scholarly journals Infection Control in Acute Care Facilities: Evidence-Based Patient Safety

2001 ◽  
Vol 12 (3) ◽  
pp. 131-132 ◽  
Author(s):  
Lindsay E Nicolle
Keyword(s):  
World War Ii ◽  
Infection Control ◽  
Acute Care ◽  
Epidemiological Analysis ◽  
Control Programs ◽  
Care Facilities ◽  
Surveillance Programs ◽  
Acute Care Facilities ◽  
Program Components ◽  
And Control

Infection control in acute care facilities has a noble history. These programs were born of the nosocomial penicillin-resistantStaphylococcus aureusoutbreaks in the post-World War II era. Over the past four decades, an impressive body of evidence has emerged that documents the effectiveness of infection control programs and systematically evaluates specific program components. Fumigation, tacky floor mats, shoe covers and 'reverse' isolation have disappeared. They are replaced by focused surveillance programs, prophylactic antimicrobial therapy, outbreak investigation and control, routine barrier practices and molecular typing of organisms for epidemiological analysis.

Surveillance Strategies: A Primer

1987 ◽  
Vol 8 (11) ◽  
pp. 459-464 ◽  
Author(s):  
Elias Abrutyn ◽  
George H. Talbot
Keyword(s):  
Nosocomial Infection ◽  
Infection Control ◽  
Control Measures ◽  
Regulatory Agencies ◽  
Surveillance Program ◽  
Infection Rates ◽  
Control Programs ◽  
Infection Surveillance ◽  
Surveillance Programs ◽  
And Control

The Centers for Disease Control's Study on the Efficacy of Nosocomial Infection Control (SENIC) showed that infection surveillance and control activities are associated with a decrease in nosocomial infection rates. Moreover, the intensity of activity correlated with the magnitude of the fall in infection rates. These results, plus the guidelines of regulatory agencies, mandate that infection control programs conduct surveillance activities. However, absolute standards for the content and nature of surveillance programs have not been established, and many descriptions of different types of surveillance programs are available. In this primer, we describe the considerations involved in development of a surveillance program with emphasis on issues concerning data collection.Langmuir considers surveillance when applied to disease as meaning the collection of data, the analysis of those data, and the distribution of the resulting information to those needing to know. The definition implies that surveillance is observational and that surveillance activities should be clearly separated from other related activities such as control measures. The latter activities, including their initiation, approval, and funding, are administrative matters underpinned by a scientific base that are undertaken by the recipients of the surveillance data and their analyses. They should be clearly separated from surveillance activities per se. There is also the implication that action results from surveillance; surveillance without action should be abandoned.

Finding the gaps: An assessment of infection control surveillance needs in British Columbia acute care facilities

2008 ◽  
Vol 36 (10) ◽  
pp. 706-710 ◽  
Author(s):  
Bruce Gamage ◽  
Monali Varia ◽  
Margaret Litt ◽  
Sarah Pugh ◽  
Elizabeth Bryce
Keyword(s):  
British Columbia ◽  
Infection Control ◽  
Acute Care ◽  
Care Facilities ◽  
Acute Care Facilities

scholarly journals The Spread and Control of Norovirus Outbreaks Among Hospitals in a Region: A Simulation Model

2014 ◽  
Vol 1 (2) ◽  
Author(s):  
Sarah M. Bartsch ◽  
Susan S. Huang ◽  
Kim F. Wong ◽  
Taliser R. Avery ◽  
Bruce Y. Lee
Keyword(s):  
Simulation Model ◽  
Acute Care ◽  
Orange County ◽  
Reproductive Rate ◽  
Agent Based ◽  
Contact Precautions ◽  
Care Facilities ◽  
Acute Care Facilities ◽  
Almost All ◽  
And Control

