scholarly journals Electronically assisted surveillance systems of healthcare-associated infections: a systematic review

2020 ◽  
Vol 25 (2) ◽  
Author(s):  
H Roel A Streefkerk ◽  
Roel PAJ Verkooijen ◽  
Wichor M Bramer ◽  
Henri A Verbrugh
Keyword(s):  
Systematic Review ◽  
Control Programme ◽  
Mature Stage ◽  
Surveillance Systems ◽  
Healthcare Associated Infections ◽  
Medical Specialties ◽  
Specificity And Sensitivity ◽  
Healthcare Associated ◽  
Traditional Surveillance

Background Surveillance of healthcare-associated infections (HAI) is the basis of each infection control programme and, in case of acute care hospitals, should ideally include all hospital wards, medical specialties as well as all types of HAI. Traditional surveillance is labour intensive and electronically assisted surveillance systems (EASS) hold the promise to increase efficiency. Objectives To give insight in the performance characteristics of different approaches to EASS and the quality of the studies designed to evaluate them. Methods In this systematic review, online databases were searched and studies that compared an EASS with a traditional surveillance method were included. Two different indicators were extracted from each study, one regarding the quality of design (including reporting efficiency) and one based on the performance (e.g. specificity and sensitivity) of the EASS presented. Results A total of 78 studies were included. The majority of EASS (n = 72) consisted of an algorithm-based selection step followed by confirmatory assessment. The algorithms used different sets of variables. Only a minority (n = 7) of EASS were hospital-wide and designed to detect all types of HAI. Sensitivity of EASS was generally high (> 0.8), but specificity varied (0.37–1). Less than 20% (n = 14) of the studies presented data on the efficiency gains achieved. Conclusions Electronically assisted surveillance of HAI has yet to reach a mature stage and to be used routinely in healthcare settings. We recommend that future studies on the development and implementation of EASS of HAI focus on thorough validation, reproducibility, standardised datasets and detailed information on efficiency.

scholarly journals The preventable proportion of healthcare-associated infections 2005–2016: Systematic review and meta-analysis

2018 ◽  
Vol 39 (11) ◽  
pp. 1277-1295 ◽  
Author(s):  
Peter W. Schreiber ◽  
Hugo Sax ◽  
Aline Wolfensberger ◽  
Lauren Clack ◽  
Stefan P. Kuster ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Ratio ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Healthcare Associated Infections ◽  
Term Care ◽  
Multifaceted Interventions ◽  
Rate Ratios ◽  
Tract Infections ◽  
Healthcare Associated

AbstractObjectiveThe preventable proportion of healthcare-associated infections (HAIs) may decrease over time as standards of care improve. We aimed to assess the proportion of HAIs prevented by multifaceted infection control interventions in different economic settings.MethodsIn this systematic review and meta-analysis, we searched OVID Medline, EMBASE, CINAHL, PubMed, and The Cochrane Library for studies published between 2005 and 2016 assessing multifaceted interventions to reduce catheter-associated urinary tract infections (CAUTIs), central-line–associated bloodstream infections (CLABSIs), surgical site infections (SSIs), ventilator-associated pneumonia (VAP), and hospital-acquired pneumonia not associated with mechanical ventilation (HAP) in acute-care or long-term care settings. For studies reporting raw rates, we extracted data and calculated the natural log of the risk ratio and variance to obtain pooled risk ratio estimates.ResultsOf the 5,226 articles identified by our search, 144 studies were included in the final analysis. Pooled incidence rate ratios associated with multifaceted interventions were 0.543 (95% confidence interval [CI], 0.445–0.662) for CAUTI, 0.459 (95% CI, 0.381–0.554) for CLABSI, and 0.553 (95% CI, 0.465–0.657) for VAP. The pooled rate ratio was 0.461 (95% CI, 0.389–0.546) for interventions aiming at SSI reduction, and for VAP reduction initiatives, the pooled rate ratios were 0.611 (95% CI, 0.414–0.900) for before-and-after studies and 0.509 (95% CI, 0.277–0.937) for randomized controlled trials. Reductions in infection rates were independent of the economic status of the study country. The risk of bias was high in 143 of 144 studies (99.3%).ConclusionsPublished evidence suggests a sustained potential for the significant reduction of HAI rates in the range of 35%–55% associated with multifaceted interventions irrespective of a country’s income level.

Incidence of healthcare-associated infections among puerperas and newborns in Russian Federation

2021 ◽  
pp. 7-11
Author(s):  
O. A. Orlova ◽  
Yu. A. Abramov ◽  
V. G. Akimkin
Keyword(s):  
Russian Federation ◽  
Systematic Approach ◽  
Economic Damage ◽  
Healthcare Associated Infections ◽  
Puerperal Sepsis ◽  
Quality Of Medical Care ◽  
The Russian Federation ◽  
Healthcare Associated ◽  
Intrauterine Infections

One of the leading problems of modern public health is healthcare-associated infections (HAIs), which lead to significant social and economic damage, and affect the quality of medical care. The proportion of HAIs in obstetric institutions among all the Ministry of Defense of the Russian Federation for 9 years decreased by 1.7 times. The number of puerperas of HAIs decreased by 1.4 times, and HAIs of newborns decreased by 1.6 times. The proportion of puerperal sepsis in the structure of purulent-septic infections of puerperas is 1.7 ± 0.5 %, and sepsis of newborns is 4.4 ± 1.5 %. The average incidence of puerperas of IUPS was 2.0 ± 2.1 per 1,000 births. The incidence of HAIs in newborns was 2.0 ± 1.8 per 1,000 newborns. The ratio of HAIs of newborns to intrauterine infections on average was 1: 9, and in some regions 1:2–1:150. The obtained data on the incidence of HAIs in puerperas and newborns indicates the insufficiency of a systematic approach to recording, analyzing and predicting the incidence of HAIs, which requires a detailed development of standard epidemiological definitions of the case HAIs of puerperas and newborns, intrauterine infections of newborns, as well as a detailed analysis of risk factors for the development of HAIs in obstetric facilities.

