Search results

Despite hospitals’ efforts to reduce health care-associated infections (HAIs), success rates vary. We studied how leadership practices might impact these efforts.

We conducted eight case studies at hospitals pursuing central line-associated blood stream infection (CLABSI)-prevention initiatives. At each hospital, we interviewed senior leaders, clinical leaders, and line clinicians (n=194) using a semi-structured interview protocol. All interviews were transcribed and iteratively analyzed.

We found that the presence of local clinical champions was perceived across organizations and interviewees as a key factor contributing to HAI-prevention efforts, with champions playing important roles as coordinators, cheerleaders, and advocates for the initiatives. Top-level support was also critical, with elements such as visibility, commitment, and clear expectations valued across interviewees.

Results suggest that leadership plays an important role in the successful implementation of HAI-prevention interventions. Improving our understanding of nonclinical differences across health systems may contribute to efforts to eliminate HAIs.

This paper aims to describe the design and evaluation of a pilot leadership development programme for infection prevention and control (IPAC) professionals during the COVID-19 pandemic. The programme’s aim was to improve IPAC knowledge and capacity in the health-care system by developing the leadership skills and capacities of novice and advanced Infection Control Professionals (ICPs), to respond flexibly, and competently, in their expanding and ever-changing roles.

The leadership programme was piloted with seven nurses, who were part of a clinical nursing team in New South Wales, Australia, over a 12-month period between 2021 and 2022. The programme was designed using a leadership development framework underpinned by transformational leadership theory, practice development approaches and collaborative and experiential learning. These principles were applied during programme design, with components adapted to learners’ interests and regular opportunities provided for collaboration in active learning and critical reflection on workplace experiences.

The authors’ evaluation suggests that the programme was feasible, acceptable and considered to be effective by this cohort. Moreover, participants valued the opportunities to engage in active and experience-based learning with peers, and with the support of senior and experienced ICPs. The action learning sets were well-received and allowed participants to critically reflect on and learn from one another’s experiences. The mentoring programme allowed them to apply their developing leadership skills to real workplace challenges that they face.

Despite a small sample size, the authors’ results provide empirical evidence about the effectiveness of using a practice development approach for strengthening ICP leadership capacity. The success of this pilot study has paved the way for a bigger second cohort of participants in the programme, for which further evaluation will be conducted.

The success of this leadership programme reflects both the need for leadership development in the IPAC professions and the applicability of this approach, with appropriate facilitation, for other professions and organizations.

ICP leadership programmes have not been previously reported in the literature. This pilot study builds on the growing interest in IPAC leadership to foster health system responsiveness and change.

Health care associated infection has become a health service priority that transcends all clinical areas. Education is commonly cited as the cornerstone of effective practice on the tacit assumption that the knowledgeable practitioner will execute their skills more effectively. Consequently, infection control training has become embedded within the pre‐registration curriculum, however, students undertaking the mental health branch have been critical of an unduly adult focus to the topic, which fails to address their specific educational requirements. An educational intervention based on a problem‐based learning approach was developed to address this contention. The intervention received a three‐way evaluation from students who attended the session, a mental health lecturer/ facilitator and an infection control educator/ adviser. The results suggest that students were able to develop salient material, which recognised the principles of infection control practice, while placing it in the context of mental health nursing. The students gave positive feedback in terms of the mode of teaching and the relevance of the content.

Health‐care associated infections (HAIs) kill about 100,000 people annually; many are preventable. In response, 18 states currently require hospitals to publicly report their infection rates and national reporting is planned. Yet there is limited evidence on the effects of public reporting on HAI rates, and none on what elements of a reporting plan affect its impact on HAI rates. The author aims to review here what little we know, emphasizing his own case study of Pennsylvania.

The paper contains a narrative description of empirical challenges in attributing changes in infection rates to the introduction of public reporting, and the author's own research findings from a case study of Pennsylvania using both infection rates estimated from administrative (billing) data (“inpatient rates”) and public reported rates.

Hospitals, faced with public HAI reporting, may respond both by reducing infection rates and through time‐inconsistent reporting (“gaming”). Both effects are likely to be stronger at hospitals with high reported rates, relative to peers. From 2003‐2008, Pennsylvania inpatient CLABSI rates dropped by 14 per cent, versus a 9 per cent increase in control states. The overall drop comes primarily from hospitals in the highest third of reported rates. Reported CLABSI rates fell much faster, by 40 per cent, from 2005 to 2007. This difference suggests time‐inconsistent reporting.

