Hand Hygiene in Japan
In summer 2011, we assessed hand hygiene rates among doctors and nurses on 4 units at Rakuwakai Otowa Hospital.
Prevention of Hospital Infections by Interventions & Training (PROHIBIT)
The aim of PROHIBIT is to understand existing guidelines and practices to prevent healthcare associated infections (HAI) in European hospitals, identify factors that enable and prevent compliance with best practices, and test the effectiveness of interventions of known efficacy. The project will employ a mixed-methods approach combining the strengths of qualitative research, survey methods, observational and experimental designs. First, we will systematically review current guidelines on prevention of the most common HAIs within the EU, as well as schemes for surveillance and public reporting. Next, we will conduct a large-scale survey of what is actually being done in European hospitals, determining factors, and how these relate to bloodstream infection rates. The project will then focus on catheter-related bloodstream infection (CRBSI), a highly transmissable and reliably measured HAI, in a selected sample of European hospitals. In-depth interviews of healthcare staff and direct observation will be used to measure compliance with key prevention practices. A randomized effectiveness trial using a stepped wedge design will be donucted in intensive care units to determine the uptake and impact of 2 interventions (WHO hand hygiene protocol and so-called catheter bundle) on CRBSI as well as clinical and utlilization outcomes. The information will be synthesized to develop recommendations for the EU, policy makers, managers and medical professionals to prevent HAI. Dissemination will include instructional workshops and on-line training materials.
National Survey of Practices to Prevent Healthcare-Associated Infections in Thailand
Catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI) and ventilator-associated pneumonia (VAP) are the three most common healthcare-associated infections (HAIs) in Thailand. We conducted a national survey to evaluate current practices used by hospitals across Thailand to prevent these HAIs.
National Survey of Practices to Prevent Healthcare-Associated Infections in the United Kingdom
Similarly to the Thai study, we conducted a national survey to evaluate current practices used by hospitals across the UK to prevent CAUTI, CLABSI and VAP. I-AASC researchers are currently tabulating results from this survey. Measures of particular interest include hospital characteristics (particularly those related to infection control); opinions of the senior infection control nurse about improving infection prevention/control; and hospital systems for and reported use of practices to prevent CAUTI, CLABSI, and VAP. A potential further direction for study may include relationships between different hospital characteristics and reported rates of preventive practice usage.
Observational study of hand hygiene in Tuscany
Subsequently, we assessed the longer term sustainability of the previously described intervention. Direct observation was used to assess hand hygiene compliance for both doctors and nurses in the emergency department. The overall effects of the intervention were sustained over a 1-year period, although a marked difference was observed between nurses and doctors.