scholarly journals Reorganization of nurse scheduling reduces the risk of healthcare associated infections

2019 ◽  
Author(s):  
Eugenio Valdano ◽  
Chiara Poletto ◽  
Pierre-Yves Boëlle ◽  
Vittoria Colizza

ABSTRACTBackgroundEfficient prevention and control of healthcare associated infections (HAIs) is still an open problem.ObjectiveTo design efficient hospital infection control strategies by reorganizing nurse scheduling.Design, setting, and participantsProof-of-concept modeling study based on high-resolution contact data from wearable sensors between patients, nurses, doctors, and administrative staff at a short-stay geriatric ward of a University hospital.MethodsWe considered isolation and contact removal to identify the most important class of individuals for HAI dissemination. We introduced a novel intervention based on the reorganization of nurse scheduling. This strategy switches and reassigns nurses’ tasks through the optimization of shift timelines, while respecting feasibility constraints and satisfying patient-care requirements. We evaluated the impact of interventions through a Susceptible-Colonized-Susceptible transmission model on the empirical and reorganized contacts.ResultsIsolation and contact removal produced the largest risk reduction when acting on nurses. Reorganizing their schedules reduced HAI risk by 27% (95% confidence interval [24,29]%) while preserving the timeliness, number, and duration of contacts. More than 30% nurse-nurse contacts should be avoided to achieve an equivalent reduction through simple contact removal. No overall change in the number of nurses per patient resulted from the intervention.ConclusionsReorganization of nurse scheduling offers an alternative change of practice that substantially limits HAI risk in the ward while ensuring the timeliness and quality of healthcare services. This calls for including optimization of nurse scheduling practices in programs for better infection control in hospitals.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eugenio Valdano ◽  
Chiara Poletto ◽  
Pierre-Yves Boëlle ◽  
Vittoria Colizza

AbstractEfficient prevention and control of healthcare associated infections (HAIs) is still an open problem. Using contact data from wearable sensors at a short-stay geriatric ward, we propose a proof-of-concept modeling study that reorganizes nurse schedules for efficient infection control. This strategy switches and reassigns nurses’ tasks through the optimization of shift timelines, while respecting feasibility constraints and satisfying patient-care requirements. Through a Susceptible-Colonized-Susceptible transmission model, we found that schedules reorganization reduced HAI risk by 27% (95% confidence interval [24, 29]%) while preserving timeliness, number, and duration of contacts. More than 30% nurse-nurse contacts should be avoided to achieve an equivalent reduction through simple contact removal. Nurse scheduling can be reorganized to break potential chains of transmission and substantially limit HAI risk, while ensuring the timeliness and quality of healthcare services. This calls for including optimization of nurse scheduling practices in programs for infection control in hospitals.


2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Moti Tolera ◽  
Dadi Marami ◽  
Degu Abate ◽  
Merga Dheresa

Background. Healthcare-associated infection is a major public health problem, in terms of mortality, morbidity, and costs. Majorities of the cause of these infections were preventable. Understanding the potential risk factors is important to reduce the impact of these avoidable infections. The study was aimed to identify factors associated with healthcare-associated infections among patients admitted at Hiwot Fana Specialized University Hospital, Harar, Eastern Ethiopia. Methods. A cross-sectional study was carried out among 433 patients over a period of five months at Hiwot Fana Specialized University Hospital. Sociodemographic and clinical data were obtained from a patient admitted for 48 hours and above in the four wards (surgical, medical, obstetrics/gynecology, and pediatrics) using a structured questionnaire. A multivariate logistic regression model was applied to identify predictors of healthcare-associated infections. A p value <0.05 was considered statistically significant. Results. Fifty-four (13.7%) patients had a history of a previous admission. The median length of hospital stay was 6.1 days. Forty-six (11.7%) participants reported comorbid conditions. Ninety-six (24.4%) participants underwent surgical procedures. The overall prevalence of healthcare-associated infection was 29 (7.4%, 95% CI: 5.2–10.6). Cigarette smoking (AOR: 5.18, 95% CI: 2.15–20.47), staying in the hospital for more than 4 days (AOR: 4.29, 95% CI: 2.31–6.15), and undergoing invasive procedures (AOR: 3.58, 95% CI: 1.11–7.52) increase the odds of acquiring healthcare-associated infections. Conclusion. The cumulative prevalence of healthcare-associated infections in this study was comparable with similar studies conducted in developing countries. Cigarette smoking, staying in the hospital for more than 4 days, and undergoing invasive procedures increase the odds of healthcare-associated infections. These factors should be considered in the infection prevention and control program of the hospital.