Much more research is needed before we can have confidence that public reporting affects HAI rates (and for which HAIs), or know how to design an effective reporting scheme. HAI reporting cannot yet be considered to be “evidence based.” National reporting mandates will foreclose the state experiments needed to address these questions.

What little we know about impact of public reporting on HAI rates comes in significant part from the case study of Pennsylvania described in this article.

The purpose of this study is to analyze the use of a team‐based organizational structure for the purpose of improving the quality of the services provided by the health care system. More specifically, the research aims to investigate the efficiency of a cross‐functional team‐based structure in regard to improving knowledge‐sharing and hereby reducing hospital‐acquired infections (i.e. health‐care associated infections) caused by insufficient hand hygiene.

The findings are drawn from interviews, observations, and desk research conducted in a large Danish university hospital. The paper has applied a case study methodology using grounded theory and has approached the analysis by employing a holistic view.

The paper identifies the necessity for educating the hygiene teams in regard to team processes. Professional knowledge of proper hygiene behavior is to be combined with knowledge of procurement, processes of change, and teamwork in such a manner that the members of the hygiene teams can implement these tools effectively.

The study is based on a small sample. The context and process imposed constraints and the findings are context specific; this has implications for the application of the findings to other settings.

Knowledge about proper hand washing is not enhanced through written policies and procedures.

The paper offers insight into means of enhancing hygiene standards by the integration of organizational processes and change with knowledge and knowledge transfer within a hospital.

This study discusses that the necessary criteria and the solution approach taken to resolve the main spatial infection problems with a burn center design should be evaluated holistically to achieve spatial infection control in a burn center. The burn center design plays an important role in protecting severely burned patients from infection because the microbial flora of the hospital can affect the infection risk. In hospitals, sterilization and disinfection are the basic components of infection prevention; however, the prevention and control of infection for burn patients also requires the design of burn centers that adhere to a specific set of criteria that considers spatial infection control in addition to appropriate burn treatment methods and treatments. In this study, a burn facility converted from a burn unit into a burn center is introduced and the necessary design inputs for the transformation are discussed because there is no holistic study in the literature that delas with all the spaces that should be in a burn center and relations between spaces. This study aims to define the functional relations between each of the units and the spaces that change according to different sterilization demands in the burn center for ensuring spatial infection control. Furthermore, it aims to propose a method for ensuring continuity in the control of spatial infections.

The burn care and health facilities guidelines are examined within the framework of spatial standards, together with a comprehensive literature review. The design method was based on the spread of microorganisms and the effect of human movement on space and spatial transitions in the burn center, according to all relevant literature reviews. To determine the extent to which the differences in treatment protocols of burn care guidelines were reflected in the space, interviews were conducted with burn facility officials. The plan–do–check–act (PDCA) method is also modeled to ensure the continuity of infection control in the burn center.

The burn center design findings are classified under three main headings, namely, location of the burn center in the hospital, spatial organization and physical features of the burn center and the air flowing system. The importance of the interactions among the criteria for spatial infection control has been revealed. Due to the physical space characteristics and air flow characteristics that change according to human movement and the way microorganisms spread, it has been seen that designing the air flow and architectural aspects together has an effective role in providing spatial infection control. Accordingly, a functional relation scheme for the center has been suggested. It is also proposed as a model to ensure the continuity of infection control in the burn center.

This research presents spatial measures for infection control in burn centers for practitioners in health-care settings such as designers, engineers, doctors and nurses. The PDCA method also leads to continuity of infection control for hospital management.

This is the first study, to the best of the authors’ knowledge, to focus on developing the criteria for spatial infection control in burn center. Moreover, the aim is to create a function chart that encompasses the relationships between the units within the burn center design so that infection control can be coordinated spatially.

Purpose – The numbers of health care transparency initiatives are increasing. Despite the growing availability of quality data, there seems to be a shortage of evidence about the effects and effectiveness of such initiatives. The aim of this systematic review is to document the effects of transparency, defined as the public release of quality performance data, on hospital care outcomes.

