VHA Mountain States conducted a survey and analysis of infection control (IC) staffing resources, organizational structures, and clinical processes related to reducing the incidence of healthcare-associated infections (HAIs) in community healthcare facilities.
Member participation was solicited for 2 study components. The first was a survey of demographic characteristics regarding the type and size of the facility and the structure and functions of IC departments. The second was an observational study of infection prevention practices related to general hand hygiene (GHH), ventilator-associated pneumonia (VAP), catheter-related bloodstream infection (CRBSI), and catheter-related urinary tract infection (CRUTI).
A total of 31 not-for-profit community healthcare facilities submitted data; the number of beds in participating centers ranged from less than 50 beds (1 facility) to more than 500 beds (7 facilities). IC department staffing ranged from 0.3 to 5.0 full-time equivalents. There was a positive correlation between average daily census and IC staffing (r = .879; P < .001). Observational studies revealed that compliance with the use of alcohol-based hand rubs (77%) was significantly better than compliance with the use of soap and water (64%; P < .001). Seven (30%) of 23 organizations observed 90% or better compliance with VAP process measures; 7 of 27 (26%) observed 90% or better compliance with guidelines for preventing CRBSI; and 14 (56%) demonstrated proper placement of urinary drainage bags at least 90% of the time.
There was variation in IC department structure and processes among the participating organizations. Infection prevention practices were inconsistent. These findings emphasize the need for more-effective implementation of current evidence-based recommendations for preventing HAIs and reducing the risk of harm to patients.
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"Urinary-tract infections represent the most frequent form of nosocomial infections in industrialized nations, while in developing countries invasive medical procedures play a major role
[1,11,12]. Surgical interventions are one of the biggest sources of nosocomial infections with an incidence ranging from 1.2% to 23.6% of all surgical interventions and Staphylococcus aureus (20%), Escherichia coli (18%) and other Enterobacteria constituting the most frequent causative pathogens in developing countries
[10,13-15]. Apart from patient-related factors (e.g. "
[Show abstract][Hide abstract]ABSTRACT: Nosocomial infections pose substantial risk to patients receiving care in hospitals. In Africa, this problem is aggravated by inadequate infection control due to poor hygiene, resource and structural constraints, deficient surveillance data and lack of awareness regarding nosocomial infections. We carried out this study to determine the incidence and spectrum of nosocomial infections, pathogens and antibiotic resistance patterns in a tertiary regional hospital in Lambarene, Gabon.
This prospective case study was carried out over a period of six months at the Albert Schweitzer Hospital, Lambarene, Gabon. All patients admitted to the departments of surgery, gynecology/obstetrics and internal medicine were screened daily for signs and symptoms of hospital-acquired infections.
A total of 2925 patients were screened out of which 46 nosocomial infections (1.6%) were diagnosed. These comprised 20 (44%) surgical-site infections, 12 (26%) urinary-tract infections, 9 (20%) bacteraemias and 5 (11%) other infections. High rates of nosocomial infections were found after hysterectomies (12%) and Caesarean sections (6%). Most frequent pathogens were Staphylococcus aureus and Escherichia coli. Eight (40%) of 20 identified E. coli and Klebsiella spp. strains were ESBL-producing organisms.
The cumulative incidence of nosocomial infections in this study was low; however, the high rates of surgical site infections and multi-resistant pathogens necessitate urgent comprehensive interventions of infection control.
Full-text · Article · Mar 2014 · BMC Infectious Diseases
[Show abstract][Hide abstract]ABSTRACT: A new Medicare rule that will take effect October 2008 will prevent hospit-als from receiving payment for the costs of treating certain hospital-acquired infections and conditions. This Note argues that the rule is un-likely to reduce the frequency of hospital-acquired conditions. The rule is based on the erroneous assumption that distorted financial incentives are responsible for the high rate of hospital-acquired conditions, and ignores the fact that hospitals lack the resources and data to tackle the systemic problems that endanger patients. This misguided approach could render the new CMS rule ineffectual, or worse, result in unintended consequences that undermine patient care. To significantly contribute to a reduction in hospital-acquired conditions, the federal government should increase funding for the Agency for Healthcare Research and Quality to develop proven strategies that hospitals can implement to reduce infection.
Preview · Article · Sep 2008 · Columbia journal of law and social problems