scholarly journals Infection Prevention and Control Policies and Staffing: A National Survey of Home Health Agencies in the United States

2020 ◽  
Vol 41 (S1) ◽  
pp. s301-s301
Author(s):  
Jingjing Shang ◽  
Ashley Chastain ◽  
U. Gayani Perera ◽  
Monika Pogorzelska-Maziarz ◽  
Patricia Stone
Keyword(s):  
Quality Improvement ◽  
Influenza Vaccination ◽  
Staff Member ◽  
Antibiotic Stewardship ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
For Profit ◽  
Healthcare Settings ◽  
And Control

Background: Infection prevention and control (IPC) is a national priority in all healthcare settings, and IPC staffing characteristics have been linked to patient safety outcomes. However, there is a lack of knowledge about IPC in home healthcare (HHC), the fastest growing healthcare sector. Our aim was to better understand the current state of IPC in HHC, as well as the HHC staff involved with IPC policy implementation. Methods: A national survey was conducted between October 2018 and November 2019. The participants included (1) agencies recruited from a national HHC conference and (2) a national random sample of 1,501 agencies stratified by census region, ownership status, and rural or urban location. Survey items included staff influenza vaccination policies, antibiotic stewardship, infection surveillance, and IPC staffing. Descriptive statistics were computed, and differences by ownership were calculated using 2 and Student t tests. Results: Of the 535 HHC agencies that responded to the survey (response rate, 33%), 64% were for-profit agencies. Overall, 30.8% of the agencies (17.9% for-profit, 57.6% nonprofit; P < .01) required staff influenza vaccination. Most nonprofit agencies (84.1%) and about half of the for-profit agencies (48.1%) offered free influenza vaccinations to staff (P < .01). During the past influenza season, 62.6% of agencies (81.5% nonprofit vs 51.6% for-profit; P < .01) had 75% of their employees vaccinated for influenza, and 9.3% (2% nonprofit vs 13.5% for-profit; P < .01) reported that they did not track this data. Only 17.9% of HHC agencies used antibiotic prescribing guidelines, and 33.3% reported that they reviewed cases to assess the appropriateness of antibiotic administration and/or indication. Most HHC agencies (86%) reported collecting and reviewing infection data to identify trends, which was often done quarterly or more frequently. Almost every responding agency reported that the staff member in charge of IPC had other responsibilities including administrative, education/training, or quality improvement, and 33.5% of those personnel had received no specific IPC training. Also, ~6% of agencies (12.5% of government-owned agencies) reported that they currently did not have a staff member in charge of IPC. Conclusions: This is the first national study of IPC in HHC, which can be used as a benchmark for quality improvement initiatives in the home care environment. Compared to other healthcare settings, HHC agencies have substantial challenges related to IPC. Most HHC agencies do not have a staff member exclusively dedicated to IPC, and staff training is inadequate. Furthermore, a significant number of agencies have no staff influenza vaccination or antibiotic stewardship policies in place. The situation is worse at for-profit agencies, which dominate the current US HHC industry.Funding: NoneDisclosures: None

scholarly journals An innovative quality improvement approach for rapid improvement of infection prevention and control at health facilities in Sierra Leone

2020 ◽  
Vol 32 (2) ◽  
pp. 85-92 ◽  
Author(s):  
Ilka Rondinelli ◽  
Gillian Dougherty ◽  
Caitlin A Madevu-Matson ◽  
Mame Toure ◽  
Adewale Akinjeji ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Best Practices ◽  
Sierra Leone ◽  
Marked Improvement ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Health Facilities ◽  
Infection Prevention And Control ◽  
Rapid Improvement ◽  
And Control

