Infection prevention and control challenges in Flemish homecare nursing: a pilot study

2020 ◽  
Vol 25 (3) ◽  
pp. 114-121
Author(s):  
Karel Maelegheer ◽  
Irina Dumitrescu ◽  
Nele Verpaelst ◽  
Hanna Masson ◽  
Caroline Broucke ◽  
...  
Keyword(s):  
Pilot Study ◽  
Home Care ◽  
Wound Care ◽  
Patient Characteristics ◽  
Personal Hygiene ◽  
Infection Prevention And Control ◽  
Surveillance Program ◽  
National Surveillance ◽  
Tract Infections ◽  
And Control

Home nursing is evolving towards more invasive care. Nevertheless, no national data are available on the prevalence of HAI in this setting. The aim of this pilot study is to explore the Flemish home care setting as a first step toward a national surveillance program. A survey, focused on patient characteristics and HAI, was conducted between 7 May and 20 July 2018 on 711 Flemish patients. Most of the patients (74%) are 65 years or older and half of them had a form of comorbidity. Assisting with personal hygiene and wound care were the most frequent services delivered by home care nurses. A comparison of the prevalence of infections diagnosed by a physician or applying uniform criteria (ECDC), revealed a similar prevalence of skin and soft tissue infections (9% vs. 8.5%) and urinary tract infections (4% vs. 4.5%). A positive MDRO-screening was found in 6% of the patients. This pilot study is a first step towards a standardized national surveillance in home care to collect information on the prevalence of HAI and it reveals several interesting facts and study pitfalls for this setting.

Methodological Considerations in the Assessment of Effectiveness of Homeopathic Care: A Critical Review of the EPI3 Study

Homeopathy ◽  
2021 ◽  
Author(s):  
Yola Moride
Keyword(s):  
Critical Review ◽  
Patient Characteristics ◽  
Upper Respiratory Tract ◽  
Specific Patient ◽  
Outcome Measurements ◽  
Apparent Loss ◽  
Therapeutic Opportunity ◽  
Methodological Considerations ◽  
Tract Infections ◽  
And Control

Abstract Background  EPI3 is an observational study of a representative sample of general practitioners (GPs) and patients in France, demonstrating that patient characteristics differ according to the prescribing preferences of their GPs for homeopathy. For selected conditions (musculoskeletal disorders, sleep disorders, anxiety/depression, upper respiratory tract infections), progression of symptoms and adverse events over follow-up in the homeopathy preference group did not significantly differ from other practice preferences, but there was a two-fold to four-fold lower usage of conventional medicines. The EPI3 study's validity was challenged due to absence of head-to-head comparison of medicines to conclude on a causal association between homeopathy and outcomes. Methods A critical review of the nine EPI3 publications was conducted, focusing on generalizability, selection bias, outcome measurements and confounding. Results The conceptual framework of EPI3 rests on a systemic construct, i.e., the homeopathic treatment concept assessed using the type of GP prescribing preference, taking into account the clinical, human and social aspects. The enrollment process enhanced the generalizability of findings. Validated instruments for outcome measurements were used for three conditions, and control of confounding was rigorous. Conclusion EPI3 was conducted according to best practices. Homeopathy prescribing preference met specific patient needs with less use of conventional medicines and without an apparent loss in therapeutic opportunity.

scholarly journals Diagnosis, prevention and control of urinary tract infections: a survey of routine practices in Belgian nursing homes

2020 ◽  
Vol 21 (5) ◽  
pp. 182-188
Author(s):  
Katrien Latour ◽  
Jan De Lepeleire ◽  
Béatrice Jans ◽  
Frank Buntinx ◽  
Boudewijn Catry
Keyword(s):  
Urinary Tract ◽  
Nursing Homes ◽  
Urinary Tract Infections ◽  
Prevention And Control ◽  
Urinary Catheter ◽  
Infection Prevention And Control ◽  
Urine Sampling ◽  
Tract Infections ◽  
And Control ◽  
Catheter Care

