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1.
Presse Med ; 48(12): 1536-1550, 2019 Dec.
Artículo en Francés | MEDLINE | ID: mdl-31784255

RESUMEN

Africa along side with south-east Asia are the epicentres of emerging and epidemic prone-infectious diseases and megacity biosecurity threat scenarios. Massive mobility and reluctance in the populations exposed to epidemic and emerging prone-infectious diseases coupled by a weak health system made disease alert and control measures difficult to implement. The investigation of virus detection and persistence in semen across a range of emerging viruses is useful for clinical and public health reasons, in particular for viruses that lead to high mortality or morbidity rates or to epidemics. Innovating built facility to safely treat patients with highly pathogenic infectious diseases is urgently need, not only to prevent the spread of infection from patients to healthcare workers but also to offer provision of relatively invasive organ support, whenever considered appropriate, without posing additional risk to staff. Despite multiple challenges, the need to conduct research during epidemics is inevitable, and candidate products must continue undergoing rigorous trials. Preparedness including management of complex humanitarian crises with community distrust is a cornerstone in response to high consequence emerging infectious disease outbreaks and imposes strengthening of the public health response infrastructure and emergency outbreak systems in high-risk regions.


Asunto(s)
Enfermedades Transmisibles Emergentes/epidemiología , Epidemias , Control de Infecciones , Enfermedades Transmisibles Emergentes/prevención & control , Brotes de Enfermedades/prevención & control , Epidemias/prevención & control , Epidemias/estadística & datos numéricos , Salud Global/normas , Salud Global/tendencias , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Control de Infecciones/tendencias , Salud Pública/normas , Salud Pública/tendencias , Administración en Salud Pública/métodos , Administración en Salud Pública/tendencias
2.
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.
MMWR Morb Mortal Wkly Rep ; 68(39): 851-854, 2019 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-31581162

RESUMEN

Infection prevention and control (IPC) in health care facilities is essential to protecting patients, visitors, and health care personnel from the spread of infectious diseases, including Ebola virus disease (Ebola). Patients with suspected Ebola are typically referred to specialized Ebola treatment units (ETUs), which have strict isolation and IPC protocols, for testing and treatment (1,2). However, in settings where contact tracing is inadequate, Ebola patients might first seek care at general health care facilities, which often have insufficient IPC capacity (3-6). Before 2014-2016, most Ebola outbreaks occurred in rural or nonurban communities, and the role of health care facilities as amplification points, while recognized, was limited (7,8). In contrast to these earlier outbreaks, the 2014-2016 West Africa Ebola outbreak occurred in densely populated urban areas where access to health care facilities was better, but contact tracing was generally inadequate (8). Patients with unrecognized Ebola who sought care at health care facilities with inadequate IPC initiated multiple chains of transmission, which amplified the epidemic to an extent not seen in previous Ebola outbreaks (3-5,7). Implementation of robust IPC practices in general health care facilities was critical to ending health care-associated transmission (8). In August 2018, when an Ebola outbreak was recognized in the Democratic Republic of the Congo (DRC), neighboring countries began preparing for possible introduction of Ebola, with a focus on IPC. Baseline IPC assessments conducted in frontline health care facilities in high-risk districts in Uganda found IPC gaps in screening, isolation, and notification. Based on findings, additional funds were provided for IPC, a training curriculum was developed, and other corrective actions were taken. Ebola preparedness efforts should include activities to ensure that frontline health care facilities have the IPC capacity to rapidly identify suspected Ebola cases and refer such patients for treatment to protect patients, staff members, and visitors.


