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American Journal of Infection Control

Rajiv S Vasudevan, Sean Mojaver, Kay-Won Chang, Alan S Maisel, W Frank Peacock, Punam Chowdhury
BACKGROUND: Stethoscopes harbor pathogens that can be transferred to patients when proper sanitary measures are not taken. Our aim was to assess medical provider stethoscope cleaning and hand hygiene in an emergency department setting. METHODS: The frequency and methods of stethoscope cleaning during and after provider-patient encounters were observed anonymously in an emergency department of the VA San Diego Healthcare System. RESULTS: Among the total of 426 encounters, 115 (26...
November 8, 2018: American Journal of Infection Control
Hyang Soon Oh
BACKGROUND: We assessed the current status of knowledge, perception, attitude, and role model regarding hand hygiene (HH) among infection control nurses (ICNs) and identified the factors influencing these variables. METHODS: A structured questionnaire was adapted from a World Health Organization survey. Data were collected from November 8, 2017, to February 2, 2018. RESULTS: ICNs showed the following scores (mean ± SD): knowledge (19.5 ± 2...
November 8, 2018: American Journal of Infection Control
Prashant Malhotra, Aradhana Khameraj, Tanzila Salim, Donna Armellino, Susan Wirostek, Marcia E Epstein, Bruce F Farber
BACKGROUND: Hospitalized patients on isolation precautions are reported to have less frequent health care provider (HCP) visits owing to time required to don and doff personal protective equipment (PPE). Thus, placement on isolation precautions leads to negative patient perception and affects their care. METHODS: A "Red Box" that extended 3 feet beyond the door was marked in 50 patient rooms of a tertiary care hospital and used for patient communication by HCPs without PPE...
November 6, 2018: American Journal of Infection Control
David Boulée, Sarathi Kalra, Alison Haddock, T David Johnson, W Frank Peacock
BACKGROUND: Stethoscopes can be microorganism reservoirs. The US Centers for Disease Control and Prevention (CDC) has published medical equipment disinfection guidelines to minimize infection transmission risk, but studies of guideline adherence have been predominately survey based, with little direct observation of disinfection practices. METHODS: We performed an observational, cross-sectional, anonymous study of patient-provider interactions, assessing practitioners' frequency and methods of stethoscope and hand disinfection practices...
November 2, 2018: American Journal of Infection Control
Areeba Kara, Madiha Tahir, William Snyderman, Allison Brinkman, William Fadel, Lana Dbeibo
BACKGROUND: The drivers behind Clostridium difficile testing are not well understood. METHODS: C difficile testing orders were reviewed. An algorithm that sequentially considered the presence of diarrhea, leukocytosis, fever, and laxative use was created. Tests deemed potentially inappropriate were discussed with the ordering team. RESULTS: Of 128 orders reviewed, 62% (n = 79) were appropriate. Patients whose testing was deemed inappropriate had longer lengths of stay...
November 1, 2018: American Journal of Infection Control
Lidia Redondo-Bravo, Enrique Gutiérrez-González, Isabel San Juan-Sanz, Inés Fernández-Jiménez, Guillermo Ruiz-Carrascoso, Sara Gallego-Lombardo, Laura Sánchez-García, Dolores Elorza-Fernández, Adelina Pellicer-Martínez, Félix Omeñaca, Ana Robustillo-Rodela
BACKGROUND: We describe the investigation undertaken and the measures adopted to control a Serratia marcescens outbreak in the neonatology unit of La Paz University Hospital in Madrid, Spain. METHODS: Weekly rectal and pharyngeal screenings for S marcescens were performed in the neonates starting after detection of the outbreak. Environmental samples and samples from health care workers (HCWs) were obtained for microbiological analysis. An unmatched case-control study was carried out to investigate risk factors for infection/colonization...
November 1, 2018: American Journal of Infection Control
Salma Abbas, Shaina Bernard, Kimberly B Lee, Amy Pakyz, Christopher Doern, Michelle Doll, Gonzalo Bearman, Michael P Stevens
No abstract text is available yet for this article.
