Urinary and faecal incontinence in hospitals and nursing homes

Knowledge of infection control measures in urinary and faecal incontinence population is limited. This article aimed to assess the incidence of, and potential risk factors for, common and healthcare-associated infection

Surgical site infections surveillance and quality management in Polish hospitals

Wstęp: Celem niniejszej pracy jest prezentacja wyników uzyskanych w 33 polskich szpitalach w latach 2003-2004 w zakresie nadzoru nad zakażeniami miejsca operowanego z zastosowaniem narzędzia do oceny jakości pracy szpitalnych zespołów kontroli zakażeń oraz oddziałów chirurgicznych uczestniczących w badaniu szpitali, to znaczy standaryzowanego indeksu ryzyka jako benchmarking. Materiały i metody: Analizie poddano dane zebrane na oddziałach zabiegowych różnych specjalności w polskich szpitalach o zróżnicowanej strukturze własności oraz stopniu specjalizacji, prowadzących nadzór nad zakażeniami szpitalnymi i ich rejestrację metodą czynną. Program objął pacjentów poddanych zabiegom operacyjnym, u których przeprowadzono ponad 67 000 zabiegów. Rozpoznano 1544 przypadki zakażeń miejsca zoperowanego. Szczegółowej analizie poddano 14 kategorii procedur, zgodnych z programem National Nosocomial Infection System (NNIS). Wyniki: Średnia zachorowalność skumulowana wyniosła 2,7%, a najwyższą stwierdzono po zabiegach w zakresie jelita grubego, układu rozrodczego i po cięciach cesarskich, wartość współczynnika w sposób istotny zależała od typu zabiegu. Wnioski: Rozwój nadzoru nad zakażeniami, jaki nastąpił w polskich szpitalach w ostatnim dziesięcioleciu, umożliwił wprowadzenie nowoczesnej metody kontroli zakażeń, jaką jest celowany nadzór nad wybranymi populacjami pacjentów, oraz zaawansowanych analiz epidemiologicznych. Dużym problemem w polskich szpitalach pozostaje nadzór nad zakażeniami pojawiającymi się po wypisie pacjenta oraz brak dobrej współpracy zespołów kontroli zakażeń z personelem oddziałów, szczególnie na oddziałach ortopedycznych oraz położniczo-ginekologicznych.Background: This study aims at presenting data on Surgical Site Infections (SSIs) obtained from 33 Polish hospitals in the years 2003–2004 making use of a quality control tool - the Standardized Surgical Site Infection ratio (benchmarking) for estimation of work of the infection control teams and surgical wards from participating hospitals. Material and methods: In this study we used data collected from surgical wards of various specialties in Polish hospitals, conducting active nosocomial infections surveillance and registration programme. The hospitals were of different degree of specialisation and ownership. The programme encompassed patients undergoing surgical procedures with a total no. of 67 000 procedures. 1544 cases of SSIs were diagnosed. Detailed analyses were performed on 14 procedure types according to National Nosocomial Infection System (NNIS). Results: Average SSIs incidence was found to be 2.7%, with the highest incidence for colon and reproductive system procedures as well as cesarean sections. The incidence value depended strongly on the type of surgical procedure. Conclusions: The development of infections surveillance that evolved in Polish hospitals over the last decade, allowed to implement a modern method of infection control, i.e. targeted surveillance of selected patient populations and advanced epidemiological analyses. Post discharge surveillance and poor coopetion of infection control teams with the ward personnel still remain a big problem in Polish hospitals, especially in Orthopaedic as well as Obstetrics and Gynaecology wards

Work experience and seniority in health care vs. Medical students' knowledge of selected hand hygiene procedures

Background: Hand hygiene (HH) is the most important element of infection prevention. The aim of the study was to analyze the level of HH knowledge among medical students of Jagiellonian University Medical College in correlation with their clinical experience and the presence and extent of trainings in hospital hygiene prior to internships, as well as with HH practice among medical staff perceived by students. Material and Methods: The study was carried out in a group of 414 students from October to December, 2014. The questionnaire built of 14 questions was used as a study tool. Results: Absolutely correct answers to questions about HH were given by 52.9%, and about HH technique by 6.5% of respondents. The degree of accuracy of answers to questions concerning HH did not correlate with the gender of the respondents or with the fact that work placement had been preceded by training in the field of HH or with its scope. A statistically significant correlation was found between the year, the field, and the type of the study. Students with greater professional practice, significantly less often claimed that medical workers comply with HH. Professional practice of 22.9% of students was not preceded by any training in the field of hospital hygiene and in 28% of cases training did not cover HH. Nearly half of the respondents declared that pre-internship training had not addressed the problem of occupational exposure to biological agents. Conclusions: The results of the study shows that knowledge gained by students participating in the study was not satisfactory. Moreover, there is a need for improving the educational scheme in the discussed subject at all levels of basic and clinical subjects as well as during internships. Med Pr 2016;67(5):623–63

