Raising Standards While Watching the Bottom Line Making a Business Case for Infection Control

2007 ◽  
Vol 28 (10) ◽  
pp. 1121-1133 ◽  
Author(s):  
Eli N. Perencevich ◽  
Patricia W. Stone ◽  
Sharon B. Wright ◽  
Yehuda Carmeli ◽  
David N. Fisman ◽  
...  
Keyword(s):  
Infection Control ◽  
Task Force ◽  
Case Analysis ◽  
Business Case ◽  
Bottom Line ◽  
Control Programs ◽  
Control Intervention ◽  
Evidence Based Guideline ◽  
Healthcare Associated ◽  
And Control

While society would benefit from a reduced incidence of nosocomial infections, there is currently no direct reimbursement to hospitals for the purpose of infection control, which forces healthcare institutions to make economic decisions about funding infection control activities. Demonstrating value to administrators is an increasingly important function of the hospital epidemiologist because healthcare executives are faced with many demands and shrinking budgets. Aware of the difficulties that face local infection control programs, the Society for Healthcare Epidemiology of America (SHEA) Board of Directors appointed a task force to draft this evidence-based guideline to assist hospital epidemiologists in justifying and expanding their programs. In Part 1, we describe the basic steps needed to complete a business-case analysis for an individual institution. A case study based on a representative infection control intervention is provided. In Part 2, we review important basic economic concepts and describe approaches that can be used to assess the financial impact of infection prevention, surveillance, and control interventions, as well as the attributable costs of specific healthcare-associated infections. Both parts of the guideline aim to provide the hospital epidemiologist, infection control professional, administrator, and researcher with the tools necessary to complete a thorough business-case analysis and to undertake an outcome study of a nosocomial infection or an infection control intervention.

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 Infection Control in Acute Care Facilities: Evidence-Based Patient Safety

2001 ◽  
Vol 12 (3) ◽  
pp. 131-132 ◽  
Author(s):  
Lindsay E Nicolle
Keyword(s):  
World War Ii ◽  
Infection Control ◽  
Acute Care ◽  
Epidemiological Analysis ◽  
Control Programs ◽  
Care Facilities ◽  
Surveillance Programs ◽  
Acute Care Facilities ◽  
Program Components ◽  
And Control

Infection control in acute care facilities has a noble history. These programs were born of the nosocomial penicillin-resistantStaphylococcus aureusoutbreaks in the post-World War II era. Over the past four decades, an impressive body of evidence has emerged that documents the effectiveness of infection control programs and systematically evaluates specific program components. Fumigation, tacky floor mats, shoe covers and 'reverse' isolation have disappeared. They are replaced by focused surveillance programs, prophylactic antimicrobial therapy, outbreak investigation and control, routine barrier practices and molecular typing of organisms for epidemiological analysis.

How Frequent Are Outbreaks of Nosocomial Infection in Community Hospitals?

1985 ◽  
Vol 6 (6) ◽  
pp. 233-236 ◽  
Author(s):  
Robert W. Haley ◽  
James H. Tenney ◽  
James O. Lindsey ◽  
Julia S. Garner ◽  
John V. Bennett
Keyword(s):  
Nosocomial Infection ◽  
Infection Control ◽  
Nosocomial Infections ◽  
Small Proportion ◽  
Community Hospital ◽  
Control Measures ◽  
Community Hospitals ◽  
Control Programs ◽  
Site Investigations ◽  
And Control

AbstractA statistical algorithm was used to identify potentially important clusters among nosocomial infections reported each month by 7 community hospitals. Epidemiologic review and on-site investigations distinguished outbreaks of clinical disease from factitious clusters. In 1 year, 8 outbreaks were confirmed. They involved 82 patients—approximately 2% of patients with nosocomial infections and 0.09% of all discharges. One true outbreak occurred for every 12,000 discharges—at least 1 outbreak per year for the average community hospital. Five (63%) outbreaks were recognized independently by the hospitals' infection control personnel. Four (50%) resolved spontaneously; the hospitals' own control measures were necessary in 2; and 2 resolved only after an outside investigation. Organized surveillance appears necessary to detect some outbreaks, and control measures are needed to stop many. Since, however, outbreaks account for such a small proportion of nosocomial infections, infection control programs should be sufficiently staffed and managed so that most of the effort is directed toward the surveillance and control of endemic infection problems, but with adequate resources remaining to respond to outbreaks when they occur.

scholarly journals Improvement in Infection Prevention and Control Measures at The Children Hospital, Lahore. A My Child Matters Collaborative Project

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 223s-223s
Author(s):  
M. Faizan ◽  
S. Anwar ◽  
R.U.A. Kashif ◽  
R. Saleem ◽  
H. Javed ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Infection Control ◽  
Pediatric Cancer ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Improvement Strategy ◽  
Targeted Interventions ◽  
Healthcare Associated ◽  
And Control