Design/methodology/approach – Through a review of the literature, we chose 46 keywords to use in our searches and focused on empirical studies published in English between 2010 and 2015. The use of combinations of these keywords in searches of four databases (PubMed, Scopus, Web of Science, and the Cochrane Library) generated 13,849 publications. The removal of duplicates and exclusion of studies that were not empirical or not relevant to transparency and quality resulted in 39 studies to be reviewed.

Findings – Our review of the literature confirmed the growth of health care transparency efforts, led by the United States, and found mixed results regarding the effects of transparency on hospital care outcomes. For example, mortality, the most frequently researched performance measure (n = 15), exhibited this mixed pattern by having studies showing a reduction (n = 4), increase (n = 1), mixed findings (n = 4), and no significant relationship (n = 6) as a result of public release. We also found a limited number of articles related to unintended consequences of public reporting. When compared with earlier systematic reviews, there seems to be a trend in the reduction of unintended consequences. Therefore, we recommend exploration of this potential trend in future studies empirically.

Practical Implications – The research findings summarized in this systematic review can be used to understand the results of existing transparency efforts and to develop future transparency initiatives that may better enhance hospital quality performance.

Originality/value – This is the latest and most comprehensive systematic review summarizing the effects of transparency of quality metrics on hospital care outcomes.

This study aims to identify and validate the environmental cleaning elements and performance criteria to prevent Covid-19 infection in health-care facilities.

Eight elements and 38 performance criteria were identified from the literature, and a questionnaire survey that involved environmental cleaning experts was carried out. Content validity index was used to validate the content of the environmental cleaning elements and performance criteria in this study.

The result indicates that the performance criteria of “Finishes, furnishings” and “Equipment Maintenance Log” were not relevant to be applied in current fighting against Covid-19 infection in health care. However, the remaining 36 performance criteria were proved as relevant and acceptable.

The findings of this study can provide a significant contribution to the built environment industry. By knowing the environmental cleaning elements and performance criteria, efforts can be carried out to explore measures that can be taken to improve the environmental cleaning practice in health care to battle against Covid-19 infection.

This paper fulfils an identified need to study how environmental cleaning can be implemented in health-care facilities.

This paper seeks to provide a narrative review of some of the factors that influence healthcare consumers' information seeking involving healthcare associated infections (HAI) on the internet.

The paper takes the form of a narrative review arising from the authors' presentation and subsequent discussions that took place during the Universities Council Symposium held in Vancouver, Canada in May 2011.

There are a number of important factors that affect healthcare consumers' desire to seek information online about HAI, including the search engine used, the type of technology used, web site usability, information availability, consumers' learning style, consumers' personality traits, and finally, consumers' situational, emotional, and psychological contexts. These factors may affect healthcare consumers' decision making about where they will obtain healthcare (i.e. in their selection of a clinic, hospital, regional health authority and/or health care system).

HAI reporting via web sites is being done by health care organizations across North America. There is a need to more fully understand the factors that affect consumer use of these web sites.

Fundamental questions have been raised about the impact of providing HAI information over the WWW. There is a need to consider the varying factors that influence consumers' information seeking involving the WWW (i.e. technology‐driven and consumer‐driven factors) especially when searching for HAI‐related information about health care organizations.

Historically, HAI information was the purview of those who had a background to interpret such data (e.g. infection control and public health practitioners). The literature focusing on what consumers want to know regarding HAIs over the WWW is only beginning to emerge. More research is needed to better understand what health care consumers need to support their decision making involving HAIs.

Healthcare-associated infections (HAIs) are a major cause of concern because of the high levels of associated morbidity, mortality, and cost. In addition, children and intensive care unit (ICU) patients are more vulnerable to these infections due to low levels of immunity. Various medical interventions and statistical process control techniques have been suggested to counter the spread of these infections and aid early detection of an infection outbreak. Methods such as hand hygiene help in the prevention of HAIs and are well-documented in the literature. This chapter demonstrates the utilization of a systems methodology to model and validate factors that contribute to the risk of HAIs in a pediatric ICU. It proposes an approach that has three unique aspects: it studies the problem of HAIs as a whole by focusing on several HAIs instead of a single type, it projects the effects of interventions onto the general patient population using the system-level model, and it studies both medical and behavioral interventions and compares their effectiveness. This methodology uses a systems modeling framework that includes simulation, risk analysis, and statistical techniques for studying interventions to reduce the transmission likelihood of HAIs.