Evidence-Based Design of Healthcare Facilities: Opportunities for Research and Practice in Infection Prevention

2013 ◽  
Vol 34 (5) ◽  
pp. 514-516 ◽  
Author(s):  
Craig Zimring ◽  
Megan E. Denham ◽  
Jesse T. Jacob ◽  
David Z. Cowan ◽  
Ellen Do ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Evidence Based ◽  
Healthcare Facilities ◽  
Research And Practice

scholarly journals Infectious Diseases Society of America Guidelines on Infection Prevention for Healthcare Personnel Caring for Patients With Suspected or Known Coronavirus Disease 2019

2020 ◽  
Author(s):  
John B Lynch ◽  
Perica Davitkov ◽  
Deverick J Anderson ◽  
Adarsh Bhimraj ◽  
Vincent Chi-Chung Cheng ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Infection Prevention ◽  
Indirect Evidence ◽  
Standards Of Care ◽  
Healthcare Personnel ◽  
Evidence Based ◽  
Healthcare Facilities ◽  
Guideline Panel ◽  
Evaluation Approach ◽  
Specific Care

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible virus that can infect healthcare personnel (HCP) and patients in healthcare settings. Specific care activities, in particular, aerosol-generating procedures, may have a higher risk of transmission. The rapid emergence and global spread of SARS-CoV-2 has created significant challenges in healthcare facilities, particularly with severe shortages of personal protective equipment (PPE) used to protect HCP. Evidence-based recommendations for what PPE to use in conventional, contingency, and crisis standards of care are needed. Where evidence is lacking, the development of specific research questions can help direct funders and investigators. Objective Our objective was to develop evidence-based rapid guidelines intended to support HCP in their decisions about infection prevention when caring for patients with suspected or known coronavirus disease 2019 (COVID-19). Methods The Infectious Diseases Society of America (IDSA) formed a multidisciplinary guideline panel that included front-line clinicians, infectious diseases specialists, experts in infection control, and guideline methodologists with representation from the disciplines of preventive care, public health, medical microbiology, pediatrics, critical care medicine, and gastroenterology. The process followed a rapid recommendation checklist. The panel prioritized questions and outcomes. Then, a systematic review of the peer-reviewed and gray literature was conducted. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the certainty of evidence and make recommendations. Results The IDSA guideline panel agreed on 8 recommendations and provided narrative summaries of other interventions undergoing evaluations. Conclusions Using a combination of direct and indirect evidence, the panel was able to provide recommendations for 8 specific questions on the use of PPE for HCP who provide care for patients with suspected or known COVID-19. Where evidence was lacking, attempts were made to provide potential avenues for investigation. Significant gaps in the understanding of the transmission dynamics of SARS-CoV-2 remain, and PPE recommendations may need to be modified in response to new evidence.

The implementation of evidence-based infection prevention in healthcare facilities in Egypt: A systematic literature review

2021 ◽  
Vol 1 (2) ◽  
pp. 093-099
Author(s):  
Nermeen Abdel-Fattah Shehab ◽  
Ahmed Atef Faggal ◽  
Ashraf Ali Nessim
Keyword(s):  
Infection Prevention ◽  
Healthcare Providers ◽  
Healthcare Facility ◽  
Hospital Staff ◽  
Evidence Based ◽  
Surveillance Systems ◽  
Environment Design ◽  
Environmental Interventions ◽  
Healthcare Facilities ◽  
The Impact

The idea of searching: This study tends to assess the impact of implementing evidence-based infection prevention in healthcare facilities in Egypt, with the aim of improving surveillance systems and altering the facility designs according to the data acquired on HAIs patterns. Background: Hospital acquired infections (HAIs) are becoming one of the major concerns for the patients and healthcare providers leading to significant increase in mortality rates, morbidity rates and financial losses for healthcare organizations. The incidence rate of HAI in Egypt was as recorded as 3.7% recently. Certain environmental interventions, implemented during construction of the healthcare facility could lead to enhanced prevention against the transmission and spread of the HAIs. Studies revealed that the integration of Surveillance programs could provide evidence for the designers to alter the healthcare facility design with the aim of infection prevention. Therefore, EBD approach is used to potentially measure psychological and physical effects of the environment design of a health facility on the patients and hospital staff. Methodology: Previous scientific literature is assessed to collect the relevant data which is then organized and analyzed in this study. A systematic review is generated based on the analytical outcomes of the selected data. Conclusion: EBD approach has the potential to prominently decrease HAIs burden in Egyptian healthcare facilities as it provides a diverse insight into the layout, equipment, and materials that contribute in the transmission of pathogens due to faulty design. Findings and recommendations: In order to improve the poor indoor quality by MEP (mechanical, electrical, and plumbing), previous studies have also indicated certain solutions including advancements in private room, improved surface selections, isolation, integration of touchless systems, and enhanced ventilation systems that must be applied in the healthcare facilities in Egypt for infection prevention.

