The implementation of evidence-based infection prevention in healthcare facilities in Egypt: A systematic literature review

2021 ◽  
Vol 1 (2) ◽  
pp. 093-099
Author(s):  
Nermeen Abdel-Fattah Shehab ◽  
Ahmed Atef Faggal ◽  
Ashraf Ali Nessim
Keyword(s):  
Infection Prevention ◽  
Healthcare Providers ◽  
Healthcare Facility ◽  
Hospital Staff ◽  
Evidence Based ◽  
Surveillance Systems ◽  
Environment Design ◽  
Environmental Interventions ◽  
Healthcare Facilities ◽  
The Impact

The idea of searching: This study tends to assess the impact of implementing evidence-based infection prevention in healthcare facilities in Egypt, with the aim of improving surveillance systems and altering the facility designs according to the data acquired on HAIs patterns. Background: Hospital acquired infections (HAIs) are becoming one of the major concerns for the patients and healthcare providers leading to significant increase in mortality rates, morbidity rates and financial losses for healthcare organizations. The incidence rate of HAI in Egypt was as recorded as 3.7% recently. Certain environmental interventions, implemented during construction of the healthcare facility could lead to enhanced prevention against the transmission and spread of the HAIs. Studies revealed that the integration of Surveillance programs could provide evidence for the designers to alter the healthcare facility design with the aim of infection prevention. Therefore, EBD approach is used to potentially measure psychological and physical effects of the environment design of a health facility on the patients and hospital staff. Methodology: Previous scientific literature is assessed to collect the relevant data which is then organized and analyzed in this study. A systematic review is generated based on the analytical outcomes of the selected data. Conclusion: EBD approach has the potential to prominently decrease HAIs burden in Egyptian healthcare facilities as it provides a diverse insight into the layout, equipment, and materials that contribute in the transmission of pathogens due to faulty design. Findings and recommendations: In order to improve the poor indoor quality by MEP (mechanical, electrical, and plumbing), previous studies have also indicated certain solutions including advancements in private room, improved surface selections, isolation, integration of touchless systems, and enhanced ventilation systems that must be applied in the healthcare facilities in Egypt for infection prevention.

Post-Occupancy Evaluation of a Mental Healthcare Facility Based on Staff Perceptions of Design Innovations

2017 ◽  
Vol 10 (4) ◽  
pp. 121-135 ◽  
Author(s):  
Saleh Kalantari ◽  
Robin Snell
Keyword(s):  
Mental Healthcare ◽  
Healthcare Facility ◽  
Hospital Staff ◽  
Practical Implementation ◽  
Specific Design ◽  
Staff Perceptions ◽  
Healthcare Facilities ◽  
Post Occupancy Evaluation ◽  
Healthcare Settings ◽  
The Impact

Objectives: This study was a post-occupancy evaluation (POE) to examine the effectiveness of three specific design innovations in a mental healthcare facility. In addition to collecting data about the impact of these specific designs, the study provides a model for the broader implementation of POE approaches in the mental healthcare context. Background: POEs in general healthcare settings have been shown to lead to better work environments and better outcomes for patients. Despite growing evidence of the value provided by POE studies, the industry has been somewhat slow to adopt their regular use, in part due to unfamiliarity with the POE process. This is particularly true in mental healthcare contexts, where POE studies remain virtually nonexistent. Method: In-depth interviews and a widely distributed, anonymous survey were used to collect hospital staff perceptions and feedback regarding the impact of specific design features. Results: The hospital staff were quite enthusiastic about two of the design innovations studied here (a new wayfinding strategy and the use of vibrant colors in specific areas of the facility). The third innovation, open-style communication centers, elicited more mixed evaluations. The results include extensive hypothesis testing about the effects of each innovation as well as narrative discussions of their pros and cons. Conclusions: The study generated new knowledge about three specific mental healthcare design innovations and provides a model for the practical implementation of a POE approach in mental healthcare contexts. The results are particularly relevant for designers who are considering innovative strategies in future mental healthcare facilities.

scholarly journals Infection control practices and challenges in Pakistan during the COVID-19 pandemic: a multicentre cross-sectional study

2021 ◽  
pp. 175717742110127
Author(s):  
Salma Abbas ◽  
Faisal Sultan
Keyword(s):  
Personal Protective Equipment ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Hospital Staff ◽  
Cross Sectional Study ◽  
Infection Prevention And Control ◽  
Protective Equipment ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
And Control