Asunto(s)
Infección Hospitalaria/prevención & control , Brotes de Enfermedades/prevención & control , Administración de Instituciones de Salud , Fiebre Hemorrágica Ebola/prevención & control , Control de Infecciones/organización & administración , República Democrática del Congo/epidemiología , Investigación sobre Servicios de Salud , Fiebre Hemorrágica Ebola/epidemiología , Humanos , Medición de Riesgo , Uganda
4.
S Afr Med J ; 109(8): 555-558, 2019 Jul 26.
Artículo en Inglés | MEDLINE | ID: mdl-31456547

RESUMEN

South Africa (SA) is in the midst of a tuberculosis (TB) epidemic and has one of the highest TB incidence rates globally. Despite increasing global commitment to eliminate TB, SA appears to be falling behind in this regard. This article examines key challenges to effective TB infection control from a rural regional hospital perspective. It uses the Eden District in Western Cape Province as an example to share lessons learnt. This quality-improvement project identifies four priorities for improving TB infection control in George Hospital and the Eden District: (i) prioritising TB infection control in local policy; (ii) improving the quality of TB screening in the emergency centre; (iii) increasing the number of TB patients followed up; and (iv) implementing TB infection control training for all staff. This project demonstrates the role of an emergency centre in TB screening, highlighting that this should not only be a priority for primary care, but also for secondary and tertiary care. Simple interventions, such as training of local healthcare workers in TB infection control and good-quality TB screening, can initiate a behavioural change. It also stresses the importance of good communication and co-ordination of care across primary and secondary care, ensuring that patients are not lost to follow-up. Local policy needs to reflect these straightforward interventions, empowering local healthcare workers and managers to increase responsibility and accountability for TB infection control.TB is preventable, and infection control needs to become a priority throughout SA primary, secondary and tertiary care. This project highlights that simple interventions, such as engaging local healthcare workers in a co-ordinated multisystem and multidisciplinary approach, could help to reduce the number of missing TB cases and bring SA's TB epidemic under control.


Asunto(s)
Control de Infecciones/organización & administración , Tamizaje Masivo , Tuberculosis/epidemiología , Tuberculosis/prevención & control , Continuidad de la Atención al Paciente , Servicio de Urgencia en Hospital , Personal de Salud/educación , Política de Salud , Prioridades en Salud , Hospitales Rurales , Humanos , Capacitación en Servicio , Mejoramiento de la Calidad , Programas Médicos Regionales , Sudáfrica/epidemiología
5.
Int J Health Care Qual Assur ; 32(6): 927-940, 2019 Jul 08.
Artículo en Inglés | MEDLINE | ID: mdl-31282256

RESUMEN

PURPOSE: Healthcare-associated infections (HAIs) constitute a major threat to patient safety and affect hundreds of millions of people worldwide. The World Health Organization in 2016 published guidelines on the core components for infection prevention and control (IPC) programme. This was in response to a global call for focused action. The purpose of this paper is to examine and promote understanding of the tenets of the IPC guidelines and highlight their implications for implementation in low-income countries. DESIGN/METHODOLOGY/APPROACH: Drawing from personal experiences in leading the implementation of health programmes as well as a review of published and grey literature on IPC, authors discussed and proposed practical approaches to implement IPC priorities in low-income setting. FINDINGS: Availability of locally generated evidence is paramount to guide strengthening leadership and institutionalisation of IPC programmes. Preventing infections is everybody's responsibility and should be viewed as such and accorded the required attention. ORIGINALITY/VALUE: Drawing from recent experiences from disease outbreaks and given the heavy burden of HAIs especially in low-income settings, this paper highlights practical approaches to guide implementation of the major components of IPC.


Asunto(s)
Infección Hospitalaria/prevención & control , Control de Infecciones/organización & administración , Pobreza , Poblaciones Vulnerables/estadística & datos numéricos , Organización Mundial de la Salud/organización & administración , Infección Hospitalaria/epidemiología , Países en Desarrollo , Femenino , Salud Global , Humanos , Masculino , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Medición de Riesgo , Zimbabwe
7.
MSMR ; 26(6): 8-13, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31237762

RESUMEN

In May 2018, an outbreak of gastrointestinal illnesses due to norovirus occurred at Camp Arifjan, Kuwait. The outbreak lasted 14 days, and a total of 91 cases, of which 8 were laboratory confirmed and 83 were suspected, were identified. Because the cases occurred among a population of several thousand service members transiting through a crowded, congregate setting of open bays of up to 250 beds, shared bathrooms and showers, and large dining facilities, the risk of hundreds or thousands of cases was significant. The responsible preventive medicine authorities promptly recognized the potential threat and organized and monitored the comprehensive response that limited the spread of the illness and the duration of the outbreak. This report summarizes findings of the field investigation and the preventive medicine response conducted from 18 May-3 June 2018 at Camp Arifjan.


