scholarly journals Electronic health record enabled track and trace in an urban hospital network: implications for infection prevention and control

2021 ◽  
Author(s):  
Li Pi ◽  
Paul Expert ◽  
Jonathan Clarke ◽  
Elita Jauneikaite ◽  
Ceire Costelloe
Keyword(s):  
Modern Medicine ◽  
Infection Prevention And Control ◽  
Urban Hospital ◽  
Contact Networks ◽  
Patient Movement ◽  
Core Set ◽  
Life Threatening ◽  
Electronic Health ◽  
Healthcare Associated ◽  
And Control

Healthcare-associated infections represent one of the most significant challenges for modern medicine as they can significantly impact patients' lives. Carbapenemase-producing Enterobacteriaceae (CPE) pose the greatest clinical threat, given the high levels of resistance to carbapenems, which are considered as agents of 'last resort' against life-threatening infections. Understanding patterns of CPE infection spreading in hospitals is paramount to design effective infection control protocols to mitigate the presence of CPE in hospitals. We used patient electronic health records from three urban hospitals to: i) track microbiologically confirmed carbapenemase producing Escherichia coli (CP-Ec) carriers and ii) trace the patients they shared place and time with until their identification. We show that yearly contact networks in each hospital consistently exhibit a core-periphery structure, highlighting the presence of a core set of wards where most carrier-contact interactions occured before being distributed to peripheral wards. We also identified functional communities of wards from the general patient movement network. The contact networks projected onto the general patient movement community structure showed a comprehensive coverage of the hospital. Our findings highlight that infections such as CP-Ec infections can reach virtually all parts of hospitals through first-level contacts.

scholarly journals The role of antimicrobial sutures in preventing surgical site infection

2017 ◽  
Vol 99 (6) ◽  
pp. 439-443 ◽  
Author(s):  
D Leaper ◽  
P Wilson ◽  
O Assadian ◽  
C Edmiston ◽  
M Kiernan ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Perioperative Period ◽  
Infection Prevention And Control ◽  
Site Infection ◽  
Skin Preparation ◽  
Life Threatening ◽  
Level I ◽  
The Uk ◽  
Healthcare Associated ◽  
And Control

INTRODUCTION Healthcare associated infections (HCAIs) are falling following widespread and enforced introduction of guidelines, particularly those that have addressed antibiotic resistant pathogens such as methicillin resistant Staphylococcus aureus or emergent pathogens such as Clostridium difficile, but no such decline has been seen in the incidence of surgical site infection (SSI), either in the UK, the EU or the US. SSI is one of the HCAIs, which are all avoidable complications of a surgical patient’s pathway through both nosocomial and community care. METHODS This report is based on a meeting held at The Royal College of Surgeons of England on 21 July 2016. Using PubMed, members of the panel reviewed the current use of antiseptics and antimicrobial sutures in their specialties to prevent SSI. FINDINGS The group agreed that wider use of antiseptics in surgical practice may help in reducing reliance on antibiotics in infection prevention and control, especially in the perioperative period of open elective colorectal, hepatobiliary and cardiac operative procedures. The wider use of antiseptics includes preoperative showering, promotion of hand hygiene, (including the appropriate use of surgical gloves), preoperative skin preparation (including management of hair removal), antimicrobial sutures and the management of dehisced surgical wounds after infection. The meeting placed emphasis on the level I evidence that supports the use of antimicrobial sutures, particularly in surgical procedures after which the SSI rate is high (colorectal and hepatobiliary surgery) or when a SSI can be life threatening even when the rate of SSI is low (cardiac surgery).

scholarly journals Human Factors Engineering Contributions to Infection Prevention and Control

2019 ◽  
Vol 61 (5) ◽  
pp. 693-701 ◽  
Author(s):  
Frank A. Drews ◽  
Lindsay C. Visnovsky ◽  
Jeanmarie Mayer
Keyword(s):  
Human Factors ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Future Research ◽  
Human Factors Engineering ◽  
Life Threatening ◽  
Current Infection ◽  
Healthcare Associated ◽  
And Control