Background: Urinary tract infections (UTIs) are one of the most frequently reported infections in older adults and the most common reason for antimicrobial prescribing in nursing homes (NHs). In this vulnerable population, both a good diagnosis and prevention of these infections are crucial as overuse of antibiotics can lead to a variety of negative consequences including the development of multidrug-resistant organisms. Objective: To determine infection prevention and control (IPC) and diagnostic practices for UTIs in Belgian NHs. Methods: Local staff members had to complete an institution-level questionnaire exploring the availability of IPC practices and resources and procedures for UTI surveillance, diagnosis, and urinary catheter and incontinence care. Results: UTIs were the second most common infections in the 87 participating NHs (prevalence: 1.0%). Dipstick tests and urine cultures were routinely performed in 30.2% and 44.6% of the facilities, respectively. In non-catheterised residents, voided or midstream urine sampling was most frequently applied. Protocols/guidelines for urine sampling, urinary catheter care and incontinence care were available in 43.7%, 45.9% and 31.0% of the NHs, respectively. Indwelling catheters were uncommon (2.3% of the residents) and urinary retention (84.9%) and wound management (48.8%) were the most commonly reported indications. Only surveillance was found to significantly impact the UTI prevalence: 2.2% versus 0.8% in NHs with or without surveillance, respectively ( P < 0.001). Discussion: This survey identified key areas for improving the diagnosis and prevention of UTIs, such as education and training regarding the basics of urine collection and catheter care.

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 Point-of-care training program on COVID-19 infection prevention and control for pediatric healthcare workers

2020 ◽  
Author(s):  
Yingzi Ye ◽  
Peng Shi ◽  
Yonghao Gui ◽  
Albert M. Li ◽  
Guoying Huang ◽  
...  
Keyword(s):  
Health Care ◽  
Infection Control ◽  
Training Program ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Online Training ◽  
Control Measures ◽  
Personal Hygiene ◽  
Infection Prevention And Control ◽  
And Control

Abstract Background: To evaluate the effectiveness of training on knowledge and practices of infection prevention and control (IPC) among pediatric health care workers (HCW) in Shanghai, China, in the context of COVID-19 pandemic. Methods: An online training program was designed by the Shanghai Pediatric Clinical Quality Control Center (SPQCC) during the early phase of COVID-19 pandemic on disease knowledge and practice of IPC. Training took place in the 81 partner hospitals affiliated with SPQCC. A 25-item self-administered questionnaire was used to evaluate knowledge gained from the training. Stratified-random sampling was used to select HCW according to three professionals (i.e., pediatricians, nurses and administrators) within each partner hospital. Awareness and knowledge of COVID-19 and its related infection control and practice was assessed by comparing survey results between different types of hospitals, professionals and professional ranks. A higher survey score meant that the respondent was more prepared and knowledgeable about COVID-19 and its infection control measures. Results: Completed questionnaires were returned from 1,062 subjects (385 pediatricians, 410 nurses, and 267 administrators), giving a response rate of 96.5%. Overall, awareness of clinical information related to COVID-19, importance of personal hygiene and isolation policy was high among the respondents. No statistical difference of scores on knowledge of COVID-19, IPC and relevant practice between the tertiary and peripheral hospitals. Among all respondents, middle-ranked health care personnel were most knowledgeable and achieved the highest score. Conclusions: Majority of pediatric HCW showed good recognition and practice in infection protection and control measures. The online training was able to achieve its aim to enhance knowledge and awareness and could have contributed to the zero infection rate among HCW caring for confirmed COVID-19 cases in Shanghai.

scholarly journals Use of Mustard Seed Footbaths for Respiratory Tract Infections: A Pilot Study

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Katja Goetz ◽  
Aune Hinz ◽  
Jost Steinhäuser ◽  
Ulrich von Rath
Keyword(s):  
Pilot Study ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Intervention Group ◽  
Repeated Measurements ◽  
Mustard Seed ◽  
Control Group ◽  
Subjective Perception ◽  
Tract Infections ◽  
And Control

Objective. Respiratory tract infections (RTIs) are the most commonly treated acute problems in general practice. Instead of treatment with antibiotics, therapies from the field of integrative medicine play an increasingly important role within the society. The aim of the study was to evaluate whether mustard footbaths improve the symptoms of patients with RTIs. Methods. The study was designed as a pilot study and was carried out as an interventional trial with two points of measurement. Between November and December 2017, six practices were invited to participate. Two of them participated in the study. Patients were included who presented with an RTI at one of the involved primary care practices during February and April 2018. Participants in the intervention group used self-administered mustard seed powder footbaths at home once a day, to be repeated for six consecutive days. The improvement of symptoms was measured using the “Herdecke Warmth Perception Questionnaire” (HeWEF). A variance analysis for repeated measurements was performed to analyse differences between the intervention and control groups. Results. In this pilot study, 103 patients were included in the intervention group and 36 patients were included in the control group. A comparison of the intervention and control group before the intervention started showed nearly no difference in their subjective perception of warmth measured by the HeWEF questionnaire. Participants of the intervention group who used mustard seed footbaths for six consecutive days showed an improvement in four of the five subscales of the HeWEF questionnaire. Conclusions. This study could provide a first insight into a possible strategy to improve symptoms regarding RTI by using mustard seed footbaths.