Asunto(s)
Infecciones por Caliciviridae , Brotes de Enfermedades , Gastroenteritis , Control de Infecciones , Instalaciones Militares , Norovirus/aislamiento & purificación , Adulto , Infecciones por Caliciviridae/epidemiología , Infecciones por Caliciviridae/etiología , Infecciones por Caliciviridae/prevención & control , Brotes de Enfermedades/prevención & control , Brotes de Enfermedades/estadística & datos numéricos , Femenino , Gastroenteritis/epidemiología , Gastroenteritis/prevención & control , Gastroenteritis/virología , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Kuwait/epidemiología , Masculino , Personal Militar , Estados Unidos
8.
MSMR ; 26(6): 14-17, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31237763

RESUMEN

Diarrheal illnesses have an enormous impact on military operations in the deployed and training environments. While bacteria and viruses are the usual causes of gastrointestinal disease outbreaks, 2 Joint Base San Antonio-Lackland, TX, training populations experienced an outbreak of diarrheal illness caused by the parasite Cyclospora cayetanensis in June and July 2018. Cases were identified from outpatient medical records and responses to patient questionnaires. A confirmed case was defined by diarrhea and laboratory confirmation, and patients without a positive lab were classified as suspected cases. In cluster 1, 46 suspected and 7 confirmed cases occurred among technical training students who reported symptom onset from 12 June to 21 June. In cluster 2, 18 suspected and 14 confirmed cases in basic military training trainees reported symptom onset from 29 June to 8 July. Numerous lessons from cluster 1 were applied to cluster 2. Crucial lessons learned during this cyclosporiasis outbreak included the importance of maintaining clinical suspicion for cyclosporiasis in persistent gastrointestinal illness and obtaining confirmatory laboratory testing for expedited diagnosis and treatment.


Asunto(s)
Cyclospora/aislamiento & purificación , Ciclosporiasis , Brotes de Enfermedades/prevención & control , Control de Infecciones , Instalaciones Militares/estadística & datos numéricos , Adulto , Ciclosporiasis/epidemiología , Ciclosporiasis/prevención & control , Ciclosporiasis/terapia , Femenino , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Masculino , Personal Militar , Enseñanza , Texas/epidemiología
9.
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
10.
PLoS Med ; 16(4): e1002795, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-31039150

RESUMEN

This month in PLOS Medicine we launched a Special Issue on New Tools and Strategies for Tuberculosis Diagnosis, Care, and Elimination. In this issue's Editorial, the Guest Editors Claudia Denkinger, Richard Chaisson, and Mark Hatherill highlight some of the research that will publish and how these studies focusing on discovery, clinical trials and implementation research collectively add to the prospects for reaching the EndTB targets of the WHO by 2035.


Asunto(s)
Erradicación de la Enfermedad , Evaluación de Necesidades , Tuberculosis/prevención & control , Erradicación de la Enfermedad/métodos , Erradicación de la Enfermedad/organización & administración , Erradicación de la Enfermedad/tendencias , Necesidades y Demandas de Servicios de Salud , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Control de Infecciones/tendencias , Invenciones/tendencias , Terapias en Investigación/métodos , Terapias en Investigación/tendencias , Tuberculosis/epidemiología
11.
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
12.
Parasit Vectors ; 12(1): 246, 2019 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-31109348

RESUMEN

BACKGROUND: The global burden of onchocerciasis is the heaviest in sub-Saharan Africa. Studies have shown the importance of the role of Community-Directed Distributors (CDDs) and nurses in onchocerciasis control, but little is known about their experience in implementing onchocerciasis control programmes. Our aim was to document the barriers that CDDs and local health administrators face in implementing onchocerciasis control activities. METHODS: We conducted a qualitative survey consisting of 16 in-depth interviews and 8 focus group discussions (FGDs) across three health districts of Cameroon. We interviewed a total of 9 local health officials at the district and Health Area levels, and 7 CDDs. Eight FGDs were conducted with CDDs and Health Committee members. RESULTS: The major barriers to the implementation of Community Directed Treatment with Ivermectin that we identified were linked and interrelated. Examples of these barriers included: contextual factors (geographical and cultural background), top-to-bottom planning, insufficient human and material resources, and lack of transparency in the management of the programme's funds. CONCLUSIONS: The CDTI at operational level still faces many obstacles which negatively affect therapeutic coverages. This can lead to the non-adhesion of the communities to the programme, consequently jeopardizing the sustainability of the onchocerciasis elimination programme. We recommend that the national programme planners put in place a transparent management and planning system for onchocerciasis elimination activities, with better communication with local programme stakeholders.


