Infection control and hospital epidemiology : the official journal of the Society of Hospital Epidemiologists of America
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Infect Control Hosp Epidemiol · Sep 2014
Comparative StudyPreventing the transmission of multidrug-resistant organisms: modeling the relative importance of hand hygiene and environmental cleaning interventions.
Hand hygiene and environmental cleaning are essential infection prevention strategies, but the relative impact of each is unknown. This information is important in assessing resource allocation. ⋯ Hand hygiene should remain a priority for infection control programs, but environmental cleaning can have significant benefit for hospitals or individual hospital units that have either high hand hygiene compliance levels or low terminal cleaning thoroughness.
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Infect Control Hosp Epidemiol · Sep 2014
Usability and impact of a computerized clinical decision support intervention designed to reduce urinary catheter utilization and catheter-associated urinary tract infections.
To evaluate the usability and effectiveness of a computerized clinical decision support (CDS) intervention aimed at reducing the duration of urinary tract catheterizations. ⋯ A urinary catheter removal reminder system was successfully integrated within a healthcare system's electronic health record. The usability of the reminder was highly dependent on its user interface, with a homegrown version of the reminder resulting in higher impact than a stock reminder.
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Infect Control Hosp Epidemiol · Sep 2014
The effect of multiple concurrent central venous catheters on central line-associated bloodstream infections.
The current central line-associated bloodstream infection (CLABSI) surveillance rate calculation does not account for multiple concurrent central venous catheters (CVCs). The presence of multiple CVCs creates more points of entry into the bloodstream, potentially increasing CLABSI risk. Multiple CVCs may be used in sicker patients, making it difficult to separate the relative contributions of multiple CVCs and comorbidities to CLABSI risk. We explored the relative impact of multiple CVCs, patient comorbidities, and disease severity on the risk of CLABSI. ⋯ Multiple CVCs is an independent risk factor for CLABSI even after adjusting for severity of illness. Adjustment for this risk may be necessary to accurately compare rates between hospitals.
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Infect Control Hosp Epidemiol · Sep 2014
Observational StudyMultisite exploration of clinical decision making for antibiotic use by emergency medicine providers using quantitative and qualitative methods.
To explore current practices and decision making regarding antimicrobial prescribing among emergency department (ED) clinical providers. ⋯ Patient, provider, and healthcare system factors should be considered when designing interventions to improve antimicrobial stewardship in the ED setting.