studies were assessed using the PRISMA and STROBE-Vet statements. A total of 14 of 1,615 identified studies met our inclusion criteria. Infection control practices included hand hygiene, sharps handling, environmental cleaning, personal protective equipment and personnel vaccination. Descriptive studies were the predominant research design for assessing IC compliance. Only three studies were interventions. Compliance with IC protocols was poor and only marginally increased with multimodal educational campaigns. There was significant variation in the implementation of IC by veterinary staff. Workplaces that had IC policies, management support and a staff member supporting their implementation were more likely to embrace good IC. Infection control data in veterinary practices were inconsistently reported and collected. Clearly defining IC and determining prevalence of these practices within the veterinary field is important given the limited research in this area. Further, developing and implementing educational campaigns for this sector is needed.


Asunto(s)
Hospitales Veterinarios/normas , Control de Infecciones/métodos , Control de Infecciones/normas , Mascotas , Animales , Desinfección , Higiene de las Manos , Humanos , Lesiones por Pinchazo de Aguja/prevención & control
13.
BMC Infect Dis ; 19(1): 551, 2019 Jun 21.
Artículo en Inglés | MEDLINE | ID: mdl-31226946

RESUMEN

BACKGROUND: At the end of March 2018, a clustered outbreak of measles associated with health care workers occurred in northern Taiwan. Prior to this study, the policy for measles vaccination for physicians and nurses in MacKay Memorial Hospital, Taiwan was encouragement of vaccination in medical personnel working in the emergency room or other high risk divisions without prior testing for measles antibody, and vaccination coverage was only 85.3%. It was important to urgently formulate a new strategy to achieve zero tolerance for intra-hospital transmission and epidemic prevention. This study aimed to explore the effectiveness of a new strategy for the prevention of an outbreak of measles. METHODS: This study was conducted from April 23, 2018 to May 22, 2018 in the MacKay Memorial Hospital, a medical center and tertiary teaching hospital with 2200 beds in northern Taiwan. First-line medical personnel in the hospital underwent a free screening for measles antibody as a new strategy for measles outbreak prevention. Susceptible medical personnel were advised to receive measles vaccination. RESULTS: A total of 719 first-line medical personnel were enrolled for the general survey. Measles seropositivity was 76.1% (287/377) in the generation born after 1978 (vaccinated), and 96.5% (330/342) in the generation born before 1978 (p < 0.001), while the overall seropositivity was 85.8% (617/719). Vaccination coverage of susceptible personnel under the new strategy reached 86.3% in the first month (88/102) following the survey. At the end of the first month after implementation of the new strategy, 98.1% of the medical personnel were seropositive or revaccinated, and reached 99.4% at the end of the second month. CONCLUSIONS: In this study, rapid, free antibody screening during a measles outbreak and subsequent vaccination of those susceptible resulted in most of the first-line medical personnel being seropositive or revaccinated. The new strategy was effective, time saving, used little manpower, and of low cost. Screening for measles antibody free of charge followed by vaccination of seronegative medical personnel can be regarded as an effective health management strategy to reduce and prevent the spread of measles infection.


Asunto(s)
Brotes de Enfermedades/prevención & control , Personal de Salud/estadística & datos numéricos , Política de Salud , Control de Infecciones , Vacuna Antisarampión/uso terapéutico , Sarampión/prevención & control , Cobertura de Vacunación , Adulto , Anciano , Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Femenino , Personal de Salud/normas , Hospitales de Enseñanza , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Control de Infecciones/normas , Masculino , Sarampión/epidemiología , Persona de Mediana Edad , Embarazo , Encuestas y Cuestionarios , Taiwán/epidemiología , Centros de Atención Terciaria , Vacunación/estadística & datos numéricos , Cobertura de Vacunación/métodos , Cobertura de Vacunación/organización & administración , Cobertura de Vacunación/normas , Adulto Joven
14.
Rev Lat Am Enfermagem ; 27: e3134, 2019 Apr 29.
Artículo en Portugués, Inglés, Español | MEDLINE | ID: mdl-31038628

