Abstract:
BACKGROUND:Philadelphia's rate of malpractice filings per population is just over double the national median. Plaintiffs prevail in 44% of verdicts in Philadelphia compared with 20% for all US jury verdicts, with 24% of awarded verdicts in excess of $1 million. OBJECTIVE:To determine patient and procedure demographic data for malpractice claims involving health care-acquired infections (HAIs) in Philadelphia. METHODS:Risk managers representing 60 acute care hospitals, members of Pennsylvania Trial Lawyers Association, and a random sample of 560 lawyers representing plaintiff and defense cases obtained from the Philadelphia Court of Common Pleas database (1996-2002) were surveyed. The survey included the following: number of HAI cases by specialty, body site, isolate, and outcome. RESULTS:Overall response rate was 25% (n = 154 cases). The highest numbers of cases were in the specialties of orthopedics (69), general surgery (20), and cardiothoracic (20). Sites infected most often were as follows: knees (26), back (26), sternum (18), and harvest site (10). Methicillin-resistant Staphylococcus aureus (MRSA) was responsible for 45 of cases, S epidermidis for 27, methicillin-susceptible S aureus (MSSA) for 14, and Pseudomonas for 16. Twenty-seven of the cases were withdrawn, 27 settled, 11 pending, 9 plaintiff verdict, and 5 defense verdict. CONCLUSIONS:Although 72% of HAI malpractice cases in Philadelphia were either withdrawn or settled, when brought to trial, the plaintiff was more likely to succeed with a verdict. Our findings also suggest that the most frequent type of infection (class I-surgical site) and isolate (MRSA) are more likely to be seen as preventable HAIs because of National Nosocomial Infection Surveillance data showing lower infection rates for this class of surgery and therefore seen as easier for the plaintiff to show that the defendant failed to adhere to the standard of care for infection control.
journal_name
Am J Infect Controljournal_title
American journal of infection controlauthors
Guinan JL,McGuckin M,Shubin A,Tighe Jdoi
10.1016/j.ajic.2005.03.005subject
Has Abstractpub_date
2005-06-01 00:00:00pages
310-2issue
5eissn
0196-6553issn
1527-3296pii
S0196655305000714journal_volume
33pub_type
杂志文章abstract:BACKGROUND:Postexposure prophylaxis for occupational exposure to hepatitis B virus (HBV) plays an important role in the prevention of HBV infections in health care workers (HCWs). We examined data concerning the acceptable duration between occupational exposure and administration of a hepatitis B immunoglobulin (HBIG) ...
journal_title:American journal of infection control
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajic.2015.08.024
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:To gain further insights into health care workers (HCWs) attitudes toward influenza vaccination to guide future interventions to increase vaccination rates. METHODS:A standardized anonymous questionnaire was sent to all employees of the University Hospital Basel, Switzerland following the influenza season 2...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2020.02.004
更新日期:2020-10-01 00:00:00
abstract::Oral care is an important component of the ventilator bundle; however, few studies have investigated the factors related to compliance with performing oral care among critical care nurses. In this observational study of 759 oral care opportunities performed by 133 critical care nurses, we found that the overall oral c...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2014.01.023
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Many hand hygiene (HH) programs have been implemented across Sub-Saharan Africa (SSA); however, most of these have been in large, referral hospitals. Our objective was to assess the impact of HH programs aimed at improving compliance at a rural hospital, and to identify unique challenges to HH sustainability...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2017.04.006
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:The guideline for staffing infection control programs of 1 infection control professional (ICP) for every 250 occupied acute care beds has been used in many health care facilities in the United States since 1985. Since that time, the health care system, patient populations, and expectations about the work of...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1067/mic.2002.127930
更新日期:2002-10-01 00:00:00
abstract:BACKGROUND:Patient and visitor hand hygiene has the potential to prevent health care-associated infections, but there are few data on the efficacy of interventions to improve patient/visitor hand hygiene. OBJECTIVE:To determine whether conventional and front-line ownership (FLO) patient/visitor hand hygiene interventi...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2019.09.026
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Minimal structure is required for effective prevention of health care-associated infection (HAI). The objective of this study was to evaluate the structure for prevention of HAI in a sample of Brazilian hospitals. METHODS:This was a cross-sectional study from hospitals in 5 Brazilian regions (n = 153; total...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2015.08.004
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:An outbreak of 5 inpatient and otherwise healthy children admitted for respiratory problems developed dry fever and cough after a few days of hospitalization. Burkhuldaria cepacia was isolated from their blood culture. The Infection Control Department (ICD) in the King Fahad Medical City (KFMC) detected and ...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2006.03.003
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to compare the frequency of glove defects for nonlatex surgical gloves while surgeons performed routine surgery and to evaluate surgeons' satisfaction with nonlatex sterile gloves. METHODS:Two brands of latex gloves and 6 brands of nonlatex gloves were tested. Gloves were colle...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2003.12.005
更新日期:2004-08-01 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::This article describes an investigation to identify risk factors for postoperative endophthalmitis caused by Pseudomonas aeruginosa. A retrospective case-control study, including 8 cases and 24 controls operated from 2005 to 2009, was undertaken. The risk factors associated with P aeruginosa infection were a particula...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2013.01.042
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Point prevalence surveys (PPSs) in Japanese hospitals have not yet been reported. The purpose of this pilot PPS study was to evaluate the epidemiology of health care-associated infections (HAIs) and antimicrobial use in a Japanese tertiary university hospital. METHODS:A 1-day, cross-sectional PPS was perfor...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2016.03.045
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Studies conducted in the first decade of the AIDS epidemic indicated that, in general, dentists had suboptimal levels of compliance with standard infection control practices, including work practices designed to reduce exposure to bloodborne pathogens. This study was designed to assess current rates of compl...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/s0196-6553(98)70058-6
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Animals could be reservoirs of extended-spectrum β-lactamases (ESBL) strains, but epidemiologic data on ESBL-producing bacteria in healthy pets are missing. We determined the prevalence of ESBL-producing Enterobacteriaceae in pets living in nursing homes and in households to investigate the potential role of...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2012.11.013
更新日期:2013-09-01 00:00:00
abstract::In a study conducted in 11 health care settings for elderly patients, we demonstrated a significant negative correlation between the proportion of glove use outside any risk of exposure to body fluids and compliance with hand hygiene (P < .02). This result underscores a major limitation of strategies for controlling t...
