Abstract:
:BACKGROUND Healthcare provider hands are an important source of intraoperative bacterial transmission events associated with postoperative infection development. OBJECTIVE To explore the efficacy of a novel hand hygiene improvement system leveraging provider proximity and individual and group performance feedback in reducing 30-day postoperative healthcare-associated infections via increased provider hourly hand decontamination events. DESIGN Randomized, prospective study. SETTING Dartmouth-Hitchcock Medical Center in New Hampshire and UMass Memorial Medical Center in Massachusetts. PATIENTS Patients undergoing surgery. METHODS Operating room environments were randomly assigned to usual intraoperative hand hygiene or to a personalized, body-worn hand hygiene system. Anesthesia and circulating nurse provider hourly hand decontamination events were continuously monitored and reported. All patients were followed prospectively for the development of 30-day postoperative healthcare-associated infections. RESULTS A total of 3,256 operating room environments and patients (1,620 control and 1,636 treatment) were enrolled. The mean (SD) provider hand decontamination event rate achieved was 4.3 (2.9) events per hour, an approximate 8-fold increase in hand decontamination events above that of conventional wall-mounted devices (0.57 events/hour); P<.001. Use of the hand hygiene system was not associated with a reduction in healthcare-associated infections (odds ratio, 1.07 [95% CI, 0.82-1.40], P=.626). CONCLUSIONS The hand hygiene system evaluated in this study increased the frequency of hand decontamination events without reducing 30-day postoperative healthcare-associated infections. Future work is indicated to optimize the efficacy of this hand hygiene improvement strategy. Infect Control Hosp Epidemiol 2016;37:888-895.
journal_name
Infect Control Hosp Epidemioljournal_title
Infection control and hospital epidemiologyauthors
Koff MD,Brown JR,Marshall EJ,O'Malley AJ,Jensen JT,Heard SO,Longtine K,O'Neill M,Longtine J,Houston D,Robison C,Moulton E,Patel HM,Loftus RWdoi
10.1017/ice.2016.106subject
Has Abstractpub_date
2016-08-01 00:00:00pages
888-95issue
8eissn
0899-823Xissn
1559-6834pii
S0899823X16001069journal_volume
37pub_type
杂志文章,随机对照试验abstract::We quantified the time burden of alcohol-based handrub accompanying nonsterile-glove use among emergency physicians, through observation in controlled and clinical settings. We report gloving episodes per hour, gloving times with and without handrub, and handrub recommendations compliance. Handrub adds 46 seconds to e...
journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章
doi:10.1086/668781
更新日期:2013-01-01 00:00:00
abstract::Surgical site infection (SSI) surveillance is performed using a variety of methods with unclear performance characteristics. We used claims data to identify records for review following hysterectomy and colorectal surgery. Claims-enhanced screening identified SSIs missed by routine surveillance and could be used for t...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/673975
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:To determine the safety and cost-effectiveness of replacing the intravenous (IV) tubing sets in hospitalized patients at 4- to 7-day intervals instead of every 72 hours. DESIGN:Prospective, randomized study of infusion-related contamination associated with changing IV tubing sets within 3 days versus within ...
