scholarly journals Guiding Principles and Practices for Healthcare Outbreak Notification and Disclosures: CORHA Policy Workgroup Framework

2020 ◽  
Vol 41 (S1) ◽  
pp. s480-s481
Author(s):  
Maureen Tierney ◽  
Moon Kim ◽  
Christopher Baliga ◽  
Martha Ngoh ◽  
Kiran Perkins ◽  
...  
Keyword(s):  
Public Health ◽  
Best Practice ◽  
Work Group ◽  
Guidance Document ◽  
Draft Guidance ◽  
Outbreak Response ◽  
Fashion Modeling ◽  
Patient Advocates ◽  
Guiding Principles ◽  
Healthcare Associated

Background: Outbreaks of infections in healthcare negatively impact patient outcomes and experience. Transparency is critical to engendering trust and optimizing health. Consistent guidance is not available regarding when to report a possible outbreak of healthcare-associated infections (HAIs) to public health and when to notify a limited population or to publicly disclose the occurrence of HAI. Recent analyses of state public health policies revealed that most states address reporting of outbreaks using terms such as clusters, unusual occurrences, or incidences over baseline. Specific wording about healthcare outbreaks or guidance for notifying patients or public is often absent. Thus, HAI outbreak notification and disclosure guidance and practices vary significantly around the country. A best-practice guidance document will provide clarity for when such reporting should occur. Methods: The Council for Outbreak Response: HAI and Antimicrobial-Resistant Pathogens (CORHA) has undertaken the task of developing this guidance by forming a multidiscipline policy work group with representation from its partner organizations. This work group has been tasked with creating a general framework that will guide notification and disclosure in the context of a possible HAI outbreak. The draft guidance document has been developed over several months of telephone and in-person conferences among work group members. Results: The standardized actions stemming from the guiding principles and recommended practices for conducting step 1 (immediate notification, initial and critical communications that occur when an outbreak is first suspected), were arranged in a table format with rows representing stakeholders and constituents to be notified and columns demonstrating the actions to be taken (Fig. 1). As an investigation progresses, notification should be revisited, especially if an investigation’s scope expands. The principles and practices for step 2 (expanded notification) have also been drafted in a table format. Next, the draft guidance addresses step 3 (public disclosure), outlining indications, practical guidance, and considerations in an outline and/or summary format. Real-world examples demonstrating application of the framework are being developed as supplementary resources to the framework. Current work group activities include engaging bioethicists, media reporters and patient advocates to review and comment on the guidance to ensure that it is clear, consistent and practical. Discussion: The draft guidance provides a framework for standardized actions for HAI outbreak notification and disclosure in a stepwise fashion, modeling public health practices and grounded in bioethical principles. The final product will provide valuable, practical advice for effectively sharing information with affected or potentially affected individuals and their caregivers in a timely manner.Funding: NoneDisclosures: Dawn Terashita reports that her spouse has received honoraria rom the speaker’s bureaus of Novo Nordisk and Abbott.

Regulatory Guidance for Risk-Informed In-Service Inspection of Nuclear Power Plants in Bulgaria

2007 ◽  
Author(s):  
Adam Toft ◽  
David Lidbury ◽  
Rossitza Miteva ◽  
Dimitar Vasilev
Keyword(s):  
Nuclear Power ◽  
Power Plants ◽  
Best Practice ◽  
Operating Conditions ◽  
Guidance Document ◽  
Draft Guidance ◽  
Nuclear Facilities ◽  
Regulatory Guidance ◽  
The Uk ◽  
Service Inspection

Risk-Informed In-Service Inspection (RI-ISI) aims to integrate service experience, plant and operating conditions, other deterministic information, and risk insights in developing augmented in-service inspection (ISI) programmes for Nuclear Power Plant (NPP). RI-ISI is a developing methodology which is increasingly being adopted world-wide, and is seen as having the potential to make ISI programmes more effective and efficient in terms of both nuclear safety and the economical operation of nuclear plant. The Nuclear Regulatory Agency (NRA) bears responsibility for regulating nuclear facilities in Bulgaria. In anticipation of a forthcoming application by Kozloduy NPP to adopt an RI-ISI programme for selected systems in WWER-1000 plant, the NRA required a suitable regulatory guidance document to help assess such an application. The UK Department of Trade and Industry-funded Project NSP/04-B23 “Assistance with the Regulatory Aspects of Risk-informed In-Service Inspection (RI-ISI)” has enabled the development of a guidance document, the initial draft of which was produced by Serco Assurance in close consultation with the NRA and other Bulgarian stakeholders. This paper presents a description of how current international best practice has been tailored to Bulgarian NPP, and provides a summary of the draft guidance document produced as the principal output of Project NSP/04-B23.

Best practice for chronic oedema in community settings: what can we learn?