Abstract Background.  Because hospitals in a region are connected via patient sharing, a norovirus outbreak in one hospital may spread to others. Methods.  We utilized our Regional Healthcare Ecosystem Analyst software to generate an agent-based model of all the acute care facilities in Orange County (OC), California and simulated various norovirus outbreaks in different locations, both with and without contact precautions. Results.  At the lower end of norovirus reproductive rate (R0) estimates (1.64), an outbreak tended to remain confined to the originating hospital (≤6.1% probability of spread). However, at the higher end of R0 (3.74), an outbreak spread 4.1%–17.5% of the time to almost all other OC hospitals within 30 days, regardless of the originating hospital. Implementing contact precautions for all symptomatic cases reduced the probability of spread to other hospitals within 30 days and the total number of cases countywide, but not the number of other hospitals seeing norovirus cases. Conclusions.  A single norovirus outbreak can continue to percolate throughout a system of different hospitals for several months and appear as a series of unrelated outbreaks, highlighting the need for hospitals within a region to more aggressively and cooperatively track and control an initial outbreak.

scholarly journals Surveillance nursing diagnoses, ongoing assessment and outcomes on in-patients who suffered a cardiorespiratory arrest

2018 ◽  
Vol 51 (0) ◽  
Author(s):  
Maria-Eulàlia Juvé-Udina ◽  
Núria Fabrellas-Padrés ◽  
Jordi Adamuz-Tomás ◽  
Sònia Cadenas-González ◽  
Maribel Gonzalez-Samartino ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Acute Care ◽  
Vital Signs ◽  
Cross Sectional ◽  
Care Plans ◽  
Care Facilities ◽  
Cross Sectional Design ◽  
Acute Care Facilities ◽  
Ongoing Assessment ◽  
Nursing Diagnoses

ABSTRACT Objective The purposes of this study were to examine the frequency of surveillance-oriented nursing diagnoses and interventions documented in the electronic care plans of patients who experienced a cardiac arrest during hospitalization, and to observe whether differences exist in terms of patients’ profiles, surveillance measurements and outcomes. Method A descriptive, observational, retrospective, cross-sectional design, randomly including data from electronic documentation of patients who experienced a cardiac arrest during hospitalization in any of the 107 adult wards of eight acute care facilities. Descriptive statistics were used for data analysis. Two-tailed p-values are reported. Results Almost 60% of the analyzed patients’ e-charts had surveillance nursing diagnoses charted in the electronic care plans. Significant differences were found for patients who had these diagnoses documented and those who had not in terms of frequency of vital signs measurements and final outcomes. Conclusion Surveillance nursing diagnoses may play a significant role in preventing acute deterioration of adult in-patients in the acute care setting.

Carbapenem-ResistantKlebsiella pneumoniaein Post-Acute-Care Facilities in Israel

2011 ◽  
Vol 32 (9) ◽  
pp. 845-853 ◽  
Author(s):  
Debby Ben-David ◽  
Samira Masarwa ◽  
Shiri Navon-Venezia ◽  
Hagit Mishali ◽  
Ilan Fridental ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Care ◽  
Case Control Study ◽  
Case Control ◽  
Antibiotic Exposure ◽  
Care Facilities ◽  
History Of ◽  
Independent Risk Factors ◽  
Acute Care Facilities ◽  
Control Study

Objective.To assess the prevalence of and risk factors for carbapenem-resistantKlebsiella pneumoniae(CRKP) carriage among patients in post-acute-care facilities (PACFs) in Israel.Design, Setting, and Patients.A cross-sectional prevalence survey was conducted in 12 PACFs. Rectal swab samples were obtained from 1,144 patients in 33 wards. Risk factors for CRKP carriage were assessed among the cohort. Next, a nested, matched case-control study was conducted to define individual risk factors for colonization. Finally, the cohort of patients with a history of CRKP carriage was characterized to determine risk factors for continuous carriage.Results.The prevalence of rectal carriage of CRKP among 1,004 patients without a history of CRKP carriage was 12.0%. Independent risk factors for CRKP carriage were prolonged length of stay (odds ratio [OR], 1.001;P< .001), sharing a room with a known carrier (OR, 3.09;P= .02), and increased prevalence of known carriers on the ward (OR, 1.02;P= .013). A policy of screening for carriage on admission was protective (OR, 0.41;P= .03). Risk factors identified in the nested case-control study were antibiotic exposure during the prior 3 months (OR, 1.66;P= .03) and colonization with other resistant pathogens (OR, 1.64;P= .03). Among 140 patients with a history of CRKP carriage, 47% were colonized. Independent risk factors for continued CRKP carriage were antibiotic exposure during the prior 3 months (OR, 3.05;P= .04), receipt of amoxicillin-clavulanate (OR, 4.18;P= .007), and screening within 90 days of the first culture growing CRKP (OR, 2.9;P= .012).Conclusions.We found a large reservoir of CRKP in PACFs. Infection-control polices and antibiotic exposure were associated with patient colonization.

