scholarly journals Analyzing Healthcare Workers’ Perspectives on Healthcare-Associated Infections and Infection Control Practices Using Video Reflexive Ethnography (VRE)

2020 ◽  
Vol 41 (S1) ◽  
pp. s116-s116
Author(s):  
Esther Paul ◽  
Ibrahim Alzaydani ◽  
Ahmed Hakami ◽  
Harish C. Chandramoorthy
Keyword(s):  
Hand Hygiene ◽  
Infection Control ◽  
Quantitative Data ◽  
Healthcare Workers ◽  
Qualitative Data ◽  
Tertiary Care ◽  
Control Measures ◽  
Infection Control Measures ◽  
Hygiene Measures ◽  
Healthcare Associated

Background: This study explores the perspectives of healthcare workers on the healthcare-associated infection (HAI) and infection control measures in a tertiary-care unit, through a self-administered questionnaire, semi-structured interviews, and reflexive sessions based on video-recorded sterile procedures performed in respondents’ work contexts. Video reflexive ethnography (VRE) is a method that provides feedback to medical practitioners through reflection analysis, whereby practitioners identify problems and find solutions. Methods: Quantitative questionnaire data were used to assess the knowledge of HAI among 50 healthcare workers and their attitude toward practice of infection control measures. Semistructured interviews based on an interview guide were used to collect qualitative data from 25 doctors and nurses. The interviews were audio recorded and transcribed verbatim immediately. Also, routine sterile procedures in the wards and intensive care unit were video recorded, and the footage was discussed by the infection control team and the personnel involved in the videos. This discussion was video recorded and transcribed. Both interview data and reflexive discussion of video-graph were analyzed using a thematic analysis. The quantitative data were analyzed using the Kruskal–Wallis test. Results: The quantitative data revealed no difference in the knowledge, attitude, and practice scores used to evaluate the infection control practices among the healthcare workers. We identified 4 themes from the qualitative data: (1) knowledge of HAI and infection control, (2) infection control measures in practice, (3) the shortfall in infection control measures and HAI, and (4) required implementation. Although the qualitative data indicated that the participants had excellent compliance with hand hygiene and personal protective equipment (PPE) use, the VRE and reflective sessions indicated otherwise. Some astounding lapses were revealed, like failure to engage in boundary maintenance between sterile and nonsterile areas, failure to observe proper hand hygiene measures, and use of traditional hijab face covers (used in an unsterile environment as well) instead of surgical masks. These findings demonstrate the advantage of combining VRE with qualitative and quantitative methodology to deduct the lapses in the practice of infection control among healthcare workers. Conclusions: Introduction of training programs focused on HAI and infection control measures in the educational system will help better inform medical and nursing students. Live video demonstrations of appropriate infection control practices during sterile procedures would be highly beneficial to educate the healthcare workers on correct infection control practices. Lapses in the use of PPE can be a possible reason for the outbreak of MERS-CoV, an endemic disease, in this part of Saudi Arabia.Disclosures: NoneFunding: None

scholarly journals Description of a Hospital Outbreak of Middle East Respiratory Syndrome in a Large Tertiary Care Hospital in Saudi Arabia

2016 ◽  
Vol 37 (10) ◽  
pp. 1147-1155 ◽  
Author(s):  
Hanan H. Balkhy ◽  
Thamer H. Alenazi ◽  
Majid M. Alshamrani ◽  
Henry Baffoe-Bonnie ◽  
Yaseen Arabi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Saudi Arabia ◽  
Infection Control ◽  
Healthcare Workers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Control Measures ◽  
Care Hospital ◽  
Infection Control Measures ◽  
Large Tertiary Care