scholarly journals Infection control practices and challenges in Pakistan during the COVID-19 pandemic: a multicentre cross-sectional study

2021 ◽  
pp. 175717742110127
Author(s):  
Salma Abbas ◽  
Faisal Sultan
Keyword(s):  
Personal Protective Equipment ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Hospital Staff ◽  
Cross Sectional Study ◽  
Infection Prevention And Control ◽  
Protective Equipment ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
And Control

Background: Patient and staff safety at healthcare facilities during outbreaks hinges on a prompt infection prevention and control response. Physicians leading these programmes have encountered numerous obstacles during the pandemic. Aim/objective: The aim of this study was to evaluate infection prevention and control practices and explore the challenges in Pakistan during the coronavirus disease 2019 pandemic. Methods: We conducted a cross-sectional study and administered a survey to physicians leading infection prevention and control programmes at 18 hospitals in Pakistan. Results: All participants implemented universal masking, limited the intake of patients and designated separate triage areas, wards and intensive care units for coronavirus disease 2019 patients at their hospitals. Eleven (61%) physicians reported personal protective equipment shortages. Staff at three (17%) hospitals worked without the appropriate personal protective equipment due to limited supplies. All participants felt overworked and 17 (94%) reported stress. Physicians identified the lack of negative pressure rooms, fear and anxiety among hospital staff, rapidly evolving guidelines, personal protective equipment shortages and opposition from hospital staff regarding the choice of recommended personal protective equipment as major challenges during the pandemic. Discussion: The results of this study highlight the challenges faced by physicians leading infection prevention and control programmes in Pakistan. It is essential to support infection prevention and control personnel and bridge the identified gaps to ensure patient and staff safety at healthcare facilities.

scholarly journals Targeted Assessment for Prevention: A Statewide Collaborative

2020 ◽  
Vol 41 (S1) ◽  
pp. s401-s401
Author(s):  
Cindy Hou ◽  
Shannon Davila ◽  
Mary Miller ◽  
Ashlee Hiester ◽  
Katherine Hosmer ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Infection Prevention ◽  
Local Level ◽  
Central Line ◽  
Interdisciplinary Teams ◽  
System Level ◽  
Healthcare Associated Infection ◽  
Hospital System ◽  
Healthcare Facilities ◽  
Clostridioides Difficile

Background: Infection preventionists (IPs) are the backbone of the quality and safety matrix of their organizations. Tools to help locate potential gaps can provide unique viewpoints from frontline staff. The CDC provides a Targeted Assessment for Prevention (TAP) strategy that identifies vulnerabilities in the prevention of healthcare-associated infection (HAIs). Methods: A statewide quality improvement organization, partnering with the CDC TAP team, administered TAP facility assessments for catheter-associated urinary tract infection (CAUTI), central-line–associated bloodstream infection (CLABSI), and Clostridioides difficile infection (CDI) to a collaborative of 15 acute-care and 2 long-term acute hospitals. More than 800 respondents filled out surveys based on their individualized perceptions of infection prevention practices. Results: The survey results yielded the following lagging indicators: lack of awareness of nursing and physician champions, need for competency-based training of clinical equipment, and feedback on device utilization. At the hospital system level, one improvement team focused on CDI, uncovered leading and lagging areas in general infrastructure, antibiotic stewardship, early detection and appropriate testing, contact precautions, and environmental cleaning. To culminate the TAP collaborative, the cohort of organizations, supported by interdisciplinary teams, participated in a full-day TAP workshop in which they reviewed detailed analyses of their HAI data and assessment results, shared best practices for infection prevention and planned for specific improvement projects using the plan-do-study-act model. Conclusions: Results of a statewide analysis of HAI prevention data and opportunities at a local level were reviewed. The TAP strategy can be used to target opportunities for improvement, to assess gaps in practice, and to develop and implement interventions for improving outcomes. Healthcare facilities and quality improvement organizations can drive infection prevention actions.Funding: NoneDisclosures: None

Understanding the characteristics of professional development programs for teachers’ health and wellbeing: Implications for research and practice

