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American Journal of Infection Control

Marcia Maria Baraldi, Juliana Rizzo Gnatta, Maria Clara Padoveze
BACKGROUND: Antimicrobial soaps containing chlorhexidine gluconate (CHG) are indicated for hand hygiene (HH) in specific situations. This study aimed to identify whether the continuous use of CHG for HH affects the reduction of healthcare-associated infections (HAI), the selection of microorganisms resistant to CHG, or hands skin damage. METHODS: Systematic review was performed using the protocol of the Joanna Briggs Institute, including clinical trials and observational comparative studies...
January 11, 2019: American Journal of Infection Control
Meng-Yang Wang, Lei Pan, Xiao-Juan Hu
BACKGROUND: Ventilator-associated pneumonia (VAP) remains a frequent and severe complication in mechanically ventilated patients. We undertook a meta-analysis to evaluate the efficacy of chest physiotherapy (CPT) for the prevention of VAP. METHODS: A systematic literature search of PubMed and Embase databases were searched up until November 25, 2018 for published studies of mechanically ventilated patients comparing CPT with controls and reporting on the occurrence of VAP...
January 11, 2019: American Journal of Infection Control
Philip L Russo, Robin Digby, Tracey Bucknall
BACKGROUND: There is little information regarding consumer knowledge of health care-associated infection (HAI). Furthermore, it is unclear how meaningful publicly reported HAI data is to consumers, how they may use it, and the most appropriate format for data presentation. The purpose of this study was to explore consumer knowledge and attitudes toward HAI and public reporting. METHODS: A qualitative study design, characterized by a series of semistructured interviews, was undertaken with purposively selected, adult elective surgical inpatients at a large metropolitan acute hospital...
January 10, 2019: American Journal of Infection Control
Chiharu Matsumoto, Kimiyo Nanke, Saori Furumura, Misao Arimatsu, Miki Fukuyama, Hitomi Maeda
BACKGROUND: Bed bath in daily nursing care is crucial for cleaning and moisturizing patients' skin. The purpose of this study was to compare the effectiveness of cleaning and level of comfort of towel and disposable baths. The 2 methods were evaluated based on measurements of the transition of resident skin bacteria, stratum corneum water content, transepidermal water loss, and perceived relaxation levels. METHODS: Twenty-six healthy women aged 65-90 years participated in this study and received disposable and towel baths...
January 10, 2019: American Journal of Infection Control
Emily J Godbout, Nadia Masroor, Michelle Doll, Michael B Edmond, Gonzalo Bearman, Michael P Stevens
We investigated the compliance of health care personnel with a voluntary, institution-wide bare below the elbows (BBE) approach to inpatient care at an academic medical center. BBE compliance increased significantly across all provider types over a 2-year period. The overall compliance with BBE by health care personnel nearly doubled from 2016-2017, increasing significantly from 40% to 84%.
January 10, 2019: American Journal of Infection Control
Stella E Hines, Clayton Brown, Marc Oliver, Patricia Gucer, Melissa Frisch, Regina Hogan, Tracy Roth, James Chang, Melissa McDiarmid
BACKGROUND: Inclusion of reusable respirators, such as elastomeric half-face respirators (EHFRs) and powered air-purifying respirators (PAPRs), in hospital respiratory protection inventories may represent 1 solution to the problem of N95 respirator shortages experienced during pandemics. User acceptance of these devices is 1 potential barrier to implementing such a strategy in respiratory protection programs. METHODS: To assess user attitudes toward various respirators, health care workers enrolled in respiratory protection programs in a medical system using EHFRs, N95s, and PAPRs and completed an online questionnaire that addressed attitudes, beliefs, and respirator preferences under different risk scenarios...
January 10, 2019: American Journal of Infection Control
Frederic S Zimmerman, Marc V Assous, Shoshana Zevin, Yonit Wiener-Well
OBJECTIVES: False positive blood cultures result from contamination, consuming laboratory resources and causing unnecessary antibiotic treatment and prolonged hospital stay. Skin disinfection reduces contamination; however, bacteria colonizing human skin are also found in tissues deep into the skin surface. A diversion device diverts the initial 1-2 mL of blood to remove any potentially contaminated skin plug. This study investigates the effect of the device on culture contamination in hospitalized patients...