Consumption of antibiotics and epidemiology of "Clostridioides difficile" in the European Union in 2016 : opportunity for practical application of aggregate ECDC data

Background: The most important pathomechanism of Clostridioides difficile infections (CDI) is post-antibiotic intestinal dysbiosis. CDI affects both ambulatory and hospital patients. Aim: The objective of the study was to analyze the possibility of utilizing databases from the European Centre for Disease Prevention and Control subject to surveillance for the purpose of identifying areas that require intervention with respect to public health. Methods: The analysis encompassed data concerning CDI incidence and antibiotic consumption expressed as defined daily doses (DDD) and quality indicators for antimicrobial-consumption involving both ambulatory and hospital patients in 2016. Results: In 2016, in the European Union countries, total antibiotic consumption in hospital and outpatient treatment amounted to 20.4 DDD (SD 7.89, range 11.04–39.69); in ambulatory treatment using average of ten times more antibiotics than hospitals. In total, 44.9% of antibiotics used in outpatient procedures were broad-spectrum antibiotics. We have found a significant relationship between the quality of antibiotics and their consumption: The more broad-spectrum antibiotics prescribed, the higher the sales of antibiotics both in the community sector and in total. CDI incidence did not statistically significantly correlate with the remaining factors analyzed on a country-wide level. Conclusion: Antibiotic consumption and the CDI incidence may depend on many national variables associated with local systems of healthcare organization and financing. Their interpretation in international comparisons does not give clear-cut answers and requires caution

Polish infection control nurses : self-assessment of their duties and professional autonomy in different types of hospitals

Background The objective of the study is self-assessment of Polish infection control nurses (ICNs) in terms of the structure of professional tasks and autonomy of decision-making. Material and Methods A questionnaire survey was filled out by 208 ICNs (around 21% of all Polish ICNs) in 15 provinces located in Poland. The research encompassed ICNs surveillance healthcare-associated infections (HAIs) in 2014. Results The work time that ICNs devote to professional tasks and decision autonomy on the scale of 1–100% was as follows: 34% (67% of decision autonomy) was dedicated to detecting and registering HAIs, 12% (71%) – internal control, 10% (58%) – devising and implementing infection prevention practices, 10% (68%) – staff trainings, 8% (65%) – identification and study of outbreaks, 7% (58%) – promoting hand hygiene, 6% (51%) – consults with infected patients, 4% (57%) – consults on decontamination, 4% (54%) – consults on maintaining cleanliness, 3% (51%) – isolation and application of personal protective measures, 2% – other tasks. Infection prevention and control nurses estimated, on average, that their autonomy of decisions concerning the professional tasks performed amounted to 60%. Conclusions Infection control nurses in Poland have difficulty in achieving balance between tasks they perform and the authority they exercise. The ICN professional task structure is dominated by duties associated with monitoring hospital infections, however, the greatest decision autonomy is visible regarding internal control. Decision-making concentrated on internal control may hinder building a positive image of an ICN. We should strive to firmly establish professional tasks and rights of ICNs in legislation concerning performing the duties of a nurse and midwife. Med Pr 2018;69(6):605–61

Selected aspects of the knowledge and practice concerning hand hygiene guidelines in the context of infection control structures in hospitals and long-term care facilities findings of a questionnaire survey

BackgroundHand hygiene (HH) is the simplest and the most fundamental means of hospital-acquired infection (HAI) prevention in both hospitals and long-term care facilities (LTCFs) which differ as to their structure, organization and epidemiology. The objective of this study was to evaluate the knowledge of, and attitudes towards, compliance with the HH guidelines by medical staff of LTCFs and hospitals, in the context of infection control organization.Material and MethodsThe study was carried out among medical staff of LTCFs and hospitals using an anonymous questionnaire designed by the authors. The questionnaire was composed of 22 questions.ResultsAmong 237 healthcare workers from LTCFs and hospitals (51.5% vs. 48.5%), the vast majority were women (97.5% vs. 94.8%), who were nurses (86.9% vs. 91.3%) with 21–30 years of experience (28.5% vs. 44.3%). The respondents, both working in hospitals and in LTCFs, declared that there was some surveillance of HAIs in their workplace – 78.8% vs. 87.8%, respectively, p = 0.082. However, the respondents from LTCFs significantly more often than those working in hospitals declared the lack of HAI registration (12.3% vs. 0.9%, p = 0.002), as well as the lack of surveillance of multidrug-resistant microorganisms (16.4% vs. 4.3%, p = 0.010). Although the knowledge of WHO HH guidelines was declared by over 90% of the respondents, only about 70% of them (with no significant difference between both types of facilities) properly indicated the 5 moments of HH.ConclusionsThe results of the study indicate that the organizational conditions and practice of HH in LTCFs and hospitals present some differences. Therefore, there is a need for observational studies concerning HH in the context of the structure and organization of infection control, as they are necessary for the development and implementation of effective programs to improve the situation in this field