Abstract：
BACKGROUND:Control chart methodology has been widely touted for monitoring and improving quality in the health care setting. P charts and U charts are frequently recommended for rate and ratio statistics, but their practical value in infection control may be limited because they (1) are not risk-adjusted, and (2) perform poorly with small denominators. The Standardized Infection Ratio is a statistic that overcomes both these obstacles. It is risk-adjusted, and it effectively increases denominators by combining data from multiple risk strata into a single value. SETTING:The AICE National Database Initiative is a voluntary consortium of US hospitals ranging in size from 50 to 900 beds. The infection control professional submits monthly risk-stratified data for surgical site infections, ventilator-associated pneumonia, and central line-associated bacteremia. METHODS:Run charts were constructed for 51 hospitals submitting data between 1996 and 1998. Traditional hypothesis tests (P values <.05) flagged 128 suspicious points, and participating infection control professionals investigated and categorized each flag as a "real problem" or "background variation." This gold standard was used to compare the performance of 5 unadjusted and 11 risk-adjusted control charts. RESULTS:Unadjusted control charts (C, P, and U charts) performed poorly. Flags based on traditional 3-sigma limits suffered from sensitivity <50%, whereas 2-sigma limits suffered from specificity <50%. Risk-adjusted charts based on the Standardized Infection Ratio performed much better. The most consistent and useful control chart was the mXmR chart. Under optimal conditions, this chart achieved a sensitivity and specificity >80%, and a receiver operating characteristic area of 0. 84 (P <.00001). CONCLUSIONS:These findings suggest a specific statistic (the Standardized Infection Ratio) and specific techniques that could make control charts valuable and practical tools for infection control.
journal_name
Am J Infect Controljournal_title
American journal of infection controlauthors
Gustafson TLdoi
10.1067/mic.2000.109883subject
Has Abstractpub_date
2000-12-01 00:00:00pages
406-14issue
6eissn
0196-6553issn
1527-3296pii
S0196-6553(00)92759-7journal_volume
28pub_type
杂志文章abstract：BACKGROUND:Clostridioides difficile is a major cause of infectious antibiotic resistant diarrhea. C. difficile spores are shed in patient stool, are hearty and difficult to kill. Bedpans are often used by patients with C. difficile infections and require proper handling and cleaning or disposal to prevent the transmiss...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2019.11.028
更新日期：2020-07-01 00:00:00
abstract：:Residents of residential aged care facilities (RACFs) are at risk of colonization and infection with multidrug-resistant bacteria, and antibiotic prescribing is often inappropriate and not based on culture-proven infection. We describe low levels of resident colonization and environmental contamination with resistant ...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2015.09.034
更新日期：2016-03-01 00:00:00
abstract：:Knowing where we have come from helps to decide where we should be going. Many principles and practices of modern infection control were developed in the nineteenth and early twentieth century. The story is one of halting, yet relentless, progress. The history of these discoveries and their application to infection co...
journal_title：American journal of infection control
pub_type： 历史文章,杂志文章
doi：10.1016/s0196-6553(81)80064-8
更新日期：1981-08-01 00:00:00
abstract：:Since first reported in Europe in the early 1980s, extended-spectrum beta-lactamases (ESBLs) have spread worldwide. When producing these broad-spectrum plasmid-encoded enzymes, organisms become highly effective at inactivating penicillins, most cephalosporins, and aztreonam. Mainly produced by Klebsiella spp, ESBLs ha...
journal_title：American journal of infection control
pub_type： 杂志文章,评审
doi：10.1016/j.ajic.2004.07.010
更新日期：2005-03-01 00:00:00
abstract：BACKGROUND:To report a quality control circle (QCC) activity on the theme of reducing the incidence of catheter-associated urinary tract infection (CAUTI), and used an interrupted time series analysis to evaluate the impact of the QCC. METHODS:In a general tertiary hospital in Shenzhen, China, we carried out a QCC act...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2020.01.006
更新日期：2020-10-01 00:00:00
abstract：:An obstetrician and two staff members developed rubella and exposed 56 susceptible pregnant women in a large prenatal and family planning clinic. Two women (3.6%) developed rubella at 27 and 38 weeks' gestation and delivered uneventfully. Sixteen hundred clinic and hospital employees were tested, with 79% of the total...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/0196-6553(82)90037-2
更新日期：1982-02-01 00:00:00
abstract：BACKGROUND:We previously published a formula to estimate the number of hand hygiene opportunities (HHOs) per patient-day using the World Health Organization's "Five Moments for Hand Hygiene" methodology (HOW2 Benchmark Study). HHOs can be used as a denominator for calculating hand hygiene compliance rates when product ...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2014.02.020
更新日期：2014-06-01 00:00:00
abstract：BACKGROUND:Hand hygiene (HH) in health care facilities is a key component to reduce pathogen transmission and nosocomial infections. However, most HH interventions (HHI) have not been sustainable. AIMS:This review aims to provide a comprehensive summary of recently published evidence-based HHI designed to improve HH c...