Surveillance for Healthcare associated Infections in Indian NICUs: Researchable Issues

2009 ◽  
Vol 23 (4) ◽  
pp. 331-336
Author(s):  
Ashwani Kumar ◽  
Praveen Kumar
Keyword(s):  
Developed Countries ◽  
Control Measures ◽  
Surveillance Systems ◽  
Healthcare Associated Infections ◽  
Infection Control Measures ◽  
Infection Surveillance ◽  
Healthcare Associated ◽  
Symptoms And Signs ◽  
Local Research ◽  
Underlying Risk

Systematic surveillance is the first and integral step of all infection control measures, especially in intensive care settings. Surveillance systems started evolving in developed countries nearly 40 years ago. With experience and wisdom gained, the surveillance methods have improved and become more standardized. It is now clearly recognized that all patients are not at equal risk. For fair comparisons over time within an unit and in between units, the denominator must take the underlying risk into account. Infection surveillance in the NICU presents a number of unique challenges regarding definitions and differing symptoms and signs in the neonate. Although the importance of surveillance is being increasingly recognized in our country and the methods of developed countries are being adopted, there are numerous issues which need local research. This is in view of the limited manpower and financial resources and different profile of organisms and their epidemiology.

scholarly journals Role of pulsed-xenon ultraviolet light in reducing healthcare-associated infections: a systematic review and meta-analysis

2020 ◽  
Vol 148 ◽  
Author(s):  
Zhenhong Dong ◽  
Na Zhou ◽  
Guijuan Liu ◽  
Li Zhao
Keyword(s):  
Systematic Review ◽  
Ultraviolet Light ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Current Evidence ◽  
Healthcare Associated Infections ◽  
Infection Rates ◽  
Healthcare Settings ◽  
Meta Regression Analysis ◽  
Healthcare Associated

Abstract Pulsed-xenon-ultraviolet light (PX-UVL) is increasingly used as a supplemental disinfection method in healthcare settings. We undertook a systematic search of the literature through several databases and conducted a meta-analysis to evaluate the efficacy of PX-UVL in reducing healthcare-associated infections. Eleven studies were included in the systematic review and nine in the meta-analysis. Pooled analysis of seven studies with before-after data indicated a statistically significant reduction of Clostridium difficile infection (CDI) rates with the use of the PX-UVL (incidence rate ratio (IRR): 0.73, 95% CI 0.57–0.94, I2 = 72%, P = 0.01), and four studies reported a reduction of risk of methicillin-resistant Staphylococcus aureus (MRSA) infections (IRR: 0.79, 95% CI 0.64–0.98, I2 = 35%, P = 0.03). However, a further four trials found no significant reduction in vancomycin-resistant enterococci (VRE) infection rates (IRR: 0.80, 95% CI 0.63–1.01, I2 = 60%, P = 0.06). The results for CDI and MRSA proved unstable on sensitivity analysis. Meta-regression analysis did not demonstrate any influence of study duration or intervention duration on CDI rates. We conclude that the use of PX-UVL, in addition to standard disinfection protocols, may help to reduce the incidence of CDI and MRSA but not VRE infection rates. However, the quality of evidence is not high, with unstable results and wide confidence intervals, and further high-quality studies are required to supplement the current evidence.

PP109 Use Of Speech Recognition In Medical Reports: A Systematic Review

2018 ◽  
Vol 34 (S1) ◽  
pp. 107-107
Author(s):  
Thomas Poder ◽  
Véronique Déry ◽  
Jean-Francois Fisette
Keyword(s):  
Systematic Review ◽  
Speech Recognition ◽  
Systematic Reviews ◽  
Grey Literature ◽  
Medical Doctor ◽  
Cochrane Library ◽  
Medical Specialties ◽  
Medical Reports ◽  
End Use

Introduction:Speech recognition is increasingly used in medical reporting. The aim of this article is to identify in the literature the advantages and weaknesses of this technology, as well as barriers and facilitators to its implementation.Methods:A systematic review of systematic reviews has been conducted in PubMed, Scopus, Cochrane Library and Center for Reviews and Dissemination up to August 2017. The grey literature has also been consulted. The quality of systematic reviews has been assessed with the AMSTAR checklist. Inclusion criteria were to use speech recognition for medical reporting (front or back-end). A Survey has also been conducted in Quebec, Canada, to identify the dissemination of this technology in this province, as well as the factors of success or failure in its implementation.Results:Five systematic reviews were identified. These reviews indicated a high level of heterogeneity across studies. The quality of the studies reported was generally poor. Speech recognition is not as accurate as human transcription but can dramatically reduce the turnaround times for reporting. In front-end use, medical doctors need to spend more time for dictation and correction than with human transcription. With speech recognition, major errors can be up to three times more frequent. In back-end use, a potential increase in the productivity of transcriptionist is noted.Conclusions:Speech recognition offers some advantages for medical reporting, the main one being a reduction in turnaround times. However, these advantages are challenged by an increased burden for medical doctor and risks of additional errors in medical reports. It is also hard to identify for which medical specialties and which clinical activities the use of speech recognition will be the most beneficial.

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