Infection control interventions in small rural hospitals with limited resources: results of a cluster-randomized feasibility trial
| العنوان: | Infection control interventions in small rural hospitals with limited resources: results of a cluster-randomized feasibility trial |
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| المؤلفون: | Grace Curry, John M. Boyce, Stéphan Juergen Harbarth, Matthew H. Samore, Gregory J. Stoddard, Katie Searle, Kurt B. Stevenson |
| المصدر: | Antimicrobial Resistance and Infection Control Antimicrobial Resistance and Infection Control, Vol. 3, No 1 (2014) P. 10 |
| بيانات النشر: | Springer Science and Business Media LLC, 2014. |
| سنة النشر: | 2014 |
| مصطلحات موضوعية: | Microbiology (medical), medicine.medical_specialty, Pediatrics, Isolation (health care), Epidemiology, media_common.quotation_subject, Psychological intervention, MRSA, Disease cluster, Hygiene, Transmission, Infection control, Medicine, Pharmacology (medical), media_common, ddc:616, business.industry, Research, Public Health, Environmental and Occupational Health, United States, Clinical trial, Infectious Diseases, Carriage, Emergency medicine, business, Hand hygiene |
| الوصف: | Background There are few reports on the feasibility of conducting successful infection control (IC) interventions in rural community hospitals. Methods Ten small rural community hospitals in Idaho and Utah were recruited to participate in a cluster-randomized trial of multidimensional IC interventions to determine their feasibility in the setting of limited resources. Five hospitals were randomized to develop individualized campaigns to promote HH, isolation compliance, and outbreak control. Five hospitals were randomized to continue with current IC practices. Regular blinded observations of hand hygiene (HH) compliance were conducted in all hospitals as the primary outcome measure. Additionally, periodic prevalence studies of patient colonization with resistant pathogens were performed. The 5-months intervention time period was compared to a 4-months baseline period, using a multi-level logistic regression model. Results The intervention hospitals implemented a variety of strategies. The estimated average absolute change in “complete HH compliance” in intervention hospitals was 20.1% (range, 7.8% to 35.5%) compared to −3.1% (range −6.3% to 5.9%) in control hospitals (p = 0.001). There was an estimated average absolute change in “any HH compliance” of 28.4% (range 17.8% to 38.2%) in intervention hospitals compared to 0.7% (range −16.7 to 20.7%) in control hospitals (p = 0.010). Active surveillance culturing demonstrated an overall prevalence of MRSA carriage of 9.7%. Conclusions A replicable intervention significantly improved hand hygiene as a primary outcome measure despite barriers of geographic distance and lack of experience with study protocols. Active surveillance culturing identified unsuspected reservoirs of MRSA colonization and further promoted IC activity. |
| تدمد: | 2047-2994 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ee8ad8ea740c50489399669db5049c1b https://doi.org/10.1186/2047-2994-3-10 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....ee8ad8ea740c50489399669db5049c1b |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 20472994 |
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