Author(s):  
André Luiz Silva Alvim ◽  
Bráulio Roberto Gonçalves Marinho Couto ◽  
Andrea Gazzinelli

ABSTRACT Objective: To study the epidemiological profile of Healthcare-associated Infections caused by Enterobacteria which carry the Klebsiella pneumoniae Carbapenemase gene (blaKPC) in the hospital environment. Method: A descriptive study was conducted in a private hospital in Belo Horizonte, MG, Brazil, which included all patients with infections caused by Enterobacteriaceae which carry the Klebsiella pneumoniae Carbapenemase gene. The data were collected by the Automated System of Hospital Infection Control and analyzed by descriptive statistics by the Epi Info 7 program. Results: Eighty-two (82) patients participated in the study. Klebsiella pneumoniae was the most frequent species (68%) isolated in blood (30%), bronchoalveolar lavage (22%) and urine (18%), while catheter-associated bloodstream infection (30%) predominated regarding topography. A case fatality rate of 62% is highlighted in evaluating the outcome. Conclusion: The resistance genes spread rapidly, limiting the antimicrobial options for treating infectious diseases. The epidemiological profile of Healthcare-Associated Infections found in this study can be prevented by prevention and infection control programs.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S279-S280
Author(s):  
Ibukunoluwa C Akinboyo ◽  
Rebecca R Young ◽  
Michael J Smith ◽  
Becky A Smith ◽  
Sarah S Lewis ◽  
...  

Abstract Background Healthcare-associated infections (HAI) remain the leading cause of morbidity and mortality among hospitalized children. Within community hospitals with targeted infection prevention efforts, participation in an infection control network has led to significant decreases in device or procedure-related infections among adult patients. The impact of these interventions has not been assessed in pediatric patients admitted to community hospitals. Methods We conducted a retrospective cohort study to describe the burden of HAI among hospitalized infants (< 1 year old) within 53 community hospitals participating in the Duke Infection Control Outreach Network (DICON) from 2013–2018. We determined the frequency of device-related HAI, central line-associated bloodstream infections (CLABSI), catheter-associated urinary tract infections (CAUTI) and hospital-associated pneumonia or ventilator-associated events (HAP/VAE) using National Healthcare Safety Network (NHSN) definitions; and the burden of HAIs among neonatal intensive care units (NICU) and non-NICU centers. The trend of HAI was analyzed with Spearman’s correlation. Results Thirty hospitals reported 150 HAI among 141 infants over the 6-year period. Median (IQR) time to infection was 10 (4, 20) days after admission. Hospitals with a NICU (15) reported more HAI (median 5, (IQR: 3, 12)) than hospitals without a NICU (median 2 (IQR: 1, 2)) (P = 0.031). CLABSI represented 35% of HAI, HAP/VAE were 23% and CAUTI were 12%. The most frequently isolated primary organism for all HAI was Escherichia coli (22 HAI, 15%) which was also isolated in 39% of CAUTI. Methicillin-resistant and methicillin-susceptible Staphylococcus aureus (S. aureus) were the most commonly isolated organisms among CLABSI (17%) and HAP/VAE (33%). Nine centers with ≥4 years of NICU and Central line (CL) use data reported a median (IQR) rate of 1.2 (0, 2.4) CLABSIs/1,000 central line days. There was no change in median CLABSI rate over time (P = 0.47), Figure 1. Conclusion CLABSI, most commonly caused by S. aureus, represented the majority of HAI reported from hospitalized infants within community hospitals participating in an infection control network. Further research into device utilization practices may inform future interventions to reduce HAI. Disclosures All authors: No reported disclosures.


Author(s):  
La Lien ◽  
Eva Johansson ◽  
Pham Lan ◽  
Nguyen Chuc ◽  
Nguyen Thoa ◽  
...  

Adequate infection control plays a key role in preventing healthcare-associated infections (HAIs). This study aimed to explore staff perceptions of hospital infection control in a rural and an urban hospital in Vietnam. Individual interviews were conducted with hospital managers, and focus group discussions were conducted with doctors, nurses and cleaning workers separately. Content analysis was applied. An interview guide including discussion points on HAIs, hand hygiene and healthcare waste management was used. Generally, the staff were knowledgeable of hospital infection control, but they were not aware of the situation in their own hospital, and infection control practices in the hospitals remained poor. Reported difficulties in infection control included lack of resources, poor awareness and patient overload. A main theme emerged: ‘Making data on HAIs available for health workers can improve their awareness and motivate them to put their existing knowledge into practice, thus decreasing the know-do gap in infection control’. This could be a feasible intervention to improve infection control practice in the hospitals with limited resources, high workload and patient overload.


Author(s):  
Māris Liepiņš ◽  
Angelika Krūmiņa ◽  
Irēna Meistere ◽  
Diāna Kosjkina ◽  
Juris Ķibilds ◽  
...  

Abstract Acinetobacter baumannii is an aerobic gram-negative opportunistic bacterial pathogen, an emerging cause of healthcare-associated infections, associated with increased morbidity, mortality and healthcare costs. It has been widely found in the hospital environment, exhibiting high resistance to antimicrobials, affecting the spread of healthcare-associated infections and preventing effective infection control. The role of virulence factors in the pathogenesis of A. baumannii related human infections remains unclear. Therefore, molecular testing of pathogenic bacteria is an important tool for improving infection control measures against A. baumannii with combined resistance. The aim of this study was to analyse A. baumannii infection cases, antimicrobial resistance profiles and to characterise the genetic heterogeneity of isolates. In general, outbreaks occurring in hospitals are presumed to be clonal, with patient-to-patient transmission of essentially identical strains. Treatment decisions are based on a combination of in vitro susceptibility assays and empirical results based on patient outcomes.