journal_title:American journal of infection control
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajic.2011.05.008
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Catheter-associated urinary tract infections (CAUTIs) are common nosocomial infections. In 2015, the Centers for Medicare and Medicaid Services began imposing financial penalties for institutions where CAUTI rates are higher than predicted. However, the surveillance definition for CAUTI is not a clinical dia...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2017.11.032
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:This study was conducted to evaluate the ongoing transmission of methicillin-resistant Staphylococcus aureus (MRSA) in a 10-bed trauma intensive care unit (TICU) in a large teaching hospital. METHODS:Surveillance cultures for MRSA were obtained on admission to the TICU. Colonized or infected patients were p...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2007.05.013
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Proper hand hygiene has been linked to lower susceptibility to infectious diseases in many types of communities, but it has not been well established on college campuses. This study investigated the hand hygiene statuses of college students and their occurrences in relation to infectious diseases, medical vi...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2015.08.012
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:The recent outbreaks of severe acute respiratory syndrome, H5N1 (avian influenza), and, most recently, the novel H1N1 influenza pandemic of 2009 have raised awareness of the danger of new and emerging infections. Preparedness and response plans for such outbreaks are crucial, and given the centrality of the ...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2011.02.021
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:We aimed to investigate the frequency of standard precautions (SPs) compliance and the factors affecting the compliance among nursing students (NSs). METHODS:A cross-sectional survey study guided by the health belief model was conducted in 2009. The study questionnaire is valid (content validity index, 0.81...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2015.03.007
更新日期:2015-07-01 00:00:00
abstract::We describe 1,132 contacts between anesthesiologists and the operating room. Objects most commonly touched included anesthesia machines and keyboards. Only 13 hand hygiene events were witnessed during 8 hours of observations. Line insertions, bronchoscopies, or blood exposures were not followed by hand hygiene. Stopco...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2013.03.306
更新日期:2013-10-01 00:00:00
abstract::We aimed to validate quality assurance (QA) criteria for rectal surveillance cultures (RSCs) for extended-spectrum β-lactamase-producing Enterobacteriaceae. QA for RSCs were tested by observing the presence or absence of fecal soiling and by examining the growth of Enterobacteriaceae on MacConkey agar. Extended-spectr...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2017.02.036
更新日期:2017-09-01 00:00:00
abstract::We report macroscopic biofilms on silver hydrogel-coated urinary catheters in 2 patients from 2 different intensive care units. The catheters were removed on observation of a white, jelly layer on the catheters, respectively, 9 and 21 days after insertion. Yeast cells and pseudohyphal structures were observed with mic...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2016.03.042
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Infection control practice compliance is commonly monitored by measuring hand hygiene compliance. The limitations of this approach were recognized in 1 acute health care organization that led to the development of an Infection Control Continuous Quality Improvement tool. METHODS:The Pronovost cycle, Barrier...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2019.06.014
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Little is known about the direct economic burden associated with health care-associated infection (HAI) in patients undergoing colorectal cancer surgery in China. This study aims to fill this knowledge gap. METHODS:This study was a prospective monitoring case-control study. The direct economic burden was pr...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2017.08.003
更新日期:2018-01-01 00:00:00
abstract::Literature suggests that cancer patients can become colonized or infected with a variety of opportunistic and health care-associated pathogens, putting them at higher risk for nonventilator health care-associated pneumonia. This section will review the epidemiology of nonventilator health care-associated pneumonia and...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2020.03.005
更新日期:2020-05-01 00:00:00
abstract::Necrotizing fasciitis is a severe polybacterial infection characterized by necrosis of the fascia and adjacent soft tissues with rapid expansion of the infection along the fascial planes. It is a rare and potentially fatal entity in the head and neck region. We present 2 patients with head and neck cancers who develop...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2015.01.010
更新日期:2015-04-01 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::Health care-associated infections impact patient morbidity and mortality, and institutions adopt evidence-based measures to prevent and control such infections. In this study, professionals were observed during patient care under empirical contact precautions. A total of 243 observations were performed in which 39.5% ...
journal_title:American journal of infection control
pub_type: 杂志文章
doi:10.1016/j.ajic.2019.10.004
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:The purpose of this educational project was to assess the effect of several interventions on the frequency of handwashing among elementary public school children. METHODS:Participants in this project were first-graders and fourth-graders from jurisdictions within a mid-Atlantic metropolitan area. Phase I in...
journal_title:American journal of infection control
pub_type: 临床试验,杂志文章
doi:10.1016/s0196-6553(98)80011-4
更新日期:1998-06-01 00:00:00