American journal of infection control
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Am J Infect Control · Feb 2020
Comparing inpatient versus emergency department clinician perceptions of personal protective equipment for different isolation precautions.
Adherence to isolation precaution practices, including use of personal protective equipment (PPE), remains a challenge in most hospitals. We surveyed inpatient and emergency department clinicians about their experiences and opinions of various isolation policies, specifically those related to wearing PPE. Our findings show several differences between inpatient and emergency department clinicians involving perceptions related to safety, and the difficulty associated with using PPE for certain types of organisms.
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Am J Infect Control · Nov 2019
Standing orders program of pneumococcal vaccination for hospitalized elderly patients in Hong Kong: A cost-effectiveness analysis.
Clinical studies support a standing orders program (SOP) to improve vaccine uptake. We aimed to examine the potential cost-effectiveness of a pneumococcal vaccination SOP for Hong Kong elderly in a hospital setting. ⋯ The pneumococcal vaccination SOP for hospitalized elderly patients appeared to reduce QALY losses at a higher cost. The cost-effective acceptance of SOPs is highly dependent on the willingness-to-pay threshold.
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Am J Infect Control · Nov 2019
A hospital-wide reduction in central line-associated bloodstream infections through systematic quality improvement initiative and multidisciplinary teamwork.
Few data are available on hospital-wide incidence of central line-associated bloodstream infection (CLABSI) rates in patients with central venous catheter (CVC) in China, where many systemic obstacles holding back evidence-based guidelines implementation exist. ⋯ The SQI and MDT CLABSI infection control program is effective in reducing hospital-wide CLABSI in patients with CVC, both in ICUs and in non-ICUs.
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Am J Infect Control · Sep 2019
Frequent and unexpected deviations from personal protective equipment guidelines increase contamination risks.
Personal protective equipment (PPE) training aims to reinforce the Centers for Disease Control and Prevention guidelines for donning and doffing; however, many health care and ancillary personnel use non-guideline methods to don and doff their PPE gowns and gloves. We found that hospital personnel commonly deviated from the guidelines, increasing the likelihood of self-contamination. Furthermore, securing the gown ties inappropriately was an especially common problem that consequently increased doffing missteps.
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Am J Infect Control · Aug 2019
Modified glove use for contact precautions: Health care workers' perceptions and acceptance.
Patients colonized or infected with methicillin-resistant Staphylococcus aureus and or vancomycin-resistant Enterococcus are placed under contact precautions. Contact precautions require patients to be placed in single rooms and their health care workers (HCWs) to wear gowns, aprons and gloves on entry and doffing on exit. Glove use is widely accepted to be associated with poor hand hygiene compliance. We trailed the removal of gloves for contact precautions for contacts not expected to involve body fluids to improve hand hygiene between multiple contacts of the patient and patient zone. ⋯ The trial of nonglove use for expected dry contact, while caring for patients under contact precautions for methicillin-resistant S aureus and or vancomycin-resistant Enterococcus, was successful in refocusing HCWs reliance on hand hygiene for self-protection. Mandatory glove use for contact precautions was believed to contribute to their failure to change gloves between procedures on the same patient and patient zone, with HCWs now recognizing multiple contacts with the same gloves as a risk for contamination.