2019 ◽  
Vol 19 (77) ◽  
Author(s):  
Josni Tauffer ◽  
Bruna Tais Zack ◽  
Manoela Cristina Berticelli ◽  
Maria Julia Navarro Kássim ◽  
Sabrina Kássia Menegusso Carmello ◽  
...  

Introdução: A prevenção e controle de infecções através de medidas que envolvam a qualificação da assistência hospitalar é primordial quando focado no conhecimento e na importância dos assuntos relacionados a essa temática. Frente a isto, o conhecimento e a concepção da equipe de enfermagem sobre o trabalho do controle de infecção auxiliam na aprimoração da qualidade e obtenção dos resultados esperados. Objetivo: Analisar a percepção dos profissionais da equipe de enfermagem quanto ao serviço de controle de infecção em um hospital escola. Métodos: A coleta de dados seguiu a proposta de estudo quantitativo e qualitativo, formadas por questões abertas e fechadas que foram transcritas de forma analítica e elencadas conforme eixos temáticos as quais sofreram análise de Bardin. Os resultados das questões fechadas foram descritos por meio do programa Excel com apresentações dos resultados em frequência e porcentagem. Resultados: 17 (85%) dos profissionais entrevistados eram do sexo feminino; 18 (90%) responderam que a falta de adesão à higienização das mãos é responsável por maior parte das infecções relacionadas à assistência à saúde na instituição; 14 (70%) dos profissionais evidenciaram que a grande circulação de profissionais propicia o surgimento de infecções relacionadas à assistência à saúde; 12 (60%) dos profissionais afirmaram ter conhecimento sobre os índices de infecções relacionadas à assistência à saúde em seu setor; 17 (85%) afirmam a disponibilização de ferramentas para o controle de infecções relacionadas à assistência à saúde; 16 (80%) afirmam ter participado em algum momento de treinamentos relacionados ao controle de infecção; 18 (90%) higienização das mãos e 11 (55%) observação nos critérios de isolamento, os demais variam entre 8 a 9% considerando respectivamente importante a esterilização de materiais e utilização de equipamento de proteção individual; 18 (90%) afirmam conhecer o trabalho do enfermeiro em controle de infecção. Conclusão: A atuação do profissional enfermeiro faz-se necessária, na vigilância da incidência das infecções relacionadas à assistência à saúde e na prestação de cuidados. O conjunto multifatorial e multiprofissional, que engloba desde incentivos financeiros quanto a prevenção continuada e eficaz ao paciente, com a implementação de linguagem horizontal definida por aplicação de práticas e protocolos assistenciais sem desvios de informações contribui significativamente na redução das infecções relacionadas à assistência à saúde.Palavras-chave: Infecções relacionadas à assistência à saúde; Controle de Infecção; Vigilância em Saúde; Enfermagem. ABSTRACTThe prevention and control of infections through measures involving the qualification of hospital care is paramount when focused on the knowledge and importance of issues related to this thematic. Faced with this, the knowledge and conception of the nursing team about the work of infection control helps to improve the quality and obtain the expected results. Objective: To analyze the perception of nursing team regarding hospital infection control service in a school hospital. Methods: The data collection followed the proposal of a quantitative and qualitative study, formed by open and closed questions which was transcribed analytically and listed according to thematic axes which were analyzed by Bardin. The results of the closed questions were described through the Excel program with presentations of results in frequency and percentage. Results: 17 (85%) of the professionals interviewed were female. 18 (90%) answered that lack of adherence to hand hygiene is responsible for most of the healthcare-associated infections in the institution; 14 (70%) of the professionals showed the large circulation of professionals facilitates the emergence of healthcare-associated infections; 12 (60%) of the professionals stated that they had knowledge about the healthcare-associated infections indices in their sector; 17 (85%) affirm the availability of tools for the control of healthcare-associated infections; 16 (80%) reported having participated in some training related to infection control; 18 (90%) hands hygiene and 11 (55%) Note in the isolation criteria, the others vary from 8 to 9% considering, respectively, material sterilization and use of individual protection equipment; 18 (90%) stated that they knew the nurse's job in infection control. Conclusion: Nursing professional performance is necessary, in the surveillance of the incidence of healthcare-associated infections and in the provision of care. The multifactorial and multiprofessional set, from financial incentives to continuous and effective prevention to the patient, with the implementation of horizontal language defined by the application of practices and protocols assists without deviations of information contributes significantly to the reduction of healthcare-associated infections.Keywords: Health-care-related infections; Infection Control; Health Surveillance; Nursing.


Sign in / Sign up

Export Citation Format

Share Document