Background: Patient and staff safety at healthcare facilities during outbreaks hinges on a prompt infection prevention and control response. Physicians leading these programmes have encountered numerous obstacles during the pandemic. Aim/objective: The aim of this study was to evaluate infection prevention and control practices and explore the challenges in Pakistan during the coronavirus disease 2019 pandemic. Methods: We conducted a cross-sectional study and administered a survey to physicians leading infection prevention and control programmes at 18 hospitals in Pakistan. Results: All participants implemented universal masking, limited the intake of patients and designated separate triage areas, wards and intensive care units for coronavirus disease 2019 patients at their hospitals. Eleven (61%) physicians reported personal protective equipment shortages. Staff at three (17%) hospitals worked without the appropriate personal protective equipment due to limited supplies. All participants felt overworked and 17 (94%) reported stress. Physicians identified the lack of negative pressure rooms, fear and anxiety among hospital staff, rapidly evolving guidelines, personal protective equipment shortages and opposition from hospital staff regarding the choice of recommended personal protective equipment as major challenges during the pandemic. Discussion: The results of this study highlight the challenges faced by physicians leading infection prevention and control programmes in Pakistan. It is essential to support infection prevention and control personnel and bridge the identified gaps to ensure patient and staff safety at healthcare facilities.

scholarly journals 60 Opening the Narrative on Deprivation of Liberty for the Older Person in Residential Healthcare Facilities: A Legal and Ethical Dilemma

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Florence Hogan ◽  
Adrian Ahern
Keyword(s):  
Human Rights ◽  
Residential Care ◽  
Healthcare Providers ◽  
Community Support ◽  
Healthcare Facility ◽  
Moral Dilemmas ◽  
Legal Framework ◽  
Best Interest ◽  
Healthcare Facilities ◽  
The Individual

Abstract Background While many people enter residential care of their own free will and because it is their preference, the evidence tells us that there are also many who if they had the choice would remain in their own homes. Lack of appropriate community supports may provide some impetus to enter residential care. According to Care Alliance Ireland, an additional four million hours of homecare needs to be provided to cope with the successful ageing demographics, at a cost of €110 million. There is no statutory or common-law power to detain a patient in a Healthcare Facility outside of the application of the Mental Health Act 2001. This presents legal, ethical and moral dilemmas for Healthcare Providers when caring for a person who lacks capacity wishes to self - discharge. A duty of care obligates healthcare professionals to act in the best interest of the individual. Under the Health Act 2007 the requirement is to provide for a ‘safe discharge’. Pending advancement of the Assisted Decision Making (Capacity) Act 2015 which provides a statutory framework to assist and support individuals to make legally-binding agreements about their welfare, their property and affairs we are currently acting under the Lunacy Regulations (1871). Methods We developed a ‘Deprivation of Liberty’ form which enable comprehensive Interdisciplinary Team discussion and direction of care. Presumption of capacity, respect for the resident’s wishes and consideration of all possible supportive actions up to and including sourcing community support services were considered. Results This format has enabled comprehensive discussion and robust adherence to human rights for three residents thus far Conclusion The situation remains that there is no legal framework to guide healthcare providers currently. Using a Human Rights based approach is imperative to guide us while awaiting advancement of the ADMA (2015) and Deprivation of Liberty legislation to be included in this act.

Investigating the Impact of Healthcare Environmental Design on Staff Security: A Systematic Review

2020 ◽  
pp. 193758672092140
Author(s):  
Soheyla MohammadiGorji ◽  
Sheila J. Bosch ◽  
Shabboo Valipoor ◽  
Giuliano De Portu
Keyword(s):  
Behavioral Health ◽  
Physical Environment ◽  
Healthcare Professionals ◽  
Environmental Design ◽  
Health Facilities ◽  
Design Strategies ◽  
Ambient Conditions ◽  
Environmental Interventions ◽  
Healthcare Facilities ◽  
The Impact

Objective: To systematically review the literature regarding the role of the physical environment in preventing or mitigating aggressive behavior toward healthcare professionals in acute care, outpatient, and psychiatric/behavioral health facilities. Background: Globally, the incidence of violence against healthcare professionals is alarming. Poor environmental design has been identified as a risk factor of violence toward employees. The design of the physical setting in which healthcare is provided may moderate the incidence and severity of violence against healthcare workers. Methods: We conducted electronic database searches of PubMed and CINAHL through November 2018. Result: Findings were organized according to four categories identified in the literature regarding crime prevention through environmental design (CPTED) including natural surveillance, access control, territoriality, and other CPTED elements. Fifteen studies (published between 1991 and 2017) met the inclusion criteria. Of the 15 studies, 4 incorporated environmental interventions. In the 11 remaining studies, physical environment attributes (i.e., layout, location, ambient conditions, equipment) were among the factors affecting violent incidents and staff security. Most study settings were hospital-based (11, with 10 of those specifically focused on emergency departments), followed by behavioral health facilities (4 studies). Design-focused recommendations, such as providing a second door in a triage room and a sub-waiting area inside the treatment zone, were summarized according to CPTED categories. Conclusion: This review suggests that the physical environment in healthcare facilities may affect the incidence of violence by patients or visitors against staff. Further research is needed to identify environmental design strategies that may protect the safety of healthcare professionals.

