National Healthcare Quality and Disparities Report
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Topics
- Ambulatory Care and Surgery (1)
- Antibiotics (3)
- Antimicrobial Stewardship (3)
- Catheter-Associated Urinary Tract Infection (CAUTI) (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (2)
- Children/Adolescents (1)
- Clostridium difficile Infections (3)
- Comparative Effectiveness (2)
- COVID-19 (2)
- Critical Care (2)
- Elderly (3)
- Evidence-Based Practice (1)
- Guidelines (1)
- (-) Healthcare-Associated Infections (HAIs) (27)
- Healthcare Costs (1)
- Home Healthcare (1)
- Hospitals (7)
- Implementation (2)
- (-) Infectious Diseases (27)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (4)
- Long-Term Care (2)
- Medication (2)
- Methicillin-Resistant Staphylococcus aureus (MRSA) (6)
- Newborns/Infants (2)
- Nursing Homes (4)
- Patient-Centered Healthcare (1)
- Patient Safety (17)
- Policy (1)
- Practice Patterns (1)
- (-) Prevention (27)
- Provider (2)
- Provider: Health Personnel (1)
- Public Health (4)
- Public Reporting (1)
- Quality Improvement (2)
- Quality of Care (2)
- Sepsis (1)
- Surgery (1)
- Urinary Tract Infection (UTI) (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 27 Research Studies DisplayedCrnich CJ
Reimagining infection control in U.S. nursing homes in the era of COVID-19.
This paper provides an overview of nursing home (NH) infection and control, reviews the 2016 CMS changes to federal regulations, and proposes recommendations to sustain improvements. COVID-19 put further pressure on nursing homes who were already strained by rising numbers of infections from C. difficile and multidrug-resistant organisms. The author puts out a call for reimagining infection prevention and control using the Systems Engineering Initiative for Patient Safety framework. Additional recommendations are made to enhance NH infection prevention and control programs in the areas of people, tasks, tools, organization, built environment, and external environment.
AHRQ-funded; HS022465.
Citation: Crnich CJ .
Reimagining infection control in U.S. nursing homes in the era of COVID-19.
J Am Med Dir Assoc 2022 Dec;23(12):1909-15. doi: 10.1016/j.jamda.2022.10.022..
Keywords: Elderly, COVID-19, Public Health, Infectious Diseases, Nursing Homes, Healthcare-Associated Infections (HAIs), Prevention
Krauss DM, Molefe A, Hung L
AHRQ Author: Henderson S, Miller M
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
In this study, researchers summarized themes for maintaining infection prevention activities learned from the implementation of a quality improvement (QI) program during the COVID-19 pandemic. They concluded that future shocks such as the pandemic must be anticipated, and the healthcare system must be resilient to the resulting disruptions to healthcare-associated infection prevention activities. Their study encountered four themes for successful maintenance of infection prevention activities during the current pandemic: the value of a pre-existing infection prevention infrastructure; a flexibility in approach; broad buy-in for maintaining QI programs; and the facilitation of idea-sharing.
AHRQ-authored; AHRQ-funded; 233201500016I.
Citation: Krauss DM, Molefe A, Hung L .
Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.
BMJ Open Qual 2022 Nov;11(4):e001926. doi: 10.1136/bmjoq-2022-001926..
Keywords: COVID-19, Central Line-Associated Bloodstream Infections (CLABSI), Catheter-Associated Urinary Tract Infection (CAUTI), Healthcare-Associated Infections (HAIs), Quality Improvement, Quality of Care, Critical Care, Intensive Care Unit (ICU), Prevention, Urinary Tract Infection (UTI), Infectious Diseases
Harris AD, Morgan DJ, Pineles L
Acquisition of antibiotic-resistant gram-negative bacteria in the Benefits of Universal Glove and Gown (BUGG) cluster randomized trial.