BACKGROUNDSince the first isolation of Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia in 2012, sporadic cases, clusters, and sometimes large outbreaks have been reported.OBJECTIVETo describe the recent (2015) MERS-CoV outbreak at a large tertiary care hospital in Riyadh, Saudi Arabia.METHODSWe conducted an epidemiologic outbreak investigation, including case finding and contact tracing and screening. MERS-CoV cases were categorized as suspected, probable, and confirmed. A confirmed case was defined as positive reverse transcription polymerase chain reaction test for MERS-CoV.RESULTSOf the 130 suspected cases, 81 (62%) were confirmed and 49 (38%) were probable. These included 87 patients (67%) and 43 healthcare workers (33%). Older age (mean [SD], 64.4 [18.3] vs 40.1 [11.3] years, P<.001), symptoms (97% vs 58%, P<.001), and comorbidity (99% vs 42%, P<.001) were more common in patients than healthcare workers. Almost all patients (97%) were hospitalized whereas most healthcare workers (72%) were home isolated. Among 96 hospitalized cases, 63 (66%) required intensive care unit management and 60 (63%) required mechanical ventilation. Among all 130 cases, 51 (39%) died; all were patients (51 [59%]) with no deaths among healthcare workers. More than half (54%) of infections were believed to be caught at the emergency department. Strict infection control measures, including isolation and closure of the emergency department, were implemented to interrupt the chain of transmission and end the outbreak.CONCLUSIONMERS-CoV remains a major healthcare threat. Early recognition of cases and rapid implementation of infection control measures are necessary.Infect Control Hosp Epidemiol 2016;1–9

scholarly journals Infection Control and Management of COVID-19: Challenges for Paediatric Tertiary Care Hospitals

2020 ◽  
Author(s):  
Jonathan Remppis ◽  
Tina Ganzenmueller ◽  
Malte Kohns Vasconcelos ◽  
Oliver Heinzel ◽  
Rupert Handgretinger ◽  
...  
Keyword(s):  
Infection Control ◽  
Patient Management ◽  
Tertiary Care ◽  
Control Measures ◽  
Severe Illness ◽  
Mild Disease ◽  
Infection Control Measures ◽  
Paediatric Patients ◽  
Risk Patients ◽  
Healthcare Associated

Abstract PURPOSE: To describe infection control measures and patient management at a tertiary children’s hospital in southern Germany during the COVID-19 pandemic.METHODS: Prospective, observational study of infection control measures, patient management, clinical and virologic data of paediatric patients treated at our hospital during the COVID-19 pandemic from February to May 2020. Infection control measures were documented beginning with preparation for the pandemic. All paediatric patients with suspected SARS-CoV-2 infection were prospectively included in the study.RESULTS: With local triage, restraint of patient admission and testing strategies implemented, healthcare capacity remained adequate and no healthcare-associated infections occurred. Workload in the paediatric emergency department significantly decreased following the lockdown of schools and kindergartens. 7 of 174 (4%) children with and 2 of 208 (1%) children without typical symptoms, respectively, were diagnosed with COVID-19 by PCR. Six out of nine inpatients treated for COVID-19 had underlying comorbidities, two were admitted to the intensive care unit. One patient died shortly after discharge.CONCLUSIONS: While COVID-19 generally causes mild disease in children, severe illness and fatal cases may occur, particularly among children with underlying diseases. Tertiary children’s hospitals may face challenges with treating potential high-risk patients during the pandemic. Thus, timely establishment of effective testing and triage strategies is crucial.

Direct costs and clinical impact of adenovirus genotype 8 conjunctivitis outbreak in a neonatology unit

2020 ◽  
pp. 1-7
Author(s):  
María Florencia Angueyra ◽  
Débora Natalia Marcone ◽  
Florencia Escarrá ◽  
Noelia Soledad Reyes ◽  
Yamile Rubies ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Median Duration ◽  
Tertiary Care ◽  
Productivity Loss ◽  
High Risk Pregnancy ◽  
Control Measures ◽  
Viral Spread ◽  
Infection Control Measures ◽  
Risk Pregnancy