2020 ◽  
Vol 25 (12) ◽  
pp. 610-614
Author(s):  
Garry Cooper-Stanton
Keyword(s):  
Service Provision ◽  
Best Practice ◽  
Evidence Base ◽  
Community Services ◽  
Guidance Document ◽  
Community Settings ◽  
Tissue Viability ◽  
Delivery Of Care ◽  
Specialist Nurses ◽  
The Uk

There are various opportunities and challenges in the delivery of care to those diagnosed with chronic oedema/lymphoedema. Service provision is not consistent within the UK, and non-specialist nurses and other health professionals may be called on to fill the gaps in this area. The latest best practice guidance on chronic oedema is directed at community services that care for people within their own homes in primary care. This guide was developed in order to increase awareness, knowledge and access to an evidence base. Those involved in its creation cross specialist fields (lymphoedema and tissue viability), resulting in the document covering a number of areas, including an explanation of chronic oedema, its assessment and management and the association between chronic oedema and wet legs. The document complements existing frameworks on the condition and its management and also increases the available tools within chronic oedema management in the community. The present article provides an overview of the guidance document and discusses its salient features.

scholarly journals Delivery of the National Child Measurement Programme in England

2020 ◽  
pp. 1-21
Author(s):  
Martin Čadek ◽  
Stuart W. Flint ◽  
Ralph Tench
Keyword(s):  
Public Health ◽  
Local Government ◽  
Best Practice ◽  
Online Survey ◽  
The Other ◽  
Service Availability ◽  
Healthy Weight ◽  
Weight Category ◽  
Convenience Sampling

Abstract Objective: The National Child Measurement Programme (NCMP) is a mandatory initiative delivered in England to children in reception and year 6. To date, no research has explored the methods used to deliver the NCMP by Local Government Authorities (LGA) across England. Design: An online survey was administered between February 2018 and May 2018 to explore the delivery of the NCMP across the 152 LGAs in England and disseminated using non-probability convenience sampling. Setting: LGAs received an anonymous link to the survey. Participants: A total of 92 LGAs participated in the survey. Results: Most LGAs who responded provide result feedback (86%), a proactive follow-up (71%) and referrals to services (80%). Additionally, 65% of the authorities tailor Public Health England specimen result letters to suit their needs, and 84% provide attachments alongside. Out of 71% of LGAs who provide proactive follow-up, 19 (29%) provide the proactive follow-up only to upper weight categories, and only 4 (6 %) include Healthy Weight category with other categories in proactive follow-up. Regarding the service availability for children, out of 80% of LGAs who indicated that services are available, 32 (43%) targeted solely upper weight categories while the other 42 (57%) offered services across all weight categories. Finally, most LGAs (88%) commission providers to manage various parts of the NCMP. Conclusions: The results show that LGAs in England localise the NCMP. Further guidance regarding standards of best practice would help LGAs to find the most suitable localisation out of various options that exist across other LGAs.

Transforming a global order in New Zealand to reduce health inequities in service provision

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Rawson
Keyword(s):  
Public Health ◽  
New Zealand ◽  
Indigenous Knowledge ◽  
Best Practice ◽  
Indigenous Health ◽  
Indigenous Communities ◽  
Health Inequities ◽  
Medical Emergency ◽  
Major Work ◽  
Health Initiatives

Abstract St John has been providing service in New Zealand for nearly 140 years since its arrival. It has now close to 4000 staff and nearly 20000 Members and over 8500 volunteers. In New Zealand the major work of St John is its Ambulance service providing front line first responders to crash, medical emergency and other life-threatening situations. St John New Zealand also provides a number of 'Community Health' initiatives focused on strengthening communities and prevention. In recent years St John has recognised that they have not engaged well with Indigenous communities and that their organisation in New Zealand must become skilled and relevant in addressing the needs of the Indigenous people of New Zealand, as they suffer the greater burden of disease and illness than any other population in the country. St John NZ Community and Health Services are embarking on a process of transformation through re-orienting its culture and practice by adopting Public Health approaches and an equity lens over all its programmes. They also have committed to understanding and using Indigenous knowledge to support this re-orientation to most effectively engage and implement programmes that will reduce Indigenous health inequities. This presentation will describe the process by which they will be implementing their strategy for change and highlight best practice for working with Indigenous communities. Key messages Indigenous Knowledge is key to addressing Indigenous Health inequities. Mainstream Public Health can learn from Indigenous Public Health approaches.

Framing Bacterial Genomics for Public Health(care)

2021 ◽  
Author(s):  
Alison Laufer Halpin ◽  
L. Clifford McDonald ◽  
Christopher A. Elkins
Keyword(s):  
Public Health ◽  
National Laboratory ◽  
Resistance Mechanisms ◽  
Public Health Care ◽  
Virulence Determinants ◽  
Top Down ◽  
Bottom Up ◽  
The Public ◽  
Bacterial Genomics ◽  
Healthcare Associated