This study is a secondary analysis of a randomized trial in 20 hospital intensive units called Benefits of Universal Glove and Gown (BUGG) to see if intervention decreases the acquisition of antibiotic-resistant gram-negative bacteria. The primary outcome included 40,492 admission and discharge perianal swabs from 20,246 individual patient admissions. A non-statistically significant decrease in acquisition of antibiotic-resistant gram-negative bacteria was associated with universal glove and gown use.
AHRQ-funded; HS024045.
Citation: Harris AD, Morgan DJ, Pineles L .
Acquisition of antibiotic-resistant gram-negative bacteria in the Benefits of Universal Glove and Gown (BUGG) cluster randomized trial.
Clin Infect Dis 2021 Feb 1;72(3):431-37. doi: 10.1093/cid/ciaa071..
Keywords: Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Patient Safety
Lee BY, Bartsch SM, Lin MY
How long-term acute care hospitals can play an important role in controlling carbapenem-resistant Enterobacteriaceae in a region: a simulation modeling study.
Researchers investigated how implementing control measures in long-term acute care hospitals (LTACHs) can impact carbapenem-resistant Enterobacteriaceae (CRE) spread regionwide. They used their own Chicago metropolitan region agent-based model to simulate CRE spread and control. They found that a prevention bundle in only LTACHs decreased prevalence and averted new carriers, infections, and deaths over 3 years compared with no CRE control measures. When LTACHs and intensive care units intervened, prevalence decreased further. They concluded that LTACHs may be more important than other acute care settings for controlling CRE, and regional efforts to control drug-resistant organisms should start with LTACHs as a centerpiece.
AHRQ-funded; HS023317.
Citation: Lee BY, Bartsch SM, Lin MY .
How long-term acute care hospitals can play an important role in controlling carbapenem-resistant Enterobacteriaceae in a region: a simulation modeling study.
Am J Epidemiol 2021 Feb 1;190(3):448-58. doi: 10.1093/aje/kwaa247..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Hospitals, Patient Safety, Implementation
Lee BY, Bartsch SM, Hayden MK
How to choose target facilities in a region to implement carbapenem-resistant Enterobacteriaceae control measures.
The authors investigated how best to choose the highest-yield facilities to target for interventions when trying to control regional spread of antibiotic-resistant pathogens such as carbapenem-resistant Enterobacteriaceae (CRE). They used their own Regional Healthcare Ecosystem Analyst-generated agent-based model of Chicago metropolitan area inpatient facilities to simulate the spread of CRE and to choose facilities to apply prevention bundles. They found that, while choosing target facilities based on single metrics (including most inpatient beds, most connections to other facilities) achieved better control than randomly choosing facilities, more effective targeting occurred when considering how these and other factors (including patient length of stay, care for higher-risk patients) interacted as a system.
AHRQ-funded; HS023317.
Citation: Lee BY, Bartsch SM, Hayden MK .
How to choose target facilities in a region to implement carbapenem-resistant Enterobacteriaceae control measures.
Clin Infect Dis 2021 Feb 1;72(3):438-47. doi: 10.1093/cid/ciaa072..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Implementation, Prevention, Patient Safety
Gaughan AA, Walker DM, DePuccio MJ
Rewarding and recognizing frontline staff for success in infection prevention.
This article discusses how managers can use reward and recognition programs as motivational tools to sustain frontline healthcare-associated infection (HAI) prevention. Data from interviews with hospital managers and frontline staff at 18 US hospitals were used to identify these tools.
AHRQ-funded; HS024958.
Citation: Gaughan AA, Walker DM, DePuccio MJ .
Rewarding and recognizing frontline staff for success in infection prevention.
Am J Infect Control 2021 Jan;49(1):123-25. doi: 10.1016/j.ajic.2020.06.208..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Quality Improvement, Quality of Care
Kim JJ, Johnson JK, Stucke EM
Burden of perianal Staphylococcus aureus colonization in nursing home residents increases transmission to healthcare worker gowns and gloves.
