Journal of Infection Prevention current issue

Patient Safety First: supporting improvements in infection prevention

Clarke, J. — Tue, 12 Jan 2010 06:27:44 PST

Tackling healthcare associated infections: an exploratory study of cleaners' perceptions of their role

Tue, 12 Jan 2010 06:27:44 PST

Good hospital hygiene is integral to the prevention of healthcare associated infections (HCAI). Clinical evidence suggests a link between poor environmental hygiene and healthcare associated infections. A qualitative design, using focus group interviews, was used to explore cleaners’ perceptions of their role in the prevention of HCAI. Focus group interviews were conducted with cleaners in two large hospitals in the Republic of Ireland. Data were analysed using thematic content analysis and four themes emerged. These were supervision and communication; roles and task allocations; workload and staffing levels; and education. Findings suggest that cleaners feel they have a role in the prevention of HCAI. However, this role is often undervalued due to the perceived low status of cleaners. Problems of communication in the workplace frequently interfere with work organisation. Furthermore, blurring of role boundaries between cleaners and healthcare assistants can create additional difficulties.

Treatment of latent Mycobacterium tuberculosis infection in intravenous drug users co-infected with HIV

Tue, 12 Jan 2010 06:27:44 PST

Objective: This clinical trial, carried out among injection drug users and the HIV-infected with tuberculin skin test ≥ 5 mm, aimed to evaluate the compliance and tolerability of two preventive strategies against tuberculosis (TB).

Methods: Study protocol prospectively compares adherence to nine months of daily therapy with isoniazid (9H) versus two months of daily therapy with rifampin plus pyrazinamide (2RZ) administered randomly. All patients were concurrently admitted to a methadone maintenance programme. To assess toxicity, liver function was monitored monthly.

Results: From 305 assessable patients, those in 2RZ arm showed better adherence (84% vs. 59%, p < 0.0001). Results on liver toxicity did not show significant differences between 9H and 2RZ (4.5% vs. 6.9%; odds ratio = 1.58, 95% confidence interval = 0.42—7.24). Conclusion: 2RZ should be considered an option to prevent TB in selected groups of patients infected with HIV, such as injection drug users on methadone treatment.

Infection outbreaks in acute hospitals: a systems approach

Waterson, P. — Tue, 12 Jan 2010 06:27:44 PST

This paper puts forward the case for applying a systems approach to the analysis of hospital-based infection outbreaks. A major advantage of the systems approach is that it affords insights into how actions or occurrences at one system level (e.g. individual error) collectively interact with team (e.g. leadership style) and organisational (e.g. safety culture) levels of analysis. Most of the research concerned with behavioural aspects of infection control has focused on a single level of analysis (e.g. interventions to improve hand washing). The infection outbreaks at the Maidstone and Tunbridge Wells NHS Trust are used as a case study in order to demonstrate the usefulness of the systems approach. The paper further outlines the human and organisational issues raised by the analysis and provides a means through which these aspects of infection can be highlighted as part of a future research agenda.

A pilot study of surveillance of intensive care unit associated infections in Scotland

Tue, 12 Jan 2010 06:27:44 PST

Healthcare associated infections (HCAI) are a significant problem in healthcare settings worldwide. H The risk of HCAI is higher in patients undergoing multiple invasive procedures such as those requiring intensive care. A pilot study was undertaken to determine the incidence of intensive care unit (ICU) acquired infection in Scotland and to test the feasibility of the implementation of a surveillance system to measure ICU acquired infection in Scottish hospitals. The overall incidence of ICU acquired infection, namely pneumonia, bloodstream infection and central venous catheter related infection, was 30.5 infections per 1000 patient days with the majority being pneumonia. Implementation of the surveillance system was found to feasible and as such may have an important role in the monitoring of ICU acquired infection.

Erratum

Tue, 12 Jan 2010 06:27:44 PST

Diary

Tue, 12 Jan 2010 06:27:44 PST