Objective: This article provides a review of areas that present significant challenges in infection prevention and control and describes human factors engineering (HFE) approaches that have been applied successfully to these areas. In addition, implications and recommendations for HFE use in future research are discussed. Background: Infection prevention and control aims to prevent patients and health care personnel from acquiring preventable infections in healthcare. Effective infection control practices of healthcare-associated infections have recently become even more critical with the emergence of life-threatening infections. HFE could benefit infection prevention and control in addressing older and more recent challenges, but uptake has been limited. Method/Results: This literature review is an integration and synthesis of recently published research that describes HFE-based approaches in infection prevention and control to address the challenges for three specific topics. The results of the review suggests that HFE is in a position to support work in infection prevention and control and improve overall healthcare safety. Conclusion: HFE provides conceptual frameworks and methods that have significant potential to improve infection prevention and control. Application: The work reviewed can provide potential solutions for current infection prevention and control challenges by applying HFE based recommendations.

scholarly journals Medicolegal Causation Investigation of Bacterial Endocarditis Associated with an Oral Surgery Practice Using the INFERENCE Approach

2021 ◽  
Vol 18 (14) ◽  
pp. 7530
Author(s):  
Putri Dianita Ika Meilia ◽  
Maurice P. Zeegers ◽  
Herkutanto ◽  
Michael D. Freeman
Keyword(s):  
Oral Surgery ◽  
Invasive Procedure ◽  
Bacterial Endocarditis ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infection ◽  
Department Of Health ◽  
The Individual ◽  
Healthcare Associated ◽  
And Control ◽  
Causation Analysis

Investigating causation is a primary goal in forensic/legal medicine, aiming to establish the connection between an unlawful/negligent act and an adverse outcome. In malpractice litigation involving a healthcare-associated infection due to a failure of infection prevention and control practices, the medicolegal causal analysis needs to quantify the individual causal probabilities to meet the evidentiary requirements of the court. In this paper, we present the investigation of the most probable cause of bacterial endocarditis in a patient who underwent an invasive procedure at a dental/oral surgical practice where an outbreak of bacterial endocarditis had already been identified by the state Department of Health. We assessed the probability that the patient’s endocarditis was part of the outbreak versus that it was an unrelated sporadic infection using the INFERENCE (Integration of Forensic Epidemiology and the Rigorous Evaluation of Causation Elements) approach to medicolegal causation analysis. This paper describes the step-by-step application of the INFERENCE approach to demonstrate its utility in quantifying the probability of causation. The use of INFERENCE provides the court with an evidence-based, transparent, and reliable guide to determine liability, causation, and damages.

Point prevalence of healthcare-associated infections and antibiotic use in a tertiary care teaching hospital in Nepal: A cross-sectional study

2021 ◽  
pp. 175717742110358
Author(s):  
Sailesh Kumar Shrestha ◽  
Swarup Shrestha ◽  
Sisham Ingnam
Keyword(s):  
Prevention And Control ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Point Prevalence ◽  
University Hospital ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Prevalence Survey ◽  
Healthcare Associated ◽  
And Control

Information on the burden of healthcare-associated infections (HAIs) and patterns of antibiotic use are prerequisites for infection prevention and control (IPC) and antibiotics stewardship programmes. However, a few studies have been reported from resource-limited settings and many of them have not used standard definitions to diagnose HAI precluding benchmarking with regional or international data. This study aims to estimate the prevalence of HAIs and antibiotic use in our centre. We conducted a point prevalence survey in a 350-bed university hospital in Kathmandu, Nepal in April 2019. We reviewed all patients aged ⩾ 18 years admitted to the hospital for at least two calendar days and evaluated for the three common HAIs—pneumonia, urinary tract infection and surgical site infection. We used the clinical criteria by the European Center for Disease Prevention and Control to diagnose the HAIs. We also collected information on the antibiotics used. Of 160 eligible patients, 18 (11.25%) had HAIs and 114 (87.5%) were on antibiotics, with more than half of them (61/114 patients, 53.5%) receiving two or more antibiotics. This highlights the need for effective implementation of IPC as well as antibiotics stewardship programmes in our centre.

scholarly journals Strengthening infection prevention and control and systematic surveillance of healthcare associated infections in India

BMJ ◽  
2017 ◽  
pp. j3768 ◽  
Author(s):  
Soumya Swaminathan ◽  
Jagdish Prasad ◽  
Akshay C Dhariwal ◽  
Randeep Guleria ◽  
Mahesh C Misra ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Healthcare Associated ◽  
And Control

scholarly journals Burden of Healthcare-Associated Infections in Italy: Disability-Adjusted Life Years