Transmission of Staphylococcus aureus (S. aureus) to health care workers (HCWs) on gowns and gloves has been an issue in nursing homes. This study evaluated the effect of the burden in 13 community-based nursing homes in Maryland and Michigan. Residents were cultured for S. aureus at the perianal skin and the anterior nares areas. A total of 403 residents were enrolled, with 169 colonized with methicillin-resistant S. aureus (MRSA) or methicillin-sensitive S. aureus (MSSA). Transmission to HCW gowns and gloves was greater from those colonized with greater quantities of S. aureus on the perianal skin. These findings inform future infection control practices for both MRSA and MSSA in nursing homes.
AHRQ-funded; HS019979; HS025451.
Citation: Kim JJ, Johnson JK, Stucke EM .
Burden of perianal Staphylococcus aureus colonization in nursing home residents increases transmission to healthcare worker gowns and gloves.
Infect Control Hosp Epidemiol 2020 Dec;41(12):1396-401. doi: 10.1017/ice.2020.336..
Keywords: Elderly, Nursing Homes, Long-Term Care, Healthcare-Associated Infections (HAIs), Infectious Diseases, Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention
Gall E, Long A, Hall KK
Chlorhexidine bathing strategies for multidrug-resistant organisms: a summary of recent evidence.
This systematic literature review investigated the latest evidence for patient bathing with a 2%-4% chlorhexidine gluconate solution to reduce multidrug-resistant organism (MDRO) transmission and infection. Three databases were searched for articles from 2008 through 2018, as well as any key articles published after 2018. Findings focused on health care-associated infections (HAIs) and 3 categories of MDROs: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and carbapenem-resistant Enterobacteriaceae (CRE). Chlorhexidine reduced MRSA acquisition and carriage, but no studies found significant reductions in infections. Several studies found that chlorhexidine bathing reduced VRE acquisition and carriage. Two very large studies found bathing significantly reduced HAIs, but these reductions may be smaller when HAIs are already controlled with other anti-infection measures.
AHRQ-funded; HHSP233201500013I.
Citation: Gall E, Long A, Hall KK .
Chlorhexidine bathing strategies for multidrug-resistant organisms: a summary of recent evidence.
J Patient Saf 2020 Sep;16(3S Suppl 1):S16-s22. doi: 10.1097/pts.0000000000000743..
Keywords: Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Prevention, Patient Safety, Infectious Diseases
Schoyer E, Hall K
Environmental cleaning and decontamination to prevent clostridioides difficile infection in health care settings: a systematic review.
The aim of this systematic review was to examine the most effective and feasible methods for environmental cleaning and decontamination to prevent Clostridioides difficile infection (CDI) in health care settings. The investigators concluded that the studied practices for environmental cleaning and decontamination were associated with significant decreases in facility-level CDI rates in most of the reviewed studies; however, study quality was low.
AHRQ-funded; 233201500013I.
Citation: Schoyer E, Hall K .
Environmental cleaning and decontamination to prevent clostridioides difficile infection in health care settings: a systematic review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S12-s15. doi: 10.1097/pts.0000000000000749..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Patient Safety
Chatterjee P, Williams MD, Coppin JD
Effectiveness of copper-impregnated solid surfaces on lowering microbial bio-burden levels in an acute care hospital.
This study examined whether using novel coper-impregnated solid materials on high-touch surfaces in patient rooms lowered bacterial contamination which may lead to health care-associated infections in acute care hospitals. Sixteen rooms were installed with copper-impregnated surfaces and were compared to standard noncopper laminate surfaces in 16 rooms over a 3-day period. Samples were taken 3 times per day. A lower level of microbial contamination was found in copper-impregnated solid surfaces as compared to standard surfaces.
AHRQ-funded; HS025598.
Citation: Chatterjee P, Williams MD, Coppin JD .
Effectiveness of copper-impregnated solid surfaces on lowering microbial bio-burden levels in an acute care hospital.
Open Forum Infect Dis 2020 Aug;7(8). doi: 10.1093/ofid/ofaa238..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Comparative Effectiveness, Prevention, Evidence-Based Practice
Bartsch SM, Wong KF, Stokes-Cawley OJ
Knowing more of the iceberg: how detecting a greater proportion of carbapenem-resistant Enterobacteriaceae carriers influences transmission.