RESUMEN

OBJECTIVE: to define the competencies for the prevention and control of healthcare-related infections that should be developed by the generalist nurse and the specialist nurse in infection control in Brazil. METHOD: the Delphi technique, developed in four rounds, was used. Thirty-one nurses and eight physicians participated in the study, with expertise in infection prevention and control. Data were collected using open-ended questionnaires, whose answers were treated using the content analysis technique. Structured instruments were used to evaluate the importance of each competency using a Likert scale. Data were analyzed and presented in a descriptive way, use of median and coefficient of variation. RESULTS: the competences were organized in 4 core, 14 generic and 17 specific, with name and description of each competency. CONCLUSION: the definition of competencies for the prevention and control of healthcare-related infections is the first step to begin the rethinking of the teaching and learning process in the initial training of nurses. The data found in the present study may help to restructure education and support permanent education programs in health.


Asunto(s)
Control de Infecciones/normas , Enfermeras Especialistas/normas , Competencia Profesional/normas , Brasil , Técnica Delfos , Educación en Salud/normas , Humanos , Enfermeras Especialistas/educación
15.
BMC Health Serv Res ; 19(1): 296, 2019 May 08.
Artículo en Inglés | MEDLINE | ID: mdl-31068203

RESUMEN

BACKGROUND: Healthcare associated infection (HCAI) is a major cause of morbidity and mortality. In recent years, there have been high profile successes in infection prevention control (IPC), such as the dramatic reductions in methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections (which is viewed as one proxy indicator of overall harm) and Clostridium difficile in the UK. Nevertheless, HCAI remains a costly burden to health services, a source of concern to patients and the public and at present, is receiving priority from policy makers as it contributes to the global threat of antimicrobial resistance. METHODS: The study involves qualitative case studies within isolation settings at two National Health Service (NHS) district general hospitals (DGHs) in Wales, in the UK. The 18-month study incorporates Manchester Patient Safety Framework (MaPSaF) workshops with health workers and other hospital staff, in depth interviews with patients and their relative / informal carer, health workers and hospital staff, and periods of hospital ward observation. DISCUSSION: The present study aims to investigate the ways in which engagement of health workers with IPC strategies and principles, shape and inform organisational patient safety culture within the context of isolation in surgical, medical and admission hospital settings; and vice-versa. We want to understand the meaning of IPC 'ownership' for health workers; the ways in which IPC is promoted, how IPC teams operate as new challenges arise, how their effectiveness is assessed and the positioning of IPC within the broader context of organisational patient safety culture, within hospital isolation settings.


Asunto(s)
Infección Hospitalaria/prevención & control , Control de Infecciones/organización & administración , Seguridad del Paciente/normas , Administración de la Seguridad/organización & administración , Investigación sobre Servicios de Salud , Humanos , Control de Infecciones/normas , Cultura Organizacional , Formulación de Políticas , Investigación Cualitativa , Gales
16.
GMS J Med Educ ; 36(2): Doc15, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30993173

RESUMEN

Objective: Insufficient hygiene knowledge increases the risk of hospital-acquired infections through insufficient compliance and therefore poses a potential risk to patient safety. Therefore in 2015 the teaching project "OT Training" was introduced at the Faculty of Medicine (MF) Leipzig and a restructuring of the series of lectures and practical training on the topic of "Hygiene" was developed and integrated in the medical study curriculum. Methodology: The "OT Training" in the pre-clinical component and the didactic restructuring of the hygiene workshops in the hospital semester were comprehensively developed by means of the currently applicable learning objective catalogues and have already been tested in existing teaching (per year N=320 students; 2015-17: N= 960). The "OT Training" and the series of lectures and practical training are evaluated externally by the Faculty of Medicine. In addition a self-developed questionnaire (for "OT Training") and an internal evaluation (for practical stations as part of the practical training series) were used. Results: Overall the "OT Training" was evaluated as "very good" (N=492; RR=51%). Alongside the high importance of hygiene in the hospital and operating area (Overallhospital=97% and OverallOperative area=98%) the salient feature of hygiene for self-protection and in particular for patient safety was also recognised at an early stage. Through the series of lectures and practical training which were also evaluated positively, the self-reported level of knowledge and the importance of hygiene for the students improved significantly (level of knowledge Mbefore=2.8 vs. Mafter=3.9; p>0.000; importance Mbefore=3.3 vs. Mafter=4.2; p>0.000; 5 point Likert scale; t-Test). Conclusion: Hygiene errors constitute a potential risk to patients. Consequently the early and continuous focus on hygiene in student education makes a contribution to increasing patient safety in the healthcare sector.