2021 ◽  
pp. 000494412110034
Author(s):  
Lucy Corbett ◽  
Philayrath Phongsavan ◽  
Louisa R Peralta ◽  
Adrian Bauman
Keyword(s):  
Professional Development ◽  
Future Research ◽  
Evidence Based ◽  
Development Programs ◽  
Research And Practice ◽  
Health And Wellbeing ◽  
Manual Search ◽  
Australian Education ◽  
Teacher Wellbeing ◽  
Evidence Based Programs

Professional development (PD) provides an opportunity to promote the psychological, social, and physical health tools teachers require to maintain teacher wellbeing. Despite their potential, little is known about PD programs targeting the health and wellbeing of Australian teachers. This study aimed to summarize the characteristics of Australian PD programs targeted at teacher wellbeing, identify gaps in existing PD and make recommendations for future research and practice. Three search strategies, (1) search engine results, (2) a manual search of known Australian education websites, and (3) requests for information from Australian education organizations, were combined to ensure a comprehensive inventory of PD programs was compiled. This study found 63 PD programs promoting health and wellbeing that currently exist for Australian teachers. Of these, only three provided evidence of their evaluation indicating programs are advertised and implemented without evidence of their effectiveness. Future PD should be evaluated with findings of the evaluations reported publicly so evidence-based programs promoting teacher’s health and wellbeing can be recommended and implemented.

scholarly journals Inactivation of Candida auris and Candida albicans by Ultraviolet-C

2020 ◽  
Vol 41 (S1) ◽  
pp. s292-s292
Author(s):  
William Rutala ◽  
Hajime Kanamori ◽  
Maria Gergen ◽  
Emily Sickbert-Bennett ◽  
David Jay Weber
Keyword(s):  
Infection Prevention ◽  
Antifungal Drugs ◽  
Candida Auris ◽  
Healthcare Facilities ◽  
Environmental Surfaces ◽  
Route Of Transmission ◽  
Indirect Exposure ◽  
Ultraviolet C ◽  
Severe Infections ◽  
Uv C

Background:Candida auris is an emerging fungal pathogen that is often resistant to major classes of antifungal drugs. It is considered a serious global health threat because it has caused severe infections with frequent mortality in over a dozen countries. C. auris can survive on healthcare environmental surfaces for at least 7 days, and it causes outbreaks in healthcare facilities. C. auris has an environmental route of transmission. Thus, infection prevention strategies, such as surface disinfection and room decontamination technologies (eg, ultraviolet [UV-C] light), will be essential to controlling transmission. Unfortunately, data are limited regarding the activity of UV-C to inactivate this pathogen. In this study, a UV-C device was evaluated for its antimicrobial activity against C. auris and C. albicans. Methods: We tested the antifungal activity of a single UV-C device using the vegetative bacteria cycle, which delivers a reflected dose of 12,000 µW/cm2. This testing was performed using Formica sheets (7.6 × 7.6 cm; 3 × 3 inches). The carriers were inoculated with C. auris or C. albicans and placed horizontal on the surface or vertical (ie, perpendicular) to the vertical UV-C lamp and at a distance from 1. 2 m (~4 ft) to 2.4 m (~8 ft). Results: Direct UV-C, with or without FCS (log10 reduction 4.57 and 4.45, respectively), exhibited a higher log10 reduction than indirect UV-C for C. auris (log10 reduction 2.41 and 1.96, respectively), which was statistically significant (Fig. 1 and Table 1). For C. albicans, although direct UV-C had a higher log10 reduction (log10 reduction with and without FCS, 5.26 and 5.07, respectively) compared to indirect exposure (log10 reduction with and without FCS, 3.96 and 3.56, respectively), this difference was not statistically significant. The vertical UV had statistically higher log10 reductions than horizontal UV against C. auris and C. albicans with FCS and without FCS. For example, for C. auris with FCS the log10 reduction for vertical surfaces was 4.92 (95% CI 3.79, 6.04) and for horizontal surfaces the log10 reduction was 2.87 (95% CI, 2.36–3.38). Conclusions:C. auris can be inactivated on environmental surfaces by UV-C as long as factors that affect inactivation are optimized (eg, exposure time). These data and other published UV-C data should be used in developing cycle parameters that prevent contaminated surfaces from being a source of acquisition by staff or patients of this globally emerging pathogen.Funding: NoneDisclosures: None

scholarly journals Implementation Science: How to Jump-Start Infection Prevention

2010 ◽  
Vol 31 (S1) ◽  
pp. S14-S17 ◽  
Author(s):  
Sanjay Saint ◽  
Joel D. Howell ◽  
Sarah L. Krein
Keyword(s):  
Patient Safety ◽  
Implementation Science ◽  
Infection Prevention ◽  
Theory And Practice ◽  
Evidence Based ◽  
Clinical Model ◽  
Healthcare Epidemiology

Implementing evidence-based infection prevention practices is challenging. Implementation science, which is the study of methods promoting the uptake of evidence into practice, addresses the gap between theory and practice. Just as healthcare epidemiology has emerged as a paradigm for patient safety, infection prevention may serve as a clinical model for implementation researchers.

