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Structured Observations and Interventions by Infection Control Practitioners: A One Year Prospective Study

Amos M. Yinnon

Background: One major responsibility of Infection Control and Prevention (ICP) Practitioners is rounding through in-patient departments, observing and providing feedback.

Aim: To facilitate structured observation and intervention, we adopted detailed checklists for eight major ICP targets.

Methods: Data were entered daily and analyzed quarterly for an entire year (July 2021-June 2022).

Results:

1. Screening for CRE was performed on admission in 224 patients and weekly in 180 patients, constituting 85% and 86%, respectively, of all candidates who should have been screened.

2. Seven aspects of urinary catheter management were evaluated in 452 patients, of which 2 were adequate (>99% adherence).

3. Cleaning was assessed with the ATP test. Of a total of 308 obtained samples, high (>45) levels, indicating inadequate cleaning, were detected from various bedside items.

4. 45/528 assessed peripheral IV catheters (9%) were >72 hours in place, the upper allowed limit in our hospital.

5. 7/11 items assessing isolation procedures in 284 patients were found adequate.

6. 7/11 items assessing safe injection procedures in 247 patients were found adequate.

7. 44/62 item ICP checklist evaluated in 112 surgical procedures, were found adequate, the remaining 18 showed inadequate adherence (2%-77%).

8. Of 78 mechanically ventilated patients, 8/10 ICP assessed items were according to guidelines. For most items significant differences were found between departments (p<0.001).

Conclusion: This one year prospective study helped identify a large range of items of ICP guidelines, which were consistently adhered to allowing their subsequent deletion from routine surveillance (and transferal for infrequent surveillance only).

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