scholarly journals Infectious Diseases Society of America Guidelines on Infection Prevention for Healthcare Personnel Caring for Patients With Suspected or Known Coronavirus Disease 2019

2020 ◽  
Author(s):  
John B Lynch ◽  
Perica Davitkov ◽  
Deverick J Anderson ◽  
Adarsh Bhimraj ◽  
Vincent Chi-Chung Cheng ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Infection Prevention ◽  
Indirect Evidence ◽  
Standards Of Care ◽  
Healthcare Personnel ◽  
Evidence Based ◽  
Healthcare Facilities ◽  
Guideline Panel ◽  
Evaluation Approach ◽  
Specific Care

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly transmissible virus that can infect healthcare personnel (HCP) and patients in healthcare settings. Specific care activities, in particular, aerosol-generating procedures, may have a higher risk of transmission. The rapid emergence and global spread of SARS-CoV-2 has created significant challenges in healthcare facilities, particularly with severe shortages of personal protective equipment (PPE) used to protect HCP. Evidence-based recommendations for what PPE to use in conventional, contingency, and crisis standards of care are needed. Where evidence is lacking, the development of specific research questions can help direct funders and investigators. Objective Our objective was to develop evidence-based rapid guidelines intended to support HCP in their decisions about infection prevention when caring for patients with suspected or known coronavirus disease 2019 (COVID-19). Methods The Infectious Diseases Society of America (IDSA) formed a multidisciplinary guideline panel that included front-line clinicians, infectious diseases specialists, experts in infection control, and guideline methodologists with representation from the disciplines of preventive care, public health, medical microbiology, pediatrics, critical care medicine, and gastroenterology. The process followed a rapid recommendation checklist. The panel prioritized questions and outcomes. Then, a systematic review of the peer-reviewed and gray literature was conducted. The Grading of Recommendations Assessment, Development and Evaluation approach was used to assess the certainty of evidence and make recommendations. Results The IDSA guideline panel agreed on 8 recommendations and provided narrative summaries of other interventions undergoing evaluations. Conclusions Using a combination of direct and indirect evidence, the panel was able to provide recommendations for 8 specific questions on the use of PPE for HCP who provide care for patients with suspected or known COVID-19. Where evidence was lacking, attempts were made to provide potential avenues for investigation. Significant gaps in the understanding of the transmission dynamics of SARS-CoV-2 remain, and PPE recommendations may need to be modified in response to new evidence.

The Impact of Environmental Design on Teamwork and Communication in Healthcare Facilities: A Systematic Literature Review

2017 ◽  
Vol 11 (1) ◽  
pp. 119-137 ◽  
Author(s):  
Arsalan Gharaveis ◽  
D. Kirk Hamilton ◽  
Debajyoti Pati
Keyword(s):  
Built Environment ◽  
English Language ◽  
Current Knowledge ◽  
Relevant Literature ◽  
Environmental Design ◽  
Healthcare Facility ◽  
Environmental Research ◽  
Design Environment ◽  
Healthcare Facilities ◽  
The Impact

The purpose of this systematic review is to investigate the current knowledge about the impact of healthcare facility design on teamwork and communication by exploring the relevant literature. Teamwork and communication are behavioral factors that are impacted by physical design. However, the effects of environmental factors on teamwork and communication have not been investigated extensively in healthcare design literature. There are no published systematic reviews on the current topic. Searches were conducted in PubMed and Google Scholar databases in addition to targeted design journals including Health Environmental Research & Design, Environment and Behavior, Environmental Psychology, and Applied Ergonomics. Inclusion criteria were (a) full-text English language articles related to teamwork and communication and (b) involving any healthcare built environment and space design published in peer-reviewed journals between 1984 and 2017. Studies were extracted using defined inclusion and exclusion criteria. In the first phase, 26 of the 195 articles most relevant to teamwork and 19 studies of the 147 were identified and reviewed to understand the impact of communication in healthcare facilities. The literature regarding the impact of built environment on teamwork and communication were reviewed and explored in detail. Eighteen studies were selected and succinctly summarized as the final product of this review. Environmental design, which involves nurses, support staff, and physicians, is one of the critical factors that promotes the efficiency of teamwork and collaborative communication. Layout design, visibility, and accessibility levels are the most cited aspects of design which can affect the level of communication and teamwork in healthcare facilities.