This study examined the impact of detecting a greater proportion of carbapenem-resistant Enterobacteriaceae (CRE) carriers in the hospital inpatient population. The researchers used the Regional Healthcare Ecosystem Analyst-generated agent-based model of adult inpatient healthcare facilities in Orange County, California. They found that only if the detection level is increased to 1 in 5 carriers does it garner large reductions in the number of new CRE carriers. At the present time the detection level is 1 in 9 carriers.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Wong KF, Stokes-Cawley OJ .
Knowing more of the iceberg: how detecting a greater proportion of carbapenem-resistant Enterobacteriaceae carriers influences transmission.
J Infect Dis 2020 May 11;221(11):1782-94. doi: 10.1093/infdis/jiz288..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Hospitals, Patient Safety, Prevention
Adams C, Young D, Gastanaduy PA
Quantifying the roles of vomiting, diarrhea, and residents vs. staff in norovirus transmission in U.S. nursing home outbreaks.
Norovirus transmissibility is poorly understood and the goal of this study was to examine transmission via vomiting, diarrhea, and patient exposures. Six nursing home outbreaks in South Carolina were examined from 2014 to 2016. Vomiting infected 2.12 times the number of individuals as non-vomiters, diarrhea 1.39 times, and resident cases infected 1.53 times the number of individuals as staff cases. This finding is important for not just nursing homes, but other sites of norovirus outbreaks such as cruise ships.
AHRQ-funded; HS025987.
Citation: Adams C, Young D, Gastanaduy PA .
Quantifying the roles of vomiting, diarrhea, and residents vs. staff in norovirus transmission in U.S. nursing home outbreaks.
PLoS Comput Biol 2020 Mar;16(3):e1007271. doi: 10.1371/journal.pcbi.1007271..
Keywords: Elderly, Nursing Homes, Long-Term Care, Infectious Diseases, Healthcare-Associated Infections (HAIs), Prevention, Public Health
Milstone AM, Voskertchian A, Koontz DW
Effect of treating parents colonized with Staphylococcus aureus on transmission to neonates in the intensive care unit: a randomized clinical trial.
This study examined the effect of treating parents of neonates in the intensive care unit (NICUs) with intranasal mupirocin and topical chlorhexidine compared with a placebo treatment and whether it reduces transmission of Staphlyococcus aureus to their babies. A double-blind randomized trial was conducted at 2 tertiary NICUs in Baltimore, MD from November 2014 to December 2018. Parents were given intranasal treatments for 5 days. Of the intervention group 13 of 89 neonates acquired S aureus, and in the control group 29 of 101 neonates acquired S aureus with the same strain as their parents. The results showed a significant reduction in transmission.
AHRQ-funded; HS022872.
Citation: Milstone AM, Voskertchian A, Koontz DW .
Effect of treating parents colonized with Staphylococcus aureus on transmission to neonates in the intensive care unit: a randomized clinical trial.
JAMA 2020 Jan;323(4):295-386. doi: 10.1001/jama.2019.20785..
Keywords: Newborns/Infants, Intensive Care Unit (ICU), Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Prevention
Chiotos K, Rock C, Schweizer ML
Current infection prevention and antibiotic stewardship program practices: a survey of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN).
This survey compares results with a similar 2013 survey that characterizes contemporary infection prevention and antibiotic stewardship program practices across 64 healthcare facilities. There was decreased frequency of active surveillance for MRSA, frequent active surveillance for carbapenem-resistant Enterobacteriaceae, and increased support for antibiotic stewardship programs.
AHRQ-funded; HS026393.
Citation: Chiotos K, Rock C, Schweizer ML .
Current infection prevention and antibiotic stewardship program practices: a survey of the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN).
Infect Control Hosp Epidemiol 2019 Sep;40(9):1046-49. doi: 10.1017/ice.2019.172.