Asunto(s)
Implementación de Plan de Salud/organización & administración , Control de Infecciones/organización & administración , Oncocercosis/prevención & control , Evaluación de Programas y Proyectos de Salud , Participación de los Interesados , África del Sur del Sahara/epidemiología , Animales , Antiparasitarios/uso terapéutico , Camerún/epidemiología , Servicios de Salud Comunitaria , Agentes Comunitarios de Salud , Costo de Enfermedad , Estudios de Evaluación como Asunto , Femenino , Filaricidas/uso terapéutico , Grupos Focales , Implementación de Plan de Salud/estadística & datos numéricos , Humanos , Control de Infecciones/estadística & datos numéricos , Ivermectina/uso terapéutico , Masculino , Oncocercosis/tratamiento farmacológico , Encuestas y Cuestionarios
13.
Health Secur ; 17(2): 117-123, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31009258

RESUMEN

Hospital infection disease preparedness gaps were brought to the forefront during the 2013-2016 Ebola virus disease (EVD) outbreak. The ability of US hospitals to rapidly identify, isolate, and manage patients with potentially high-consequence pathogens is a critical component to health security. Since the EVD cases in Dallas, Texas, the continuity of hospital preparedness has been questionable. While certain hospitals were designated as EVD treatment facilities, the readiness of most American hospitals remains unknown. A gap analysis of a hospital system in Phoenix, Arizona, underscores the challenges of maintaining infectious disease preparedness in the existing US healthcare system.


Asunto(s)
Control de Enfermedades Transmisibles/organización & administración , Brotes de Enfermedades/prevención & control , Control de Infecciones/organización & administración , Sistemas Multiinstitucionales/normas , Arizona , Control de Enfermedades Transmisibles/normas , Brotes de Enfermedades/economía , Instituciones de Salud/normas , Fiebre Hemorrágica Ebola/prevención & control , Hospitales , Humanos , Sistemas Multiinstitucionales/organización & administración , Aislamiento de Pacientes , Equipo de Protección Personal/provisión & distribución , Personal de Hospital/educación , Encuestas y Cuestionarios
15.
PLoS Negl Trop Dis ; 13(4): e0007263, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30990822

RESUMEN

BACKGROUND: In October 2010, Haiti was struck by a large-scale cholera epidemic. The Haitian government, UNICEF and other international partners launched an unprecedented nationwide alert-response strategy in July 2013. Coordinated NGOs recruited local rapid response mobile teams to conduct case-area targeted interventions (CATIs), including education sessions, household decontamination by chlorine spraying, and distribution of chlorine tablets. An innovative red-orange-green alert system was also established to monitor the epidemic at the communal scale on a weekly basis. Our study aimed to describe and evaluate the exhaustiveness, intensity and quality of the CATIs in response to cholera alerts in Haiti between July 2013 and June 2017. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed the response to 7,856 weekly cholera alerts using routine surveillance data and severity criteria, which was based on the details of 31,306 notified CATIs. The odds of CATI response during the same week (exhaustiveness) and the number of complete CATIs in responded alerts (intensity and quality) were estimated using multivariate generalized linear mixed models and several covariates. CATIs were carried out significantly more often in response to red alerts (adjusted odds ratio (aOR) [95%-confidence interval, 95%-CI], 2.52 [2.22-2.87]) compared with orange alerts. Significantly more complete CATIs were carried out in response to red alerts compared with orange alerts (adjusted incidence ratio (aIR), 1.85 [1.73-1.99]). Over the course of the eight-semester study, we observed a significant improvement in the exhaustiveness (aOR, 1.43 [1.38-1.48] per semester) as well as the intensity and quality (aIR, 1.23 [1.2-1.25] per semester) of CATI responses, independently of funds available for the strategy. The odds of launching a CATI response significantly decreased with increased rainfall (aOR, 0.99 [0.97-1] per each accumulated cm). Response interventions were significantly heterogeneous between NGOs, communes and departments. CONCLUSIONS/SIGNIFICANCE: The implementation of a nationwide case-area targeted rapid response strategy to control cholera in Haiti was feasible albeit with certain obstacles. Such feedback from the field and ongoing impact studies will be very informative for actors and international donors involved in cholera control and elimination in Haiti and in other affected countries.


