Supporting evidence-based infection prevention and control practice in the National Health Service in England. The NHS/TVU/Intuition Approach

2007 ◽  
Vol 65 ◽  
pp. 142-147 ◽  
Author(s):  
R.J. Pratt ◽  
B. O'Malley
2021 ◽  
Author(s):  
T. E. F. Abbott ◽  
A. J. Fowler ◽  
T. D. Dobbs ◽  
J. Gibson ◽  
T. Shahid ◽  
...  

AbstractObjectivesTo confirm the incidence of perioperative SARS-CoV-2 infection and associated mortality after surgery.Design and settingAnalysis of routine electronic health record data from National Health Service (NHS) hospitals in England.MethodsWe extracted data from Hospital Episode Statistics in England describing adult patients undergoing surgery between 1st January 2020 and 31st October 2020. The exposure was SARS-CoV-2 infection defined by ICD-10 codes. The primary outcome measure was 90-day in-hospital mortality. Data were analysed using multivariable logistic regression adjusted for age, sex, Charlson co-morbidity index, index of multiple deprivation, presence of cancer, surgical procedure type and admission acuity. Results are presented as n (%) and odds ratios (OR) with 95% confidence intervals.ResultsWe identified 1,972,153 patients undergoing surgery of whom 11,940 (0.6%) had SARS-CoV-2. In total, 19,100 (1.0%) patients died in hospital. SARS-CoV-2 infection was associated with a much greater risk of death (SARS-CoV-2: 2,618/11,940 [21.9%] vs No SARS-CoV-2: 16,482/1,960,213 [0.8%]; OR: 5.8 [5.5 – 6.1]; p<0.001). Amongst patients undergoing elective surgery 1,030/1,374,985 (0.1%) had SARS-CoV-2 of whom 83/1,030 (8.1%) died, compared with 1,092/1,373,955 (0.1%) patients without SARS-CoV-2 (OR: 29.0 [22.5 −37.3]; p<0.001). Amongst patients undergoing emergency surgery 9,742/437,891 (2.2%) patients had SARS-CoV-2, of whom 2,466/9,742 (25.3%) died compared with 14,817/428,149 (3.5%) patients without SARS-CoV-2 (OR: 5.7 [5.4 – 6.0]; p<0.001).ConclusionsThe low incidence of SARS-CoV-2 infection in NHS surgical pathways suggests current infection prevention and control policies are highly effective. However, the high mortality amongst patients with SARS-CoV-2 suggests these precautions cannot be safely relaxed.Summary boxesWhat is already known on this topicHigh mortality rates have been reported amongst surgical patients who develop COVID-19 but we don’t know how this compares to the concurrent surgical population unaffected by COVID-19.Strict infection prevention and control procedures have substantially reduced the capacity of surgical treatment pathways in many hospitals.The very large backlog in delayed and cancelled surgical procedures is a growing public health concern.What this study addsFewer than 1 in 100 surgical patients are affected by COVID-19 in the English National Health Service.Elective surgical patients who do develop COVID-19 are 30 times more likely to die while in hospital.Infection prevention and control procedures in NHS surgical pathways are highly effective but cannot be safely relaxed.


2019 ◽  
Vol 15 (2) ◽  
Author(s):  
Walelegn Worku Yallew ◽  
Abera Kumie ◽  
Feleke Moges Yehuala

Healthcare workers have good perception towards infection prevention, but there has been a poor practice towards it. Therefore, the aim of this study was to explore barriers to practice of infection prevention and control practice in teaching hospitals in Amhara region. A phenomenological approach used to explore the lived experience of healthcare workers and management staffs towards infection prevention practice and control. The data was collected from ten in-depth interviews and 23 focus group discussion participants, by face to face interview using open ended interview performed in safe and quiet places. Data was managed using OpenCode software version 4.03 and contents were analyzed thematically. Totally ten different barriers were identified, such as availability of facilities, shortage of material supply, lack of maintenance of facilities and equipment, high patient flow, experience, emergency situation, healthcare worker behaviour and healthcare worker’s information about infection prevention, low awareness of patients and visitors and overflow of families and visitors to the hospital. For effective infection prevention practice implementation, barriers should be considered via identifying specific organizational, healthcare worker, patients and visitors as targets.


