C D Russell1, I Young2, V Leung3, K Morris4. 1. Department of Clinical Microbiology and Infection Control, Victoria Hospital, Kirkcaldy, Fife, UK; College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK. Electronic address: clarkdrussell@gmail.com. 2. Department of Clinical Microbiology and Infection Control, Victoria Hospital, Kirkcaldy, Fife, UK; College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK. 3. Infection Prevention and Control, St Paul's Hospital, Providence Healthcare, Vancouver, British Columbia, Canada. 4. Department of Clinical Microbiology and Infection Control, Victoria Hospital, Kirkcaldy, Fife, UK.
Abstract
BACKGROUND: Transmission-based precautions (TBPs) are infection control measures designed to interrupt pathogen transmission. Success relies on early recognition of patients with potentially infectious syndromes, then the implementation of appropriate TBPs. We are aware of no literature evaluating interventions to facilitate healthcare workers (HCWs) in implementing TBPs. AIM: To evaluate the impact of a TBP guidance summary card on HCWs' decision-making about the appropriate implementation of TBPs. METHODS: A prospective audit was carried out to assess HCWs' ability to make decisions about TBP implementation. Following the first audit phase, staff were issued with a guidance card summarizing local TBP guidelines, identifying and addressing relevant TBP measures for infectious syndromes and specific organisms. The audit cycle was then completed to assess the impact of this intervention. FINDINGS: Baseline knowledge of appropriate TBP measures was low. Provision of a TBP summary card was significantly associated with the ability of staff carrying the card to correctly decide what TBPs are required in a variety of clinical situations, including Clostridium difficile infection [N = 107; odds ratio (OR): 27.0; 95% confidence interval (CI): 8.37-86.8; P < 0.0001], norovirus diarrhoea and vomiting (N = 107; OR: 94.3, 95% CI: 25.0-356; P < 0.0001), influenza-like illness (N = 107; OR: 85.2; 95% CI: 4.94-1470; P < 0.0001) and the difference between surgical and FFP3 masks (N = 107; OR: 412; 95% CI: 23.4-7246; P < 0.0001). CONCLUSION: There is a lack of knowledge about TBP among HCWs. This study demonstrates how an inexpensive TBP summary card is an effective mechanism for improving (i) point-of-care access to TBP guidance and (ii) decision-making about appropriate implementation of TBP.
BACKGROUND: Transmission-based precautions (TBPs) are infection control measures designed to interrupt pathogen transmission. Success relies on early recognition of patients with potentially infectious syndromes, then the implementation of appropriate TBPs. We are aware of no literature evaluating interventions to facilitate healthcare workers (HCWs) in implementing TBPs. AIM: To evaluate the impact of a TBP guidance summary card on HCWs' decision-making about the appropriate implementation of TBPs. METHODS: A prospective audit was carried out to assess HCWs' ability to make decisions about TBP implementation. Following the first audit phase, staff were issued with a guidance card summarizing local TBP guidelines, identifying and addressing relevant TBP measures for infectious syndromes and specific organisms. The audit cycle was then completed to assess the impact of this intervention. FINDINGS: Baseline knowledge of appropriate TBP measures was low. Provision of a TBP summary card was significantly associated with the ability of staff carrying the card to correctly decide what TBPs are required in a variety of clinical situations, including Clostridium difficile infection [N = 107; odds ratio (OR): 27.0; 95% confidence interval (CI): 8.37-86.8; P < 0.0001], norovirus diarrhoea and vomiting (N = 107; OR: 94.3, 95% CI: 25.0-356; P < 0.0001), influenza-like illness (N = 107; OR: 85.2; 95% CI: 4.94-1470; P < 0.0001) and the difference between surgical and FFP3 masks (N = 107; OR: 412; 95% CI: 23.4-7246; P < 0.0001). CONCLUSION: There is a lack of knowledge about TBP among HCWs. This study demonstrates how an inexpensive TBP summary card is an effective mechanism for improving (i) point-of-care access to TBP guidance and (ii) decision-making about appropriate implementation of TBP.
Authors: Jos H Verbeek; Blair Rajamaki; Sharea Ijaz; Christina Tikka; Jani H Ruotsalainen; Michael B Edmond; Riitta Sauni; F Selcen Kilinc Balci Journal: Cochrane Database Syst Rev Date: 2019-07-01
Authors: Jos H Verbeek; Blair Rajamaki; Sharea Ijaz; Riitta Sauni; Elaine Toomey; Bronagh Blackwood; Christina Tikka; Jani H Ruotsalainen; F Selcen Kilinc Balci Journal: Cochrane Database Syst Rev Date: 2020-05-15
Authors: Jos H Verbeek; Blair Rajamaki; Sharea Ijaz; Riitta Sauni; Elaine Toomey; Bronagh Blackwood; Christina Tikka; Jani H Ruotsalainen; F Selcen Kilinc Balci Journal: Cochrane Database Syst Rev Date: 2020-04-15