Background: Overcrowding, lack of operational funds, and healthcare associated infections are major challenges at the Children Hospital Lahore, a public healthcare facility in Pakistan with 900 new pediatric cancer admissions annually. In 2014, a collaboration between My Child Matters (MCM), St. Jude Global Infectious Diseases Program (SJ-GID), and our institution was established to address these issues. Aim: To describe the effect of a collaborative improvement strategy on the infection prevention and control (IPC) standards in a pediatric oncology unit in a resource-limited setting. Methods: Our study was a prospective before-and-after study. We compare the WHO Hand Hygiene Self-Assessment Framework (HHSAF) and 4 modules of the St. Jude modified Infection Control Assessment Tool (ICAT) scores. Our strategy included: (1) creating a multidisciplinary team of pediatric hematology-oncology, infectious disease physicians, nurses, microbiologist, and a data manager, (2) engaging on monthly online IPC mentoring sessions with the SJ-GID and MCM mentors, (3) performing daily inpatient healthcare associated (HAI) surveillance rounds, and (4) providing regular hand hygiene training and compliance audits. Results: Our hand hygiene facility level per WHO scores increased from “Inadequate” during the baseline assessment to “Intermediate/Consolidation” by the end of 3-year implementation (122 vs 352 HHSAF scores). The sink: bed and hand sanitizer: bed ratios improved to 1:6 and 1:1 respectively. Six washrooms were added to our unit. ICAT general infection control module increased by 40% (45 vs 78 ICAT score) and hygiene compliance improved by 20% from baseline. Identification of HAI increased from baseline (4.07 vs 8.7 infections per 1000 patient days). A 25% of the isolates were multidrug-resistant microorganisms. Conclusion: Implementing a collaborative improvement strategy improved the IPC standards in our pediatric cancer center. The increase of HAI might be a result of a better surveillance and laboratory identification. Further targeted interventions should be develop to decrease HAI rates and infection-related morbidity and mortality in our population.

scholarly journals Evaluation of Nosocomial Infection Control Programs in health services

2015 ◽  
Vol 23 (1) ◽  
pp. 98-105 ◽  
Author(s):  
Mayra Gonçalves Menegueti ◽  
Silvia Rita Marin da Silva Canini ◽  
Fernando Bellissimo-Rodrigues ◽  
Ana Maria Laus
Keyword(s):  
Health Services ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Epidemiological Surveillance ◽  
Control Programs ◽  
Control And Prevention ◽  
Study Population ◽  
Prevention Of Nosocomial Infection ◽  
And Control ◽  
Mean Compliance

OBJECTIVES: to evaluate the Nosocomial Infection Control Programs in hospital institutions regarding structure and process indicators.METHOD: this is a descriptive, exploratory and quantitative study conducted in 2013. The study population comprised 13 Nosocomial Infection Control Programs of health services in a Brazilian city of the state of São Paulo. Public domain instruments available in the Manual of Evaluation Indicators of Nosocomial Infection Control Practices were used.RESULTS: The indicators with the highest average compliance were "Evaluation of the Structure of the Nosocomial Infection Control Programs" (75%) and "Evaluation of the Epidemiological Surveillance System of Nosocomial Infection" (82%) and those with the lowest mean compliance scores were "Evaluation of Operational Guidelines" (58.97%) and "Evaluation of Activities of Control and Prevention of Nosocomial Infection" (60.29%).CONCLUSION: The use of indicators identified that, despite having produced knowledge about prevention and control of nosocomial infections, there is still a large gap between the practice and the recommendations.

An Outbreak of Bloodstream Infections in an Outpatient Hemodialysis Center

2002 ◽  
Vol 23 (12) ◽  
pp. 725-729 ◽  
Author(s):  
Connie S. Price ◽  
Donna Hacek ◽  
Gary A. Noskin ◽  
Lance R. Peterson
Keyword(s):  
Infection Control ◽  
Povidone Iodine ◽  
Bloodstream Infections ◽  
Baseline Period ◽  
Access Site ◽  
Control Programs ◽  
Before And After ◽  
And Control ◽  
Control Study ◽  
Microbiological Data

Objectives:Investigate and control an increase in bloodstream infections (BSIs) in an outpatient hemodialysis center.Patients and Design:A retrospective cohort study was conducted for patients receiving dialysis at the center from February 2000 to April 2001. A case–control study compared microbiological data for all BSIs that occurred during the study period with those for BSIs that occurred during a baseline period Qanuary 1999 to January 2000). BSI rates before and after a 1-month intervention (May 2001) were assessed. A case was defined as a new BSI during the study period.Results:The outbreak was polymicrobial, with approximately 30 species. The baseline BSI rate was 0.7 per 100 patient-months. From February 2000 to April 2001, the BSI rate increased to 4.2 per 100 patient-months. Overall, 75% of the BSIs were associated with central venous catheters (CVCs), but CVC use did not fully explain the increase in BSIs. In January 2000, when the center changed ownership, prepackaged CVC dressing kits and biweekly infection control monitoring were discontinued. Beginning in May 2001, staff were educated on CVC care, chlorhexidine replaced povidone-iodine for cutaneous antisepsis, gauze replaced transparent dressings, antimicrobial ointments containing polyethylene glycol at CVC exit sites were discontinued, and patients with CVCs were educated on cutaneous hygiene. After the intervention period, by October 2001, rates decreased to less than 1 BSI per 100 patient-months.Conclusions:Proper cutaneous antisepsis and access site care is crucial in preventing BSIs in patients receiving hemodialysis. Infection control programs, staff and patient education, and use of optimal antisepsis agents or prepackaged kits are useful toward this end.