journal_title:Infection control and hospital epidemiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1086/501879
更新日期:2001-03-01 00:00:00
abstract::How the media communicate and how the scientific community influences the media are important factors to consider in the public health response to emerging pathogens, including methicillin-resistant Staphylococcus aureus. Social representation theory suggests that the media link "the threatening" to commonplace "ancho...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/656000
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:To study the cost-effectiveness of vaccination for hepatitis A. SETTING:Hypothetical analysis of students currently enrolled in medical school in the United States. METHOD:A Markov-based model was developed using data from the literature, actual hospital costs, and an annual discount rate of 5%. The inciden...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/647513
更新日期:1997-10-01 00:00:00
abstract:OBJECTIVE:Laboratory-based characterization and traceback of Clostridium butyricum isolates linked to outbreak cases of neonatal necrotizing enterocolitis (NEC) in a hospital in China. METHODS:In total, 37 samples were collected during the NEC outbreak. Classical bacteriological methods were applied to isolate and ide...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2019.289
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:To describe the use of laminar airflow, body exhaust, and ultraviolet lights during total knee replacement (TKR) in four U.S. states. DESIGN:Survey of healthcare facilities. SETTING:Hospitals in Illinois, North Carolina, Ohio, and Tennessee that performed TKR during 2000 as identified by Medicare claims dat...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章,多中心研究
doi:10.1086/505452
更新日期:2005-12-01 00:00:00
abstract::A surgeon-specific computer-generated monthly questionnaire was used to improve surveillance of surgical wound infections in outpatients as well as inpatients following discharge. From July 1988 through June 1989, 20,536 surgical procedures were performed at our medical center, of which 53% were for outpatients. The t...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646084
更新日期:1990-10-01 00:00:00
abstract::OBJECTIVE To assess the clinical effectiveness of a universal screening program compared with a risk factor-based program in reducing the rates of nosocomial methicillin-resistant Staphylococcus aureus (MRSA) among admitted patients at the Ottawa Hospital. DESIGN Quasi-experimental study. SETTING Ottawa Hospital, a mu...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2015.230
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:To evaluate the cost-effectiveness of a dual strategy of tuberculin skin test (TST) and QuantiFERON-TB Gold (QFT-G) for screening of latent tuberculosis infection (LTBI) in healthcare workers (HCWs) and, as a secondary objective, to study relationships between TST results, QFT-G results, and sociodemographic ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/668436
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVE:To describe the incidence of device-associated nosocomial infections in medical-surgical intensive care units (MS ICUs) in a university hospital in Turkey and compare it with National Nosocomial Infections Surveillance (NNIS) system rates. DESIGN:Prospective surveillance study during a period of 27 months. D...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/503344
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:To evaluate changing Clostridioides difficile infection (CDI) testing among inpatients with indeterminate enzyme immunoassay (EIA) results (antigen+/toxin-) from reflexive polymerase chain reaction (PCR) testing to clinician-ordered PCR testing. DESIGN:Multicenter, before-and-after, quasi-experimental study....
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.56
更新日期:2020-06-01 00:00:00
abstract::OBJECTIVE To evaluate the agreement between the current National Healthcare Safety Network (NHSN) definition for ventriculitis and others found in the literature among patients with an external ventricular drain (EVD) DESIGN Retrospective cohort study from January 2009 to December 2014 SETTING Neurology and neurosurge...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.21
更新日期:2017-05-01 00:00:00
abstract::OBJECTIVE To evaluate the efficacy of copper-coating in reducing environmental colonization in an intensive-care unit (ICU) with multidrug-resistant-organism (MDRO) endemicity DESIGN Interventional, comparative crossover trial SETTING The general ICU of Attikon University hospital in Athens, Greece PATIENTS Those admi...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2017.52
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVES:Describe an outbreak of surgical wound infections associated with total hip arthroplasty; identify risk factors for surgical wound infection during the pre-outbreak and outbreak periods. SETTING:A 100-bed hospital. From May 1 to September 30, 1988, 7 of 15 patients who underwent total hip arthroplasty devel...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646592
更新日期:1992-09-01 00:00:00
abstract:OBJECTIVE:To characterize occupationally acquired human immunodeficiency virus (HIV) infection detected through case surveillance efforts in the United States. DESIGN:National surveillance systems, based on voluntary case reporting. SETTING:Healthcare or laboratory (clinical or research) settings. PATIENTS:Healthcar...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502178
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:To develop an automated method for ventilator-associated condition (VAC) surveillance and to compare its accuracy and efficiency with manual VAC surveillance SETTING:The intensive care units (ICUs) of 4 hospitals METHODS:This study was conducted at Detroit Medical Center, a tertiary care center in metropoli...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2015.127
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:Prevalence of multidrug-resistant (MDR) gram-negative (GN) bacteria is increasing globally and is complicated by patient movement between acute and long-term care facilities (LTCFs). In Asia, the contribution of LTCFs as a source of MDR GN infections is poorly described. We aimed to define the association bet...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/675823
更新日期:2014-05-01 00:00:00
abstract::In 1997 the Association for Professionals in Infection Control and Epidemiology and the Society for Healthcare Epidemiology of America established a consensus panel to develop recommendations for optimal infrastructure and essential activities of infection control and epidemiology programs in out-of-hospital settings....
