American journal of infection control
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Am J Infect Control · May 2009
Measuring adherence to hand hygiene guidelines: a field survey for examples of effective practices.
Measuring adherence to hand hygiene guidelines is resource intensive and complicated by lack of standardized methodology. The multiplicity of approaches in use makes it difficult to meaningfully compare performance across health care organizations. The goal of this project was to identify promising and effective practices for measuring adherence with hand hygiene guidelines across a variety of settings. ⋯ Among respondents who considered their approach to be an example of an effective practice, there was substantial variation in methods and little evidence of reliability. Standardization of methods is needed to compare performance across organizations or within an organization over time.
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Am J Infect Control · May 2009
National point prevalence of Clostridium difficile in US health care facility inpatients, 2008.
Recent published estimates of Clostridium difficile infection (CDI) incidence have been based on small numbers of hospitals or national hospital discharge data. These data suggest that CDI incidence is increasing. ⋯ Our survey documents a higher C difficile prevalence rate than previous estimates using different methodologies. The majority of inpatient CDI appears to be health care associated. Given that not all patients with diarrhea are tested for CDI and that most facilities use enzyme immunoassays with limited sensitivity to detect C difficile, these are minimum estimates of the US health care facility C difficile burden.
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Am J Infect Control · May 2009
Association between use of hand hygiene products and rates of health care-associated infections in a large university hospital in Norway.
An association between use of hand hygiene products and health care-associated infection rates was investigated in a large Norwegian university hospital. ⋯ These data suggests that infection rates may be reflected by amount of hand hygiene products used. Quantification of such products over time may serve as an indicator for hand hygiene performance in hospitals.
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Am J Infect Control · May 2009
Hand hygiene compliance by physicians: marked heterogeneity due to local culture?
Physician compliance with hand hygiene guidelines often has been reported as insufficient. ⋯ The remarkable heterogeneity in physicians' hand hygiene compliance among sites within the same institution is consistent with an important role of the local ward culture.
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Am J Infect Control · May 2009
Marked variability in adherence to hand hygiene: a 5-unit observational study in Tuscany.
International authorities recommend that the hand hygiene of health care workers be improved to prevent health care-associated infection. In 2005, Tuscany, a region in central Italy, initiated a campaign to improve hand hygiene that focused on raising awareness and educating health care workers. We assessed hand hygiene rates approximately 3 years after the campaign was initiated in 5 units of 2 hospitals in Florence, Italy, the capital of Tuscany. We also were curious whether variability would exist in the hand hygiene rates despite the close proximity of the units. ⋯ The overall rates of hand hygiene adherence observed were similar to those found when Tuscany initiated a hand hygiene campaign 3 years earlier. Focusing on overall rates may be misleading, however, because substantial variability existed between units. Furthermore, these rates come only from the "first moment" (before touching the patient) and can only be compared with rates from studies using the same approach.