Unlabelled: During COVID-19 in the US, social determinants of health (SDH) have driven health disparities. However, the use of SDH in COVID-19 vaccine modeling is unclear. This review aimed to summarize the current landscape of incorporating SDH into COVID-19 vaccine transmission modeling in the US.
View Article and Find Full Text PDFObjectives: The Centers for Disease Control and Prevention (CDC) recommends implementing Enhanced Barrier Precautions (EBP) for all nursing home (NH) residents known to be colonized with targeted multidrug-resistant organisms (MDROs), wounds, or medical devices. Differences in health care personnel (HCP) and resident interactions between units may affect risk of acquiring and transmitting MDROs, affecting EBP implementation. We studied HCP-resident interactions across a variety of NHs to characterize MDRO transmission opportunities.
View Article and Find Full Text PDFImportance: The effectiveness and importance of contact precautions for endemic pathogens has long been debated, and their use has broad implications for infection control of other pathogens.
Objective: To estimate the association between contact precautions and transmission of methicillin-resistant Staphylococcus aureus (MRSA) across US Department of Veterans Affairs (VA) hospitals.
Design, Setting, And Participants: This retrospective cohort study used mathematical models applied to data from a population-based sample of adults hospitalized in 108 VA acute care hospitals for at least 24 hours from January 1, 2008, to December 31, 2017.
Background: Contact precautions for endemic methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) are under increasing scrutiny, in part due to limited clinical trial evidence.
Methods: We retrospectively analyzed data from the Strategies to Reduce Transmission of Antimicrobial Resistant Bacteria in Intensive Care Units (STAR*ICU) trial to model the use of contact precautions in individual intensive care units (ICUs). Data included admission and discharge times and surveillance test results.
Background: Environmental contamination is an important source of hospital multidrug-resistant organism (MDRO) transmission. Factors such as patient MDRO contact precautions (CP) status, patient proximity to surfaces, and unit type likely influence MDRO contamination and bacterial bioburden levels on patient room surfaces. Identifying factors associated with environmental contamination in patient rooms and on shared unit surfaces could help identify important environmental MDRO transmission routes.
View Article and Find Full Text PDFInfect Control Hosp Epidemiol
July 2019
Objective: Determine the effectiveness of a personal protective equipment (PPE)-free zone intervention on healthcare personnel (HCP) entry hand hygiene (HH) and PPE donning compliance in rooms of patients in contact precautions.
Design: Quasi-experimental, multicenter intervention, before-and-after study with concurrent controls.
Setting: All patient rooms on contact precautions on 16 units (5 medical-surgical, 6 intensive care, 5 specialty care units) at 3 acute-care facilities (2 academic medical centers, 1 Veterans Affairs hospital).
Personal protective equipment (PPE) training aims to reinforce the Centers for Disease Control and Prevention guidelines for donning and doffing; however, many health care and ancillary personnel use non-guideline methods to don and doff their PPE gowns and gloves. We found that hospital personnel commonly deviated from the guidelines, increasing the likelihood of self-contamination. Furthermore, securing the gown ties inappropriately was an especially common problem that consequently increased doffing missteps.
View Article and Find Full Text PDFObjective: This article provides a review of areas that present significant challenges in infection prevention and control and describes human factors engineering (HFE) approaches that have been applied successfully to these areas. In addition, implications and recommendations for HFE use in future research are discussed.
Background: Infection prevention and control aims to prevent patients and health care personnel from acquiring preventable infections in healthcare.
Background: Coordinated approaches are needed to optimally control the spread of resistant organisms across facilities that share patients. Our goal was to understand social tensions that may inhibit public health-led community partnerships and to identify factors for success.
Methods: A collaborative to control transmission of multidrug-resistant organisms (MDROs) was formed in Utah following a regional outbreak, with members from public health, hospitals, laboratories, and transport services.