Politically Incorrect: Legislation Must Not Mandate Specific Healthcare Epidemiology and Infection Prevention and Control Practices

2007 ◽  
Vol 28 (05) ◽  
pp. 594-595 ◽  
Author(s):  
Victoria Fraser ◽  
Denise Murphy ◽  
P. J. Brennan ◽  
Janet Frain ◽  
Kathleen Meehan Arias ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Boards Of Directors ◽  
Task Force ◽  
Scientific Evidence ◽  
Position Statement ◽  
Infection Prevention And Control ◽  
Healthcare Settings ◽  
Surveillance Cultures ◽  
Healthcare Epidemiology ◽  
And Control

In this issue of the journal, Dr. Farr offers his perspective on the recent position statement from the Joint SHEA and APIC Task Force regarding legislative mandates for use of active surveillance cultures to screen for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE). The position statement specifically addresses the issue of whether the use of MRSA and VRE surveillance cultures in healthcare settings should be mandated by legislation. It does not attempt to address whether or not, when, or for whom active surveillance cultures should be performed. A broad range of experts and the Boards of Directors of the Society for Healthcare Epidemiology (SHEA) and the Association of Professionals in Infection Control (APIC) reviewed this position statement, which summarizes the effectiveness of active surveillance culturing as it pertains to potential legislation. Both Boards agree the position statement represents a well-reasoned, systematic, and fair review of the literature. Of course, no single document, group, or individual should ever be viewed as having the final word on this or any subject. Thoughtful debate regarding the scientific evidence, when conducted in a professional and constructive manner, is a critical and necessary step in the translation of research and clinical observations into bedside practices. Such debate should also lead to a research agenda that will help fill gaps in knowledge that become apparent in the discussion.

Legislative Mandates for Use of Active Surveillance Cultures to Screen for Methicillin-ResistantStaphylococcus aureusand Vancomycin-Resistant Enterococci: Position Statement From the Joint SHEA and APIC Task Force

2007 ◽  
Vol 28 (3) ◽  
pp. 249-260 ◽  
Author(s):  
Stephen G. Weber ◽  
Susan S. Huang ◽  
Shannon Oriola ◽  
W. Charles Huskins ◽  
Gary A. Noskin ◽  
...  
Keyword(s):  
Active Surveillance ◽  
Task Force ◽  
Position Statement ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Vancomycin Resistant Enterococci ◽  
Surveillance Cultures ◽  
Vancomycin Resistant ◽  
State And Local ◽  
Healthcare Associated

Legislation aimed at controlling antimicrobial-resistant pathogens through the use of active surveillance cultures to screen hospitalized patients has been introduced in at least 2 US states. In response to the proposed legislation, the Society for Healthcare Epidemiology of America (SHEA) and the Association of Professionals in Infection Control and Epidemiology (APIC) have developed this joint position statement. Both organizations are dedicated to combating healthcare-associated infections with a wide array of methods, including the use of active surveillance cultures in appropriate circumstances. This position statement reviews the proposed legislation and the rationale for use of active surveillance cultures, examines the scientific evidence supporting the use of this strategy, and discusses a number of unresolved issues surrounding legislation mandating use of active surveillance cultures. The following 5 consensus points are offered. (1) Although reducing the burden of antimicrobial-resistant pathogens, including methicillin-resistantStaphylococcus aureus(MRSA) and vancomycin-resistant enterococci (VRE), is of preeminent importance, APIC and SHEA do not support legislation to mandate use of active surveillance cultures to screen for MRSA, VRE, or other antimicrobial-resistant pathogens. (2) SHEA and APIC support the continued development, validation, and application of efficacious and cost-effective strategies for the prevention of infections caused by MRSA, VRE, and other antimicrobial-resistant and antimicrobial-susceptible pathogens. (3) APIC and SHEA welcome efforts by healthcare consumers, together with private, local, state, and federal policy makers, to focus attention on and formulate solutions for the growing problem of antimicrobial resistance and healthcare-associated infections. (4) SHEA and APIC support ongoing additional research to determine and optimize the appropriateness, utility, feasibility, and cost-effectiveness of using active surveillance cultures to screen both lower-risk and high-risk populations. (5) APIC and SHEA support stronger collaboration between state and local public health authorities and institutional infection prevention and control experts.