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Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Methicillin-Resistant Staphylococcus aureus (MRSA), Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Practice Patterns
Musuuza JS, Guru PK, O'Horo JC
The impact of chlorhexidine bathing on hospital-acquired bloodstream infections: a systematic review and meta-analysis.
This review and meta-analysis examined the effect of chlorhexidine gluconate (CHG) bathing on reducing hospital-acquired bloodstream infections (HABSIs) and also assessed fidelity to the implementation of this intervention. The literature research included randomized controlled trials, cluster randomized trials, and quasi-experimental studies that evaluated the effect of CHG bathing versus a non-CHG comparator; studies involving pediatric patients, pre-surgical CHG use, and those without a non-CHG comparison arm were excluded. Outcomes were HABSIs, patient-centered outcomes, and implementation fidelity assessed through five elements: adherence, exposure or dose, quality of delivery, participant responsiveness, and program differentiation. The findings indicate that patient bathing with CHG significantly reduced the incidence of HABSIs in both ICU and non-ICU settings. Many studies, however, did not report fidelity to intervention or patient-centered outcomes.
AHRQ-funded; HS024039.
Citation: Musuuza JS, Guru PK, O'Horo JC .
The impact of chlorhexidine bathing on hospital-acquired bloodstream infections: a systematic review and meta-analysis.
BMC Infect Dis 2019 May 14;19(1):416. doi: 10.1186/s12879-019-4002-7..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Prevention
Woodard JA, Leekha S, Jackson SS
Beyond entry and exit: Hand hygiene at the bedside.
This study assessed compliance with, knowledge of, and attitudes toward the World Health Organization (WHO) 5 moments for hand hygiene (HH) using a modified WHO HH observation form and a survey that assessed health care personnel (HCP) knowledge, opinions, and barriers to HH. Of the 218 HCPs who completed the survey, less than one-third were familiar with the WHO 5 moments and only 21& of that group could recall the 5 moments. 302 HH opportunities in 104 unique HCP-patient interactions were observed, but with infrequent compliance. The researchers conclude that lack of recognition of opportunities at the bedside and for glove use may contribute to low compliance.
AHRQ-funded; HS024108.
Citation: Woodard JA, Leekha S, Jackson SS .
Beyond entry and exit: Hand hygiene at the bedside.
Am J Infect Control 2019 May;47(5):487-91. doi: 10.1016/j.ajic.2018.10.026..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Prevention, Provider, Public Health
Pogorzelska-Maziarz M, de Cordova PB, Herzig M, de Cordova PB, Herzig CTA
Perceived impact of state-mandated reporting on infection prevention and control departments.
Currently, most US states have adopted legislation requiring hospitals to submit health care-associated infection (HAI) data. In this study, the authors evaluated the perceived impact of state HAI laws on infection prevention and control (IPC) departments. They concluded that respondents in states with laws reported negative effects on their IPC department, beyond what was required by federal mandates.
AHRQ-funded; HS024339.
Citation: Pogorzelska-Maziarz M, de Cordova PB, Herzig M, de Cordova PB, Herzig CTA .
Perceived impact of state-mandated reporting on infection prevention and control departments.
Am J Infect Control 2019 Feb;47(2):118-22. doi: 10.1016/j.ajic.2018.08.012..
Keywords: Public Reporting, Policy, Public Health, Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention, Hospitals
Keller SC, Williams D, Rock C
A new frontier: central line-associated bloodstream infection surveillance in home infusion therapy.
As more home infusion agencies consider ways to perform surveillance for central line–associated bloodstream infection (CLABSI), an understanding of the assorted challenges is necessary. The authors discussed these challenges, which include a lack of a widely accepted standard definition of CLABSIs in home infusion therapy, the lack of a reporting platform, the absence of a reporting requirement, and barriers in obtaining the needed information to identify the presence of a potential CLABSI and adjudicate whether it meets a CLABSI definition. The 21st Century Cures Act will expand Medicare coverage for home infusion therapy services by 2021, likely leading to increased pressure for home infusion therapy CLABSI surveillance. Benchmarking of CLABSI data can usher in informed work to reduce CLABSIs and enhance patient safety in home infusion therapy.
