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Study Finds Hospitals Don’t Follow Infection Prevention Rules

Authors conduct most comprehensive review in more than three decades (February 6)

While most hospitals have policies in place to prevent health care-associated infections, clinicians often fail to follow evidence-based guidelines established to prevent these infections, according to new research from the Columbia University School of Nursing.

The findings were published in the American Journal of Infection Control.

The study, the most comprehensive review of infection-control efforts at U.S. hospitals in more than three decades, found lax compliance even in intensive care units (ICUs), where patients are more likely to be treated with devices linked to preventable infections, such as central lines, urinary catheters, and ventilators.

The researchers investigated compliance with evidence-based policies to prevent infection in 1,653 ICUs at 975 hospitals nationwide. The study focused on three of the most common preventable infections: central line-associated bloodstream infections, ventilator-associated pneumonia, and catheter-associated urinary tract infections.

Despite decades of research establishing best practices for the prevention of these infections, approximately one in 10 hospitals lacked checklists to prevent bloodstream infections, and one in four lacked checklists to help avoid pneumonia in ventilated patients. Even worse, these checklists were followed only about half of the time, the study found.

The study also found that only about one-third of the ICUs had an electronic surveillance system to track compliance with infection-prevention policies at the clinician level. Electronic monitoring systems that offer report cards on compliance have been proven effective at getting clinicians to follow the rules, lowering infection rates, previous research has found. At the same time, more than one-third of hospitals also failed to employ a full-time clinician certified in infection prevention to supervise compliance, the study found.

“We’ve come a long way in understanding what causes health care-associated infections and how to prevent them,” said lead investigator Patricia Stone, PhD, MPH, RN, FAAN. “This study shows we still have a long way to go in compliance with well-established, life-saving, and cost-saving measures that we know will lower infection rates.”

Source: EurekAlert; February 6, 2014.

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