Evidence-Based Design of Healthcare Facilities: Opportunities for Research and Practice in Infection Prevention

2013 ◽  
Vol 34 (5) ◽  
pp. 514-516 ◽  
Author(s):  
Craig Zimring ◽  
Megan E. Denham ◽  
Jesse T. Jacob ◽  
David Z. Cowan ◽  
Ellen Do ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Evidence Based ◽  
Healthcare Facilities ◽  
Research And Practice

scholarly journals Development of Key Performance Indicators for Capturing Impact of Pharmaceutical Care in Palestinian Integrative Healthcare Facilities: A Delphi Consensus Study

2020 ◽  
Vol 2020 ◽  
pp. 1-14 ◽  
Author(s):  
Ramzi Shawahna
Keyword(s):  
Pharmaceutical Care ◽  
Integrative Medicine ◽  
Performance Indicators ◽  
Sampling Technique ◽  
Key Performance Indicators ◽  
Evidence Based ◽  
Delphi Consensus ◽  
Healthcare Facilities ◽  
Number Of Patients ◽  
The Impact

Background. The current study was performed to develop a consensus-based core inventory of key performance indicators (KPIs) to be used in capturing the impact of pharmaceutical care in healthcare facilities that employ integrative medicine paradigm in Palestine. Methods. A panel of healthcare professionals and risk/quality assurance managers was composed employing a judgmental sampling technique. The study tool was a questionnaire. Views and opinions of the panelists on the roles of pharmacists in caring for patients admitted to or visiting healthcare facilities that employ integrative medicine were collected using 11 statements. An initial inventory of activities and services that potentially can be used as KPIs was compiled from the literature and interviews with key contact experts in the domain. Three iterative Delphi rounds were conducted among the panelists (n = 50) to achieve formal consensus on the KPIs that should be used. The consensus-based KPIs were ordered by the scores of the panelists. Results. A total of 8 consensus-based KPIs were developed. The KPIs related to the number of problems related to medications and complementary and alternative medicine (CAM) that were resolved by pharmacists and CAM practitioners (p < 0.0001), number of patients for whom reconciliations were documented (p < 0.0001), number of patients receiving direct, comprehensive, and/or collaborative care (p < 0.0001), and number of patients for whom pharmacists and CAM practitioners were involved in implementing a therapeutic plan (p < 0.05) were rated significantly higher than the KPI (#8) related to the participation in multi-healthcare provider discussions/deliberations. Conclusions. Consensus-based KPIs that can be used in capturing the impact of evidence-based CAM and pharmaceutical care of patients in healthcare facilities that employ integrative medicine paradigm were developed. Future studies are still needed to investigate if implementing these KPIs might promote evidence-based CAM and pharmaceutical care in healthcare facilities that employ the integrative medicine paradigm.

Staff participation in design with multiple tools: Impact on design and POE results

2021 ◽  
pp. 193758672110607
Author(s):  
Tiina Jouppila
Keyword(s):  
Online Survey ◽  
Research Study ◽  
Healthcare Providers ◽  
Evidence Based ◽  
Staff Satisfaction ◽  
Healthcare Staff ◽  
Design Studies ◽  
Significant Difference ◽  
Technical Solutions ◽  
The Impact

Objective: This is a concluding part of an action research study to evaluate the impact on healthcare staff participation in the design of a new intensive care unit (ICU). Staff participated with multiple tools in the design; during the predesign phase utilizing co-design and virtual mock-ups, and also participating in the predesign evaluation (PDE) and postoccupancy evaluation (POE). Both the ICU design and evaluations were based on the principles of evidence-based design studies. Method: Staff satisfaction was evaluated with an online survey comprising 116 statements on 13 different topics used both in PDE and POE. There was space for open-ended comments after each topic. Results: There was a statistically significant difference (<.001) between PDE and POE results. There were considerable improvements in privacy, accessibility, safety and security, and acoustics. It was assumed that participation in the predesign phase would positively influence POE results, but there were no statistical differences in any topics. However, as a result of collaborative predesign phase, the staff was satisfied with these jointly designed patient rooms. Open-ended questions revealed the importance to continue functional and technical support for staff after commissioning and ensure that technical solutions are practical and well-functioning. Conclusion: The use of PDE and POE assists to set predetermined criteria and evaluate the success of design. Healthcare providers should see POE as a valuable part of design and commissioning process. Additionally, the use of POE should be made more effortless and the results more easily accessible to promote increased interest and usage.

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