scholarly journals Infection Prevention and Control in Residential Facilities for Pediatric Patients and Their Families

2013 ◽  
Vol 34 (10) ◽  
pp. 1003-1041 ◽  
Author(s):  
Judith A. Guzman-Cottrill ◽  
Karen A. Ravin ◽  
Kristina A. Bryant ◽  
Danielle M. Zerr ◽  
Larry Kociolek ◽  
...  

The Society for Healthcare Epidemiology of America (SHEA) guideline “Infection Prevention and Control in Residential Facilities for Pediatric Patients and Their Families” is the first infection prevention and control (IPC) guideline to address preventing transmission of infectious agents in “home away from home” residential settings, of which the Ronald McDonald Houses (RMHs) serve as a prototype. These types of facilities provide support services, including overnight lodging, for ill and injured children and their families. Food preparation occurs in common areas, and cleaning of rooms or apartments is performed by the occupants during their stay and before departure. Pediatric patients are frequent guests of the family-centered facilities while receiving or recovering from specialized medical therapy. Examples of high-risk populations served in these facilities include families of patients with cancer, recipients of stem cell or solid organ transplants, surgical and/or very-low-birthweight infants who receive care in neonatal intensive care units (NICUs), those with cystic fibrosis, and women with high-risk pregnancies awaiting delivery in a nearby medical center. Such facilities are located worldwide and vary in their physical structure and the predominant population served.

2020 ◽  
Vol 41 (S1) ◽  
pp. s471-s471
Author(s):  
Maureen Kesande ◽  
Mohammed Lamorde ◽  
Elizabeth Bancroft ◽  
Carolyn Herzig ◽  
Judith Nanyondo ◽  
...  

Background: In June 2019, 3 people were diagnosed with Ebola virus disease (EVD) in Kasese district, Uganda, all of whom had come from the Democratic Republic of Congo (DRC). Although no secondary transmission of Ebola occurred, an assessment of infection prevention and control (IPC) using the WHO basic IPC facility assessment checklist revealed significant gaps. Robust IPC systems are critical for the prevention of healthcare-associated infections like EVD. A rapid intervention was developed and implemented in Kasese to strengthen IPC capacity in high-risk facilities. Methods: Of 117 healthcare facilities, 50 were considered at high risk of receiving suspected EVD cases from DRC based on population movement assessments. In August 2019, IPC mentors were selected from 25 high-risk facilities and assigned to support their facility and a second high-risk facility. Mentors ensured formation of IPC committees and implemented the national mentorship strategy for IPC preparedness in non-EVD treatment facilities. This effort focused on screening, isolation, and notification of suspect cases: 4 mentorship visits were conducted (1 per week for 1 month). Middle and terminal assessments were conducted using the WHO IPC checklist 2 and 4 weeks after the intervention commenced. Results were evaluated against baseline data. Results: Overall, 39 facilities had data from baseline, middle, and end assessments. Median scores in facility IPC standard precautions increased from baseline 50% (IQR, 39%–62%) to 73% (IQR, 67%–76%) at the terminal assessments. Scores increased for all measured parameters except for water source (access to running water). Greatest improvements were seen in formation of IPC committees (41% to 75%), hand hygiene compliance (47% to 86%), waste management (51% to 83%), and availability of dedicated isolation areas (16% to 42%) for suspect cases. Limited improvement was noted for training on management of suspect isolated cases and availability of personal protective equipment (PPE) (Fig. 1). No differences were noted in scores for facilities with nonresident mentors versus those with resident mentors at baseline (48% vs 50%) and end assessments (72% vs 74%). Conclusions: This intervention improved IPC capacity in health facilities while avoiding the cost and service disruption associated with large-scale classroom-based training of health workers. The greatest improvements were seen in activities relying on behavior change, such as hand hygiene, IPC committee, and waste management. Smaller changes were seen in areas requiring significant investments such as isolation areas, steady water source, and availability of personal protective equipment (PPE). Mentorship is ongoing in moderate- and lower-risk facilities in Kasese district.Funding: NoneDisclosures: Mohammed Lamorde reports contract research for Janssen Pharmaceutica, ViiV, Mylan.


2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Esubalew T. Mindaye ◽  
Bekalu Assaminew ◽  
Goytom K. Tesfay

Coronavirus disease 2019 (COVID-19) is a pandemic affecting over 106 million and killing over 2.3 million people. Inadequate knowledge of the disease coupled with scarce or improper use of infection prevention and control (IPC) measures by healthcare workers (HCWs) and support staff may be contributing to the rapid spread of infection. This survey aims to assess knowledge, risk perception, and precaution practices of HCWs and support staff toward COVID-19 under resource-constrained circumstances at a major referral hospital in Ethiopia. An institution-based survey was conducted in April 2020 using 422 subjects selected by stratified random sampling. A five-section survey instrument was distributed, and the collected responses were cleaned and entered into Epi data (v3.1) and exported to SPSS (v.26) for further statistical analysis. The survey found that about 58% of the HCWs and support staff in the hospital appear to have adequate awareness and perceive COVID-19 to be a high-risk disease. Seven out of 10 subjects practice some form of IPC measures. However, the knowledge among allied HCWs and support staff appears to be inadequate. Gender, occupation, and years in service correlated with the level of awareness. Of those surveyed, 78% were concerned about the lack of personal protective equipment and perceived public transportation to be a high-risk factor for the transmission of infection. Additional campaigns may be necessary to reinforce existing knowledge of HCWs, but more emphasis should be geared toward educating allied HCWs and support staff.