scholarly journals Attitudes, knowledge and practices of healthcare workers regarding occupational exposure of pulmonary tuberculosis

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Lesley T. Bhebhe ◽  
Cornel Van Rooyen ◽  
Wilhelm J. Steinberg
Keyword(s):  
Infection Control ◽  
Prevention And Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Significant Proportion ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Attitudes And Practices ◽  
Healthcare Associated ◽  
And Control

Background: Healthcare-associated tuberculosis (TB) has become a major occupational hazard for healthcare workers (HCWs). HCWs are inevitably exposed to TB, due to frequent interaction with patients with undiagnosed and potentially contagious TB. Whenever there is a possibility of exposure, implementation of infection prevention and control (IPC) practices is critical.Objective: Following a high incidence of TB among HCWs at Maluti Adventist Hospital in Lesotho, a study was carried out to assess the knowledge, attitudes and practices of HCWs regarding healthcare-associated TB infection and infection controls.Methods: This was a cross-sectional study performed in June 2011; it involved HCWs at Maluti Adventist Hospital who were involved with patients and/or sputum. Stratified sampling of 140 HCWs was performed, of whom, 129 (92.0%) took part. A self-administered, semi-structured questionnaire was used.Results: Most respondents (89.2%) had appropriate knowledge of transmission, diagnosis and prevention of TB; however, only 22.0% of the respondents knew the appropriate method of sputum collection. All of the respondents (100.0%) were motivated and willing to implement IPC measures. A significant proportion of participants (36.4%) reported poor infection control practices, with the majority of inappropriate practices being the administrative infection controls (> 80.0%). Only 38.8% of the participants reported to be using the appropriate N-95 respirator.Conclusion: Poor infection control practices regarding occupational TB exposure were demonstrated, the worst being the first-line administrative infection controls. Critical knowledge gaps were identified; however, there was encouraging willingness by HCWs to adapt to recommended infection control measures. Healthcare workers are inevitably exposed to TB, due to frequent interaction with patients with undiagnosed and potentially contagious TB. Implementation of infection prevention and control practices is critical whenever there is a possibility of exposure.

Screening for MRSA: A Flawed Hospital Infection Control Intervention

2008 ◽  
Vol 29 (11) ◽  
pp. 1012-1018 ◽  
Author(s):  
Richard P. Wenzel ◽  
Gonzalo Bearman ◽  
Michael B. Edmond
Keyword(s):  
Infection Control ◽  
Bloodstream Infections ◽  
Population Based ◽  
Attributable Mortality ◽  
Antibiotic Resistant ◽  
Control Programs ◽  
Basic Model ◽  
Control Intervention ◽  
Hospital Infection Control ◽  
Hospital Resources

Focusing hospital resources on a single antibiotic-resistant pathogen as a sole approach to infection control is inherently flawed. We applied attributable mortality principles to a basic model of bloodstream infections to outline the argument. Screening for methicillin-resistantStaphylococcus aureusalone made sense in the 1980s, but the ongoing emergence of vancomycin-resistant enterococci and antibiotic-resistant strains of gram-negative rods andCandidaspecies, as well as the recognition of the value of team-based infection control programs, support a population-based approach.

The “Hospital Epidemiologist” in U.S. Hospitals, 1976-1977: A Description of the Head of the Infection Surveillance and Control Program Report from the SENIC Project

1980 ◽  
Vol 1 (1) ◽  
pp. 21-32 ◽  
Author(s):  
Robert W. Haley
Keyword(s):  
Infection Control ◽  
Nosocomial Infections ◽  
Professional Training ◽  
Control Program ◽  
Clinical Problem ◽  
Control Programs ◽  
Project Study ◽  
Infection Surveillance ◽  
Urban Rural ◽  
And Control

AbstractAs part of the first two phases of the SENIC Project (Study on the Efficacy of Nosocomial Infection Control), information was collected from the heads of the infection surveillance and control programs (ISCPs) in U.S. hospitals. The data were analyzed to describe these respondents and to determine whether differences among them were related to their areas of professional training or to characteristics of the hospitals where they were located. The findings indicate that the ISCP heads constitute a very heterogeneous group, with substantial differences in age, professional training (40% are pathologists), characteristics of their medical practices, memberships in professional organizations related to infection control, time spent in ISCP activities, approach to epidemiologic problems, and opinions on the preventability of nosocomial infections and the seriousness of infection problems in their hospitals. These differences are related strongly to the ISCP heads' professional training, size of hospital, and, to a lesser extent, medical school affiliation, but there is little evidence that the differences are related to regional or urban-rural location or type of ownership of the hospitals. The average ISCP head estimates that about half of all nosocomial infections are preventable, but these estimates vary inversely with tenure in the position and the tendency to approach a clinical problem epidemiologically.

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