AHRQ-funded; HS025782.
Citation: Keller SC, Williams D, Rock C .
A new frontier: central line-associated bloodstream infection surveillance in home infusion therapy.
Am J Infect Control 2018 Dec;46(12):1419-21. doi: 10.1016/j.ajic.2018.05.016..
Keywords: Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Home Healthcare, Patient Safety, Sepsis, Infectious Diseases, Prevention
Blanco N, Johnson JK, Sorkin JD
Transmission of resistant Gram-negative bacteria to healthcare personnel gowns and gloves during care of residents in community-based nursing facilities.
The purpose of this study was to estimate the risk of transmission of antibiotic-resistant Gram-negative bacteria (RGNB) to gowns and gloves worn by healthcare personnel when providing care to residents of community-based nursing facilities to identify the types of care and resident characteristics associated with transmission. The investigators found that RGNB transmission to either gloves or gowns occurred during 11% of the 584 interactions. Showering the resident, hygiene or toilet assistance, and wound dressing changes were associated with a high risk of transmission.
AHRQ-funded; HS019979.
Citation: Blanco N, Johnson JK, Sorkin JD .
Transmission of resistant Gram-negative bacteria to healthcare personnel gowns and gloves during care of residents in community-based nursing facilities.
Infect Control Hosp Epidemiol 2018 Dec;39(12):1425-30. doi: 10.1017/ice.2018.247.
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Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Nursing Homes, Prevention, Provider, Provider: Health Personnel
Kline SE, Sanstead EC, Johnson JR
Cost-effectiveness of pre-operative Staphylococcus aureus screening and decolonization.
In this study, the investigators developed a decision analytic model to evaluate the impact of a preoperative Staphylococcus aureus decolonization bundle on surgical site infections (SSIs), health-care-associated costs (HCACs), and deaths due to SSI. The investigators predict that the treat-all strategy would be the most effective and cost-saving strategy for preventing SSIs. However, they concluded that because this strategy might select more extensively for mupirocin-resistant S. aureus and cause more medication adverse effects than the test-and-treat approach or the SOC, additional studies are needed to define its comparative benefits and harms.
AHRQ-funded; HS022912.
Citation: Kline SE, Sanstead EC, Johnson JR .
Cost-effectiveness of pre-operative Staphylococcus aureus screening and decolonization.
Infect Control Hosp Epidemiol 2018 Nov;39(11):1340-46. doi: 10.1017/ice.2018.228..
Keywords: Surgery, Antibiotics, Antimicrobial Stewardship, Healthcare-Associated Infections (HAIs), Infectious Diseases, Patient Safety, Prevention, Healthcare Costs
Anderson DJ, Moehring RW, Weber DJ
Effectiveness of targeted enhanced terminal room disinfection on hospital-wide acquisition and infection with multidrug-resistant organisms and Clostridium difficile: a secondary analysis of a multicentre cluster randomised controlled trial with crossover
In this study, the investigators aimed to assess the effectiveness of four disinfection strategies on hospital-wide incidence of multidrug-resistant organisms and Clostridium difficile in the Benefits of Enhanced Terminal Room (BETR) Disinfection study. The investigators found that enhanced terminal room disinfection with ultraviolet (UV) in a targeted subset of high-risk rooms led to a decrease in hospital-wide incidence of C difficile and vancomycin-resistant enterococci.
AHRQ-funded; HS023866.
Citation: Anderson DJ, Moehring RW, Weber DJ .
Effectiveness of targeted enhanced terminal room disinfection on hospital-wide acquisition and infection with multidrug-resistant organisms and Clostridium difficile: a secondary analysis of a multicentre cluster randomised controlled trial with crossover
Lancet Infect Dis 2018 Aug;18(8):845-53. doi: 10.1016/s1473-3099(18)30278-0..