journal_title：American journal of infection control
pub_type： 杂志文章,评审
doi：10.1016/j.ajic.2015.11.034
更新日期：2016-06-01 00:00:00
abstract：:From 1988 through 1992, we conducted a prospective study of postdischarge surgical wound infection surveillance in our institution. A total of 6604 patients were seen after discharge in a centralized outpatient clinic, supervised by the infection control commission. Wounds were inspected, stitches were removed, and dr...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/0196-6553(95)90059-4
更新日期：1995-10-01 00:00:00
abstract：:Cleaning reusable medical devices removes organic and inorganic soil, which allows for effective disinfection and sterilization. However, it is not always clear what variables to consider when validating cleaning. This study compared the ability of 3 different cleaning agents (ie, water, alcohol, and bleach) to remove...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2016.07.025
更新日期：2017-02-01 00:00:00
abstract：:To assess the implementation of hepatitis B virus (HBV) vaccination programs for hospital workers, we mailed questionnaires to all 229 licensed Michigan hospitals. The response rate was 96% (221/229); of these, 68% (150/221) had vaccination programs. Although multiple hospital characteristics were associated with the ...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/0196-6553(88)90059-4
更新日期：1988-10-01 00:00:00
abstract：BACKGROUND:Pseudomonas aeruginosa is an important nosocomial pathogen that commonly colonizes hospital water supplies, including in taps and sinks. We report the transmission of P. aeruginosa from water to patients in a clinical hematology setting. METHODS:P. aeruginosa from water samples were compared to clinical iso...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2017.10.013
更新日期：2018-04-01 00:00:00
abstract：BACKGROUND:Meticulous care of intravenous catheters could be expected to minimize associated nosocomial bloodstream infections, but care is often suboptimal. METHODS:To examine the ostensible benefits of a professional, dedicated intravenous therapy team, we compared the secular trends in nosocomial bloodstream infect...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/s0196-6553(98)70033-1
更新日期：1998-08-01 00:00:00
abstract：:Dental sterilization techniques have become a focus of attention as a result of disclosure of occupational HIV transmission from an infected dentist to a cluster of patients. Although there has never been a confirmed report of a patient acquiring an infectious blood-borne disease from a dental instrument or device, re...
journal_title：American journal of infection control
pub_type： 杂志文章,评审
doi：10.1016/0196-6553(94)90119-8
更新日期：1994-04-01 00:00:00
abstract：BACKGROUND:Health care-associated infections (HCAIs) are preventable with adoption of recognized preventive measures. The first step is to identify patients at higher risk of HCAI. This study aimed to identify patient risk factors (RFs) present on admission and acquired during inpatient stay which could be associated w...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2017.03.036
更新日期：2017-10-01 00:00:00
abstract：:Microbial contamination of used, unprocessed internal components of dental handpieces (HPs) was assessed. HPs were dismantled aseptically, immersed in phosphate-buffered saline, ultrasonicated, and cultured. A median of 200 CFU per turbine (n = 40), 400 CFU per spray channel (n = 40), and 1000 CFU per item of surgical...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2014.06.008
更新日期：2014-09-01 00:00:00
abstract：BACKGROUND:Most studies challenging the integrity of the glove barrier have compared the permeability of vinyl and latex gloves. However, no studies of a new nonlatex, nonvinyl thermoplastic elastomer have been reported. This pilot study therefore compared the protective barriers provided by latex and thermoplastic ela...
