American journal of infection control
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Am J Infect Control · Feb 2014
Randomized Controlled TrialApplication of a theoretical framework for behavior change to hospital workers' real-time explanations for noncompliance with hand hygiene guidelines.
Insufficient use of behavioral theory to understand health care workers' (HCWs) hand hygiene compliance may result in suboptimal design of hand hygiene interventions and limit effectiveness. Previous studies examined HCWs' intended, rather than directly observed, compliance and/or focused on just 1 behavioral model. This study examined HCWs' explanations of noncompliance in "real time" (immediately after observation), using a behavioral theory framework, to inform future intervention design. ⋯ An explanation of HCW's "real-time" explanations for noncompliance identified "Memory/Attention/Decision Making" and "Knowledge" as the 2 behavioral domains commonly linked to noncompliance. This suggests that hand hygiene interventions should target both automatic associative learning processes and conscious decision making, in addition to ensuring good knowledge. A theoretical framework to investigate HCW's "real-time" explanations of noncompliance provides a coherent way to design hand hygiene interventions.
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Am J Infect Control · Feb 2014
Observational StudySustained low incidence of central venous catheter-related infections over six years in a Swedish hospital with an active central venous catheter team.
There are limited data on the long-term effects of implementing a central venous catheter (CVC) program for prevention of CVC infections. The aims of this study were to evaluate the incidence of CVC colonization, catheter-related infections (CRI), catheter-related bloodstream infections (CRBSI), and their risk factors over a 6-year period in a hospital with an active CVC team. ⋯ We found that a CRI prevention program led by an active CVC team and adhered to by the entire staff at a county hospital is successful in keeping CVC infections at a low rate over a long period of time.
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Am J Infect Control · Feb 2014
Hospital-acquired infections and thermally injured patients: chlorhexidine gluconate baths work.
Thermally injured patients are at high risk for infections, including hospital acquired infections (HAIs). We modeled a twice-daily chlorhexidine gluconate (CHG) bath protocol aimed at decreasing HAIs. ⋯ Using this nurse-driven protocol, we decreased, in a sustainable manner, the HAI rate in our intensive care unit to zero. No integumentary difficulties or wound healing delays were related to this protocol.
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Am J Infect Control · Feb 2014
ReviewScreening for methicillin-resistant Staphylococcus aureus: a comparative effectiveness review.
Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of health care-associated infections. Although the evidence in support of MRSA screening has been promising, a number of questions remain about the effectiveness of active surveillance. ⋯ Although there is low SOE that universal screening of hospital patients decreases MRSA infection, there is insufficient evidence to determine the consequences of universal screening or the effectiveness of other screening strategies.
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Am J Infect Control · Feb 2014
Ventilator-associated pneumonia due to extensive drug-resistant Acinetobacter baumannii: risk factors, clinical features, and outcomes.
Acinetobacter baumannii is characterized by a rapid development of resistance to the commonly used antimicrobial agents. We investigated the risk factors, clinical features, and outcomes in ventilator-associated pneumonia (VAP) caused by extensive drug-resistant Acinetobacter baumannii (XDRAB). ⋯ This study showed that VAP caused by XDRAB was not associated with in-hospital mortality. However, it was related to high Simplified Acute Physiology Score II scores and increasing durations of hospital stays.