scholarly journals Infection prevention measures for patients undergoing hemodialysis during the COVID-19 pandemic in Japan: a nationwide questionnaire survey

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuka Sugawara ◽  
◽  
Masao Iwagami ◽  
Kan Kikuchi ◽  
Yoko Yoshida ◽  
...  
Keyword(s):  
Infection Control ◽  
Questionnaire Survey ◽  
Infection Prevention ◽  
Control Measures ◽  
Nosocomial Transmission ◽  
Third Wave ◽  
Prevention Measures ◽  
Infection Control Measures ◽  
Before And After ◽  
Dialysis Facilities

Abstract Background Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic affecting a variety of medical treatments, including hemodialysis. This study aims to investigate the implementation of infection control measures, to examine the shortage of personal protective equipment (PPE) and disinfectants, and to quantify the number of nosocomial COVID-19 transmissions in hemodialysis facilities in Japan during the pandemic. Methods We conducted a nationwide questionnaire survey between 20 October and 16 November 2020 (i.e., between the “second wave” and “third wave” in Japan) in the 4198 dialysis facilities of the Japanese Association of Dialysis Physicians and the Japanese Society for Dialysis Therapy. A total of 2227 facilities (53.0%) responded. The questionnaire consisted of (i) characteristics of facilities, (ii) infection prevention measures in routine dialysis practices, (iii) shortage of PPE, (iv) feasibility of various isolation measures, and (v) nosocomial transmission. Results Half of the responding facilities were hospitals with multiple departments, and the other half were clinics specialized in dialysis. Several infection prevention measures such as health checks of staff and patients, donning of masks before and after hemodialysis, and disinfection of frequently contacted areas were implemented during the COVID-19 pandemic. There was a significant improvement in the implementation rate of these measures during the pandemic, compared to before it, which reached over 90%. More than half of the facilities reported a shortage of disposable masks (67.2%) and hand sanitizer alcohol (56.7%). Isolation of COVID-19 patients in private rooms was possible only in 52.7% of the facilities. The majority of facilities (73.3%) could not accept COVID-19 dialysis patients due to lack of space and manpower. Nosocomial transmission of COVID-19 occurred in 4.0% of the facilities. Of those infected, 51.9% were staff. Conclusions This survey revealed that most hemodialysis facilities in Japan had improved implementation of infection control measures and had shortage of PPEs and disinfectants, though some facilities did not implement infection prevention measures adequately, mainly due to the limited space of the facility. It may be recommended that each facility immediately establishes isolation measures to prepare for the pandemic of COVID-19.

scholarly journals Nosocomial Outbreak of SARS-CoV-2 in a Non-COVID Zone of a Tertiary Care Hospital of North India: Need to Upgrade Infection Control Practices

2021 ◽  
Vol 12 ◽  
pp. 215013272110507
Author(s):  
Kirtan Rana ◽  
Bhawna Sharma ◽  
Pinnaka Venkata Maha Lakshmi ◽  
ManharPreet Kaur ◽  
Mini P. Singh ◽  
...  
Keyword(s):  
Infection Control ◽  
Infection Prevention ◽  
Tertiary Care Hospital ◽  
Ventilation System ◽  
Tertiary Care ◽  
Control Measures ◽  
North India ◽  
Care Hospital ◽  
Prevention Measures ◽  
Infection Control Measures

Background Hospital acquired infections are preventable cause for morbidity and mortality worldwide. In the current pandemic era proper implementation of infection control measures can prevent the spread of such infections including SARS-CoV 2. The study was done to identified the source and reason for spread of COVID-19 infection and devise recommendations to halt the progress of infection in a non-COVID area. Methods An outbreak in a non-COVID area of a tertiary care hospital was investigated by the infection control team along with the epidemiologist when they were notified about the rising cases of COVID-19 from Advanced Trauma Center’s (ATC) disaster ward. The time, place and person distribution of the cases were studied. Recommendations based on gaps identified were developed onsite and implemented to control the outbreak. Results The outbreak lasted from 19th December 2020 to 12th January 2021, affecting 34 people (25 patients and 9 health care workers). The attack rate was 9.2%. We identified the causes of current outbreak as compromises in infection prevention measures, high bed patient ratio, irregularities in the ventilation system, overcrowding by patient attendants and communication gaps between nursing officers and doctors. Measures required to control the outbreak were implemented and no cases were reported for 2 weeks following the last positive case. Conclusion Non-COVID areas of hospitals are also at risk of nosocomial outbreaks of SARS-CoV 2 and therefore strict infection prevention measures those designated to COVID areas should be followed in non-COVID zones also to prevent such outbreaks.