scholarly journals 459. Outcomes and Factors Associated with a SARS-CoV-2 Positive Test in Asymptomatic and Symptomatic Healthcare Workers of a Mexican Hospital Converted to Treat COVID-19 Patients

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S297-S297
Author(s):  
Sandra Rajme-López ◽  
Patricia E Leal-Morán ◽  
Fernanda Gonzalez-Lara ◽  
Abril T Vargas-Fernández ◽  
Eric Ochoa-Hein ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Face Mask ◽  
Lower Percentage ◽  
Infection Prevention And Control ◽  
Surveillance Program ◽  
Median Hospital Stay ◽  
Factors Associated ◽  
Epidemic Curve ◽  
And Control

Abstract Background Starting on 03/16/2020, the hospital was converted to attend only patients with COVID-19. A surveillance program for healthcare workers (HCWs) that included free in-site medical consultation and RT-PCR for detection of SARS-CoV-2 was initiated. On 04/28/2020, screening of HCWs was started to detect asymptomatic carriers. We report the results of such programs updated to 05/21/2020. Methods Sex, worker category, working area, use of personal protective equipment, date of screening, date of onset of symptoms and home address were retrieved from electronic databases. Logistic regression was done to identify factors associated with being a COVID-19 case or carrier, with p&lt; 0.05 being significant. Odds ratios and incidence densities were calculated. Results Of 2566 HCWs in the hospital, 976 (38.0%) underwent screening and 41 (4.2%) were positive for SARS-CoV-2 (7.4 carriers x 10,000 person-days; median follow-up of 55.5 days); none of the latter were diagnosed with COVID-19 after completing a 14-day follow-up. Of HCWs with negative screen results, 6 (0.6%) ultimately developed COVID-19 after a median of 10 days (1.1 cases x 10,000 person-days). Of 232 symptomatic HCWs that did not undergo basal screening, 131 (56.5%) were diagnosed with COVID-19 (8.8 cases x 10,000 person-days). Ten COVID-19 cases (7.6%) were hospitalized and all were discharged without complications after a median hospital stay of 9 days. Factors associated with COVID-19 were working in a non-clinical area (OR=9.3, 95% CI=1.1–78.6) and being a nurse (OR=1.9, 95% CI=1.1–3.4). Factors associated with being a carrier were living in the State of Mexico (OR=3.7, 95% CI=1.8–8.0) and being a hospital cook (OR=3.7, 95% CI=1.7–8.5). Being a physician was associated with not being a carrier (OR=0.07, 95% CI=0.01–0.5). Wearing a face mask at all times tended to be associated with not being a carrier. Hospital epidemic curves closely ressembled those of the community (Mexico City). Hospital Epidemic Curve, 03/16/2020 - 05/21/2020 Conclusion This study suggests that factors present inside and outside of the hospital are associated with COVID-19 and asymptomatic carriage in HCWs. This information is of utmost importance for infection prevention and control policies. Additionally, a lower percentage of severe cases and no deaths were observed in this cohort as compared to others. Disclosures All Authors: No reported disclosures

scholarly journals Hand Hygiene Practices to Reduce Hospital Acquired Infection

2019 ◽  
pp. 1-4
Author(s):  
Liana Monica DEAC Babes ◽  
Keyword(s):  
Hand Hygiene ◽  
Personal Hygiene ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Effective Measure ◽  
Hospital Acquired Infection ◽  
Hygiene Practices ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
And Control

Hands are the most effective mode of transfer of microorganism in healthcare and can result in healthcare associated infections which are major causes of morbidity and mortality worldwide. Reduction of infection by this mode of transfer can be achieved by a simple but very effective measure of performing hand hygiene at the appropriate time which is one of the most fundamental principles in infection prevention and control. Good hand hygiene practices have been shown to reduce healthcare associated infections. Hand washing with soap and water has been considered a measure of personal hygiene for several years

scholarly journals Hand Hygiene Practices to Reduce Hospital Acquired Infection

2019 ◽  
Vol 3 (3) ◽  
Keyword(s):  
Hand Hygiene ◽  
Personal Hygiene ◽  
Infection Prevention And Control ◽  
Healthcare Associated Infections ◽  
Effective Measure ◽  
Hospital Acquired Infection ◽  
Hygiene Practices ◽  
Healthcare Associated ◽  
Hospital Acquired ◽  
And Control

Hands are the most effective mode of transfer of microorganism in healthcare and can result in healthcare associated infections which are major causes of morbidity and mortality worldwide. Reduction of infection by this mode of transfer can be achieved by a simple but very effective measure of performing hand hygiene at the appropriate time which is one of the most fundamental principles in infection prevention and control. Good hand hygiene practices have been shown to reduce healthcare associated infections. Hand washing with soap and water has been considered a measure of personal hygiene for several years [1].

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