scholarly journals 1196. Is the Weekend Staff Really to Blame? Challenges in Isolation Compliance at an Academic Tertiary Care Center

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S429-S429
Author(s):  
Sonia Bassett ◽  
Kelley M Boston ◽  
Luis Ostrosky-Zeichner
Keyword(s):  
Hand Hygiene ◽  
Infection Control ◽  
Significant Variation ◽  
Normal Approximation ◽  
Care Center ◽  
Tertiary Care ◽  
Visual Observation ◽  
Protective Equipment ◽  
Drug Resistant ◽  
Tertiary Care Center

Abstract Background Transmission-based isolation precautions are implemented in an effort to decrease the risk of transmission of pathogens. Weekend staff are perceived to have lower compliance. Methods Visual observation of healthcare worker (HCW) compliance with an institutional isolation precautions practices was done at an academic tertiary care center. In the first quarter of 2019, observations were completed for 894 patients who required contact, droplet or airborne isolation precautions. Observations included patients with infection or colonization with multi-drug-resistant organisms (MDRO) or highly transmissible infections. Observations focused on availability of appropriate supplies, compliance with infection control practices, and documentation. Audits were performed on workdays and weekends, and results were communicated to unit leadership via email. Comparison of proportions was calculated using the normal approximation in Minitab18. Results Compliance with the different elements of the audit can be seen in Table 1. HCW compliance with the use of personal protective equipment and hand hygiene on exit from the room had the lowest compliance and was statistically lower on weekends than on weekdays, and compliance was significantly lower than all other categories for both weekday and weekend measurements. Fifty-seven percent of all patients had missed compliance on one or more elements. There was not a statistically significant variation in practice between weekends and weekdays in overall compliance. Conclusion There is opportunity for improvement in all compliance on isolation practices facility-wide, and elements that require changes in behavior had the lowest compliance, and were lower on weekend shifts. We did not find other differences in performance for weekend staff vs. weekday staff. Educational measures should focus on all individual staff across all shifts. Disclosures All authors: No reported disclosures.

scholarly journals A Longitudinal Seroprevalence Study Evaluating Infection Control and Prevention Strategies at a Large Tertiary Care Center with Low COVID-19 Incidence

2021 ◽  
Vol 18 (8) ◽  
pp. 4201
Author(s):  
Lorenz Schubert ◽  
Robert Strassl ◽  
Heinz Burgmann ◽  
Gabriella Dvorak ◽  
Matthias Karer ◽  
...  
Keyword(s):  
Infection Control ◽  
Personal Protective Equipment ◽  
Care Center ◽  
Tertiary Care ◽  
Protective Equipment ◽  
Tertiary Care Center ◽  
Prevention Strategies ◽  
Travel History ◽  
Specific Antibodies ◽  
Prospective Longitudinal

Personal protective equipment and adherence to disinfection protocols are essential to prevent nosocomial severe acute respiratory syndrome coronavirus (SARS-CoV-2) transmission. Here, we evaluated infection control measures in a prospective longitudinal single-center study at the Vienna General Hospital, the biggest tertiary care center in Austria, with a structurally planned low SARS-CoV-2 exposure. SARS-CoV-2-specific antibodies were assessed by Abbott ARCHITECT chemiluminescent assay (CLIA) in 599 health care workers (HCWs) at the start of the SARS-CoV-2 epidemic in early April and two months later. Neutralization assay confirmed CLIA-positive samples. A structured questionnaire was completed at both visits assessing demographic parameters, family situation, travel history, occupational coronavirus disease 2019 (COVID-19) exposure, and personal protective equipment handling. At the first visit, 6 of 599 participants (1%) tested positive for SARS-CoV-2-specific antibodies. The seroprevalence increased to 1.5% (8/553) at the second visit and did not differ depending on the working environment. Unprotected SARS-CoV-2 exposure (p = 0.003), positively tested family members (p = 0.04), and travel history (p = 0.09) were more frequently reported by positively tested HCWs. Odds for COVID-19 related symptoms were highest for congestion or runny nose (p = 0.002) and altered taste or smell (p < 0.001). In conclusion, prevention strategies proved feasible in reducing the risk of transmission of SARS-CoV-2 from patients and among HCWs in a low incidence hospital, not exceeding the one described in the general population.

scholarly journals Impact of an Infection Control Program on the Prevalence of Nosocomial Infections at a Tertiary Care Center in Switzerland

2008 ◽  
Vol 29 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Corina Ebnöther ◽  
Beate Tanner ◽  
Flavia Schmid ◽  
Vittoria La Rocca ◽  
Ivo Heinzer ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Care Center ◽  
Tertiary Care ◽  
Control Program ◽  
Tertiary Care Center ◽  
Infection Control Program ◽  
Before And After ◽  
Hygiene Compliance

