Goldsteen K, Jefferson JA, Goldsteen RL; AcademyHealth. Meeting (2005 : Boston, Mass.).
Abstr AcademyHealth Meet. 2005; 22: abstract no. 4272.
State University of New York, Stony Brook, Graduate Program in Public Health, Health Sciences Center, Level 3, Room 071, Stony Brook, NY 11794 Tel. (631) 444-6658 Fax (631) 444-3480
RESEARCH OBJECTIVE: To indicate the extent to which evidence-based infection control guidelines are implemented in U.S. hospitals. STUDY DESIGN: We interviewed Infection Control Practitioners (ICPs) in 20 acute care hospitals in the U.S. We selected five hospitals each from the Northeast, Southeast, Midwest, and West. One of the five hospitals in each region was chosen for its excellent reputation in infection control. Of the remaining four hospitals, two were selected for their very high score and two for their very low score on a measure of overall hospital performance developed by HealthGrades. A telephone interview, using a structured questionnaire developed by the authors, was conducted in February-March 2004. The main outcome measure was the Infection Control Performance Indicator developed by the authors and based on reported implementation of Category I guidelines in thirteen areas of infection control: surgical site infections, intravascular catheter-related infections, construction and environmental risks, isolation precautions, disinfection and sterilization, health care-associated pneumonia, nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE), emerging antimicrobial resistance, hand hygiene, Legionnaires Disease and dialysis unit, bloodborne pathogens, surveillance, and employee health policies. POPULATION STUDIED: U.S. teaching and community hospitals with more than 200 beds. PRINCIPAL FINDINGS: No hospital was 100% compliant with the infection control guidelines measured by our Infection Control Performance Indicator. The highest rate of compliance was 88%, and the lowest compliance rate was 53%. Just one-quarter of the hospitals we interviewed were 80-88% compliant. About half were 70-79% compliant. CONCLUSIONS: The findings suggest that the evidence-based guidelines for infection control are not fully implemented in most hospitals, and many hospitals fall very far short of achieving full implementation. IMPLICATIONS FOR POLICY, DELIVERY OR PRACTICE: The U.S. might significantly reduce the hospital-acquired infection rate by ensuring that current, evidence-based infection control guidelines are fully implemented. Further work is needed to determine how to: (1) reduce internal barriers to full implementation of guidelines; and (2) develop policies in the external environment that facilitate infection control within hospitals.
Publication Types:
Keywords:
- Cross Infection
- Enterococcus
- Guidelines as Topic
- Hospitals
- Hospitals, Community
- Infection Control
- Infection Control Practitioners
- Klebsiella Infections
- Pilot Projects
- Staphylococcus aureus
- standards
- hsrmtgs
UI: 103623735
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