scholarly journals Universal Masking to Control Healthcare-Associated Transmission of SARS-CoV-2

2021 ◽  
pp. 1-24
Author(s):  
Eliza R. Thompson ◽  
Faith S. Williams ◽  
Pat A. Giacin ◽  
Shay Drummond ◽  
Eric Brown ◽  
...  
Keyword(s):  
Large Scale ◽  
Infection Prevention ◽  
Index Patient ◽  
Field Investigation ◽  
Point Prevalence ◽  
Control Measures ◽  
Prevention Measures ◽  
Infection Control Measures ◽  
Va Health Care System ◽  
Healthcare Associated

Abstract Objective: To assess extent of a healthcare-associated outbreak of SARS-CoV-2 and evaluate effectiveness of infection control measures, including universal masking Design: Outbreak investigation including 4 large-scale point-prevalence surveys Setting: Integrated VA Health Care System with 2 facilities and 330 beds Participants: Index patient and 250 exposed patients and staff Methods: We identified exposed patients and staff and classified them as probable and confirmed cases based on symptoms and testing. We performed a field investigation and assessment of patient and staff interactions to develop probable transmission routes. Infection prevention interventions implemented included droplet and contact precautions, employee quarantine, and universal masking with medical and cloth facemasks. Four point-prevalence surveys of patient and staff subsets were conducted using real-time reverse-transcriptase polymerase chain reaction for SARS-CoV-2. Results: Among 250 potentially exposed patients and staff, 14 confirmed cases of Covid-19 were identified. Patient roommates and staff with prolonged patient contact were most likely to be infected. The last potential date of transmission from staff to patient was day 22, the day universal masking was implemented. Subsequent point-prevalence surveys in 126 patients and 234 staff identified 0 patient cases and 5 staff cases of Covid-19, without evidence of healthcare-associated transmission. Conclusions: Universal masking with medical facemasks was effective in preventing further spread of SARS-CoV-2 in our facility in conjunction with other traditional infection prevention measures.

Variation in Infection Prevention Practices in Dialysis Facilities: Results From the National Opportunity to Improve Infection Control in ESRD (End-Stage Renal Disease) Project

2015 ◽  
Vol 36 (7) ◽  
pp. 802-806 ◽  
Author(s):  
Carol E. Chenoweth ◽  
Stephen C. Hines ◽  
Kendall K. Hall ◽  
Rajiv Saran ◽  
John D. Kalbfleisch ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Infection Control ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Infection Prevention ◽  
Quality Improvement Initiative ◽  
Before And After ◽  
Dialysis Facilities ◽  
Stage Renal Disease ◽  
End Stage

OBJECTIVETo observe patient care across hemodialysis facilities enrolled in the National Opportunity to Improve Infection Control in ESRD (end-stage renal disease) (NOTICE) project in order to evaluate adherence to evidence-based practices aimed at prevention of infection.SETTING AND PARTICIPANTSThirty-four hemodialysis facilities were randomly selected from among 772 facilities in 4 end-stage renal disease participating networks. Facility selection was stratified on dialysis organization affiliation, size, socioeconomic status, and urban/rural status.MEASUREMENTSTrained infection control evaluators used an infection control worksheet to observe 73 distinct infection control practices at the hemodialysis facilities, from October 1, 2011, through January 31, 2012.RESULTSThere was considerable variation in infection control practices across enrolled facilities. Overall adherence to recommended practices was 68% (range, 45%–92%) across all facilities. Overall adherence to expected hand hygiene practice was 72% (range, 10%–100%). Compliance to hand hygiene before and after procedures was high; however, during procedures hand hygiene compliance averaged 58%. Use of chlorhexidine as the specific agent for exit site care was 19% overall but varied from 0% to 35% by facility type. The 8 checklists varied in the frequency of perfect performance from 0% for meeting every item on the checklist for disinfection practices to 22% on the arteriovenous access practices at initiation.CONCLUSIONSOur findings suggest that there are many areas for improvement in hand hygiene and other infection prevention practices in end-stage renal disease. These NOTICE project findings will help inform the development of a larger quality improvement initiative at dialysis facilities.Infect Control Hosp Epidemiol 2015;36(7):802–806

scholarly journals Implementation of an infection prevention bundle and increased physician awareness improves surgical outcomes and reduces costs associated with spine surgery

