Atlisa Young

Loyola University Maryland, Baltimore, Maryland, United States

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Publications (3)10.05 Total impact

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    ABSTRACT: BACKGROUND: Hand hygiene is considered a critical factor in the prevention of health care-associated infections, and there have been many studies on ways to measure hand hygiene compliance. OBJECTIVE: Our objective was to evaluate the utility of estimating hand hygiene compliance using automated count technology versus direct human observation before and after a feedback intervention. We used a before and after quasi-experimental study over 30 weeks, in the setting of one 12-bed neurocare intensive care unit (NCICU) and one 15-bed cardiac intensive care unit (CCU) in a university, tertiary care hospital. METHODS: We assessed hand hygiene through a quasi-experimental study comparing estimated compliance using automated count technology and direct observation by a secret shopper with a feedback intervention at month 3. We used Poisson segmented regression and χ(2) tests to compare trends before and after the intervention. RESULTS: Over 30 weeks, we collected 424,682 dispenser counts and 338 hours of human observations that included 1,783 room entries. Electronic hand hygiene dispenser counts increased significantly in the post-intervention period relative to the pre-intervention period (average count/patient-day increased 22.7 in the NCICU and 7.3 in the CCU, both P < .001), but direct observation of compliance did not change significantly (percent compliant increased by 2.9% in the NCICU and decreased by 6.7% in the CCU, P = .47 and P = .07, respectively). CONCLUSION: Passive electronic monitoring of hand hygiene dispenser counts does not closely correlate with direct human observation and was more responsive than observation to a feedback intervention.
    American journal of infection control 05/2012; · 3.01 Impact Factor
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    ABSTRACT: Contact Precautions (CP) have been associated with depression and anxiety. We enrolled 103 patients on admission to a VA hospital and administered the Hospital Depression and Anxiety Scale (HADS). The mean unadjusted HADS score was 10% higher in patients on CP (14.3 vs 13.0; P = .47), and the association was stronger after adjusting for other variables (mean difference, 2.2; P = .21). Although underpowered, in the largest study to date, patients on CP tended toward more depression and anxiety.
    American journal of infection control 03/2011; 39(2):163-5. · 3.01 Impact Factor
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    ABSTRACT: Mandatory active surveillance culturing of all patients admitted to Veterans Affairs (VA) hospitals carries substantial economic costs. Clinical prediction rules have been used elsewhere to identify patients at high risk of colonization with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE). We aimed to derive and evaluate the clinical efficacy of prediction rules for MRSA and VRE colonization in a VA hospital. Design and setting.  Prospective cohort of adult inpatients admitted to the medical and surgical wards of a 119-bed tertiary care VA hospital. Within 48 hours after admission, patients gave consent, completed a 44-item risk factor questionnaire, and provided nasal culture samples for MRSA testing. A subset provided perirectal culture samples for VRE testing. Of 598 patients enrolled from August 30, 2007, through October 30, 2009, 585 provided nares samples and 239 provided perirectal samples. The prevalence of MRSA was 10.4% (61 of 585) (15.0% in patients with and 5.6% in patients without electronic medical record (EMR)-documented antibiotic use during the past year; P < .01). The prevalence of VRE was 6.3% (15 of 239) (11.3% in patients with and 0.9% in patients without EMR-documented antibiotic use; P < .01). The use of EMR-documented antibiotic use during the past year as the predictive rule for screening identified 242.8 (84%) of 290.6 subsequent days of exposure to MRSA and 60.0 (98%) of 61.0 subsequent days of exposure to VRE, respectively. EMR documentation of antibiotic use during the past year identified 301 (51%) of 585 patients as high-risk patients for whom additional testing with active surveillance culturing would be appropriate. EMR documentation of antibiotic use during the year prior to admission identifies most MRSA and nearly all VRE transmission risk with surveillance culture sampling of only 51% of patients. This approach has substantial cost savings compared with the practice of universal active surveillance.
    Infection Control and Hospital Epidemiology 10/2010; 31(12):1230-5. · 4.02 Impact Factor

Publication Stats

24 Citations
10.05 Total Impact Points


  • 2012
    • Loyola University Maryland
      Baltimore, Maryland, United States
  • 2010–2012
    • University of Maryland, Baltimore
      • Department of Medicine
      Baltimore, Maryland, United States