January 10, 2019: American Journal of Infection Control
Lynelle J Murrell, Erin Kinzel Hamilton, Helen Boehm Johnson, Maureen Spencer
BACKGROUND: A growing body of research has demonstrated that manual cleaning and disinfection of the operating room (OR) is suboptimal. Residual environmental contamination may pose an infection risk to the surgical wound. This study evaluates the impact of a visible-light continuous environmental disinfection (CED) system on microbial surface contamination and surgical site infections (SSI) in an OR. METHODS: Samples from 25 surfaces within 2 contiguous ORs sharing an air supply were obtained after manual cleaning on multiple days before and after a visible-light CED system installation in 1 of the ORs...
January 10, 2019: American Journal of Infection Control
Heba Alhmidi, Melany Gonzalez-Orta, Jennifer L Cadnum, Thriveen S C Mana, Annette L Jencson, Brigid M Wilson, Curtis J Donskey
In simulations of contaminated glove removal, 37% of health care personnel using their typical doffing technique contaminated their skin with a fluorescent solution. The frequency of contamination was significantly lower when the technique recommended by the Centers for Disease Control and Prevention was used versus not used (8 of 34, 24% vs 29 of 66, 44%). In simulations in which only the palm of the glove was contaminated, a modified doffing technique, to minimize the risk for contact with contaminated surfaces, reduced contamination of personnel...
January 9, 2019: American Journal of Infection Control
Elisa Van Kenhove, Karla Dinne, Arnold Janssens, Jelle Laverge
BACKGROUND: Legionnaires disease occurs worldwide. Many authorities have guidelines and regulations to prevent and control Legionella in water systems. These regulations are based on often very limited field and laboratory observations and measurements. They are, therefore, very different from country to country. This article aims to map the existing regulatory framework of worldwide Legionella control to assess the feasibility of regulatory unification. METHODS: This article gives an overview of the different standards, guidelines, and recommendations as well as how various authorities and/or countries deal with Legionella infection...
January 9, 2019: American Journal of Infection Control
Fontaine Sands, Linda Fairbanks
BACKGROUND: In the United States, the laundry industry has not reliably measured microbial levels on hygienically clean textiles. The aim of this study was to quantitatively measure the microbial levels found on a sample of hygienically clean textiles. METHODS: Forty-eight health care textile samples were collected from hygienically clean linen scheduled to be used on 3 different patient care units. Samples were taken at 2 separate points in time representing laundry facility processing practices and hospital linen management practices...
January 9, 2019: American Journal of Infection Control
Jennifer L Hefner, Naleef Fareed, Daniel M Walker, Timothy R Huerta, Ann Scheck McAlearney
Our descriptive analyses show a wide distribution in rates of central line device days and central line-associated bloodstream infections for a given standardized infection ratio-the measure linked to federal payment penalties-among 215 US hospitals serving highly complex patient populations. We established that the standardized infection ratio masks hospital-level variation in device use and associated patient safety.
January 9, 2019: American Journal of Infection Control
Nataliya Hilt, Marlies E J L Hulscher, Laura Antonise-Kamp, Alfons OldeLoohuis, Andreas Voss
BACKGROUND: Good infection prevention is an important aspect of quality of medical care. The aim was to evaluate infection prevention and control (IPC) performance among Dutch general practitioners (GPs). METHODS: Based on the current national IPC guidelines for GPs, a self-administered anonymous online questionnaire was developed and sent to GPs in the Nijmegen region of the Netherlands. Thirty-two questions were constructed to survey characteristics of GPs' offices and assess current performance of IPC measures...
January 5, 2019: American Journal of Infection Control
Gebrael Saliba, Nadim El Kary, Ziad Bakouny, Lilas Dagher, May Mallah Hamdan, Wassim Abdallah
BACKGROUND: Medical students are often potential vectors for resistant bacteria to their entourage. We therefore conducted this study to evaluate the variation of medical students' multiple drug resistant bacterial flora throughout their medical training. METHODS: We performed a cross-sectional study enrolling medical students of the 2016 academic year from the Saint-Joseph University - Faculty of Medicine, Lebanon. RESULTS: The multivariate analysis identified the medical year as the sole factor contributing to the extended spectrum beta-lactamase producing Enterobacteriaceae colonization (OR = 2...
