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  1. Article ; Online: Using a human factors framework to assess clinician perceptions of and barriers to high reliability in hand hygiene.

    Vaughan-Malloy, Ana M / Chan Yuen, Jenny / Sandora, Thomas J

    American journal of infection control

    2023  Volume 51, Issue 5, Page(s) 514–519

    Abstract: Background: Hand hygiene (HH) is critical to prevent health care-associated infections (HAIs). Clinician perspectives on maintaining high reliability are poorly defined.: Methods: We surveyed physicians, nurse practitioners, and physician assistants ... ...

    Abstract Background: Hand hygiene (HH) is critical to prevent health care-associated infections (HAIs). Clinician perspectives on maintaining high reliability are poorly defined.
    Methods: We surveyed physicians, nurse practitioners, and physician assistants to understand perceptions of and barriers to high reliability in HH. The Systems Engineering Initiative for Patient Safety 2.0 model was used to develop an electronic survey exploring 6 human factors engineering (HFE) domains.
    Results: Among 61 respondents, 70% perceived HH as "essential" to patient safety. While 87% reported alcohol-based hand rub (ABHR) availability as very effective in improving HH reliability, 77% reported dispensers to be "sometimes" or "often" empty. Clinicians in surgery/anesthesia were more likely than those in medical specialties to note skin irritation from ABHR (OR 4.94; 95% CI 1.37-17.81) and less likely to believe feedback was effective in improving HH (OR 0.26; 95% CI 0.08-0.88). One quarter of respondents indicated the layout of patient care areas was not conducive to performing HH. Staffing shortages and the pace and demands of work precluded HH for 15% and 11% of respondents, respectively.
    Conclusions: Aspects of organizational culture, environment, tasks, and tools were identified as barriers to high reliability in HH. HFE principles can be applied to more effectively promote HH.
    MeSH term(s) Humans ; Hand Hygiene ; Hand Disinfection ; Reproducibility of Results ; Guideline Adherence ; Cross Infection/prevention & control ; Ethanol
    Chemical Substances Ethanol (3K9958V90M)
    Language English
    Publishing date 2023-03-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 392362-9
    ISSN 1527-3296 ; 0196-6553
    ISSN (online) 1527-3296
    ISSN 0196-6553
    DOI 10.1016/j.ajic.2023.01.013
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1773: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Pediatric Clostridioides difficile Infection: Diagnosis and Diagnostic Stewardship.

    Schwenk, Hayden T / Pollock, Nira R / Vaughan-Malloy, Ana M

    Journal of the Pediatric Infectious Diseases Society

    2021  Volume 10, Issue Supplement_3, Page(s) S16–S21

    Abstract: Although the pathogenesis of Clostridioides difficile infection (CDI) is complex and incompletely understood, it is believed that the elaboration of C. difficile toxins is necessary for disease. There are a variety of tests available for the detection of ...

    Abstract Although the pathogenesis of Clostridioides difficile infection (CDI) is complex and incompletely understood, it is believed that the elaboration of C. difficile toxins is necessary for disease. There are a variety of tests available for the detection of both the C. difficile organism and its toxins; however, each has limitations and the best application of these tests to the diagnosis of CDI in children remains uncertain. Nucleic acid amplification tests are unable to reliably discriminate between CDI and C. difficile colonization, while commercially available enzyme immunoassays for toxin detection lack sensitivity. An understanding of preanalytic factors, relevant patient features, and test performance characteristics is essential to the accurate diagnosis of CDI in children. Specific diagnostic stewardship strategies can also increase the likelihood that positive tests reflect disease rather than colonization. Ultimately, CDI remains a clinical diagnosis and clinical judgment is essential when interpreting test results, regardless of the methods used.
    MeSH term(s) Bacterial Proteins ; Bacterial Toxins ; Child ; Clostridioides ; Clostridioides difficile ; Clostridium Infections/diagnosis ; Feces ; Humans
    Chemical Substances Bacterial Proteins ; Bacterial Toxins
    Language English
    Publishing date 2021-11-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 2668791-4
    ISSN 2048-7207 ; 2048-7193
    ISSN (online) 2048-7207
    ISSN 2048-7193
    DOI 10.1093/jpids/piab054
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Preventing pediatric catheter-associated urinary tract infections utilizing urinary catheter Kamishibai cards (K-cards).

    Lehane, Renee / Svensson, Catherine / Ormsby, Jennifer A / Yuen, Jenny Chan / Priebe, Gregory P / Sandora, Thomas J / Vaughan-Malloy, Ana M

    American journal of infection control

    2022  Volume 51, Issue 8, Page(s) 919–925

    Abstract: Background: We instituted Kamishibai (K-card rounding) with the goals of improving indwelling urinary catheter maintenance bundle reliability and decreasing catheter-associated urinary tract infection (CAUTI) rates.: Method: In a free-standing ... ...

    Abstract Background: We instituted Kamishibai (K-card rounding) with the goals of improving indwelling urinary catheter maintenance bundle reliability and decreasing catheter-associated urinary tract infection (CAUTI) rates.
    Method: In a free-standing children's hospital, we undertook a hospital-wide quality improvement project from January 2019 to June 2021 after developing a K-card based on our urinary catheter maintenance bundle. Auditors used K-cards to ask standardized questions during weekly rounds. Bundle reliability and CAUTI rates were analyzed prospectively.
    Results: During the study period, 826 K-card audits were performed for 657 unique patients. While overall maintenance bundle reliability remained stable at 84%, there was a statistically significant improvement in reliability to the bundle element "medical discussion of need for the urinary catheter" from 88% to 94% (P = .01). The hospital-wide CAUTI rate significantly decreased (incidence rate ratio, 0.38; 95% CI, 0.15-0.93; P = .04).
    Discussion: Hospital-wide urinary catheter K-card rounding facilitated standardized data collection, discussion of reliability and real-time feedback to nurses. Maintenance bundle reliability remained stable after implementation, accompanied by a significant decrease in the CAUTI rate.
    Conclusions: Implementation of hospital-wide urinary catheter K-card rounding was associated with reduction in CAUTI rates. The project demonstrated likelihood of reproducibility with support of a multidisciplinary team.
    MeSH term(s) Humans ; Child ; Urinary Catheters/adverse effects ; Catheter-Related Infections/epidemiology ; Catheter-Related Infections/prevention & control ; Reproducibility of Results ; Urinary Tract Infections/epidemiology ; Urinary Tract Infections/prevention & control ; Urinary Tract Infections/complications ; Quality Improvement ; Urinary Catheterization/adverse effects ; Cross Infection/epidemiology ; Cross Infection/prevention & control ; Cross Infection/etiology
    Language English
    Publishing date 2022-12-02
    Publishing country United States
    Document type Journal Article
    ZDB-ID 392362-9
    ISSN 1527-3296 ; 0196-6553
    ISSN (online) 1527-3296
    ISSN 0196-6553
    DOI 10.1016/j.ajic.2022.11.019
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1773: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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