Advancements in comparative genomics have generated significant interest in defining applications for healthcare-associated pathogens. Clinical microbiology, however, relies on increasingly automated platforms to quickly identify pathogens, resistance mechanisms, and therapy options within CLIA- and FDA-approved frameworks. Additionally, and most notably, healthcare-associated pathogens, especially those that are resistant to antibiotics, represent a diverse spectrum of genera harboring complex genetic targets including antibiotic, biocide, and virulence determinants that can be highly transmissible and, at least for antibiotic resistance, serve as potential targets for containment efforts. U.S. public health investments have focused on rapidly detecting outbreaks and emerging resistance in healthcare-associated pathogens using reference, culture-based, and molecular methods that are distributed, for example, across national laboratory network infrastructures. Herein we describe the public health applications of genomic science that are built from the top-down for broad surveillance, as well as the bottom-up, starting with identification of infections and infectious clusters. For healthcare-associated, including antimicrobial-resistant, pathogens, we propose a combination of top-down and bottom-up genomic approaches leveraged across the public health spectrum, from local infection control, to regional and national containment efforts, to national surveillance for understanding emerging strain ecology and fitness of healthcare pathogens.

scholarly journals Master of public health practicum: Global trends and current practices.

2020 ◽  
Author(s):  
Hannah Gummeson ◽  
Sonika Raj Goel ◽  
Khalifa Elmusharaf
Keyword(s):  
Public Health ◽  
Health Education ◽  
Experiential Learning ◽  
Best Practices ◽  
Best Practice ◽  
Public Health Education ◽  
Health Programs ◽  
Public Health Programs ◽  
Master Of Public Health ◽  
Study Results

Abstract Background The field of graduate public health (GPH) education currently lacks clear, universal criteria for the integration of practice-based elements into the curriculum. The concept of the ‘practicum’ is well endorsed and there is a growing recognition that experiential learning is a crucial aspect of career development for the next generation of public health professionals, benefiting not only students, but also the profession and communities it serves. However, many leading academic institutions continue to emphasize research over experiential learning in public health, making practicums much less commonplace in education centers across the globe. Methods The purpose of this research was to review global best practices in graduate public health program design in order to identify commonalities and use the findings to inform practicum development.Data collection for this research was entirely web-based. Practicum guidelines from a globally diverse sample of graduate public health programs were reviewed. Data was compiled from universities’ websites and available online sources and collated into an Excel file. Descriptive statistics were computed for each study variable.Results We screened 108 graduate public health programs and 35 eligible programs were included in the study. Results were reported according to prerequisites & practicum scheduling, practicum contact hours & duration, credit hours & overall credit weighting, competencies, supervision, written agreement, objectives & deliverables, and approach to assessment. This research resulted in 13 recommendations intended to guide graduate public health practicum design. Based on the analysis of current best practice, the recommendations address the following four key domains: practicum design, mentorship & supervision, learning outcomes and evaluation. Conclusions This research demonstrates a global recognition of the benefit of practice experience in graduate public health education. However, the integration of practical components into curricula is inconsistent when viewed through a global lens. There is also significant variation in the structure of existing practical components. We propose that this study be utilized as a tool spark a global dialogue about best practices in graduate public health education through the identification common practices and opportunities for improvement.

Predicting Methicillin-Resistant Staphylococcus aureus (MRSA) Bloodstream Infection Incidence Rates using Canadian Nosocomial Infection Surveillance Program (CNISP)

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Jona Gjevori ◽  
Kahina Abdesselam
Keyword(s):  
Public Health ◽  
Staphylococcus Aureus ◽  
Nosocomial Infection ◽  
Bloodstream Infection ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Incidence Rates ◽  
Surveillance Program ◽  
Methicillin Resistant ◽  
Infection Surveillance ◽  
Healthcare Associated

Methicillin-Resistant Staphylococcus aureus (MRSA) is among the most prevalent nosocomial pathogens globally, causing significant morbidity, mortality, and healthcare costs. MRSA bloodstream infection (BSI) incidence rates in Canadian hospitals have significantly risen by almost 60% and have a mortality of over 20% upon Intensive Care Unit admission. MRSA is believed to be spread through healthcare workers; thus, high hand hygiene compliancy in addition to environmental cleaning are the cornerstone countermeasures to disrupting its transmission. The Public Health Agency of Canada (PHAC), in collaboration with the Canadian Nosocomial Infection Surveillance Program (CNISP), conducts national, sentinel surveillance on healthcare-associated infections like MRSA. As a Student Epidemiologist, I developed a research proposal detailing two study objectives: 1) develop a regression model to predict all incident MRSA BSI rates among acute-care hospitals in Canada using CNISP MRSA BSI incident cases from 2000 to 2019, and 2) create a compartmental (Susceptible-Infected-Recovered-Deceased) model to determine the impact of various Infection Prevention and Control (IPC) measures on the risk of healthcare-associated MRSA BSI transmission specifically. This study hopes to demonstrate that proper IPC compliance is associated with lower incident MRSA BSI rates with the goal being to produce a manuscript draft by 2021. MRSA poses a serious threat to patient safety globally and is becoming a growing national public health concern in Canada; determining which IPC strategy is most effective at disrupting MRSA transmission is essential to reducing incidence and mortality rates.

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