MUST-Plus: A Machine Learning Classifier That Improves Malnutrition Screening in Acute Care Facilities

2020 ◽  
pp. 1-10 ◽  
Author(s):  
Prem Timsina ◽  
Himanshu N. Joshi ◽  
Fu-Yuan Cheng ◽  
Ilana Kersch ◽  
Sara Wilson ◽  
...  
Keyword(s):  
Machine Learning ◽  
Acute Care ◽  
Learning Classifier ◽  
Care Facilities ◽  
Acute Care Facilities

scholarly journals CIHI Survey: Dying of Cancer in Canada's Acute Care Facilities

2005 ◽  
Vol 8 (3) ◽  
pp. 26-28 ◽  
Author(s):  
Kira Leeb ◽  
Kathleen Morris ◽  
Naomi Kasman
Keyword(s):  
Acute Care ◽  
Care Facilities ◽  
Acute Care Facilities

scholarly journals Frequently Identified Infection Control Gaps Related to Hand Hygiene in Long-Term Care Facilities

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S407-S407
Author(s):  
Kate Tyner ◽  
Regina Nailon ◽  
Sue Beach ◽  
Margaret Drake ◽  
Teresa Fitzgerald ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Infection Control ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Long Term Care ◽  
Infection Prevention And Control ◽  
Term Care ◽  
Care Facilities ◽  
And Control

Abstract Background Little is known about hand hygiene (HH) policies and practices in long-term care facilities (LTCF). Hence, we decided to study the frequency of HH-related infection control (IC) gaps and the factors associated with it. Methods The Nebraska (NE) Infection Control Assessment and Promotion Program (ICAP) in collaboration with NE Department of Health and Human Services conducted in-person surveys and on-site observations to assess infection prevention and control programs (IPCP) in 30 LTCF from 11/2015 to 3/2017. The Centers for Disease Control and Prevention (CDC) Infection Prevention and Control Assessment tool for LTCF was used for on-site interviews and the Centers for Medicare and Medicaid (CMS) Hospital IC Worksheet was used for observations. Gap frequencies were calculated for questions (6 on CDC survey and 8 on CMS worksheet) representing best practice recommendations (BPR). The factors studied for the association with the gaps included LTCF bed size (BS), hospital affiliation (HA), having trained infection preventionists (IP), and weekly hours (WH)/ 100 bed spent by IP on IPCP. Fisher’s exact test and Mann Whitney test were used for statistical analyses. Results HH-related IC gap frequencies from on-site interviews are displayed in Figure 1. Only 6 (20%) LTCF reported having all 6 BPR in place and 10 (33%) having 5 BPR. LTCF with fewer gaps (5 to 6 BPR in place) appear more likely to have HA as compared with the LTCF with more gaps but the difference didn’t reach statistical significance (37.5% vs. 7.1%, P = 0.09). When analyzed separately for each gap, it was found that LTCF with HA are more likely to have a policy on preferential use of alcohol based hand rubs than the ones without HA. (85.7%, vs. 26.1% P = 0.008). Several IC gaps were also identified during observations (Figure 2) with one of them being overall HH compliance of &lt;80%. LTCF that have over 90% HH compliance are more likely to have higher median IP WH/100 beds dedicated towards IPCP as compared with the LTCFs with less than 90% compliance (16.4 vs. 4.4, P &lt; 0.05). Conclusion Many HH-related IC gaps still exist in LTCF and require mitigation. Mitigation strategies may include encouraging LTCF to collaborate with IP at local acute care hospitals for guidance on IC activities and to increase dedicated IP times towards IPCP in LTCF. Disclosures All authors: No reported disclosures.

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