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
V Bordino ◽  
C Vicentini ◽  
A D'Ambrosio ◽  
F Quattrocolo ◽  
C M Zotti
Keyword(s):  
Prevention And Control ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years ◽  
Significant Burden ◽  
Tract Infections ◽  
Healthcare Associated ◽  
And Control

Abstract Background Healthcare-Associated Infections (HAIs) significantly increase adverse clinical outcomes and healthcare costs. In 2016 Italy participated in the second European Centre for Disease Prevention and Control (ECDC) Point Prevalence Survey (PPS) of HAIs and antimicrobial use in acute care hospitals. The aim of this study was to estimate the burden of the 5 most common HAIs in Italy, by evaluating incidence, attributable deaths, Years of Life Lost (YLL), Years Lived with Disability (YLD) and Disability-Adjusted Life-Years (DALYs). Methods National PPS data were used to establish sex- and age-specific incidence of Healthcare-associated Pneumonia (HAP), HA Urinary tract infections (HA UTI), HA Bloodstream Infections (HA BSI) excluding neonatal BSI, Surgical Site Infections (SSI), HA Clostridium Difficile infections (HA CDI). Patients' life expectancy was adjusted according to the severity of underlying conditions using the McCabe score. Following the methodology from the Burden of Communicable Diseases in Europe (BCoDE)-project, an adapted version of the disease models of the BCoDE toolkit was used. Results An overall yearly incidence of 643434 new cases of HAI in Italy was estimated. The aggregate burden of the 5 HAIs was 426411.98 DALYs (86731.03 YLD + 339680.96 YLL), corresponding to 702.53 DALYs per 100000 total population. HA BSI and HAP had the highest burden with respectively 253868.22? and 126038.26 DALYs. The population strata with the highest burden were the ones with McCabe Score 1 for every considered HAI. The age groups with the highest burden were 70-74 for male and 45-49 for female patients. In total, 56% of DALYs were attributable to men and 44% to women. Conclusions This nation-wide study found a significant burden of disease due to HAIs in Italy. Results of this study could be used to guide policy-makers in the implementation of measures aiming to reduce the impact of HAIs. Key messages This study estimated the burden of 5 HAIs in Italy was 426411.98 DALYs (86731.03 YLD + 339680.96 YLL according to 2016 PPS data. Considering the significant burden of HAIs found in this study, infection prevention and control measures should be a Public Health priority in Italy.

scholarly journals Improvement in Infection Prevention and Control Measures at The Children Hospital, Lahore. A My Child Matters Collaborative Project

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 223s-223s
Author(s):  
M. Faizan ◽  
S. Anwar ◽  
R.U.A. Kashif ◽  
R. Saleem ◽  
H. Javed ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Infection Control ◽  
Pediatric Cancer ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Improvement Strategy ◽  
Targeted Interventions ◽  
Healthcare Associated ◽  
And Control

Background: Overcrowding, lack of operational funds, and healthcare associated infections are major challenges at the Children Hospital Lahore, a public healthcare facility in Pakistan with 900 new pediatric cancer admissions annually. In 2014, a collaboration between My Child Matters (MCM), St. Jude Global Infectious Diseases Program (SJ-GID), and our institution was established to address these issues. Aim: To describe the effect of a collaborative improvement strategy on the infection prevention and control (IPC) standards in a pediatric oncology unit in a resource-limited setting. Methods: Our study was a prospective before-and-after study. We compare the WHO Hand Hygiene Self-Assessment Framework (HHSAF) and 4 modules of the St. Jude modified Infection Control Assessment Tool (ICAT) scores. Our strategy included: (1) creating a multidisciplinary team of pediatric hematology-oncology, infectious disease physicians, nurses, microbiologist, and a data manager, (2) engaging on monthly online IPC mentoring sessions with the SJ-GID and MCM mentors, (3) performing daily inpatient healthcare associated (HAI) surveillance rounds, and (4) providing regular hand hygiene training and compliance audits. Results: Our hand hygiene facility level per WHO scores increased from “Inadequate” during the baseline assessment to “Intermediate/Consolidation” by the end of 3-year implementation (122 vs 352 HHSAF scores). The sink: bed and hand sanitizer: bed ratios improved to 1:6 and 1:1 respectively. Six washrooms were added to our unit. ICAT general infection control module increased by 40% (45 vs 78 ICAT score) and hygiene compliance improved by 20% from baseline. Identification of HAI increased from baseline (4.07 vs 8.7 infections per 1000 patient days). A 25% of the isolates were multidrug-resistant microorganisms. Conclusion: Implementing a collaborative improvement strategy improved the IPC standards in our pediatric cancer center. The increase of HAI might be a result of a better surveillance and laboratory identification. Further targeted interventions should be develop to decrease HAI rates and infection-related morbidity and mortality in our population.