journal_title：American journal of infection control
pub_type： 杂志文章,评审
doi：10.1016/0196-6553(93)90385-h
更新日期：1993-12-01 00:00:00
abstract：:A telephone survey involving 200 household members in and around Seoul, South Korea, was completed during the maturity stage of the outbreak of Middle East respiratory syndrome (MERS) in Korea during June 2015. The study found that respondents perceived low risk from contracting MERS, had low trust in government in co...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2016.03.014
更新日期：2016-11-01 00:00:00
abstract：:In 1982 the Centers for Disease Control published a set of recommendations and measures to protect persons working in health care settings or performing mortician services from possible exposure to the human immunodeficiency virus. This study of a number of funeral homes in the Fort Worth area was designed to determin...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/0196-6553(89)90130-2
更新日期：1989-08-01 00:00:00
abstract：BACKGROUND:The British Columbia Provincial Hand Hygiene Working Group was formed in September 2010 and tasked with the development and implementation of a provincial hand hygiene (HH) program for health care. METHODS:As part of an evaluation of the provincial HH program, qualitative key informant interviews of program...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2014.04.004
更新日期：2014-07-01 00:00:00
abstract：BACKGROUND:Thorough drying of flexible endoscope channels has been identified as an essential reprocessing step. Yet, instructions are not specific on how to dry endoscopes. There is lack of data supporting efficacy of current drying practices, due to limitations in determining channel dryness. METHODS:Novel endoscope...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2020.08.034
更新日期：2020-09-03 00:00:00
abstract：BACKGROUND:Health care workers' compliance with infection control practices and principles is vital in preventing the spread of disease. One tool to assess infection control practice in clinical areas is the infection control audit; however, many institutions do not approach this in a systematic fashion. METHODS:Key f...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2006.05.293
更新日期：2007-05-01 00:00:00
abstract：BACKGROUND:Medical devices inserted into the human body can be divided into single-use devices and reusable medical devices (RMDs) depending on the method of use. RMDs are applied to >1 patient, and users reprocess them prior to repeat use. Therefore, reprocessing of RMDs has become more difficult, and issues related t...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2015.01.017
更新日期：2015-05-01 00:00:00
abstract：OBJECTIVES:The World Health Organization recommends empowering patients/families to remind healthcare workers (HCWs) to perform hand hygiene (HH). We sought to understand acceptability of a family empowerment strategy in a Vietnamese pediatric intensive care unit (PICU). METHODS:With end-user input, we designed a tool...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2020.05.030
更新日期：2020-12-01 00:00:00
abstract：:Healthcare facility-onset Clostridioides difficile infection rates substantially dropped in a Mexican hospital after its conversion to a full COVID-19 setting, despite heavy contamination of the environment the previous year. Better adherence to hand hygiene and contact precautions may help explain this finding. ...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2020.12.008
更新日期：2020-12-19 00:00:00
abstract：BACKGROUND:Removing unnecessary central lines is a critical step in reducing risk of infection and was 1 focus of a national quality improvement collaborative. We examined if participating adult intensive care units (ICUs) reduced central line days during the project period compared with the period before implementatio...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2014.06.003
更新日期：2014-10-01 00:00:00
abstract：BACKGROUND:Gloves are a necessary contact precaution to prevent transmission of infectious pathogens that spread by direct or indirect contact with an infected person or a contaminated environment. This article reports a study investigating hand and environmental contamination levels when health care workers (HCWs) fol...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2010.06.007
更新日期：2011-03-01 00:00:00
abstract：BACKGROUND:The prevalence of nosocomial infection in Australian hospitals is estimated to be between 5.5% and 6.3%. Since 1989, infection control professionals (ICPs) in hospitals accredited by the Australian Council on Health Care Standards (ACHS) have been encouraged to collect nosocomial infection data according to ...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/s0196-6553(99)70024-6
更新日期：1999-12-01 00:00:00
abstract：:Disease transmission from percutaneous injury occurs in 2% to 40% of health care workers (HCWs) after exposure to the hepatitis B virus (HBV), in 3% to 10% after exposure to the hepatitis C (HCV) virus, and in 0.2% to 0.5% after exposure to the HIV virus. According to a recently published case-control study from the C...
journal_title：American journal of infection control
pub_type： 杂志文章,评审
doi：10.1016/s0196-6553(97)90094-8
更新日期：1997-10-01 00:00:00
abstract：:We report a historic nosocomial outbreak of Salmonella enteritidis affecting 4 inpatients who underwent endoscopic retrograde cholangiopancreatography. The cause was attributed to inadequate decontamination of an on-loan endoscope used over a weekend. This report highlights the risks of using on-loan endoscopes, parti...
journal_title：American journal of infection control
pub_type： 杂志文章
doi：10.1016/j.ajic.2016.11.024
更新日期：2017-04-01 00:00:00