Abstract Quality challenge The Sierra Leone (SL) Ministry of Health and Sanitation’s National Infection Prevention and Control Unit (NIPCU) launched National Infection and Prevention Control (IPC) Policy and Guidelines in 2015, but a 2017 assessment found suboptimal compliance with standards on environmental cleanliness (EC), waste disposal (WD) and personal protective equipment (PPE) use. Methods ICAP at Columbia University (ICAP), NIPCU and the Centers for Disease Control and Prevention (CDC) designed and implemented a Rapid Improvement Model (RIM) quality improvement (QI) initiative with a compressed timeframe of 6 months to improve EC, WD and PPE at eight purposively selected health facilities (HFs). Targets were collaboratively developed, and a 37-item checklist was designed to monitor performance. HF teams received QI training and weekly coaching and convened monthly to review progress and exchange best practices. At the final learning session, a “harvest package” of the most effective ideas and tools was developed for use at additional HFs. Results The RIM resulted in marked improvement in WD and EC performance and modest improvement in PPE. Aggregate compliance for the 37 indicators increased from 67 to 96% over the course of 4 months, with all HFs showing improvement. Average PPE compliance improved from 85 to 89%, WD from 63 to 99% and EC from 51 to 99%. Lessons learned The RIM QIC approach is feasible and effective in SL’s austere health system and led to marked improvement in IPC performance. The best practices are being scaled up and the RIM QIC methodology is being applied to other domains.

scholarly journals Improvement of Infection Prevention and Control Practices Using Quality Improvement Approach in Two Model Hospitals in Kenya

2020 ◽  
Vol 41 (S1) ◽  
pp. s286-s287
Author(s):  
Loyce Kihungi ◽  
Mary Ndinda ◽  
Samantha Dolan ◽  
Evelyn Wesangula ◽  
Linus Ndegwa ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Data Collection ◽  
Hand Hygiene ◽  
Waste Management ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Technical Assistance ◽  
Infection Prevention And Control ◽  
Waste Segregation ◽  
And Control

Background: Little is known about how best to implement infection prevention and control programs in low-resource settings. The quality improvement approach using plan-do-study-act (PDSA) cycles provides a framework for data-driven infection prevention and control implementation. We used quality improvement techniques and training to improve infection prevention and control practices in 2 model hospitals in Kenya. Methods: The 2 hospitals were chosen by the Kenya Ministry of Health for capacity building on infection prevention and control. At each site, the project team (the University of Washington International Training for Education and Training in Health, Ministry of Health, and Centers for Disease Control) conducted infection prevention and control training to infection prevention and control committee members. Infection prevention and control quality improvement activities were introduced in a staggered manner, focusing on hand hygiene and waste management practices. For hand hygiene, the project team’s technical assistance focused on facility hand hygiene infrastructure, hand hygiene practice adherence, hand hygiene supply quantification, and monitoring and evaluation using WHO hand hygiene audit tools. Waste management technical assistance focused on availability of policy, guidelines, equipment and supplies, waste segregation, waste quantification, and monitoring and evaluation using a data collection tool customized based on previously published tools. Regular interactive video conference sessions between the project team and the sites that included didactic sessions and sharing of data provided ongoing mentorship and feedback on quality improvement implementation, data interpretation, and data use. Results: Hand hygiene data collection began in April 2018. In hospital A, hand hygiene compliance increased from a baseline of 3% to 51% over 9 months. In Hospital B, hand hygiene compliance rates increased from 23% at baseline to 44% after 9 months. Waste management data collection began in November 2018. At hospital A, waste segregation compliance scores increased from 73% at baseline to 80% over 6 months, whereas hospital B, waste segregation compliance went from 44% to 80% over 6 months. Conclusions: A quality improvement approach appears to be a feasible means of infection prevention and control program strengthening in low resource settings.Funding: NoneDisclosures: None

A comparison of surgical site infections following total hip replacement and total knee replacement surgeries identified by Infection Prevention and Control and the National Surgical Quality Improvement Program in Alberta, Canada

2021 ◽  
pp. 1-7
Author(s):  
Jennifer J. R. Ellison ◽  
Lesia R. Boychuk ◽  
David Chakravorty ◽  
A. Uma Chandran ◽  
John M. Conly ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Surgical Site Infections ◽  
Infection Prevention And Control ◽  
Improvement Program ◽  
Surgical Quality ◽  
Total Hip ◽  
Total Knee ◽  
And Control

