1,720,987 research outputs found
An investigation of the assumptions that inform contemporary hospital infection control programs.
No full textThe purpose of the study was to investigate the assumptions that underpin contemporary hospital infection control programs from the perspective of the influence of clinical culture on the integration and ownership of the infection control program.
The results of numerous studies have linked low levels of adherence with infection control principles amongst health care providers as the most significant factor contributing to nosocomial infection. Despite early successes in reducing nosocomial infection rates, results derived from current research demonstrate that nosocomial infection has remained a challenge to healthcare providers and patients alike and outbreaks are regularly reported in the infection control literature.
Serious economic and social impact has resulted from the increasing levels of antibiotic resistance that have been reported amongst pathogens associated with nosocomial infection.
This interpretive study takes an ethnographic approach, using multiple data sources to provide insight into the culture and context of infection control practice drawing upon clinicians' work and the clinician's perspective.
There were three approaches to data collection. A postal survey of surgeons was conducted, a group of nurses participated in a quality activity, and a clinical ethnography was conducted in an intensive care unit and an operating theatre complex.
Data were analysed in accordance with the qualitative and quantitative approaches to data management.
Findings indicate that the clinical culture exerts significant influence over the degree to which the infection control program activities change practice and that rather than imposing the infection control program on the clinical practice setting from outside, sustained practice change is more likely to be achieved if the motivation and impetus for change is culturally based. Moreover surveillance, if it is to influence clinicians and their practice, must provide confidence in its accuracy. It must be meaningful to them and linked to patient care outcomes.
Contemporary hospital infection control programs, based on assumptions about a combination of surveillance and control activities have resulted in decreased nosocomial infection rates. However, sustained infection control practice change has not been achieved despite the application of a range of surveillance and control strategies. This research project has utilized an ethnographic approach to provide an emic perspective of infection control practice within a range of practice contexts. The findings from this study are significant within the context of spiraling health costs and increasing antibiotic resistance associated with nosocomial infection
Credentialing the infection control practitioner
No full textThe following proposal is submitted by the AICA's credentialling and certification subcommittee for your consideration. It outlines a process and procedure for interim credentialling of infection control practitioners. In submitting this proposal, the subcommittee acknowledges that, while competency-based education is the preferred process for credentialling, there are clinicians who, in the absence of educational opportunities, have developed a specialist level of competency in infection control practice through self education and experience. Committee members also recognise the need for self-regulation of accrediting processes, to maintain standards in practice and support members in their clinical roles. We ask you to review the following proposal and invite your comments and critique, to be received by the last week in January 1998
Surgeons' perspectives on surgical wound infection rate data in Queensland, Australia
No full textBackground: The results of the Study on the Efficacy of Nosocomial Infection Control (SENIC) project demonstrated that hospitals with active infection control programs had lower rates of nosocomial infection than those without such programs. A key component of these programs was the inclusion of a systematic method for monitoring nosocomial infection and reporting these infections to clinicians. Objectives: To identify the perspectives of surgeons in Queensland, Australia, regarding infection rate data in terms of its accuracy and usefulness as well as their perceptions regarding acceptable infection rates for surgical procedures classified as "clean" or "contaminated." Methods: A postal survey was conducted, with a convenience sample of 510 surgeons. Results: More than 40% (n = 88) of respondents believed that the acceptable infection rate associated with clean surgical procedures should be less than 1%, a rate much lower than the threshold of 1.4% to 4.1% set by the Australian Council on Healthcare Standards (ACHS). Almost 30% (n = 55) of respondents reported that they would accept infection rates of 10% or higher for contaminated surgical procedures, which is higher than the ACHS threshold of 1.4% to 7.9%. Respondents identified failure to include postdischarge infections in the data and difficulties standardizing criteria for diagnosis of infection as the major impediments to the accuracy and usefulness of data provided. Conclusion: The results of this study have significant implications in relation to the preparation of surgical site infection reports, especially in relation to the inclusion of postdischarge surveillance data and information regarding pathogens, antibiotic sensitivities, and comorbidities of patients developing surgical site infection. Surgeons also identified the need to include information regarding the use of standardized definitions in the diagnosis of wound infection and parameters that allow comparison of infection rates to improve their perceptions regarding data accuracy and usefulness
Auditing hand hygiene rates for quality and improvement
No full textSince the work of Ignaz Philipp Semmelweis, hand hygiene has been recognised as an effective means of preventing healthcare-associated infection. More recently, the World Health Organisation developed guidelines and strategies for improving hand hygiene compliance which have subsequently been adopted and implemented in healthcare facilities around the world. In Australia the imperative to ensure appropriate hand hygiene as a component of safe healthcare provision has been supported and promoted at state and national levels by various bodies. However, in spite of improvements in compliance rates and reported decreases in multi-resistant organisms, criticism has arisen around the commitment of scarce healthcare resources to hand hygiene auditing. This study demonstrates that hand hygiene audits can contribute to quality healthcare delivery and improvement.Griffith Health, School of Nursing and MidwiferyNo Full Tex
Infection control standards and credentialing
No full textInfection control professionals (ICPs) play an integral part of developing, implementing, and evaluating infection control programs. In Australia, there is no minimum or standardized education to practice as an ICP. The Australasian College of Infection Prevention and Control, the professional body for ICPs in Australasia, sought to address the issue by developing a credentialing process.1, 2 and 3 This decision was made in recognition that self-regulation is one of the hallmarks of professionalism.4 The process of becoming credentialed as an ICP in Australia involves the submission of evidence against a range of criteria with a subsequent peer-review process..