January 5, 2019: American Journal of Infection Control
Kerry E Wilson, Shannon M Wood, Kurt E Schaecher, Karen B Cromwell, Joan Godich, Melissa H Knapp, Marvin J Sklar, Daniel Ewing, Kanakatte Raviprakash, Gabriel Defang, Timothy J Whitman
OBJECTIVE: To describe an outbreak of influenza A in an oncology unit, highlighting infection control methods implemented, and examining reasons health care workers (HCWs) present to work with influenza-like illness (ILI). METHODS: Confirmed cases were defined by the presence of ILI and a positive nasopharyngeal polymerase chain reaction swab for influenza A H3. Probable cases were defined as exposed HCWs with ILI who were unavailable for polymerase chain reaction testing...
January 5, 2019: American Journal of Infection Control
Justin J Kim, Maria W Blevins, Deborah J Brooks, John R Stehle, Christopher J McLouth, James P Viviano, James H Holmes Iv, Werner E Bischoff
BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is frequently implicated in health care-associated outbreaks in burn intensive care units, incurring substantial morbidity and mortality to these high-risk patients and excess costs to health care systems. METHODS: MRSA health care-associated infections (HAIs) were noted before and after the implementation of basic infection prevention measures and the subsequent implementation of universal decolonization with intranasal mupirocin...
January 4, 2019: American Journal of Infection Control
Jure Baloh, Kerri A Thom, Eli Perencevich, Clare Rock, Gwen Robinson, Melissa Ward, Loreen Herwaldt, Heather Schacht Reisinger
BACKGROUND: Understanding the perceptions and beliefs of health care workers (HCWs) regarding glove use and associated hand hygiene (HH) may be informative and ultimately improve practice. Research in this area is limited. This study examined the practices and beliefs of HCWs surrounding the use of nonsterile gloves and HH before gloving. METHODS: The study was conducted at 3 large academic US hospitals using a parallel convergent mixed-method design. To estimate compliance rates, the gloving and HH practices of HCWs were observed at entry to patient rooms for 6 months...
January 4, 2019: American Journal of Infection Control
Peggy P L Or, Patricia T Y Ching, Joanne W Y Chung
BACKGROUND: Hand hygiene prevents cross-infection and is the most effective defense against contagious diseases. Preschoolers, without proper hand hygiene skills, are a vulnerable group to such diseases. The aim of this study was to evaluate whether hand hygiene compliance training of preschoolers in Hong Kong improves their hand hygiene knowledge and performance, and whether the training reduces their absenteeism resulting from influenza symptoms. METHODS: This was a quasi-experimental study with a pretest-posttest design...
January 4, 2019: American Journal of Infection Control
Aliakbar Nasiri, Abbas Balouchi, Khadije Rezaie-Keikhaie, Salehoddin Bouya, Mahmood Sheyback, Omar Al Rawajfah
BACKGROUND: The purpose of this study was to systematically review the literature to describe nurses' knowledge and practice of and attitude toward infection control and prevention standards. METHODS: In the present systematic review, 4 electronic databases were searched from the inception of databases through March 2018. Quality of included studies was assessed using the Hoy tool. RESULTS: Eighteen studies conducted on 4,577 employed nurses and nursing students entered the final stage...
January 4, 2019: American Journal of Infection Control
Ji Liu, Shenglei Zhang, Jiaxuan Chen, Yiping Mao, Xiaoqing Shao, Yang Li, Jianmei Cao, Wei Zheng, Bing Zhang, Zhiyong Zong
BACKGROUND: In January 2013, the Centers for Disease Control and Prevention released new surveillance definitions for ventilator-associated event (VAE) to replace ventilator-associated pneumonia (VAP) in adult patients. VAEs are associated with prolonged mechanical ventilation and hospital death, but little is known about their risk factors and how best to prevent them. METHODS: We compared VAE cases with non-VAE cases with regard to demographics, comorbidities, sedative exposures, opioids exposures, paralytic exposures, routes of nutrition, blood products, gastric retention, and fluid balance...
December 22, 2018: American Journal of Infection Control
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