journal_title:Infection control and hospital epidemiology
pub_type: 共识发展会议,指南,杂志文章,评审
doi:10.1086/501569
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:To determine risk factors for and modes of transmission of Xanthomonas maltophilia infection/colonization. DESIGN:Surveillance and cohort study. SETTING:A 470-bed tertiary trauma-referral community hospital. PATIENTS:From January 1, 1988 to March 17, 1989, 106 intensive care unit patients developed X malto...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646510
更新日期:1992-04-01 00:00:00
abstract::Storage cabinets for heat-sensitive endoscopes (SCHEs) are designed to store gastrointestinal (GI) endoscopes in a clean, dry and well-ventilated cupboard to prevent microbiological proliferation. The use of SCHEs in a GI endoscopy unit has significally reduced the rate of contaminated endoscopes (13.0% vs 45.0%, P<.0...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2015.139
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVE:In-hospital transmission of methicillin-susceptible Staphylococcus aureus (MSSA) among neonates remains enigmatic. We describe the epidemiology of MSSA colonization and infection in a 30-bed neonatal ward. DESIGN:Multimodal outbreak investigation SETTING:A public 800-bed tertiary care university hospital in...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2015.184
更新日期:2015-11-01 00:00:00
abstract::We employed a questionnaire to survey 334 registered nurses regarding their knowledge, perceptions and vaccine acceptance for Hepatitis B virus (HBV) infections. The study population was those persons working in areas considered at high-risk for contracting HBV. The nurses were asked to provide information regarding b...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/646135
更新日期:1990-03-01 00:00:00
abstract:OBJECTIVE:To screen copper and noncopper paints for their bactericidal effectiveness in rendering surfaces self-disinfecting. DESIGN:Tested paints were applied to glass coverslips, cured, inoculated with test organisms (Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, and Enterococcus faecalis), and dr...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/648361
更新日期:1995-08-01 00:00:00
abstract::We observed bacterial or fungal coinfections in COVID-19 patients admitted between March 1 and April 18, 2020 (152 of 4,267, 3.6%). Among these patients, mortality was 57%; 74% were intubated; 51% with bacteremia had central venous catheters. Time to culture positivity was 6-7 days, and 79% had received prior antibiot...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2020.368
更新日期:2021-01-01 00:00:00
abstract::We investigated 4 hepatitis C virus (HCV) infection outbreaks at hemodialysis units to identify practices associated with transmission. Apparent failures to follow recommended infection control precautions resulted in patient-to-patient HCV transmission, through cross-contamination of the environment or intravenous me...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/605472
更新日期:2009-09-01 00:00:00
abstract::OBJECTIVE To define how often methicillin-resistant Staphylococcus aureus (MRSA) is spread from resident to resident in long-term care facilities using whole-genome sequencing DESIGN Prospective cohort study SETTING A long-term care facility PARTICIPANTS Elderly residents in a long-term care facility METHODS Cultures ...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1017/ice.2016.41
更新日期:2016-06-01 00:00:00
abstract::Antimicrobial agents used as disinfectants and antiseptics are increasing in epidemiologic importance. The regulation of topical antiseptics has ranged from nonexistent, lax and confusing to inclusion in the Food and Drug Administration (FDA) over-the-counter (OTC) review of drug ingredients. This article simplifies t...
journal_title:Infection control and hospital epidemiology
pub_type: 历史文章,杂志文章
doi:10.1086/645935
更新日期:1989-11-01 00:00:00
abstract::Surveillance for methicillin-resistant Staphylococcus aureus (MRSA) was implemented in Rio de Janeiro and Uberlândia University Hospitals, which had different policies on use of mupirocin. One hundred fourteen multiresistant MRSA strains were isolated from 62 patients. Mupirocin resistance was observed in 63% of strai...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:
更新日期:1996-12-01 00:00:00
abstract::A case-control study of patients with and without confirmed UTI was performed to identify risk factors for nosocomial UTI. Duration of hospitalization, unit of admission, history of diabetes mellitus or debilitating diseases, and duration and number of urinary catheters were independently associated with increased ris...
journal_title:Infection control and hospital epidemiology
pub_type: 杂志文章
doi:10.1086/502336
更新日期:2004-11-01 00:00:00