Roles, responsibilities and scope of practice: describing the ‘state of play’ for infection control professionals in Australia and New Zealand
Full text linkBackground\ud
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In the past decade the policy and practice context for infection control in Australia and New Zealand has changed, with infection control professionals (ICPs) now involved in the implementation of a large number of national strategies. Little is known about the current ICP workforce and what they do in their day-to-day positions. The aim of this study was to describe the ICP workforce in Australia and New Zealand with a focus on roles, responsibilities, and scope of practice.\ud
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Methods\ud
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A cross-sectional design using snowball recruitment was employed. ICPs completed an anonymous web-based survey with questions on demographics; qualifications held; level of experience; workplace characteristics; and roles and responsibilities. Chi-squared tests were used to determine if any factors were associated with how often activities were undertaken.\ud
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Results\ud
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A total of 300 ICPs from all Australian states and territories and New Zealand participated. Most ICPs were female (94%); 53% were aged over 50, and 93% were employed in registered nursing roles. Scope of practice was diverse: all ICPs indicated they undertook a large number and variety of activities as part of their roles. Some activities were undertaken on a less frequent basis by sole practitioners and ICPs in small teams.\ud
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Conclusion\ud
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This survey provides useful information on the current education, experience levels and scope of practice of ICPs in Australia and New Zealand. Work is now required to establish the best mechanisms to support and potentially streamline scope of practice, so that infection-control practice is optimised
Time spent by infection control professionals undertaking healthcare associated infection surveillance: A multi-centred cross sectional study
No full text<b>Background</b>\ud
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- There is limited contemporary information on how <i>infection control professionals (ICPs)</i> in hospitals utilise their time, with even less providing any specific data on time taken to undertake HAI surveillance. HAI surveillance is a critical component of any infection control program.\ud
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<b>Methods</b>\ud
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- An anonymous online web-based survey was used to conduct a cross-sectional study of infection control units in public and private Australian hospitals. Participants were asked demographic information and time spent undertaking infection control activities, including surveillance.\ud
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<b>Results</b>\ud
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- Forty infection control units, responsible for providing services to 138 hospitals completed the survey. The percentage of time spent undertaking HAI surveillance activities by members of the infection control units was 1675 h or 36.0% (95% CI 34.3%–37.8%; range 17%–61%) of all contracted infection control professionals time (4653 h). Of the time spent undertaking HAI surveillance, 56% was spent collecting data, 27% collecting data on compliance with infection control activities and 17% feeding HAI data back to clinicians and management. There was no difference in the proportion of time spent undertaking HAI surveillance between public and privately funded hospitals or infection control units led by a credentialed ICP. Infection control units with a form of electronic surveillance dedicated more time to surveillance, compared to units that did not use such a system. Demands for surveillance increased with larger number of hospitals beds.\ud
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<b>Conclusion</b>\ud
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- The costs of undertaking HAI surveillance and collecting data can be considerable. The efficiency of undertaking surveillance should be considered, weighing investment against the likely improvement in infection rates and patient quality of life
Hospital infection control units: Staffing, costs, and priorities
No full textBackground: This article describes infection prevention and control professionals’ (ICPs’) staffing levels,\ud
patient outcomes, and costs associated with the provision of infection prevention and control services in\ud
Australian hospitals. A secondary objective was to determine the priorities for infection control units.\ud
Methods: A cross-sectional study design was used. Infection control units in Australian public and private\ud
hospitals completed a Web-based anonymous survey. Data collected included details about the\ud
respondent; hospital demographics; details and services of the infection control unit; and a description\ud
of infection prevention and control-related outputs, patient outcomes, and infection control priorities.\ud
Results: Forty-nine surveys were undertaken, accounting for 152 Australian hospitals. The mean number\ud
of ICPs was 0.66 per 100 overnight beds (95% confidence interval, 0.55-0.77). Privately funded hospitals\ud
have significantly fewer ICPs per 100 overnight beds compared with publicly funded hospitals (P < .01).\ud
Staffing costs for nursing staff in infection control units in this study totaled 16,364,392 (mean,\ud
380,566). Infection control units managing smaller hospitals (<270 beds) identified the need for\ud
increased access to infectious diseases or microbiology support.\ud
Conclusion: This study provides valuable information to support future decisions by funders, hospital\ud
administrators, and ICPs on service delivery models for infection prevention and control. Further, it is the\ud
first to provide estimates of the resourcing and cost of staffing infection control in hospitals at a national\ud
level.\ud
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Exploring the context for effective clinical governance in infection control
No full textBackground\ud
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Effective clinical governance is necessary to support improvements in infection control. Historically, the focus has been on ensuring that infection control practice and policy is based on evidence, and that there is use of surveillance and auditing for self-regulation and performance feedback. There has been less exploration of how contextual and organizational factors mediate an infection preventionists (IP's) ability to engage with evidence-based practice and enact good clinical governance.\ud
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Methods\ud
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A cross sectional Web-based survey of IPs in Australia and New Zealand was undertaken. Questions focused on engagement in evidence-based practice and perceptions about the context, culture, and leadership within the infection control team and organization. Responses were mapped against dimensions of Scally and Donaldson's clinical governance framework.\ud
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Results\ud
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Three hundred surveys were returned. IPs appear well equipped at an individual level to undertake evidence-based practice. The most serious set of perceived challenges to good clinical governance related to a lack of leadership or active resistance to infection control within the organization. Additional challenges included lack of information technology solutions and poor access to specialist expertise and financial resources.\ud
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Conclusions\ud
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Focusing on strengthening contextual factors at the organizational level that otherwise undermine capacity to implement evidence-based practice is key to sustaining current infection control successes and promoting further practice improvements
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