American journal of infection control
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Am J Infect Control · Mar 2017
Reduction in hospital-associated methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus with daily chlorhexidine gluconate bathing for medical inpatients.
Daily bathing with chlorhexidine gluconate (CHG) is increasingly used in intensive care units to prevent hospital-associated infections, but limited evidence exists for noncritical care settings. ⋯ This prospective pragmatic study to assess daily bathing for CHG on inpatient medical units was effective in reducing hospital-associated MRSA and VRE. A critical component of CHG bathing on medical units is sustained and appropriate application, which can be a challenge to accurately assess and needs to be considered before systematic implementation.
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Am J Infect Control · Feb 2017
Review Meta AnalysisSkin antisepsis with chlorhexidine versus iodine for the prevention of surgical site infection: A systematic review and meta-analysis.
Surgical site infection (SSI) is one of the most frequent health care-associated infections. One of the practices to reduce their incidence is preoperative skin antisepsis. Two of the most commonly active components used are chlorhexidine gluconate and povidone iodine. Of 3 reviews conducted between 2010 and 2012 comparing antiseptics, 2 were in favor of chlorhexidine; however, the latest was unable to draw conclusions. ⋯ There is moderate-quality evidence supporting the use of chlorhexidine for preoperative skin antisepsis and high-quality evidence that the use of chlorhexidine is associated with fewer positive skin cultures. Further rigorous trials will be welcomed to attain stronger evidence as to the best antiseptic to be used before surgery.
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Am J Infect Control · Jan 2017
Antimicrobial stewardship in Kansas: Results from a statewide survey.
The availability of effective antibiotics is considered one of the most important developments in medicine. However, many organisms that were once susceptible to common antibiotics are becoming resistant. Antimicrobial stewardship programs (ASPs) are considered to be vital for combating the emergence of resistance. To understand current antimicrobial stewardship practices in Kansas, the authors designed a 36-question survey. Results of this survey will be used to develop a coordinated, public health strategy for improving current practices. ⋯ In a world with increasing microbial resistance, the role of public health in antimicrobial stewardship is becoming more important. After surveying all hospitals in Kansas about antimicrobial stewardship practices, we realize that critical access hospitals have the greatest need for support and may see the greatest opportunities for development and improvements.
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Am J Infect Control · Dec 2016
Central venous catheter infections in home parenteral nutrition patients: Outcomes from Sustain: American Society for Parenteral and Enteral Nutrition's National Patient Registry for Nutrition Care.
Home parenteral nutrition (HPN) is a high-cost, complex nutrition support therapy that requires the use of central venous catheters. Central line-associated bloodstream infections (CLABSIs) are among the most serious risks of this therapy. Sustain: American Society for Parenteral and Enteral Nutrition's National Patient Registry for Nutrition Care (Sustain registry) provides the most current and comprehensive data for studying CLABSI among a national cohort of HPN patients in the United States. This is the first Sustain registry report detailing longitudinal data on CLABSI among HPN patients. ⋯ Additional studies are needed to determine effective interventions that will reduce HPN-associated CLABSI.
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Am J Infect Control · Dec 2016
Combating antibiotic resistance: The role of nursing in antibiotic stewardship.
Antibiotic resistance is one of the top infectious disease threats facing the world today. The escalating resistance to antibiotics has been named by the Centers for Disease Control and Prevention as one of the top 5 threats to health in the United States and has led to the development of the National Action Plan for Combating Antibiotic-Resistant Bacteria. ⋯ For antibiotic stewardship programs to achieve optimal success they must include nursing's perspectives and the active participation of nurses and the nursing profession. Although clearly any successful efforts to address this complex problem must be comprehensive, sustained, and involve all sectors of the health care community and public, the aim of this article is to convey the immediate need for nurses and the nursing profession to actively engage in initiatives, strategies, and solutions to combat antibiotic resistance, and to recommend what stakeholders within the nursing profession might contribute to antibiotic stewardship.