Abstract Objective: To understand how the different data collections methods of the Alberta Health Services Infection Prevention and Control Program (IPC) and the National Surgical Quality Improvement Program (NSQIP) are affecting reported rates of surgical site infections (SSIs) following total hip replacements (THRs) and total knee replacements (TKRs). Design: Retrospective cohort study. Setting: Four hospitals in Alberta, Canada. Patients: Those with THR or TKR surgeries between September 1, 2015, and March 31, 2018. Methods: Demographic information, complex SSIs reported by IPC and NSQIP were compared and then IPC and NSQIP data were matched with percent agreement and Cohen’s κ calculated. Statistical analysis was performed for age, gender and complex SSIs. A P value <.05 was considered significant. Results: In total, 7,549 IPC and 2,037 NSQIP patients were compared. The complex SSI rate for NSQIP was higher compared to IPC (THR: 1.19 vs 0.68 [P = .147]; TKR: 0.92 vs 0.80 [P = .682]). After matching, 7 SSIs were identified by both IPC and NSQIP; 3 were identified only by IPC, and 12 were identified only by NSQIP (positive agreement, 0.48; negative agreement, 1.0; κ = 0.48). Conclusions: Different approaches to monitor SSIs may lead to different results and trending patterns. NSQIP reports total SSI rates that are consistently higher than IPC. If systems are compared at any point in time, confidence on the data may be eroded. Stakeholders need to be aware of these variations and education provided to facilitate an understanding of differences and a consistent approach to SSI surveillance monitoring over time.

Infection prevention and control and antibiotic stewardship practices in pediatric long-term care facilities

2019 ◽  
Vol 41 (1) ◽  
pp. 116-119
Author(s):  
Candace L. Johnson ◽  
Alexandra Hill-Ricciuti ◽  
Emily Grohs ◽  
Lisa Saiman
Keyword(s):  
Infection Control ◽  
Antibiotic Stewardship ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Long Term Care ◽  
Infection Prevention And Control ◽  
Term Care ◽  
Care Facilities ◽  
And Control

AbstractPediatric long-term care facilities were surveyed to assess infection control and antimicrobial stewardship practices. Policies mandated by the Centers of Medicare and Medicaid Services (CMS) were included. Only 40% of sites reported implementing >90% of surveyed CMS policies. The survey also identified several gaps in non–CMS-mandated policies.

scholarly journals Current knowledge of COVID-19 and infection prevention and control strategies in healthcare settings: A global analysis

2020 ◽  
Vol 41 (10) ◽  
pp. 1196-1206 ◽  
Author(s):  
M. Saiful Islam ◽  
Kazi M. Rahman ◽  
Yanni Sun ◽  
Mohammed O. Qureshi ◽  
Ikram Abdi ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Infection Prevention ◽  
Global Analysis ◽  
Transmission Dynamics ◽  
World Health ◽  
Current Evidence ◽  
Infection Prevention And Control ◽  
Healthcare Settings ◽  
Surgical Masks ◽  
And Control

AbstractObjective:In the current absence of a vaccine for COVID-19, public health responses aim to break the chain of infection by focusing on the mode of transmission. We reviewed the current evidence on the transmission dynamics and on pathogenic and clinical features of COVID-19 to critically identify any gaps in the current infection prevention and control (IPC) guidelines.Methods:In this study, we reviewed global COVID-19 IPC guidelines by organizations such as the World Health Organization (WHO), the US Centers for Disease Control and Prevention (CDC), and the European Centre for Disease Prevention and Control (ECDC). Guidelines from 2 high-income countries (Australia and United Kingdom) and from 1 middle-income country (China) were also reviewed. We searched publications in English on ‘PubMed’ and Google Scholar. We extracted information related to COVID-19 transmission dynamics, clinical presentations, and exposures that may facilitate transmission. We then compared these findings with the recommended IPC measures.Results:Nosocomial transmission of SARS-CoV-2 in healthcare settings occurs through droplets, aerosols, and the oral–fecal or fecal–droplet route. However, the IPC guidelines fail to cover all transmission modes, and the recommendations also conflict with each other. Most guidelines recommend surgical masks for healthcare providers during routine care and N95 respirators for aerosol-generating procedures. However, recommendations regarding the type of face mask varied, and the CDC recommends cloth masks when surgical masks are unavailable.Conclusion:IPC strategies should consider all the possible routes of transmission and should target all patient care activities involving risk of person-to-person transmission. This review may assist international health agencies in updating their guidelines.

Sign in / Sign up

Export Citation Format

Share Document