Examining Teaming and Tier 2 and 3 Practices Within a PBIS Framework

2021 ◽  
pp. 109830072110510
Author(s):  
Rhonda N. T. Nese ◽  
Angus Kittelman ◽  
M. Kathleen Strickland-Cohen ◽  
Kent McIntosh
Keyword(s):  
Behavioral Interventions ◽  
Data Use ◽  
Future Research ◽  
Evidence Based ◽  
Tier 2 ◽  
Behavior Support ◽  
Evidence Based Practices ◽  
Research And Practice ◽  
Positive Behavioral Interventions ◽  
Core Feature

One core feature of Positive Behavioral Interventions and Support (PBIS) is a systems-level teaming process for coordinating staff implementation of evidence-based practices and monitoring student progress across all three tiers. Prior research has shown schools that report regular teaming and team-based data use are more likely to successfully adopt and sustain implementation of multi-tiered systems of behavior support. However, more research is currently needed to better understand the various teaming configurations, structures, and practices commonly used by PBIS teams in typical schools, particularly at advanced tiers. For the current study, members of school and district PBIS teams representing 718 schools were surveyed to better understand (a) teaming configurations and practices currently being used in schools implementing PBIS and (b) common interventions that PBIS teams report implementing at Tiers 2 and 3. Survey findings are discussed, along with implications of those results for future research and practice in applied settings.

scholarly journals Implementation of a Quality Improvement Role for Unlicensed Assistive Personnel and Effects on Infection Prevention

2021 ◽  
Vol 1 (S1) ◽  
pp. s73-s74
Author(s):  
Natalie Schnell ◽  
Lauren DiBiase ◽  
Amy Selimos ◽  
Lisa Stancill ◽  
Shelley Summerlin-Long ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Data Collection ◽  
Patient Care ◽  
Patient Outcomes ◽  
Infection Prevention ◽  
Central Line ◽  
Direct Patient Care ◽  
Evidence Based ◽  
Infection Rates ◽  
Process Measure

Background: Care bundles comprise evidence-based practices and interventions that are easily and consistently implemented while improving patient outcomes. As patient acuity and task overload continue to increase, infection prevention bundle and process measure compliance and data collection may become a lower priority for registered nurses (RNs). In early 2019, a certified nursing assistant (CNA) began full-time quality liaison work on a 53-bed inpatient adult oncology unit at UNC Medical Center to provide targeted compliance data collection and to correct deficits in real time when possible and within the appropriate scope of practice. Methods: The quality liaison CNA is highly motivated, with a relevant clinical background and effective communication skills. After conducting a gap analysis, the unit developed specific responsibilities for several areas of quality improvement, including infection prevention. In addition to rounding on all patients daily, the quality liaison (1) performs direct patient care tasks like Foley catheter care, (2) conducts patient education on topics such as chlorhexidine gluconate treatments, (3) performs all relevant process measure audits, and (4) easily relays missed or needed care to RNs with a door sign created as part of this initiative. High-risk findings, such as a loose central-line dressing, prompt immediate communication to the RN, with follow-up and escalation when necessary. Results: Patients and staff received the quality liaison well, and the increased attention to care bundle components and auditing ensured consistent, evidence-based care along with accurate and reliable data collection. Compared to the previous calendar year, the number of central-line audits on the unit increased by >1,400 by the end of 2019. Patient outcomes improved, and during 1 fiscal year, the unit achieved rate reductions between 40% and 55% for central-line–associated bloodstream infections, catheter-associated urinary tract infections, and healthcare-associated C. difficile infections. Staffing and logistical challenges imposed by the COVID-19 global pandemic have hampered this work because the quality liaison was redeployed to direct patient care intermittently. Correspondingly, from July to October 2020, the same infection rates increased between 30% and 353%. Conclusions: Having a designated quality liaison is an effective means to achieving quality improvements while remaining an integral member of the patient care team. As staffing has improved on this unit, the quality liaison has refocused efforts, and infection rates are beginning to improve. Given the success of the quality liaison role in improving quality outcomes on this unit, the hospital is exploring expansion of this model to additional units.Funding: NoDisclosures: None

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