COVID-19: The Importance of Adequate Personal Protective Equipment in Healthcare Medical Staff

2020 ◽  
Author(s):  
Anne Weissenstein
Keyword(s):  
Health Care ◽  
Personal Protective Equipment ◽  
Health Care Services ◽  
Infection Prevention And Control ◽  
Protective Equipment ◽  
Emotional Resilience ◽  
Healthcare Facilities ◽  
Care Services ◽  
Healthcare Settings ◽  
And Control

We present an update on infection prevention and control for COVID-19 in healthcare settings. This update focuses on measures to be applied in settings with increasing community transmission, growing demand for concern about COVID-19 patients, and subsequent staffing issues in the event of shortages of personal protective equipment for healthcare facilities worldwide. The comfort and emotional resilience of health care workers are key components in maintaining essential health care services during the COVID-19 virus (coronavirus) outbreak.

scholarly journals Challenges to Infection Control Team during COVID-19 Pandemic in a Quaternary Medical Center in Saudi Arabia

2021 ◽  
pp. 1-20
Author(s):  
Hala A Amer ◽  
Ibrahim A Alowidah ◽  
Chasteffi Bugtai ◽  
Barbara M. Soule ◽  
Ziad A Memish
Keyword(s):  
Saudi Arabia ◽  
Infection Control ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Task Force ◽  
Care Center ◽  
Capital City ◽  
Infection Prevention And Control ◽  
Team Approach ◽  
And Control

Abstract Background: King Saud Medical City (KSMC) is a quaternary care center based in the center of the capital city, Riyadh, Kingdom of Saudi Arabia (KSA) and is one of the key Ministry of Health (MoH) facilities dedicated to the care of COVID-19 patients in the central region. Methods: A comprehensive surge plan was promptly launched in mid-March 2020 to address the pandemic and then expanded in a phase-wise approach. Supporting the capacity of the infection prevention and control department (IPCD) was one of the main pillars of KSMC surge plan. Task force Infection Control teams have been formulated to tackle the different aspects of pandemic containment processes. The challenges and measures undertaken by the IPC team have been described. Conclusion: Realizing the more prominent role of infection prevention and control staff as frontline responders to public health emergencies like COVID-19, a solid infection prevention and control system at the healthcare setting supported by qualified and sufficient manpower, a well-developed multidisciplinary team approach, electronic infrastructure and efficient supply utilization is required for effective crisis management.

scholarly journals Compliance with Standard Precautions and Its Relationship with Views on Infection Control and Prevention Policy among Healthcare Workers during COVID-19 Pandemic

2021 ◽  
Vol 18 (7) ◽  
pp. 3420
Author(s):  
Eliza Lai-Yi Wong ◽  
Kin-Fai Ho ◽  
Dong Dong ◽  
Annie Wai-Ling Cheung ◽  
Peter Sen-Yung Yau ◽  
...  
Keyword(s):  
High Risk ◽  
Infection Control ◽  
High Risk Group ◽  
Infection Prevention And Control ◽  
Prevention Policy ◽  
Standard Precautions ◽  
Healthcare Settings ◽  
Control And Prevention ◽  
And Control ◽  
Infection Control And Prevention