October 30, 2018: American Journal of Infection Control
Sarah H Alfaraj, Jaffar A Al-Tawfiq, Ziad A Memish
BACKGROUND: Middle East respiratory syndrome coronavirus (MERS-CoV) continues to be reported from the Kingdom of Saudi Arabia. Data on the phenomenon of intermittent positive results for MERS-CoV on reverse-transcription polymerase chain reaction (RT-PCR) with negative results in between are lacking. Here we describe cases with intermittent positive MERS-CoV test results and highlight the required number of tests to rule out or rule in MERS-CoV infection based on a large retrospective cohort of patients with confirmed MERS-CoV...
October 20, 2018: American Journal of Infection Control
Motoyuki Tsuboi, Kayoko Hayakawa, Kazuhisa Mezaki, Yuichi Katanami, Kei Yamamoto, Satoshi Kutsuna, Nozomi Takeshita, Norio Ohmagari
We retrospectively studied the epidemiology and microbiology of peripheral line-associated bloodstream infection (PLABSI) in comparison with central line-associated bloodstream infection (CLABSI). Among 2,208 bacteremia episodes, 106 (4.8%) PLABSI and 229 (10.4%) CLABSI were identified. In PLABSI, gram-negative rods, especially Enterobacteriaceae, were more frequently identified than in CLABSI, and infectious disease consultation was more frequently involved. The 7-day mortality rate was similar between the 2 groups, suggesting similar adverse effects of PLABSI and CLABSI on patient outcomes...
October 15, 2018: American Journal of Infection Control
Haitham Mutlak, Odilo Maurer, Kai Zacharowski, Julika Schön, Matthias Jacob, Matthias May
No abstract text is available yet for this article.
October 15, 2018: American Journal of Infection Control
Tara A Russell, Elyse Fritschel, Jennifer Do, Melanie Donovan, Maureen Keckeisen, Vatche G Agopian, Douglas G Farmer, Tisha Wang, Zachary Rubin, Ronald W Busuttil, Fady M Kaldas
BACKGROUND: Increases in liver transplant patient perioperative acuity have resulted in frail immunosuppressed patients at elevated risk for nosocomial infections. Avoiding central line-associated bloodstream infections (CLABSIs) is paramount to facilitate transplantation and post-transplant recovery. In 2015, our liver transplant intensive care unit (ICU) CLABSIs accounted for more than 25% of all CLABSI at our institution. We therefore undertook a multidisciplinary collaborative among clinical epidemiology, nursing, transplant surgery, and critical care to eliminate CLABSI events...
October 14, 2018: American Journal of Infection Control
Annette Jeanes, Pietro G Coen, Dinah J Gould, Nicolas S Drey
BACKGROUND: Hand hygiene is monitored by direct observation to improve practice, but this approach can potentially cause information, selection, and confounding bias, threatening the validity of findings. The aim of this study was to identify and describe the potential biases in hand hygiene compliance monitoring by direct observation; develop a typology of biases and propose improvements to reduce bias; and increase the validity of compliance measurements. METHODS: This systematic review of hospital-based intervention studies used direct observation to monitor health care workers' hand hygiene compliance...
October 13, 2018: American Journal of Infection Control
Monika Pogorzelska-Maziarz, Pamela B de Cordova, Carolyn T A Herzig, Andrew Dick, Julie Reagan, Patricia W Stone
BACKGROUND: Currently, most US states have adopted legislation requiring hospitals to submit health care-associated infection (HAI) data. We evaluated the perceived impact of state HAI laws on infection prevention and control (IPC) departments. METHODS: A web-based survey of a national sample of all non-veteran hospitals enrolled in the National Healthcare Safety Network was conducted in fall 2011. Variations in IPC department resources and characteristics in states with and without laws were compared by use of χ², Mann-Whitney (Wilcoxon), and Student t tests...
