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“Beyond the Guidelines” – Deviations in Adherence to Infection Control Measures in Tyrolean hospitals, Austria

  • Author Footnotes
    # (Schöpfstrasse 41, 6020 – Innsbruck, Austria)
    ,
    Author Footnotes
    & Michael Berktold, Stefan Fuchs, Bettina Kuppelwieser, Hanno Ulmer, Margareth Kettner, Lucas Thummer and Ewald Wöll report no Conflict of Interest.
    Michael Berktold
    Correspondence
    Corresponding author: Dr. Michael Berktold, Schöpfstrasse 41, 6020 – Innsbruck, Austria. Phone: +43 512 9003 70764.
    Footnotes
    # (Schöpfstrasse 41, 6020 – Innsbruck, Austria)
    & Michael Berktold, Stefan Fuchs, Bettina Kuppelwieser, Hanno Ulmer, Margareth Kettner, Lucas Thummer and Ewald Wöll report no Conflict of Interest.
    Affiliations
    Institute for Hygiene and Medical Microbiology, Medical University of Innsbruck, Austria
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  • Author Footnotes
    # (Schöpfstrasse 41, 6020 – Innsbruck, Austria)
    ,
    Author Footnotes
    & Michael Berktold, Stefan Fuchs, Bettina Kuppelwieser, Hanno Ulmer, Margareth Kettner, Lucas Thummer and Ewald Wöll report no Conflict of Interest.
    Stefan Fuchs
    Footnotes
    # (Schöpfstrasse 41, 6020 – Innsbruck, Austria)
    & Michael Berktold, Stefan Fuchs, Bettina Kuppelwieser, Hanno Ulmer, Margareth Kettner, Lucas Thummer and Ewald Wöll report no Conflict of Interest.
    Affiliations
    Institute for Hygiene and Medical Microbiology, Medical University of Innsbruck, Austria
    Search for articles by this author
  • Author Footnotes
    # (Schöpfstrasse 41, 6020 – Innsbruck, Austria)
    ,
    Author Footnotes
    & Michael Berktold, Stefan Fuchs, Bettina Kuppelwieser, Hanno Ulmer, Margareth Kettner, Lucas Thummer and Ewald Wöll report no Conflict of Interest.
    Bettina Kuppelwieser
    Footnotes
    # (Schöpfstrasse 41, 6020 – Innsbruck, Austria)
    & Michael Berktold, Stefan Fuchs, Bettina Kuppelwieser, Hanno Ulmer, Margareth Kettner, Lucas Thummer and Ewald Wöll report no Conflict of Interest.
    Affiliations
    Institute for Hygiene and Medical Microbiology, Medical University of Innsbruck, Austria
    Search for articles by this author
  • Author Footnotes
    # (Schöpfstrasse 41, 6020 – Innsbruck, Austria)
    ,
    Author Footnotes
    & Michael Berktold, Stefan Fuchs, Bettina Kuppelwieser, Hanno Ulmer, Margareth Kettner, Lucas Thummer and Ewald Wöll report no Conflict of Interest.
    Hanno Ulmer
    Footnotes
    # (Schöpfstrasse 41, 6020 – Innsbruck, Austria)
    & Michael Berktold, Stefan Fuchs, Bettina Kuppelwieser, Hanno Ulmer, Margareth Kettner, Lucas Thummer and Ewald Wöll report no Conflict of Interest.
    Affiliations
    Department for Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Austria
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  • Author Footnotes
    $ (Bahnhofstrasse 14, 6380 – St. Johann in Tirol, Austria)
    ,
    Author Footnotes
    & Michael Berktold, Stefan Fuchs, Bettina Kuppelwieser, Hanno Ulmer, Margareth Kettner, Lucas Thummer and Ewald Wöll report no Conflict of Interest.
    Margareth Kettner
    Footnotes
    $ (Bahnhofstrasse 14, 6380 – St. Johann in Tirol, Austria)
    & Michael Berktold, Stefan Fuchs, Bettina Kuppelwieser, Hanno Ulmer, Margareth Kettner, Lucas Thummer and Ewald Wöll report no Conflict of Interest.
    Affiliations
    Infection Control Team, District Hospital St. Johann, Austria
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  • Author Footnotes
    $ (Bahnhofstrasse 14, 6380 – St. Johann in Tirol, Austria)
    ,
    Author Footnotes
    & Michael Berktold, Stefan Fuchs, Bettina Kuppelwieser, Hanno Ulmer, Margareth Kettner, Lucas Thummer and Ewald Wöll report no Conflict of Interest.
    Lucas Thummer
    Footnotes
    $ (Bahnhofstrasse 14, 6380 – St. Johann in Tirol, Austria)
    & Michael Berktold, Stefan Fuchs, Bettina Kuppelwieser, Hanno Ulmer, Margareth Kettner, Lucas Thummer and Ewald Wöll report no Conflict of Interest.
    Affiliations
    Infection Control Team, District Hospital St. Johann, Austria
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  • Author Footnotes
    ^ (Sanatoriumstraße 43, 6511 – Zams, Austria)
    ,
    Author Footnotes
    & Michael Berktold, Stefan Fuchs, Bettina Kuppelwieser, Hanno Ulmer, Margareth Kettner, Lucas Thummer and Ewald Wöll report no Conflict of Interest.
    Ewald Wöll
    Footnotes
    ^ (Sanatoriumstraße 43, 6511 – Zams, Austria)
    & Michael Berktold, Stefan Fuchs, Bettina Kuppelwieser, Hanno Ulmer, Margareth Kettner, Lucas Thummer and Ewald Wöll report no Conflict of Interest.
    Affiliations
    Department of Internal Medicine, Hospital St. Vinzenz, Zams, Austria
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  • Author Footnotes
    # (Schöpfstrasse 41, 6020 – Innsbruck, Austria)
    ,
    Author Footnotes
    @ Cornelia Lass-Flörl reports payments made to institution as well as personal fees (all indicated separately in the Conflict of Interest form) within the past 36 months.
    Cornelia Lass-Flörl
    Footnotes
    # (Schöpfstrasse 41, 6020 – Innsbruck, Austria)
    @ Cornelia Lass-Flörl reports payments made to institution as well as personal fees (all indicated separately in the Conflict of Interest form) within the past 36 months.
    Affiliations
    Institute for Hygiene and Medical Microbiology, Medical University of Innsbruck, Austria
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  • the Study Group Hygiene Tyrol
  • Author Footnotes
    # (Schöpfstrasse 41, 6020 – Innsbruck, Austria)
    & Michael Berktold, Stefan Fuchs, Bettina Kuppelwieser, Hanno Ulmer, Margareth Kettner, Lucas Thummer and Ewald Wöll report no Conflict of Interest.
    $ (Bahnhofstrasse 14, 6380 – St. Johann in Tirol, Austria)
    ^ (Sanatoriumstraße 43, 6511 – Zams, Austria)
    @ Cornelia Lass-Flörl reports payments made to institution as well as personal fees (all indicated separately in the Conflict of Interest form) within the past 36 months.

