Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America
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Infect Control Hosp Epidemiol · Oct 2014
Observational StudyDo peer effects improve hand hygiene adherence among healthcare workers?
To determine whether hand hygiene adherence is influenced by peer effects and, specifically, whether the presence and proximity of other healthcare workers has a positive effect on hand hygiene adherence. ⋯ The presence and proximity of other healthcare workers is associated with higher hand hygiene rates. Furthermore, our results also indicate that rates increase as the social environment becomes more crowded, but with diminishing marginal returns.
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Infect Control Hosp Epidemiol · Oct 2014
Substantial shifts in ranking of California hospitals by hospital-associated methicillin-resistant Staphylococcus aureus infection following adjustment for hospital characteristics and case mix.
States have established public reporting of hospital-associated (HA) infections-including those of methicillin-resistant Staphylococcus aureus (MRSA)-but do not account for hospital case mix or postdischarge events. ⋯ When adjusting for nonmodifiable facility characteristics and case mix, hospital rankings based on HA-MRSA infections substantially changed. Quality indicators for hospitals require adequate adjustment for patient population characteristics for valid interhospital performance comparisons.
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Infect Control Hosp Epidemiol · Oct 2014
Randomized Controlled TrialCost savings of universal decolonization to prevent intensive care unit infection: implications of the REDUCE MRSA trial.
To estimate and compare the impact on healthcare costs of 3 alternative strategies for reducing bloodstream infections in the intensive care unit (ICU): methicillin-resistant Staphylococcus aureus (MRSA) nares screening and isolation, targeted decolonization (ie, screening, isolation, and decolonization of MRSA carriers or infections), and universal decolonization (ie, no screening and decolonization of all ICU patients). ⋯ A strategy of universal decolonization for patients admitted to the ICU would both reduce bloodstream infections and likely reduce healthcare costs compared with strategies of MRSA nares screening and isolation or screening and isolation coupled with targeted decolonization.
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Infect Control Hosp Epidemiol · Oct 2014
Randomized Controlled Trial Pragmatic Clinical TrialDoes chlorhexidine bathing in adult intensive care units reduce blood culture contamination? A pragmatic cluster-randomized trial.
To determine rates of blood culture contamination comparing 3 strategies to prevent intensive care unit (ICU) infections: screening and isolation, targeted decolonization, and universal decolonization. ⋯ In this large cluster-randomized trial, we demonstrated that universal decolonization with CHG bathing resulted in a significant reduction in blood culture contamination.