American journal of infection control
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Am J Infect Control · Aug 2008
Impact of 2 different levels of performance feedback on compliance with infection control process measures in 2 intensive care units.
Performance monitoring and feedback of infection control process measures is an important tool for improving guideline adherence. Different feedback strategies may lead to distinctive outcomes. ⋯ Feedback of infection control process measures and major HAIs to unit leadership significantly improved compliance with HOB elevation rate and FC use but not HH. Multilevel feedback significantly improved HH compliance and delivered a satisfactory level of compliance with HOB and FC use in both ICUs during the study period.
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Am J Infect Control · Jun 2008
ReviewAn integrative review of the current evidence on the relationship between hand hygiene interventions and the incidence of health care-associated infections.
The objectives of this integrative review were to critically examine the overall state of the current evidence on the relationship between hand hygiene interventions and the incidence of health care-associated infections (HCAIs) in acute care and long-term care settings, and offer recommendations for future directions in the field based on our findings. ⋯ There is a lack of rigorous evidence linking specific hand hygiene interventions with the prevention of HCAIs. The varied nature of the interventions used and the diverse factors affecting the acquisition of HCAIs make it difficult to show the specific effect of hand hygiene alone. The most frequent methodologies currently used in this research area are before and after observational studies without a control comparison group. Based on these findings, we recommend that researchers used a modified version of Larson's 2005 criteria to guide the design and conduct of future before and after observational studies in this area. We also argue that as we accumulate stronger evidence of which interventions are most effective, we need to develop additional research approaches to study how organizations succeed and fail in fostering the uptake of evidence-based hand hygiene interventions.
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Am J Infect Control · May 2008
Comparative StudyPilot study of directional airflow and containment of airborne particles in the size of Mycobacterium tuberculosis in an operating room.
Containment of airborne microorganisms to prevent transmission in a positively pressured operating room (OR) is challenging. Occupational transmission of Mycobacterium tuberculosis (M tuberculosis) to perioperative personnel has occurred, but protection of the surgical site is of equal importance. High-efficiency particulate air (HEPA) filters can mitigate occupational exposure and improve air quality. Smoke plumes and submicron particulates were released to simulate aerobiology of M tuberculosis and assess impact and efficacy of particle removal in an OR suite using different HEPA filtration units and configurations. ⋯ This pilot study clearly indicates that avoiding the use of freestanding HEPA filters inside an OR during a surgical procedure is prudent and consistent with Centers for Disease Control and Prevention guidelines. A PAS-HEPA unit is effective in removing submicron particles and will enhance safety of care of a patient with an airborne infection requiring surgery.
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Am J Infect Control · May 2008
Review Practice GuidelineAntimicrobial resistance in major pathogens of hospital-acquired pneumonia in Asian countries.
Antimicrobial resistance is a worldwide problem. For patients with hospital-acquired or ventilator-associated pneumonia, resistant pathogens pose a significant challenge to successful treatment outcomes and to the cost-effective delivery of health care. ⋯ The emergence of these strains has provided a major impetus toward development of the present consensus treatment recommendations of the Asian HAP Working Group. The following review provides summary data regarding the incidence and prevalence of antibiotic-resistant pathogens in 10 Asian countries.
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Am J Infect Control · May 2008
Appraisal of recommended respiratory infection control practices in primary care and emergency department settings.
The severe acute respiratory syndrome (SARS) epidemic and concern about pandemic influenza prompted the Centers for Disease Control and Prevention (CDC) to develop guidelines to prevent the transmission of all respiratory infections in health care settings during first contact with a potentially infected person. The extent to which health care workers and institutions use these CDC recommended practices is uncertain. ⋯ This study found significant gaps in adherence to CDC recommendations for the control of respiratory infections in ambulatory care clinical settings. Practical strategies are needed to identify and reduce barriers to implementation of recommended practices for control of respiratory infections.