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Barratt R, Gilbert GL. Hospital health care workers' use of facial protective equipment before the COVID-19 pandemic, implications for future policy. Am J Infect Control 2024; 52:502-508. [PMID: 38092070 DOI: 10.1016/j.ajic.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 12/03/2023] [Accepted: 12/04/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Prepandemic routine use of facial (respiratory and eye) protective equipment (FPE) by health care workers was suboptimal. Understanding factors affecting routine use would facilitate escalation to high level use during infectious disease emergencies. This study explored health care workers FPE-related knowledge, attitudes and behaviors. METHODS Mixed methods were used in a respiratory ward and adult and pediatric emergency departments (EDs), prior to the COVID-19 pandemic. Study design and thematic analysis were based on the theoretical domains framework. Emergent themes were categorized, using the COM-B behavior model, into capability(C), opportunity(O) and motivation(M), which influence behavior(B). RESULTS 22 emergent themes, representing factors influencing FPE use, were mapped to theoretical domains framework domains. Personal experience and departmental cultures influenced motivation. Compared with respiratory ward staff, ED clinicians were less knowledgeable about FPE; the unique ED environment and culture inhibited opportunities and motivation for FPE use. Eye protection was infrequently used. DISCUSSION Optimal FPE use is challenged by ED care models and settings. Changes are needed to translate pandemic-related improvements into routine care of other respiratory infections. CONCLUSIONS This study identified key determinants of FPE behavior. A review of context-specific FPE guidance for ED by infection prevention and control professionals would help to promote practicable, sustainable compliance.
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Affiliation(s)
- Ruth Barratt
- Westmead Clinical School, University of Sydney, Westmead, NSW 2145, Australia.
| | - Gwendolyn L Gilbert
- Westmead Clinical School, University of Sydney, Westmead, NSW 2145, Australia; Sydney Institute for Infectious Diseases, University of Sydney, Westmead, NSW 2145, Australia
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Zheng F, Wang K, Wang Q, Yu T, Wang L, Zhang X, Wu X, Zhou Q, Tan L. Factors Influencing Clinicians' Use of Hospital Information Systems for Infection Prevention and Control: Cross-Sectional Study Based on the Extended DeLone and McLean Model. J Med Internet Res 2023; 25:e44900. [PMID: 37347523 PMCID: PMC10337337 DOI: 10.2196/44900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 05/18/2023] [Accepted: 05/30/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Healthcare-associated infections have become a serious public health problem. Various types of information systems have begun to be applied in hospital infection prevention and control (IPC) practice. Clinicians are the key users of these systems, but few studies have assessed the use of infection prevention and control information systems (IPCISs) from their perspective. OBJECTIVE This study aimed to (1) apply the extended DeLone and McLean Information Systems Success model (D&M model) that incorporates IPC culture to examine how technical factors like information quality, system quality, and service quality, as well as organizational culture factors affect clinicians' use intention, satisfaction, and perceived net benefits, and (2) identify which factors are the most important for clinicians' use intention. METHODS A total of 12,317 clinicians from secondary and tertiary hospitals were surveyed online. Data were analyzed using partial least squares-structural equation modeling and the importance-performance matrix analysis. RESULTS Among the technical factors, system quality (β=.089-.252; P<.001), information quality (β=.294-.102; P<.001), and service quality (β=.126-.411; P<.001) were significantly related to user satisfaction (R2=0.833), use intention (R2=0.821), and perceived net benefits (communication benefits [R2=0.676], decision-making benefits [R2=0.624], and organizational benefits [R2=0.656]). IPC culture had an effect on use intention (β=.059; P<.001), and it also indirectly affected perceived net benefits (β=.461-.474; P<.001). In the importance-performance matrix analysis, the attributes of service quality (providing user training) and information quality (readability) were present in the fourth quadrant, indicating their high importance and low performance. CONCLUSIONS This study provides valuable insights into IPCIS usage among clinicians from the perspectives of technology and organization culture factors. It found that technical factors (system quality, information quality, and service quality) and hospital IPC culture have an impact on the successful use of IPCISs after evaluating the application of IPCISs based on the extended D&M model. Furthermore, service quality and information quality showed higher importance and lower performance for use intention. These findings provide empirical evidence and specific practical directions for further improving the construction of IPCISs.
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Affiliation(s)
- Feiyang Zheng
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Kang Wang
- School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Qianning Wang
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Tiantian Yu
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Lu Wang
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Xiang Wu
- School of Medicine and Health Management, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Qian Zhou
- Department of Hospital Infection Management, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Tan
- Tongji Hospital, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
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Zhang J, Hu L, Zhang Q, Guo C, Wu C, Shi Y, Shu R, Tan L. Polyhexamethylene guanidine hydrochloride modified sodium alginate nonwoven with potent antibacterial and hemostatic properties for infected full-thickness wound healing. Int J Biol Macromol 2022; 209:2142-2150. [PMID: 35500777 DOI: 10.1016/j.ijbiomac.2022.04.194] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 02/08/2023]
Abstract
The development of multifunctional wound dressings has always been considered as a promising strategy to promote blood coagulation, inhibit bacterial infection, and accelerate wound healing. Herein, an antibacterial and hemostatic dressing (SA-PHMG) was developed based on sodium alginate (SA) nonwoven and polyhexamethylene guanidine hydrochloride (PHMG) through a completely green industrial route, including dipping, padding, and drying. According to studies, SA-PHMG dressings exhibited excellent liquid absorption capacity and water vapor permeability. Moreover, bactericidal assays have demonstrated that SA-PHMG dressings have ideal antibacterial activity against Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa and mixed bacteria, maintaining potent antibacterial activity even after 10 cycles of antibacterial trials or 50 times of washing or soaping. The in vitro evaluation of the hemostatic effect indicated that the SA-PHMG could significantly promote blood clotting by activating platelets, and in vitro and in vivo hemolysis, cytotoxicity and skin irritation studies demonstrated the ideal biocompatibility of the dressings. In addition, better wound closure and tissue regeneration were recorded using SA-PHMG nonwoven as the dressing based on an infected full-thickness wound model. In conclusion, this antibacterial, hemostatic, biocompatible, and environmentally friendly SA-PHMG nonwoven exhibit the potential for infected wound healing.