Objective.To study the impact of a multimodal infection control program on the rate of nosocomial infections at a 550-bed tertiary care center.Methods.Before and after the implementation of an infection control program, the rate of nosocomial infection was recorded in time-interval prevalence studies. Hand hygiene compliance was studied before and after the intervention. As a surrogate marker of compliance, the amount of alcohol-based hand rub consumed before the intervention was compared with the amount consumed after the intervention. The intervention included additional staff for infection control, repeated instructions for hand hygiene, new guidelines for preoperative antibiotic prophylaxis, and isolation of patients infected or colonized with multidrug-resistant bacteria.Results.The rate of nosocomial infection decreased from approximately 11.7% to 6.8% in 2 years. The rate of hand hygiene compliance increased by 20.0%; it was 59.0% before the intervention and increased to 79.0% afterward. These results correlate with data on the consumption of alcohol-based hand rub, but not with data on the use of antibiotics.Conclusion.Within 2 years, a multimodal infection control program intervention such as this one may reduce the rate of nosocomial infection at a tertiary care center by more than one-third and improve both the quality of care and patient outcomes. It may also generate considerable savings. Therefore, such programs should be promoted not only by hospital epidemiologists but also by hospital administrators.

Observations of Cleaning Techniques at a Tertiary Care Center during Observational Infection Control Rounds

2011 ◽  
Vol 39 (5) ◽  
pp. E72
Author(s):  
Lori Coddington ◽  
Dianne DeAngelis ◽  
Jackie Sanner ◽  
Rashida A. Khakoo
Keyword(s):  
Infection Control ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center

Improving Family and Visitor Hand Hygiene in a Pediatric Tertiary Care Center

2011 ◽  
Vol 39 (5) ◽  
pp. E83
Author(s):  
Karin Rogers ◽  
Joan Heath ◽  
Kimberly Arthur ◽  
Lindsay Hill ◽  
Amanda Adler ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Care Center ◽  
Tertiary Care ◽  
Tertiary Care Center

scholarly journals Outbreak of Postoperative Endophthalmitis in a Thai Tertiary Care Center

2008 ◽  
Vol 29 (6) ◽  
pp. 564-566
Author(s):  
Anucha Apisarnthanarak ◽  
Supanee Jirajariyavej ◽  
Kanokporn Thongphubeth ◽  
Chananart Yuekyen ◽  
David K. Warren ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Multivariate Analysis ◽  
Infection Control ◽  
Care Center ◽  
Tertiary Care ◽  
Postoperative Endophthalmitis ◽  
Tertiary Care Center ◽  
Associated Risk Factors

We performed a study with a 1:3 ratio of case patients (n = 11) to control patients (n = 33) to evaluate risk factors for postoperative endophthalmitis in a Thai tertiary care center. Multivariate analysis revealed that diabetes mellitus and surgeon A were associated risk factors. Preoperative diabetes mellitus control and the improvement of infection control practices led to the termination of the outbreak.

scholarly journals Prevalence of Colistin-resistant Gram-negative Isolates Carrying the mcr-1 Gene among Patients Visiting a Tertiary Care Center

2020 ◽  
Vol 58 (232) ◽  
Author(s):  
Ashmita Paudel ◽  
Surya Prasad Devkota ◽  
Anima Shrestha ◽  
Anil Kumar Shah
Keyword(s):  
Confidence Interval ◽  
Binary Data ◽  
Care Center ◽  
Tertiary Care ◽  
Point Estimate ◽  
Drug Resistant ◽  
Tertiary Care Center ◽  
Colistin Resistance ◽  
Cross Sectional ◽  
Gram Negative

Introduction: Gram-negative isolates harboring mobilized colistin resistance (mcr-1) gene are a great threat to human health. They have been reported worldwide among various bacterial isolates. This work aimed to study the prevalence of colistin resistance among Gram-negative bacteria and the incidence of mcr-1 gene among these isolates. Methods: A descriptive cross-sectional study was done at a tertiary care center from June 2016 to February 2017. An ethical approval was taken from review board of the Nepal Health Research Council (Reg. no: 274/2016). Convenience sampling was used. The data was collected and analyzed using Microsoft Excel 2010 and Statistical Package for Social Sciences (SPSS) Version 16 . Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 485 gram-negative isolates, only 13 (2.68%) (1.26-6.62 at 95% Confidence Interval) isolates were colistin-resistant and mcr-1 was present in two isolates. Predominant colistin-resistant isolates were E. coli 6 (4.1%), Enterobacter spp 2 (2.81%), and Acinetobacter spp 2 (2.81%). A high level of colistin-resistance was noted in 4 (30.7%) isolates as indicated by the very high value of colistin MIC (>256 µg/ml). ICU was the major site of isolation of colistin-resistant and mcr-1 positive pathogens. The majority of colistin-resistant isolates were highly drug-resistant and were sensitive only to polymyxin B. Antibiotics like imipenem, amikacin, gentamicin, aztreonam, ciprofloxacin, and piperacillin-tazobactam were effective for few of these isolates. Conclusions: Though the prevalence of mcr-1 gene was low among colistin-resistant gram-negative isolates, the resistant pattern was quite alarming as these isolates were highly drug-resistant.

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