Asunto(s)
Cólera/epidemiología , Cólera/prevención & control , Brotes de Enfermedades , Transmisión de Enfermedad Infecciosa/prevención & control , Investigación sobre Servicios de Salud , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Haití/epidemiología , Humanos
17.
J Forensic Leg Med ; 64: 42-44, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30974385

RESUMEN

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (MTB) that is most often transmitted by the inhalation of bacteria-containing aerosols. While there has been a decline in numbers of cases in certain countries, large population movements, the increasing emergence of drug-resistant strains and the association with human immunodeficiency virus (HIV) infection make it a disease that is increasingly seen in forensic practice. Mortuary staff are at risk of infection from penetrating sharp injuries, droplet inhalation, ingestion, direct inoculation, through skin breaks or through mucous membranes of the eyes, nose and mouth. While the health and safety measures outlined by agencies may vary slightly, the principles of handling infectious autopsy cases remain the same with awareness and education, immunisation and regular tuberculin testing of staff, pre-necropsy screening of decedents, use of personal protective equipment, and the implementation of safe sharps practices and measures to reduce aerosol formation.


Asunto(s)
Control de Infecciones/organización & administración , Prácticas Mortuorias , Tuberculosis/prevención & control , Tuberculosis/transmisión , Vacuna BCG , Humanos , Lesiones por Pinchazo de Aguja/prevención & control , Enfermedades Profesionales/prevención & control , Ropa de Protección , Dispositivos de Protección Respiratoria
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.
Curr Med Sci ; 39(1): 153-158, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30868506

RESUMEN

The purpose of this study was to construct the model of organization system, management, training and surveillance in healthcare-associated infection prevention and control (IC) of primary health care institutions and identify its effect on patient safety and decreasing economic burden by standardizing IC. A cross-sectional survey was conducted with questionnaires. Data were collected from 268 primary health care institutions in Hubei province, China. Hypotheses on the model of IC were analyzed by means of confirmatory factor analysis and structural equation modeling. The results showed that the fit indices of the hypothesized model of IC satisfied recommended levels: root mean square error of approximation (RMSEA)=0.071; comparative fit index (CFI)=0.965; tucker-lewis index (TLI)=0.956; weighted root mean square residual (WRMR)=1.014. The model showed that organization system had a direct effect on management (ß=0.311, P<0.01), and training (ß=0.365, P<0.01). Management and training played an intermediary role that partially promoted organization system impact on surveillance. Results also showed that institutional factors such as the number of physicians, the number of nurses, the designated capacity of beds, the actual number of open beds and surgery trips had positive impacts on management (ß=0.050, P<0.01; ß=0.181, P<0.01; ß=0.111, P<0.01; ß=0.064, P<0.01; ß=0.084, P=0.04) and training (ß=0.21, P=0.03; ß=0.050, P=0.02; ß=0.586, P=0.01; ß=-0.995, P=0.02; ß=-0.223, P=0.03). In conclusion, the model of organization system, management, training and surveillance in IC of primary health care institutions is valuable for guiding IC practice.


Asunto(s)
Infección Hospitalaria/epidemiología , Control de Infecciones/organización & administración , Atención Primaria de Salud/organización & administración , China , Infección Hospitalaria/prevención & control , Estudios Transversales , Educación Médica/organización & administración , Humanos , Control de Infecciones/métodos , Análisis de Clases Latentes , Vigilancia de la Población , Encuestas y Cuestionarios
20.
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
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