Abstract Objective: To report a conjunctivitis outbreak in a neonatology intensive care unit (NICU) and determine the associated economic impact. Design: Prospective observational study. Setting: Centro de Educación Médica e Investigaciones Clínicas (CEMIC) University Hospital, a private, tertiary-care healthcare institution in Buenos Aires, Argentina. Participants: The study included 52 NICU neonates and 59 NICU-related healthcare workers (HCWs) from CEMIC hospital. Methods: Neonates and HCWs were swabbed for real-time polymerase chain reaction (PCR) testing, viral culture, and typing by sequencing. Infection control measures, structural and logistic changes were implemented. Billing records were analyzed to determine costs. Results: From January 30 to April 28, 2018, 52 neonates were hospitalized in the NICU. Among them, 14 of 52 (21%) had bilateral conjunctivitis with pseudomembranes. Symptomatic neonates and HCWs were HAdV-D8 positive. Ophthalmological symptoms had a median duration of 18 days (IQR, 13–24.5). PCR positivity and infectious range had a median duration of 18.5 days. As part of containment measures, the NICU and the high-risk pregnancy unit were closed to new patients. The NICU was divided into 2 areas for symptomatic and asymptomatic patients; a new room was assigned for the general nursery, and all deliveries from the high-risk pregnancy unit were redirected to other hospitals. The outbreak cost the hospital US$205,000: implementation of a new nursery room and extra salaries cost US$30,350 and estimated productivity loss during 1 month cost US$175,000. Conclusions: Laboratory diagnosis confirmed the cause of this outbreak as HAdV-D8. The immediate adoption and reinforcement of rigorous infection control measures limited the nosocomial viral spread. This outbreak represented a serious institutional problem, causing morbidity, significant economic loss, and absenteeism.

Management of Candida auris outbreak in a tertiary-care setting in Saudi Arabia

2020 ◽  
pp. 1-7 ◽  
Author(s):  
Majid M. Alshamrani ◽  
Aiman El-Saed ◽  
Azzam Mohammed ◽  
Majed F. Alghoribi ◽  
Sameera M. Al Johani ◽  
...  
Keyword(s):  
Infection Control ◽  
Care Setting ◽  
Tertiary Care ◽  
Sharp Decrease ◽  
Control Measures ◽  
Candida Auris ◽  
Environmental Cleaning ◽  
Infection Control Measures ◽  
Local Experience ◽  
Tertiary Care Setting

Abstract Objective: To describe local experience in managing an outbreak of Candida auris in a tertiary-care setting. Methods: In response to emerging Candida auris, an outbreak investigation was conducted at our hospital between March 2018 and June 2019. Once a patient was confirmed to have Candida auris, screening of exposed patients and healthcare workers (HCWs) was conducted. Postexposure screening included those who had had direct contact with or shared the same unit or ward with a laboratory-confirmed case. In response to the increasing number of cases, new infection control measures were implemented. Results: In total, 23 primary patients were detected over 15 months. Postexposure screening identified 11 more cases, and all were patients. Furthermore, ~28.6% of patients probably caught infection in another hospital or in the community. Infection control measures were strictly implemented including hand hygiene, personal protective equipment, patient hygiene, environmental cleaning, cohorting of patients and HCWs, and avoiding the sharing of equipment. The wave reached a peak in April 2019, followed by a sharp decrease in May 2019 and complete clearance in June 2019. The case patients were equally distributed between intensive care units (51.4%) and wards (48.6%). More infections (62.9%) occurred than colonizations (37.1%). Urinary tract infection (42.9%) and candidemia (17.1%) were the main infections. In total, 7 patients (20.0%) died during hospitalization; among them, 6 (17.1%) died within 30 days of diagnosis. Conclusions: Active screening of exposed patients followed by strict infection control measures, including environmental cleaning, was successful in ending the outbreak. Preventing future outbreaks is challenging due to outside sources of infection and environmental resistance.

First Outbreak of Colonization and Infection With Vancomycin-ResistantEnterococcus faeciumin a Tertiary Care Hospital in Singapore

2006 ◽  
Vol 27 (9) ◽  
pp. 991-993 ◽  
Author(s):  
Maciej Piotr Chlebicki ◽  
Moi Lin Ling ◽  
Tse Hsien Koh ◽  
Li Yang Hsu ◽  
Ban Hock Tan ◽  
...  
Keyword(s):  
Infection Control ◽  
Enterococcus Faecium ◽  
Public Hospital ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Control Measures ◽  
Care Hospital ◽  
Infection Control Measures ◽  
Vancomycin Resistant

We report the first outbreak of vancomycin-resistantEnterococcus faeciumcolonization and infection among inpatients in the hematology ward of an acute tertiary care public hospital in Singapore. Two cases of bacteremia and 4 cases of gastrointestinal carriage were uncovered before implementation of strict infection control measures resulted in control of the outbreak.