Asunto(s)
Educación Médica/normas , Higiene/educación , Competencia Clínica/normas , Curriculum/tendencias , Humanos , Higiene/normas , Control de Infecciones/métodos , Control de Infecciones/normas , Seguridad del Paciente/normas , Encuestas y Cuestionarios
17.
Rev Bras Enferm ; 72(2): 476-483, 2019.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31017213

RESUMEN

OBJECTIVE: To identify and map nursing care to the adult patient with Healthcare-Associated Infections admitted to the Intensive Care Unit. METHOD: Scoping Review, conducted in January 2018, through the search of studies in national and international databases, journals, catalogs of theses and dissertations, and websites of Brazilian health institutions. We included full surveys published in the Portuguese, Spanish or English language; which had as object of study the researched subject, besides manuals and protocols. We analyzed the type of material, year, country, population, method, Level of Evidence, and nursing care. The final sample consisted of 33 publications. RESULTS: Among the nursing care to the patient, hand hygiene was identified, general care in nursing procedures, use of protocols, effective communication and periodic training. CONCLUSION: Identifying patient care with infection was important in order to list methods and reorient nursing activities.


Asunto(s)
Infecciones Comunitarias Adquiridas/enfermería , Control de Infecciones/normas , Atención de Enfermería/métodos , Brasil , Hospitalización/tendencias , Humanos , Control de Infecciones/métodos , Encuestas y Cuestionarios
18.
Curr Pharm Biotechnol ; 20(8): 625-634, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30961487

RESUMEN

BACKGROUND: Healthcare Associated Infections (HAIs) represent a crucial issue in health and patient safety management due to the persistent nature, economic impact and possible preventability of the phenomenon. Compensation claims for damages resulting from HAI could provide insights that can improve the understanding of suboptimal steps in the therapeutic process, enable an estimate of costs related to infectious complications, and guide the development of planning tools for implementation of the quality of care. OBJECTIVE: This paper analyzes all the HAI claims received at the Umberto I General Hospital of Rome across a five-year period with the aim of outlining a methodological approach to the litigation management and of characterizing the economic impact of infections on health facilities resources. METHODS: All claims received during the study period have been classified according to the International Classification for Patient Safety (ICPS) system. Subsequently, claims related to Healthcare Associated Infections were evaluated through an innovative tool for determination of the risk of loss, the Advanced Loss Eventuality Assessment (ALEA) score. RESULTS: The results obtained demonstrate the relevance of a correct management of HAI claims in the administration of a health care system. Specifically, the cases examined during the study highlighted the significant impact of infectious diseases of a nosocomial nature in terms of frequency and economic exposure. CONCLUSION: The proposed methodological approach allows a productive analysis of the internal processes, providing fundamental data for the refinement of the preventive strategies and for the rationalization of the resources through the expenditure forecasts. Article Highlights Box: Healthcare-Associated Infections represent an essential element to consider in the management of health facilities. • Many studies highlight the economic burden of Healthcare-Associated Infections in health policies. • Litigation management represents a useful resource in the prevention of Healthcare Associated Infections. • Appropriate clinical risk management policies in the field of Healthcare-Associated Infections allow the implementation of preventive measures, the reduction of the incidence of the phenomenon and the quality of care. • The costs of Healthcare-Associated Infections can be limited through a systematic methodological approach based on Advanced Loss Eventuality Assessment and technical estimate of the value of each case. • The application of a standardized system would be desirable in any health facility despite the potential methodological, technical, behavioral and financial issues.