Keywords: Clostridium difficile Infections, Healthcare-Associated Infections (HAIs), Hospitals, Infectious Diseases, Inpatient Care, Patient Safety, Prevention
Khamash DF, Voskertchian A, Milstone AM
Manipulating the microbiome: evolution of a strategy to prevent S. aureus disease in children.
Hospitalized infants have the highest rates of invasive Staphylococcus aureus disease of any population and infection control strategies such as decolonization have been insufficient. In this article, the authors review what is known about bacterial communities in the nasal cavity of infants and discuss how future microbiome studies may help identify novel interventions to protect high-risk infants from S. aureus disease.
AHRQ-funded; HS022872.
Citation: Khamash DF, Voskertchian A, Milstone AM .
Manipulating the microbiome: evolution of a strategy to prevent S. aureus disease in children.
J Perinatol 2018 Feb;38(2):105-09. doi: 10.1038/jp.2017.155..
Keywords: Healthcare-Associated Infections (HAIs), Infectious Diseases, Children/Adolescents, Prevention, Newborns/Infants, Patient Safety
Seibert G, Ewers T, Barker AK
What do visitors know and how do they feel about contact precautions?
This study surveyed visitors of Clostridium difficile infection (CDI) patients to understand their compliance, knowledge, and perceptions of contact precautions. Nursing staff were the fundamental source for information on personal protective equipment (PPE) for visitors, but the researchers discovered variation in staff communication regarding the need for PPE use. Although most visitors knew where to find required personal protective equipment, less than half were fully compliant with gown and gloves.
AHRQ-funded; HS024039.
Citation: Seibert G, Ewers T, Barker AK .
What do visitors know and how do they feel about contact precautions?
Am J Infect Control 2018 Jan;46(1):115-17. doi: 10.1016/j.ajic.2017.05.011..
Keywords: Clostridium difficile Infections, Guidelines, Healthcare-Associated Infections (HAIs), Infectious Diseases, Prevention
Wares JR, Lawson B, Shemin D
Evaluating infection prevention strategies in out-patient dialysis units using agent-based modeling.
The researchers hypothesized that targeting patients receiving antimicrobial treatment would more effectively reduce transmission and acquisition of multidrug-resistant organisms (MDRO) and further that environmental contamination plays a role in the dissemination of MDRO in the dialysis unit. They found that reducing antimicrobial treatment markedly reduces overall colonization rates and also the levels of environmental contamination in the dialysis unit. They suggested that improving the environmental decontamination efficacy between patient dialysis treatments as an effective method for reducing colonization and contamination rates.
AHRQ-funded; HS021666.
Citation: Wares JR, Lawson B, Shemin D .
Evaluating infection prevention strategies in out-patient dialysis units using agent-based modeling.
PLoS One 2016 May 19;11(5):e0153820. doi: 10.1371/journal.pone.0153820.
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Keywords: Antimicrobial Stewardship, Antibiotics, Medication, Healthcare-Associated Infections (HAIs), Prevention, Ambulatory Care and Surgery, Infectious Diseases
Harris AD, Pineles L, Belton B
Universal glove and gown use and acquisition of antibiotic-resistant bacteria in the ICU: a randomized trial.
Antibiotic-resistant bacteria are associated with increased patient morbidity and mortality. It is unknown whether wearing gloves and gowns for all patient contact in the intensive care unit (ICU) decreases acquisition of antibiotic-resistant bacteria. The purpose of this study was to assess whether wearing gloves and gowns for all patient contact in the ICU decreases acquisition of methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) compared with usual care.
AHRQ-funded; HS018111; 290200600015.
Citation: Harris AD, Pineles L, Belton B .
Universal glove and gown use and acquisition of antibiotic-resistant bacteria in the ICU: a randomized trial.
JAMA 2013 Oct 16;310(15):1571-80. doi: 10.1001/jama.2013.277815..
Keywords: Patient Safety, Healthcare-Associated Infections (HAIs), Methicillin-Resistant Staphylococcus aureus (MRSA), Infectious Diseases, Intensive Care Unit (ICU), Hospitals, Prevention, Critical Care