New paper calls for more infection control surveillance, standardization in the emergency department
Washington, DC, September 3, 2014 – When researchers searched the literature to determine adherence rates for various infection prevention protocols in the emergency department (ED), they discovered both a dearth of studies reporting ED practices and a lack of standardization that rendered some studies incomparable, according to a literature review published in the September issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).
A team of researchers from Columbia University performed a literature review of the available medical literature to determine adherence rates in the ED for hand hygiene during routine patient care, aseptic technique during the placement of central venous catheters and urinary catheters, urinary catheter insertion guidelines, and rates of equipment contamination. Of the 853 records they identified, 589 abstracts were screened, and ultimately 23 papers were included in the study.
Of studies that reported hand hygiene rates, the use of multiple guidelines prevented meaningful comparisons, despite disparate rates of compliance ranging from 7.7 percent to 89.7 percent. Four studies examined the appropriateness of urinary catheter insertions, with one finding that only 69.7 percent of urinary catheters in the ED were warranted. Seven studies examined central venous catheter insertions and determined that video-based online training led to increased compliance. In only one study was aseptic technique observed during urinary catheter insertion, and while 27 percent adherence was reported in one hospital and 58 percent in another, these percentages reflect aseptic technique during various procedures and not solely urinary catheter insertion.
“To our knowledge, this is one of the first literature reviews detailing adherence rates with common infection prevention practices in the ED setting,” said lead author Eileen J. Carter, RN, BSN. “While this review adds new information about infection prevention practices in the ED, there is clearly more to be learned, since EDs are a vital and important component of our health care system.”
ABOUT AJIC: AMERICAN JOURNAL OF INFECTION CONTROL
AJIC: American Journal of Infection Control (www.ajicjournal.org) covers key topics and issues in infection control and epidemiology. Infection preventionists, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of APIC, AJIC is the foremost resource on infection control, epidemiology, infectious diseases, quality management, occupational health, and disease prevention. AJIC also publishes infection control guidelines from APIC and the CDC. Published by Elsevier, AJIC is included in MEDLINE and CINAHL.
APIC’s mission is to create a safer world through prevention of infection. The association’s more than 15,000 members direct infection prevention programs that save lives and improve the bottom line for hospitals and other healthcare facilities. APIC advances its mission through patient safety, implementation science, competencies and certification, advocacy, and data standardization. Visit APIC online at www.apic.org. Follow APIC on Twitter: http://twitter.com/apic and Facebook: www.facebook.com/APICInfectionPreventionandYou. For information on what patients and families can do, visit APIC’s Infection Prevention and You website at www.apic.org/infectionpreventionandyou.
NOTES FOR EDITORS
“Common infection control practices in the emergency department: A literature review” by Eileen J. Carter, Stephanie M. Pouch and Elaine L. Larson appears in the American Journal of Infection Control, Volume 42, Issue 9 (September 2014).
Eileen J. Carter, RN, BSN (Corresponding Author)
School of Nursing, Columbia University, New York, NY
Stephanie M. Pouch, MD
College of Physicians and Surgeons, Columbia University, New York, NY
Elaine L. Larson, RN, PhD, FAAN, CIC
Mailman School of Public Health, Columbia University, New York, NY
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