Asunto(s)
Infección Hospitalaria/economía , Infección Hospitalaria/prevención & control , Prestación de Atención de Salud/normas , Control de Infecciones/organización & administración , Guías de Práctica Clínica como Asunto/normas , Infección Hospitalaria/epidemiología , Humanos , Incidencia , Control de Infecciones/economía , Control de Infecciones/normas , Mejoramiento de la Calidad , Roma
19.
Med Mal Infect ; 49(6): 447-455, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30914214

RESUMEN

OBJECTIVES: Communication represents a key component of the control of highly drug-resistant bacteria (HDRB) in healthcare settings. This survey assessed communication strategies developed and adopted in a large hospital network. METHODS: An online survey was sent to 83 infection control specialists working in hospitals of the Pays de la Loire region, France, in June 2016. Internal and external systems of identification and communication of HDRB status (colonized and contact patients) were assessed at the following steps of the hospital pathway: patient admission, during the stay, at discharge, and at readmission. RESULTS: Sixty-one hospitals (73%) participated in the survey: 31 (51%) had recently managed colonized patients and 51 (93%) had recently managed contact patients. At patient admission, 28 (46%) hospitals had an identification system for repatriated patients. During hospital stay, the colonized or contact status was informed in computerized patient records for 47/57 (82%) and 43 (75%) hospitals, respectively. At patient discharge, 56/61 (92%) hospitals declared transmitting the HDRB status to the downstream ward. Twenty-six and 25/60 (43% and 42%) hospitals had an automated alert system at readmission of colonized or contact patients, respectively. This strategy met the expectations of 15/61 (26%) infection control specialists. CONCLUSION: Efforts are still required in terms of communication for HDRB control. Sharing experiences and tools developed by hospitals may be beneficial for the entire hospital network.


Asunto(s)
Programas de Optimización del Uso de los Antimicrobianos , Farmacorresistencia Bacteriana Múltiple , Hospitales , Control de Infecciones/organización & administración , Control de Infecciones/normas , Comunicación Interdisciplinaria , Programas de Optimización del Uso de los Antimicrobianos/organización & administración , Programas de Optimización del Uso de los Antimicrobianos/normas , Comunicación , Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Estudios Transversales , Francia/epidemiología , Hospitales/normas , Hospitales/estadística & datos numéricos , Humanos , Control de Infecciones/estadística & datos numéricos , Registro Médico Coordinado/métodos , Registro Médico Coordinado/normas , Sistemas de Registros Médicos Computarizados/organización & administración , Sistemas de Registros Médicos Computarizados/normas , Sistemas de Registros Médicos Computarizados/estadística & datos numéricos
20.
Artículo en Inglés | MEDLINE | ID: mdl-30909536

RESUMEN

Standard precautions (SPs) guidelines are the minimum infection prevention practices that apply to all types of patient care, regardless of suspected or confirmed infection status of the patient. They are based on risk assessment, make use of common sense practices and personal protective equipment that protect healthcare providers from infection and prevent the spread of infection from patient to patient. The aim of this study was to determine medical staff's attitudes towards SPs and analyse the factors shaping these attitudes. The study was conducted using a questionnaire that comprised 25 statements describing the attitudes of medical personnel towards SPs. They were designed to pinpoint the factors that determine these attitudes. There were five factors identified that shape employees' attitudes towards SPs: assessment of the situation, favourable patterns of behaviour, negative norms, unfavourable patterns of behaviour and rationalising. The study analysed 505 questionnaires filled in by hospital workers from five Polish cities. The majority of the respondents were women (92.1%), nurses (87.5%); the average age was 41.8 and the average seniority was 19.2 years. Over one-third of the respondents worked in non-surgical (36.4%) and surgical (31.6%) wards, 12.3% were employed in intensive care units (ICUs) and 8.9% in emergency departments (EDs). The variable significantly affecting the level of acceptance of SPs was seniority: initially the support was high, then it later decreased, with the greatest decrease occurring between the third and eighth year of work. The staff of medical wards and ICUs demonstrated significantly lower support for SPs and strong environmental impact on SPs perception; low degree of acceptance among medical ward staff correlated negatively with factors from the category "favourable patterns of behaviour". The substantially strongest support for SPs was found in ED workers. The results indicate the need for continuous education of individual groups of workers concerning the application of SPs, but also the necessity to change the organisational culture in Polish hospitals.


Asunto(s)
Actitud del Personal de Salud , Control de Infecciones/normas , Cuerpo Médico/estadística & datos numéricos , Personal de Hospital/psicología , Adulto , Competencia Clínica/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Personal de Hospital/estadística & datos numéricos , Polonia , Encuestas y Cuestionarios , Adulto Joven
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