scholarly journals Infection Prevention and Control

2020 ◽  
pp. 99-116
Author(s):  
Anna L. Costa ◽  
Gaetano Pierpaolo Privitera ◽  
Giorgio Tulli ◽  
Giulio Toccafondi
Keyword(s):  
Public Health ◽  
Risk Management ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Clinical Risk Management ◽  
Cross Sectional ◽  
Healthcare Associated ◽  
And Control ◽  
Avoidable Risk

AbstractHealthcare-associated infections (HAI) are adverse events exposing patients to a potentially avoidable risk of morbidity and mortality. Antimicrobial resistance (AMR) is increasingly contributing to the burden of HAIs and emerging as of the most alarming challenges for public health worldwide. Practically, harm mitigation and risk containment demand cross-sectional initiatives incorporate both approaches to infection prevention and control and methodologies from clinical risk management.

scholarly journals Analysis of The Implementation of Nosocomial Infection Prevention and Control in Hospitals (A Literature Study)

2021 ◽  
Vol 1 (1) ◽  
pp. 79-90
Author(s):  
Amira Mhuthia Adila ◽  
Nur Ramadhan ◽  
Puspa Nujulla ◽  
Putri Dwi Ardiyanti ◽  
Rina Oktavia ◽  
...  
Keyword(s):  
Nosocomial Infection ◽  
Nosocomial Infections ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Reporting System ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infection ◽  
Literature Study ◽  
Healthcare Associated ◽  
And Control

Infections due to health services or Healthcare-Associated Infection (HAI) or known as nosocomial infections are infections that occur in patients during treatment in hospitals or other health facilities. The prevention and control of nosocomial infections is a worldwide challenge. This study aims to examine the literature, articles, or journals of research results regarding the implementation of prevention and control of nosocomial infections in hospitals. The method used is a literature review with 10 journals that were reviewed and written from 2015 to 2020, or written in the last 6 years with the keywords "Analysis of the Implementation of Nosocomial Infection Prevention and Control". The results obtained are 8 journals that have obstacles such as lack of Human Resources (HR), insufficient funds and infrastructure, there are still many officers who have not taken action according to Standard Operating Procedures (SOP), many officers have not received training, there is no incentive for officers. , there is an unbalanced workload, the reporting system is not maximized, the use of Personal Protective Equipment (PPE) is not optimal, and cough etiquette has not been carried out by officers. So it is necessary to add things that must be met such as training of officers, completing the needs (facilities and infrastructure) for officers, providing sanctions for officers when violating (not taking actions according to SOPs), providing incentives for officers, and even giving rewards for officers who obey comply SOP, especially given strict supervision from the hospital so that officers and patients do not transmit their disease to each other or other people.

scholarly journals Nosocomial Transmission of Coronavirus Disease 2019: A Retrospective Study of 66 Hospital-acquired Cases in a London Teaching Hospital

2020 ◽  
Author(s):  
Hannah M Rickman ◽  
Tommy Rampling ◽  
Karen Shaw ◽  
Gema Martinez-Garcia ◽  
Leila Hail ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Infection Prevention ◽  
Case Fatality ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Infection Rates ◽  
Prevention And Control Measures ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
And Control

Abstract Coronavirus disease 2019 (COVID-19) can cause deadly healthcare-associated outbreaks. In a major London teaching hospital, 66 of 435 (15%) COVID-19 inpatient cases between 2 March and 12 April 2020 were definitely or probably hospital-acquired, through varied transmission routes. The case fatality was 36%. Nosocomial infection rates fell following comprehensive infection prevention and control measures.

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