2018 ◽  
Vol 29 (1) ◽  
pp. 108-114 ◽  
Author(s):  
Nitin Agarwal ◽  
Prateek Agarwal ◽  
Ashley Querry ◽  
Anna Mazurkiewicz ◽  
Zachary J. Tempel ◽  
...  
Keyword(s):  
Infection Control ◽  
Infection Rate ◽  
Spine Surgery ◽  
Infection Prevention ◽  
Cost Savings ◽  
Control Measures ◽  
Control Group ◽  
Infection Rates ◽  
Infection Control Measures ◽  
Physician Awareness

OBJECTIVEPrevious studies have demonstrated the efficacy of infection prevention protocols in reducing infection rates. This study investigated the effects of the development and implementation of an infection prevention protocol that was augmented by increased physician awareness of spinal fusion surgical site infection (SSI) rates and resultant cost savings.METHODSA cohort clinical investigation over a 10-year period was performed at a single tertiary spine care academic institution. Preoperative infection control measures (chlorohexidine gluconate bathing, Staphylococcus aureus nasal screening and decolonization) followed by postoperative infection control measures (surgical dressing care) were implemented. After the implementation of these infection control measures, an awareness intervention was instituted in which all attending and resident neurosurgeons were informed of their individual, independently adjudicated spinal fusion surgery infection rates and rankings among their peers. During the course of these interventions, the overall infection rate was tracked as well as the rates for those neurosurgeons who complied with the preoperative and postoperative infection control measures (protocol group) and those who did not (control group).RESULTSWith the implementation of postoperative surgical dressing infection control measures and physician awareness, the postoperative spine surgery infection rate decreased by 45% from 3.8% to 2.1% (risk ratio 0.55; 95% CI 0.32–0.93; p = 0.03) for those in the protocol cohort, resulting in an estimated annual cost savings of $291,000. This reduction in infection rate was not observed for neurosurgeons in the control group, although the overall infection rate among all neurosurgeons decreased by 54% from 3.3% to 1.5% (risk ratio 0.46; 95% CI 0.28–0.73; p = 0.0013).CONCLUSIONSA novel paradigm for spine surgery infection control combined with physician awareness methods resulted in significantly decreased SSI rates and an associated cost reduction. Thus, information sharing and physician engagement as a supplement to formal infection control measures result in improvements in surgical outcomes and costs.

scholarly journals COVID-19 infection control measures and outcomes in urban dialysis centers in predominantly African American communities

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ibironke W. Apata ◽  
Jason Cobb ◽  
Jose Navarrete ◽  
John Burkart ◽  
Laura Plantinga ◽  
...  
Keyword(s):  
African American ◽  
Infection Control ◽  
Time Frame ◽  
Control Measures ◽  
National Guidelines ◽  
Infection Control Measures ◽  
Dialysis Facility ◽  
Baseline Characteristics ◽  
Dialysis Facilities

Abstract Background Emory Dialysis serves an urban and predominantly African American population at its four outpatient dialysis facilities. We describe COVID-19 infection control measures implemented and clinical characteristics of patients with COVID-19 in the Emory Dialysis facilities. Methods Implementation of COVID-19 infection procedures commenced in February 2020. Subsequently, COVID-19 preparedness assessments were conducted at each facility. Patients with COVID-19 from March 1–May 31, 2020 were included; with a follow-up period spanning March–June 30, 2020. Percentages of patients diagnosed with COVID-19 were calculated, and characteristics of COVID-19 patients were summarized as medians or percentage. Baseline characteristics of all patients receiving care at Emory Dialysis (i.e. Emory general dialysis population) were presented as medians and percentages. Results Of 751 dialysis patients, 23 (3.1%) were diagnosed with COVID-19. The median age was 67.0 years and 13 patients (56.6%) were female. Eleven patients (47.8%) were residents of nursing homes. Nineteen patients (82.6%) required hospitalization and 6 patients (26.1%) died; the average number of days from a positive SARS-CoV-2 (COVID) test to death was 16.8 days (range 1–34). Two patients dialyzing at adjacent dialysis stations and a dialysis staff who cared for them, were diagnosed with COVID-19 in a time frame that may suggest transmission in the dialysis facility. In response, universal masking in the facility was implemented (prior to national guidelines recommending universal masking), infection control audits and re-trainings of PPE were also done to bolster infection control practices. Conclusion We successfully implemented recommended COVID-19 infection control measures aimed at mitigating the spread of SARS-CoV-2. Most of the patients with COVID-19 required hospitalizations. Dialysis facilities should remain vigilant and monitor for possible transmission of COVID-19 in the facility.

