American journal of infection control
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Am J Infect Control · Feb 2014
Randomized Controlled TrialApplication of a theoretical framework for behavior change to hospital workers' real-time explanations for noncompliance with hand hygiene guidelines.
Insufficient use of behavioral theory to understand health care workers' (HCWs) hand hygiene compliance may result in suboptimal design of hand hygiene interventions and limit effectiveness. Previous studies examined HCWs' intended, rather than directly observed, compliance and/or focused on just 1 behavioral model. This study examined HCWs' explanations of noncompliance in "real time" (immediately after observation), using a behavioral theory framework, to inform future intervention design. ⋯ An explanation of HCW's "real-time" explanations for noncompliance identified "Memory/Attention/Decision Making" and "Knowledge" as the 2 behavioral domains commonly linked to noncompliance. This suggests that hand hygiene interventions should target both automatic associative learning processes and conscious decision making, in addition to ensuring good knowledge. A theoretical framework to investigate HCW's "real-time" explanations of noncompliance provides a coherent way to design hand hygiene interventions.
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Am J Infect Control · Aug 2012
Randomized Controlled Trial Comparative StudyComparison of bacterial contamination of blood conservation system and stopcock system arterial sampling lines used in critically ill patients.
Commonly placed to monitor blood pressure and to aspirate blood, arterial lines frequently cause complications. The blood conservation system (BCS) forms a closed infusion line and may be expected to reduce complications caused by intraluminal contamination. We compared microbial contamination resulting from use of BCS and 3-way stopcock catheterization. ⋯ There was less microbial contamination of intraluminal fluid when BCS was used for arterial catheterization.
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Am J Infect Control · Mar 2012
Randomized Controlled TrialProspective, randomized in vivo comparison of a dual-active waterless antiseptic versus two alcohol-only waterless antiseptics for surgical hand antisepsis.
This study aimed to demonstrate the value of adding an active level of a persistent antimicrobial agent, such as chlorhexidine gluconate (CHG), to an alcohol-based surgical hand antiseptic. ⋯ Given the primary objective of surgical hand antisepsis of reducing resident skin flora for the duration of the surgical procedure, using an alcohol-based hand antiseptic containing CHG appears to be the most appropriate choice for maintaining microbial levels as low as possible for as long as possible.
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Am J Infect Control · May 2011
Randomized Controlled TrialA prospective clinical trial on prevention of catheter contamination using the hub protection cap for needleless injection device.
Catheter hub contamination has been recognized as a source of catheter-related bloodstream infections. We have investigated the efficacy of a protection cap for a needleless injection device in preventing intraluminal catheter contamination, compared with a conventional 3-way stopcock. ⋯ The protection cap for needleless injection devices decreased microbial transfer from the injection port to the intraluminal fluid pathway and lowered the risk of catheter-related bloodstream infections.
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Am J Infect Control · Mar 2011
Randomized Controlled TrialAssociation of preservative-free propofol use and outcome in critically ill patients.
Propofol is widely used to provide sedation to patients in the intensive care unit (ICU). This study examined whether preservative-free propofol infusion independently influences outcome in critically ill patients. ⋯ Preservative-free propofol infusion in critically ill patients may be associated with increased risk of ICU-acquired infections and ICU-acquired sepsis, with no significant difference in ICU or hospital mortality. This association might have been related to the use of preservative-free preparations.