2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Kemal Jemal ◽  
Ketema Gashaw ◽  
Tadele Kinati ◽  
Worku Bedada ◽  
Belete Getahun

Background. Infection prevention and control practice (IPCP) is essential for healthcare safety and quality service delivery. The Ethiopian government has already put in place programs and initiatives for clean and safe healthcare facilities. However, in the North Showa Zone of the Oromiya Region, the infection prevention and control practice level was not well understood. Therefore, this study aimed to assess the knowledge, attitude, and practice of infection prevention and control practice among the health workforce (HWF) in North Shoa healthcare facilities (NSHCFs) environment. Methods. Healthcare facility-based cross-sectional study design was employed. Structured and pretested self-administered questionnaires were distributed for 373 health workforce. Three hospitals and six health centers were randomly selected, and the study participants were selected by systematic sampling technique. Data were entered into Epi-data version 3.5.2 and then exported to SPSS version 23 for analysis. Multivariable logistic regression was performed to determine the associated factors with infection prevention practice, and a p value of less than 0.05 was considered statistically significant. Results. A total of 361 (96.8%) health workforce responded to self-administered questionnaires. About 55.70% of study participants had good knowledge, 59.3% of them had a positive attitude, and 46.8% had a good infection prevention practice. Age category of 20–29(AOR = 4.08, 95%, CI = (1.97, 8.49)), female participants (AOR = 3.87, 95%, CI = (1.91, 7.86)), single participants (AOR = 3.89, 95%, CI = (1.92, 7.87)), having greater than ten years of working experience (AOR = 3.10, 95% CI = (1.19, 8.10)), positive attitude (AOR = 10.07, 95% CI = (4.82, 21.05)), and availability of water at working area (AOR = 2.27, 95% CI = (1.18, 4.35)) were significantly associated with good infection prevention practice. Conclusion. In this study, a significant number of health workers had low knowledge, negative attitudes, and poor infection prevention practices. Female participants, higher work experience, a positive attitude, and water availability in the healthcare facilities were positively associated with infection prevention and control practice. Healthcare facilities should be continued capacitating the health workforce on infection prevention and control measures and equipping health facilities with infection prevention materials.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Luís Irgang ◽  
Magnus Holmén ◽  
Fábio Gama ◽  
Petra Svedberg

PurposeFacilitation activities support implementation of evidence-based interventions within healthcare organizations. Few studies have attempted to understand how facilitation activities are performed to promote the uptake of evidence-based interventions in hospitals from resource-poor countries during crises such as pandemics. This paper aims to explore facilitation activities by infection prevention and control (IPC) professionals in 16 hospitals from 9 states in Brazil during the COVID-19 pandemic.Design/methodology/approachPrimary and secondary data were collected between March and December 2020. Semi-structured interviews were conducted with 21 IPC professionals in Brazilian hospitals during the COVID-19 pandemic. Public and internal documents were used for data triangulation. The data were analyzed through thematic analysis technique.FindingsBuilding on the change response theory, this study explores the facilitation activities from the cognitive, behavioral and affective aspects. The facilitation activities are grouped in three overarching dimensions: (1) creating and sustaining legitimacy to continuous and rapid changes, (2) fostering capabilities for continuous changes and (3) accelerating individual commitment.Practical implicationsDuring crises such as pandemics, facilitation activities by IPC professionals need to embrace all the cognitive, behavioral and affective aspects to stimulate positive attitudes of frontline workers toward continuous and urgent changes.Originality/valueThis study provides unique and timely empirical evidence on the facilitation activities that support the implementation of evidence-based interventions by IPC professionals during crises in hospitals in a resource-poor country.


2020 ◽  
Vol 29 (8) ◽  
pp. 491-491
Author(s):  
Sam Foster

Sam Foster, Chief Nurse, Oxford University Hospitals, considers the balance of the benefits of enabling visiting with infection prevention and control practice during this pandemic


2011 ◽  
Vol 13 (1) ◽  
pp. 24-27 ◽  
Author(s):  
H Slyne ◽  
C Phillips ◽  
J Parkes

Aretrospective audit evaluation was conducted to determine whether the introduction of two clinical skills trainers for four months in a district general hospital improved compliance with infection prevention and control practices. Saving Lives (Department of Health, 2010) peripheral venous cannula and urinary catheter high impact intervention audit data were analysed for six months before, four months during and six months after the clinical skills training was implemented for six control wards and seven intervention wards. Findings showed that although the control wards did not improve compliance significantly over the study period, the intervention wards improved compliance with the high impact intervention care bundles studied and that this practice was sustained for six months after the clinical skills training. The findings suggest that education is required to improve clinical skills surrounding cannulation and catheterisation, which can then be sustained by Saving Lives audits to reduce the risk of infection to patients.


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