Background: Standard precautions prevent the spread of infections in healthcare settings. Incompliance with infection control guidelines of healthcare workers (HCWs) may increase their risk of exposure to infectious disease, especially under pandemics. The purpose of this study was to assess the level of compliance with the infection prevention and control practices among HCWs in different healthcare settings and its relationship with their views on workplace infection control measures during the COVID-19 pandemic. Methods: Nurses in Hong Kong were invited to respond to a cross-sectional online survey, in which their views on workplace infection and prevention policy, compliance with standard precautions and self-reported health during pandemics were collected. Results: The respondents were dissatisfied with workplace infection and prevention policy in terms of comprehensiveness (62%), clarity (64%), timeliness (63%), and transparency (60%). For the protective behavior, the respondents did not fully comply with the standard precautions when they were involved in medical care. Their compliance was relatively low when having proper patient handling (54%) and performing invasive procedures (46%). A multivariate analysis model proved that the level of compliance of the standard precautions was positively associated with the satisfaction on infection control and prevention policy among high risk group (0.020; 95% CI: 0.005–0.036), while older respondents had higher level of compliance among the inpatient and outpatient groups (coefficient range: 0.065–0.076). The higher level of compliance was also significantly associated with working in designated team and having chronic condition of the respondents among high-risk and inpatient groups. Conclusions: Standard precautions are the most important elements to reduce cross-transmission among HCWs and patients while the satisfaction on infection control and prevention policy would increase the compliance among the high-risk group. An overall suboptimal compliance and poor views on the infection prevention and control guidelines is a warning signal to healthcare system especially during pandemics.

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 Reduction of Methicillin-ResistantStaphylococcus aureusInfection among Veterans in Atlanta

2013 ◽  
Vol 34 (1) ◽  
pp. 62-68 ◽  
Author(s):  
Edward Stenehjem ◽  
Cortney Stafford ◽  
David Rimland
Keyword(s):  
Active Surveillance ◽  
Medical Center ◽  
Veterans Health ◽  
Health Administration ◽  
Healthcare Settings ◽  
Surveillance Cultures ◽  
Mrsa Infection ◽  
The Impact ◽  
Mrsa Colonization ◽  
Community Onset

Objective.Describe local changes in the incidence of community-onset and hospital-onset methicillin-resistantStaphylococcus aureus(MRSA) infection and evaluate the impact of MRSA active surveillance on hospital-onset infection.Design.Observational study using prospectively collected data.Setting.Atlanta Veterans Affairs Medical Center (AVAMC).Patients.All patients seen at the AVAMC over an 8-year period with clinically and microbiologically proven MRSA infection.Methods.All clinical cultures positive for MRSA were prospectively identified, and corresponding clinical data were reviewed. MRSA infections were classified into standard clinical and epidemiologic categories. The Veterans Health Administration implemented the MRSA directive in October 2007, which required active surveillance cultures in acute care settings.Results.The incidence of community-onset MRSA infection peaked in 2007 at 5.45 MRSA infections per 1,000 veterans and decreased to 3.14 infections per 1,000 veterans in 2011 (P< .001 for trend). Clinical and epidemiologic categories of MRSA infections did not change throughout the study period. The prevalence of nasal MRSA colonization among veterans admitted to AVAMC decreased from 15.8% in 2007 to 11.2% in 2011 (P<.001 for trend). The rate of intensive care unit (ICU)-related hospital-onset MRSA infection decreased from October 2005 through March 2007, before the MRSA directive. Rates of ICU-related hospital-onset MRSA infection remained stable after the implementation of active surveillance cultures. No change was observed in rates of non-ICU-related hospital-onset MRSA infection.Conclusions.Our study of the AVAMC population over an 8-year period shows a consistent trend of reduction in the incidence of MRSA infection in both the community and healthcare settings. The etiology of this reduction is most likely multifactorial.

scholarly journals Clinical Guideline Highlights for the Hospitalist: Diagnosis and Management of Measles

2019 ◽  
Vol 15 (01) ◽  
pp. 47-48
Author(s):  
Marie E Wang ◽  
Adam J Ratner
Keyword(s):  
Infection Prevention ◽  
Healthcare Professionals ◽  
Clinical Guideline ◽  
Target Population ◽  
Infection Prevention And Control ◽  
Release Date ◽  
Title 1 ◽  
Healthcare Settings ◽  
Control And Prevention ◽  
And Control

GUIDELINE TITLE: (1) Measles (Rubeola): For Healthcare Professionals and (2) Interim Infection Prevention and Control Recommendations for Measles in Healthcare Settings. RELEASE DATE: (1) February 5, 2018, and (2) July 2019 PRIOR VERSION(s): n/a DEVELOPER: Centers for Disease Control and Prevention (CDC) FUNDING SOURCE: CDC TARGET POPULATION: Children and adults with suspected or confirmed measles

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