RESUMEN
High level disinfection (HLD) is a complex process, requiring appropriate materials and highly trained personnel. An investigation of the HLD process was performed at an outpatient urology practice upon notification of expired chemical test strips being utilized. Infection Prevention (IP) identified various breaches in the reprocessing of flexible cystoscopes and transrectal prostate biopsy probes. Contributing factors identified were gaps in staff training, availability of all necessary supplies and staff supervision.
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Cistoscopía , Desinfección , Masculino , Humanos , Pacientes Ambulatorios , Contaminación de EquiposRESUMEN
A multidisciplinary team collaborated to develop and validate a process to electronically capture patient and device denominator data at 6 hospitals in the same healthcare system. Validation was completed within 4-16 months. Manual count errors were identified as the main driver of electronic versus manual discrepancies.
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Hospitales , Proyectos de Investigación , Humanos , Registros Electrónicos de SaludRESUMEN
Hospital linen is a potential source for health care acquired infections. The elements of cleaning, transport and storage should be part of an Infection Prevention (IP) consult. The incorporation of linen reprocessing into the IP program ensures compliance with linen standards and patient safety.
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Ropa de Cama y Ropa Blanca , Infección Hospitalaria , Humanos , Hospitales , Infección Hospitalaria/prevención & controlRESUMEN
While there are established and effective guidelines for prevention of hospital-acquired infections (HAIs), the impact of the COVID-19 pandemic on those implemented practices and policies have not been thoroughly investigated. This report examines the impact of COVID-19 on HAI rates at 2 hospitals within the same healthcare system. HAIs significantly increased during the COVID-19 pandemic which correlated with the use of overtime and agency nursing hours.
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COVID-19 , Infecciones Relacionadas con Catéteres , Infección Hospitalaria , Infecciones Relacionadas con Catéteres/prevención & control , Infección Hospitalaria/epidemiología , Infección Hospitalaria/prevención & control , Hospitales , Humanos , Pandemias/prevención & controlRESUMEN
Health care systems are expanding and the health care industry is growing in complexity, necessitating the importance of competent Infection Preventionists (IPs). At Northwestern Medicine, a health care system consisting of diverse facilities with varied patient populations and environments of care, the need for a standardized approach to developing competent IPs became apparent. This Infection Prevention department utilized the APIC Competency Model to develop a framework for Infection Prevention program development, including a standardized orientation guide and career ladder.
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Profesionales para Control de Infecciones , Control de Infecciones , Atención a la Salud , Humanos , Desarrollo de Programa , Encuestas y CuestionariosRESUMEN
BACKGROUND The nationally reported metric for Clostridium difficile infection (CDI) relies solely on laboratory testing, which can result in overreporting due to asymptomatic C. difficile colonization. OBJECTIVE To review the clinical scenarios of cases of healthcare facility-onset CDI (HO-CDI) and to determine the appropriateness of C. difficile testing on the basis of presence of symptomatic diarrhea in order to identify areas for improvement. DESIGN Retrospective cohort study. SETTING Northwestern Memorial Hospital, a large, tertiary academic hospital in Chicago, Illinois. PATIENTS The cohort included all patients with a positive C. difficile test result who were reported to the National Healthcare Safety Network as HO-CDI during a 1-year study period. METHODS We reviewed the clinical scenario of each HO-CDI case. On the basis of documentation and predefined criteria, appropriateness of C. difficile testing was determined; cases were deemed appropriate, inappropriate, or indeterminate. Statistical analysis was performed to compare demographic and clinical parameters among the categories of testing appropriateness. RESULTS Our facility reported 168 HO-CDI cases to NHSN during the study period. Of 168 cases, 33 (19.6%) were judged to be appropriate tests, 25 (14.8%) were considered inappropriate, and 110 (65.5%) were indeterminate. Elimination of inappropriate testing would have improved our facility's standardized infection ratio from 0.962 to 0.819. CONCLUSION Approximately 15% of HO-CDI cases were judged to be tested inappropriately. Testing only patients with clinically significant diarrhea would more accurately estimate CDI incidence, reduce unnecessary antibiotic use, and improve facilities' performance of reportable CDI metrics. Improved documentation could facilitate targeted interventions. Infect Control Hosp Epidemiol 2016;1395-1400.
Asunto(s)
Clostridioides difficile/aislamiento & purificación , Diarrea/microbiología , Enterocolitis Seudomembranosa/diagnóstico , Uso Excesivo de los Servicios de Salud , Centros Médicos Académicos , Análisis de Varianza , Chicago/epidemiología , Infección Hospitalaria , Diarrea/epidemiología , Enterocolitis Seudomembranosa/epidemiología , Humanos , Notificación Obligatoria , Reacción en Cadena de la Polimerasa , Estudios RetrospectivosRESUMEN
OBJECTIVE: This study evaluated the impact of a simulation-based mastery learning (SBML) curriculum on central line maintenance and care among a group of ICU nurses. METHODS: The intervention included 5 tasks: (a) medication administration, (b) injection cap (needleless connector) changes, (c) tubing changes, (d) blood drawing, and (e) dressing changes. All participants underwent a pretest, engaged in deliberate practice with directed feedback, and completed a posttest. We compared pretest and posttest scores and assessed correlations between demographics, self-confidence, and pretest performance. RESULTS: The number of nurses passing each task at pretest varied from 24 of 49 (49%) for dressing changes to 44 of 49 (90%) for tubing changes. At pretest, scores ranged from a median of 0.0% to 73.1%. At posttest, all scores rose to a median of 100.0%. Total years in nursing and ICU nursing had significant, negative correlations with medication administration pretest performance (r = -0.42, P = .003; r = -0.42, P = .003, respectively). CONCLUSION: ICU nurses displayed large variability in their ability to perform central line maintenance tasks. After SBML, there was significant improvement, and all nurses reached a predetermined level of competency.