American journal of infection control
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Am J Infect Control · Sep 2009
Polymerase chain reaction screening for methicillin-resistant Staphylococcus aureus and contact isolation.
Methicillin-resistant Staphylococcus aureus (MRSA) infections are thought to now be endemic in some populations. The early identification of individuals admitted to the hospital who are harboring this organism is important for the timely implementation of appropriate control strategies. Our objective was to measure the prevalence of MRSA carriage in high-risk patients entering our hospital and to determine which of these patients screened for MRSA should be placed in contact precautions on admission. ⋯ We used a rapid screening test to identify patients harboring MRSA. Our findings support that MRSA is harbored sporadically and patients do not have to be placed in contact isolation based on a history of previously being MRSA positive.
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Am J Infect Control · Jun 2009
Surgical site infection: incidence and impact on hospital utilization and treatment costs.
Surgical site infections (SSIs) are serious operative complications that occur in approximately 2% of surgical procedures and account for some 20% of health care-associated infections. ⋯ SSI is associated with a significant economic burden in terms of extended length of stay and increased costs of treatment. Our analysis documented nearly 1 million additional inpatient-days and $1.6 billion in excess costs.
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Am J Infect Control · May 2009
Measuring adherence to hand hygiene guidelines: a field survey for examples of effective practices.
Measuring adherence to hand hygiene guidelines is resource intensive and complicated by lack of standardized methodology. The multiplicity of approaches in use makes it difficult to meaningfully compare performance across health care organizations. The goal of this project was to identify promising and effective practices for measuring adherence with hand hygiene guidelines across a variety of settings. ⋯ Among respondents who considered their approach to be an example of an effective practice, there was substantial variation in methods and little evidence of reliability. Standardization of methods is needed to compare performance across organizations or within an organization over time.
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Am J Infect Control · May 2009
Marked variability in adherence to hand hygiene: a 5-unit observational study in Tuscany.
International authorities recommend that the hand hygiene of health care workers be improved to prevent health care-associated infection. In 2005, Tuscany, a region in central Italy, initiated a campaign to improve hand hygiene that focused on raising awareness and educating health care workers. We assessed hand hygiene rates approximately 3 years after the campaign was initiated in 5 units of 2 hospitals in Florence, Italy, the capital of Tuscany. We also were curious whether variability would exist in the hand hygiene rates despite the close proximity of the units. ⋯ The overall rates of hand hygiene adherence observed were similar to those found when Tuscany initiated a hand hygiene campaign 3 years earlier. Focusing on overall rates may be misleading, however, because substantial variability existed between units. Furthermore, these rates come only from the "first moment" (before touching the patient) and can only be compared with rates from studies using the same approach.
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Am J Infect Control · May 2009
Hand hygiene compliance by physicians: marked heterogeneity due to local culture?
Physician compliance with hand hygiene guidelines often has been reported as insufficient. ⋯ The remarkable heterogeneity in physicians' hand hygiene compliance among sites within the same institution is consistent with an important role of the local ward culture.