scholarly journals Prevention of Nosocomial Transmission of Norovirus by Strategic Infection Control Measures

2011 ◽  
Vol 32 (3) ◽  
pp. 229-237 ◽  
Author(s):  
Vincent C. C. Cheng ◽  
Lisa M. W. Wong ◽  
Josepha W. M. Tai ◽  
Jasper F. W. Chan ◽  
Kelvin K. W. To ◽  
...  
Keyword(s):  
Infection Control ◽  
Control Measures ◽  
Nosocomial Transmission ◽  
Infection Control Team ◽  
Concurrent Control ◽  
Infection Control Measures ◽  
Control Team ◽  
Hospital Networks ◽  
Polymerase Chain ◽  
Hospital Acquired

Background.Nosocomial outbreaks of norovirus infection pose a great challenge to the infection control team.Methods.Between November 1, 2009, and February 28, 2010, strategic infection control measures were implemented in a hospital network. In addition to timely staff education and promotion of directly observed hand hygiene, reverse-transcription polymerase chain reaction for norovirus was performed as an added test by the microbiology laboratory for all fecal specimens irrespective of the request for testing. Laboratory-confirmed cases were followed up by the infection control team for timely intervention. The incidence of hospital-acquired norovirus infection per 1,000 potentially infectious patient-days was compared with the corresponding period in the preceding 12 months, and the incidence in the other 6 hospital networks in Hong Kong was chosen as the concurrent control. Phylogenetic analysis of norovirus isolates was performed.Results.Of the 988 patients who were tested, 242 (25%) were positive for norovirus; 114 (47%) of those 242 patients had norovirus detected by our added test. Compared with the corresponding period in the preceding 12 months, the incidence of hospital-acquired norovirus infection decreased from 131 to 16 cases per 1,000 potentially infectious patient-days (P < .001 ), although the number of hospital-acquired infections was low in both the study period (n = 8) and the historical control periods (n = 11). The incidence of hospital-acquired norovirus infection in our hospital network (0.03 cases per 1,000 patient-days) was significantly lower than that of the concurrent control (0.06 cases per 1,000 patient-days) (P = .015). Forty-three (93%) of 46 norovirus isolates sequenced belonged to the genogroup II.4 variant.Conclusions.Strategic infection control measures with an added test maybe useful in controlling nosocomial transmission of norovirus.

scholarly journals Infection Control Measures in Dental Clinics during Coronavirus Disease-19 Pandemic in Kingdom of Saudi Arabia: A Pilot Study

2021 ◽  
Vol 9 (D) ◽  
pp. 61-67
Author(s):  
Rawa Kamal Abdelrahim ◽  
Husham Abu Elgasim Abdoun ◽  
Pradeep Koppolu ◽  
Lingam Amara Swapna
Keyword(s):  
Saudi Arabia ◽  
Infection Control ◽  
Control Measures ◽  
Categorical Variables ◽  
Prevention Measures ◽  
Kingdom Of Saudi Arabia ◽  
Cross Sectional ◽  
Infection Control Measures ◽  
Dental Clinics ◽  
Number Of Patients

BACKGROUND: Coronavirus disease (COVID)-19 is an infectious respiratory disease causing different symptoms ranging from mild to more complicated cases. In dental clinics, there is a potential risk of cross-infection between dental health worker and patients. Therefore, new infection prevention measures have been recommended to minimize spread of COVID-19 in dental clinics. AIM: The aim of this study is to get an insight into the infection control measures followed by dentists and modification done in personal protective equipment (PPE) to combat spread of infection during COVID-19 in Kingdom of Saudi Arabia. METHODS: A cross-sectional data using online Google survey. The sample included dentists working in either private or government from different regions in Kingdom of Saudi Arabia. Chi-square test was used to investigate the association between categorical variables (p < 0.05) RESULTS: Seventy dentists included in the study of which 40% are working in Riyadh. Dental clinics are undertaken respiratory triage and reduce number of patients in waiting area (91% and 98%, respectively). Increased usage of PPE (head cap, face shield, and N95 mask) during the pandemic was observed in the study sample (p = 0.001). Working hours and number of patients were reduced during COVID-19. CONCLUSION: Evidence shows that majority of dentists working in KSA are following recommended measures to minimize the spread of COVID-19. Some dentists modified their PPE during the pandemic. However, further research is required to investigate adherence to infection control measures by dentists.

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