      Highlights

      • Infection control measures in Tyrolean hospitals vary according to discipline
      • Best congruence to CDC-recommendations was observed in Infection Control teams
      • Clinical disciplines showed only fair congruence to CDC-recommendations

      Abstract

      Background

      Hospital-acquired infections (HAI) represent increasing problems in health-care facilities worldwide. Adequate infection control measures are key elements in preventing those infections. Expert societies have published recommendations that help to reduce HAI.

      Methods

      In November 2019, a questionnaire-based point-prevalence survey, eliciting the adherence of 14 Tyrolean hospitals to the recommendations of the Centers of Disease Control and Prevention (CDC) was performed. Additionally, standard infection control measures performed by different medical (clinical and infection control specialists) disciplines as well as the performed infection control measures of nurses and physicians were compared.

      Results

      The survey revealed varying adherence to CDC-recommendations of different medical disciplines, with highest congruence by the infection control specialists and lower congruencies by all surveyed clinical disciplines. Concordance rate between nurses and physicians was high.

      Discussion

      Explanations for the varying congruencies of clinical disciplines on the one hand and the infection control specialists on the other hand may be versatile. Possible lacks of knowledge about the required hygiene measures should be taken into account.

      Conclusion

      The present survey showed moderate adherence of Tyrolean hospitals to the recommendations provided by CDC, however with noticeable differences between different medical disciplines. Nurses and doctors in most cases reported identically.