October 12, 2018: American Journal of Infection Control
Ginger Vanhoozer, Ian Lovern Bs, Nadia Masroor, Salma Abbas, Michelle Doll, Kaila Cooper, Michael P Stevens, Gonzalo Bearman
Many studies indicate that daily chlorhexidine gluconate (CHG) bathing reduces the risk of hospital-acquired infections. In this study, we found that patient perceptions can be a barrier to bathing practice, and many independent-care patients do not use CHG bathing products correctly. Furthermore, electronic medical record documentation may be a reliable tool to assess CHG bathing compliance.
October 12, 2018: American Journal of Infection Control
Marie A de Perio, Kerton R Victory, Matthew R Groenewold
BACKGROUND: We determined the incidence and circumstances of needlestick injuries and other body substance exposures among police officers in a city police department. METHODS: We analyzed data extracted from the city's centralized human resource database on all incidents from January 1, 2011, to December 31, 2016, and characterized their circumstances. We calculated the annual incidence of needlestick injuries per 1,000 officers and per 10,000 reactive calls. We ran a Poisson regression model to determine the trend in the annual incidence over time...
October 11, 2018: American Journal of Infection Control
Carrie S Tilton, Steven W Johnson
BACKGROUND: Clostridium difficile infection (CDI) is recognized as a significant challenge in health care. Identification of high-risk individuals is essential for the development of CDI prevention strategies. The objective of this study was to develop an easily implementable risk prediction model for hospital-onset CDI in patients receiving systemic antimicrobials. METHODS: This retrospective, case-control, multicenter study included adult patients admitted to Novant Health Forsyth Medical Center and Novant Health Presbyterian Medical Center from July 1, 2015, to July 1, 2017, who received systemic antibiotics...
October 11, 2018: American Journal of Infection Control
Nicole Brys, Julie A Keating, Mary Jo Knobloch, Nasia Safdar
BACKGROUND: We describe stakeholder engagement from a Patient-Centered Outcomes Research Institute-funded project to identify patients' research priorities for health care-associated infections (HAI). We summarize insights from these activities to highlight feasibility and benefits of stakeholder engagement in health care epidemiology research.Patients and caregivers who had an HAI experience were involved in a patient and caregiver stakeholder group. We engaged clinicians, infection prevention experts, state public health professionals, and quality improvement experts in an institutional stakeholder (IS) group in an academic tertiary care medical center...
October 9, 2018: American Journal of Infection Control
Pei-Hsuan Li, Shou-Yu Wang, Jung-Ying Tan, Li-Hung Lee, Cheng-I Yang
BACKGROUND: Infection preventionists (IPs) play an important role in preventing health care-associated infections in a health care system. However, the limitations of the clinical setting and the unique characteristics of psychiatric patients could be barriers to effective infection prevention. The purpose of this study was to understand how IPs perceived their challenges and how these challenges negatively affect their infection prevention work in psychiatric clinical settings. METHODS: A descriptive, qualitative research approach was used in this study...
October 9, 2018: American Journal of Infection Control
Alissa Werzen, Kerri A Thom, Gwen L Robinson, Shanshan Li, Clare Rock, Loreen A Herwaldt, Daniel J Diekema, Heather S Reisinger, Eli N Perencevich
Hand hygiene compliance is subject to the Hawthorne effect, which may be attenuated by covert observers and brief observation periods. This study demonstrated that hand hygiene compliance rates were between 8% and 29% greater when reported by infection prevention programs than when reported by covert observers over brief observation periods.
October 9, 2018: American Journal of Infection Control
Angela Vassallo, Kelley M Boston
Infectionprevention is a rapidly changing field with regulatory requirements and emerging global public health threats. Infection preventionists (IPs) must use advanced epidemiologic skills for health care-associated infection investigation and prevention. A potential talent pool for IPs is the Master of Public Health graduate. Those hiring IPs should consider master of public health graduates as candidates who can help drive the future of this profession.
October 9, 2018: American Journal of Infection Control
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