Exogenous Sources ofPseudomonas aeruginosain Intensive Care Unit Patients Implementation of Infection Control Measures and Follow-Up With Molecular Typing

2006 ◽  
Vol 27 (9) ◽  
pp. 953-957 ◽  
Author(s):  
Christiane Petignat ◽  
Patrick Francioli ◽  
Immaculée Nahimana ◽  
Aline Wenger ◽  
Jacques Bille ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Tertiary Care ◽  
Clinical Specimen ◽  
Pfge Pattern ◽  
Control Measures ◽  
Icu Patients ◽  
Infection Control Measures ◽  
Exogenous Origin

Background.In 1998, a study in the intensive care unit (ICU) of our institution suggested possible transmission of Pseudomonas aeruginosa from faucet to patient and from patient to patient. Infection-control measures were implemented to reduce the degree ofP. aeruginosacolonization in faucets, to reduce the use of faucet water in certain patient care procedures, and to reduce the rate of transmission from patient to patient.Objective.To evaluate the effect of the control measures instituted in 1999 to preventP. aeruginosainfection and colonization in ICU patients.Design.Prospective, molecular, epidemiological investigation.Setting.A 870-bed, university-affiliated, tertiary care teaching hospital.Methods.The investigation was performed in a manner identical to the 1998 investigation. ICU patients with a clinical specimen positive forP. aeruginosawere identified prospectively. Swab specimens from the inner part of the ICU faucets were obtained for the culture on 9 occasions between September 1997 and December 2000. All patients and environmental isolates were typed by pulsed-field gel electrophoresis (PFGE).Results.Compared with the 1998 study, in 2000 we found that the annual incidence of ICU patients colonized or infected withP. aeruginosahad decreased by half (26.6 patients per 1,000 admissions in 2000 vs 59.0 patients per 1,000 admissions in 1998), although the populations of patients were comparable. This decrease was the result of the decreased incidence of cases in which an isolate had a PFGE pattern identical to that of an isolate from a faucet (7.0 cases per 1,000 admissions in 2000, vs 23.6 per 1,000 admissions in 1998) or from another patient (6.5 cases per 1,000 admissions in 2000 vs 16.5 cases per 1,000 admissions in 1998), whereas the incidence of cases in which the isolate had a unique PFGE pattern remained nearly unchanged (13.1 cases per 1,000 admissions in 2000 vs 15.6 cases per 1,000 admissions in 1998).Conclusions.These results suggest that infection control measures were effective in decreasing the rate ofP. aeruginosacolonization and infection in ICU patients, confirming thatP. aeruginosastrains were of exogenous origin in a substantial proportion of patients during the preintervention period.

Transmission and control in an institutional pandemic influenza A(H1N1) 2009 outbreak

2011 ◽  
Vol 140 (6) ◽  
pp. 1102-1110 ◽  
Author(s):  
N. ARINAMINPATHY ◽  
N. RAPHAELY ◽  
L. SALDANA ◽  
C. HODGEKISS ◽  
J. DANDRIDGE ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
Pandemic Influenza ◽  
Summer School ◽  
Influenza A ◽  
Control Measures ◽  
Infection Control Measures ◽  
Influenza A H1n1 ◽  
Hygiene Measures ◽  
The Impact

SUMMARYA pandemic influenza A(H1N1) 2009 outbreak in a summer school affected 117/276 (42%) students. Residential social contact was associated with risk of infection, and there was no evidence for transmission associated with the classroom setting. Although the summer school had new admissions each week, which provided susceptible students the outbreak was controlled using routine infection control measures (isolation of cases, basic hygiene measures and avoidance of particularly high-risk social events) and prompt treatment of cases. This was in the absence of chemoprophylaxis or vaccination and without altering the basic educational activities of the school. Modelling of the outbreak allowed estimation of the impact of interventions on transmission. These models and follow-up surveillance supported the effectiveness of routine infection control measures to stop the spread of influenza even in this high-risk setting for transmission.

Sign in / Sign up

Export Citation Format

Share Document