      Keywords

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      References

        • European Centre for Disease Prevention and Control
        Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals.
        ECDC, Stockholm2013
        • Suetens C
        • Latour K
        • Kärki T
        • Ricchizzi E
        • Kinross P
        • Moro ML
        • et al.
        Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017.
        Euro Surveill. 2018; 231800516
        • Huang GKL
        • Stewardson AJ
        • Grayson ML
        Back to basics: hand hygiene and isolation.
        Curr Opin Infect Dis. 2014; 27: 379-389
        • Exner M
        • Bhattacharya S
        • Gebel J
        • Goroncy-Bermes P
        • Hartemann P
        • Heeg P
        • et al.
        Chemical disinfection in healthcare settings: crucial aspects for the development of global strategies.
        GMS Hyg Infect Control. 2020; 15: Doc36
        • Gottenborg EW
        • Barron MA
        Isolation precautions in the Inpatient Setting.
        Hosp Med Clin. 2016; 5: 30-42
        • Noto MJ
        • Domenico HJ
        • Byrne DW
        • Talbot T
        • Rice TW
        • Bernard GR
        • et al.
        Chlorhexidine Bathing and Healthcare-Associated Infections: A randomized clinical trial.
        JAMA. 2015; 313: 369-378
        • Huang H
        • Chen B
        • Wang H-Y
        • He M
        The efficacy of daily chlorhexidine bathing for preventing healthcare-associated infections in adult intensive care units.
        Korean J Intern Med. 2016; 31: 1159-1170
        • Landis JR
        • Koch GG
        The measurement of observer agreement for categorical data.
        Biometrics. 1977; 33: 159-174
      1. Händehygiene in Einrichtungen des Gesundheitswesens: Empfehlungen der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut (RKI).
        Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2016; 59: 1189-1220
        • Kampf G
        • Ostermeyer C
        • Heeg P
        Surgical hand disinfection with propanol-based handrub: equivalence of shorter application times.
        J Hosp Inf. 2005; 59: 304-310
      2. WHO guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care is Safer Care.
        World Health Organisation, 2009
      3. Prävention und Kontrolle Katheter-assoziierter Harnwegsinfektionen: Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert-Koch-Institut (RKI).
        Bundesgesundheitsbl. 2015; 58: 641-650
        • Gould CV
        • Umscheid CA
        • Agarwal RK
        • Kuntz G
        Pegues DA and the Healthcare Infection Control Practices Advisory Committee, Guideline for Prevention of catheter-associated urinary tract infections 2009.
        Infect Control Hosp Epidemiol. 2010; 31: 319-326
      4. Prävention postoperativer Wundinfektionen: Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert-Koch-Institut.
        Bundesgesundheitsbl. 2018; 61: 448-473
      5. Global guidelines on the prevention of surgical site infection.
        World Health Organisation, 2018
        • Berríos-Torres SI
        • Umscheid CA
        • Bratzler DW
        • Leas B
        • Stone EC
        • Kelz RR
        • et al.
        Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017.
        JAMA Surg. 2017; 152: 784-791
        • Webster J
        • Alghamdi A
        Use of plastic adhesive drapes during surgery for preventing surgical site infections.
        Cochrane Database Syst Rev. 2015; 2015CD006353
        • Hasselgren PO
        • Hagberg E
        • Malmer H
        • Saljo A
        • Seemann T
        One instead of two knives for surgical incision. Does it increase the risk of postoperative wound infection?.
        Arch Surg. 1984; 119: 917-920
        • Pedersen CM
        • Rosendahl-Nielsen M
        • Hjermind J
        • Egerod I
        Endotracheal suctioning of the adult intubated patient – what is the evidence?.
        Intensive Crit Care Nurs. 2009; 25: 21-30
      6. Prävention von Infektionen, die von Gefäßkathetern ausgehen Teil 1 – Nichtgetunnelte zentralvenöse Katheter Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert-Koch-Institut.
        Bundesgesundheitsbl. 2017; 60: 171-206
        • O'Gready NP
        • Alexander M
        • Burns LA
        • Dellinger EP
        • Garland J
        • Heard SO
        • et al.
        Guidelines for the prevention of intravascular catheter-related infections.
        Clin Infect Dis. 2011; 52: e162-e193
      7. Prävention von Infektionen, die von Gefäßkathetern ausgehen Teil 2 – Periphervenöse Verweilkanülen und arterielle Katheter Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert-Koch-Institut.
        Bundesgesundheitsbl. 2017; 60: 207-215
      8. Anforderungen an die Hygiene bei der Reinigung und Desinfektion von Flächen Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention beim Robert-Koch-Institut.
        Bundesgesundheitsbl. 2004; 47: 51-61
      9. Rutala WA, Weber DJ and the Healthcare Infection Control Practices Advisory Committee (HICPAC), Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008.

        • Siegel JD
        • Rhinehart E
        • Jackson M
        • Chiarello L
        • the Health Care Infection Control Practices Advisory Committee
        2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings.
        Am J Infect Control. 2007; 35: S65-164