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Affiliation(s)
- Jie Zhang
- College of Biomass Science and Engineering, Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu 610065, China; Yibin Institute of Industrial Technology, Sichuan University, Research Center for Fiber Science and Engineering Technology, Yibin Park, Yibin 64460, China
| | - Liwei Hu
- West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Qiang Zhang
- College of Biomass Science and Engineering, Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu 610065, China
| | - Chuan Guo
- College of Biomass Science and Engineering, Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu 610065, China; Yibin Institute of Industrial Technology, Sichuan University, Research Center for Fiber Science and Engineering Technology, Yibin Park, Yibin 64460, China
| | - Chenyi Wu
- West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yidong Shi
- College of Biomass Science and Engineering, Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu 610065, China; Yibin Institute of Industrial Technology, Sichuan University, Research Center for Fiber Science and Engineering Technology, Yibin Park, Yibin 64460, China
| | - Rui Shu
- West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China; State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu 610041, China.
| | - Lin Tan
- College of Biomass Science and Engineering, Key Laboratory of Leather Chemistry and Engineering of Ministry of Education, Sichuan University, Chengdu 610065, China; Yibin Institute of Industrial Technology, Sichuan University, Research Center for Fiber Science and Engineering Technology, Yibin Park, Yibin 64460, China; State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065, China.
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Positive deviance in infection prevention and control: A systematic literature review. Infect Control Hosp Epidemiol 2020; 43:358-365. [PMID: 33172508 DOI: 10.1017/ice.2020.1256] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Healthcare-associated infections (HAIs) remain a major challenge. Various strategies have been tried to prevent or control HAIs. Positive deviance, a strategy that has been used in the last decade, is based on the observation that a few at-risk individuals follow uncommon, useful practices and that, consequently, they experience better outcomes than their peers who share similar risks. We performed a systematic literature review to measure the impact of positive deviance in controlling HAIs. METHODS A systematic search strategy was used to search PubMed, CINAHL, Scopus, and Embase through May 2020 for studies evaluating positive deviance as a single intervention or as part of an initiative to prevent or control healthcare-associated infections. The risk of bias was evaluated using the Downs and Black score. RESULTS Of 542 articles potentially eligible for review, 14 articles were included for further analysis. All studies were observational, quasi-experimental (before-and-after intervention) studies. Hand hygiene was the outcome in 8 studies (57%), and an improvement was observed in association with implementation of positive deviance as a single intervention in all of them. Overall HAI rates were measured in 5 studies (36%), and positive deviance was associated with an observed reduction in 4 (80%) of them. Methicillin-resistant Staphylococcus aureus infections were evaluated in 5 studies (36%), and positive deviance containing bundles were successful in all of them. CONCLUSIONS Positive deviance may be an effective strategy to improve hand hygiene and control HAIs. Further studies are needed to confirm this effect.
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Yu M, Park CG. Factors associated with patient safety in neonatal intensive care units: A multicenter study using ordinal logistic regression. Jpn J Nurs Sci 2020; 18:e12374. [PMID: 32893444 DOI: 10.1111/jjns.12374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 07/14/2020] [Accepted: 07/15/2020] [Indexed: 10/23/2022]
Abstract
AIM This study aimed to identify nurses' staffing levels, neonatal infection experience, infection control knowledge, and infection control performance, as well as levels of patient safety, and to verify the factors influencing patient safety related to infection control in multi-centered neonatal intensive care units (NICUs). METHODS A self-administered questionnaire was completed by 251 NICU nurses working in seven hospitals throughout South Korea. The data were collected in February 2019 and analyzed using generalized ordinal logistic regression. RESULTS The distribution of patient safety was as follows: level 1 (very poor) 0%, level 2 (poor) 6.8%, level 3 (fair) 29.7%, level 4 (good) 35.0%, level 5 (very good) 21.5%, and level 6 (excellent) 7.2%. The factors influencing patient safety differed across the different levels of patient safety. Comparing patient safety level 2 with the other levels (3, 4, 5, 6), the nurse staffing level (b = 1.12) was a significant influencing factor. Comparing patient safety levels 2, 3, 4 and 5 with level 6, the influencing factors were neonatal infection experience (b = -1.18) and infection control performance (b = 5.77). CONCLUSION The nurse staffing level was a factor when patient safety levels were low, and nurses' neonatal infection experience and infection control performance were factors when patient safety levels were high. Institutional policy efforts are required to identify patient safety levels in NICUs to develop comprehensive strategies to ensure appropriate nurse staffing and enhance neonatal infection control performance to prevent infections.
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Affiliation(s)
- Mi Yu
- College of Nursing, Institute of Health Sciences, Gyeongsang National University, Jinju, South Korea
| | - Chang Gi Park
- Department of Health System Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA
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