2021 ◽  
Vol 1 (S1) ◽  
pp. s16-s16
Author(s):  
Mohammed Alsuhaibani ◽  
Takaaki Kobayashi ◽  
Lorinda Sheeler ◽  
Alexandra Trannel ◽  
Stephanie Holley ◽  
...  

Background: Bats are recognized as important vectors in disease transmission. Frequently, bats intrude into homes and buildings, increasing the risk to human health. We describe bat intrusions and exposure incidents in our hospital over a 3-year period. Methods: The University of Iowa Hospitals and Clinics (UIHC) is an 811-bed academic medical center in Iowa City, Iowa. Established in 1928, UIHC currently covers 209,031.84 m2 (~2,250,000 ft2) and contains 6 pavilions built between 1928 and 2017. We retrospectively obtained bat intrusion calls from the infection prevention and control program call database at UIHC during 2018–2020. We have also described the event management for intrusions potentially associated with patient exposures. Results: In total, 67 bat intrusions occurred during 2018–2020. The most frequent locations were hallways or lounges 28 (42%), nonclinical office spaces 19 (14%), and stairwells 8 (12%). Most bat intrusions (65%) occurred during the summer and fall (June–November). The number of events were 15 in 2018, 28 in 2019, and 24 in 2020. We observed that the number of intrusions increased with the age of each pavilion (Figure 1). Of 67 intrusions, 2 incidents (3%) were associated with potential exposure to patients. In the first incident, reported in 2019, the bat was captured in a patient care area and released before an investigation of exposures was completed and no rabies testing was available. Also, 10 patients were identified as having had potential exposure to the bat. Among them, 9 patients (90%) received rabies postexposure prophylaxis. In response to this serious event, we provided facility-wide education on our bat control policy, which includes the capture and safe handling of the bat, assessment of potential exposures, and potential need for rabies testing. We also implemented a bat exclusion project focused on the exterior of the oldest hospital buildings. The second event, 1 patient was identified to have potential exposure to the bat. The bat was captured, tested negative for rabies, no further action was needed. Conclusions: Bat intrusions can be an infection prevention and control challenge in facilities with older buildings. Hospitals may need animal intrusion surveillance systems, management protocols, and remediation efforts.Funding: NoDisclosures: None


2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S569-S570
Author(s):  
M Salman Ashraf ◽  
Mounica Soma ◽  
Jody Scebold ◽  
Angela Vasa ◽  
Kate Tyner ◽  
...  

Abstract Background Critical Access Hospitals (CAH) may face challenges with limited resources in their infection prevention and control (IPC) program. As part of the Project Firstline collaborative, the University of Nebraska Medical Center and its clinical partner Nebraska Medicine sought to identify needs and develop resources to mitigate IPC program gaps in small and rural hospitals, including CAHs. Since, little is known about the resources needed by CAHs to strengthen their IPC program, a needs assessment survey was deployed to Federal Emergency Management Agency Region VII CAHs. Methods A 49-question Research Electronic Data Capture (REDCap) survey was distributed via email to infection preventionists in Region VII CAHs. The survey had 4 sections with questions focused on IPC program infrastructure, competency-based training, audit and feedback, and identification and isolation of high-risk pathogens/serious communicable diseases. An IPC practice score was assigned to each CAH by totaling “yes” responses. A “no” or “not sure” response was considered an IPC gap. Respondents who selected “no” were asked to identify resources that would assist in mitigating identified gaps. Descriptive analyses evaluated frequency of gaps and most cited resources. Welch t-test was used to study differences in IPC practice score between states. Results 50 CAHs (33 in NE, 16 in IA and 1 in KS) and 1 small NE hospital (not licensed as CAH but included in the analyses as CAH) participated in the survey. Majority (n=38) responded to all sections with IPC scores ranging from 13 to 48. There was no significant difference between IPC practice scores of CAHs in NE and IA (average score 33 vs 36; p = 0.38). Specific IPC practice gaps present in > 50% of CAHs were related to audit and feedback practices (Table 1). Additional gaps included lack of drug diversion program, absence of input from IPC team prior to purchasing equipment and failure to conduct risk assessment for the laboratory. Most CAHs cited a standardized audit tool and staff training materials as much needed resources (Table 1). Table 1. Needs/Resources for the identified Infection Prevention and Control Gaps. Conclusion Major IPC gaps exist in CAHs with many of them related to implementing audit and feedback practices that are an essential component of a successful IPC program. Focus should be directed on developing resources to mitigate identified IPC gaps. Disclosures M. Salman Ashraf, MBBS, Merck & Co. Inc (Grant/Research Support, I have recieved grant funding for an investigator initiated research project from Merck & Con. Inc. However, I do not see any direct conflict of interest related to the submitted abstract)


2020 ◽  
Author(s):  
Daniel Poremski ◽  
Sandra Henrietta Subner ◽  
Grace Lam Fong Kin ◽  
Raveen Dev Ram Dev ◽  
Mok Yee Ming ◽  
...  

The Institute of Mental Health in Singapore continues to attempt to prevent the introduction of COVID-19, despite community transmission. Essential services are maintained and quarantine measures are currently unnecessary. To help similar organizations, strategies are listed along three themes: sustaining essential services, preventing infection, and managing human and consumable resources.


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