Literature Evaluation Table: Nursing Strategies for Infection Control
Change Topic: In patients with acute respiratory failure (Population), how effective are droplet precautions onsite (DroPS) (Intervention) compared to the standard pathogen-based single room isolation (Comparison) in controlling the spread of healthcare-associated infections (Outcome) within a three-month implementation period (Time)
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| Criteria | Article 1 | Article 2 | Article 3 | Article 4 |
| Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
|
Cristina, M. L., Spagnolo, A. M., Giribone, L., Demartini, A., & Sartini, M. (2021). Epidemiology and prevention of healthcare-associated infections in geriatric patients: A narrative review. International Journal of Environmental Research and Public Health, 18(10), 5333. https://doi.org/10.3390/ijerph18105333
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Ershova, K., Savin, I., Kurdyumova, N., Wong, D., Danilov, G., Shifrin, M., Alexandrova, I., Sokolova, E., Fursova, N., Zelman, V., & Ershova, O. (2018). Implementing an infection control and prevention program decreases the incidence of healthcare-associated infections and antibiotic resistance in a Russian neuro-ICU. Antimicrobial Resistance & Infection Control, 7(1). https://doi.org/10.1186/s13756-018-0383-4 | Furmenti, M., Rossello, P., Bianco, S., Olivero, E., Thomas, R., Emelurumonye, I., Zotti, C., Moro, M. L., Brusaferro, S., Sticchi, C., Chadenier, G. M., D’Errico, M., Ripabelli, G., Prato, R., Mura, I. I., Agodi, A., Collini, F., Torri, E., Novati, R., … Fedeli, U. (2019). Healthcare-associated infections and antimicrobial use in long-term care facilities (HALT3): An overview of the Italian situation. Journal of Hospital Infection, 102(4), 425-430. https://doi.org/10.1016/j.jhin.2019.02.007 | Haque, M., McKimm, J., Sartelli, M., Dhingra, S., Labricciosa, F. M., Islam, S., Jahan, D., Nusrat, T., Chowdhury, T. S., Coccolini, F., Iskandar, K., Catena, F., & Charan, J. (2020). Strategies to prevent healthcare-associated infections: A narrative Overview. Risk Management and Healthcare Policy, 13, 1765-1780. https://doi.org/10.2147/rmhp.s269315
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| Article Title and Year Published
|
Epidemiology and prevention of healthcare-associated infections in geriatric patients: A narrative review. International Journal of Environmental Research and Public Health, 18(10), 5333.
Published: 2021 |
“Implementing an infection control and prevention program decreases the incidence of healthcare-associated infections and antibiotic resistance in a Russian neuro-ICU”
Published: 2018 |
Healthcare-associated infections and antimicrobial use in long-term care facilities (HALT3): An overview of the Italian situation.
Published: 2019. |
Strategies to prevent healthcare-associated infections: A narrative Overview
Published: 2020 |
| Research Questions (Qualitative)/Hypothesis (Quantitative)
|
What is the epidemiology and prevention of healthcare-associated infections in geriatric patients?
|
What is the effect of an infection prevention and control (IPC) program on the incidence of healthcare-associated infections (HAIs) in a Russian ICU? | What is the prevalence of healthcare-associated infections and antimicrobial use in long-term care facilities in Italy? | What strategies are available to prevent healthcare-associated infections. |
| Purposes/Aim of Study | To provide a summary on the epidemiology and prevention of healthcare-associated infections in geriatric patients. | To evaluate the effect of an IPC program with respect to healthcare-associated infection (HAI) prevention and to define the incidence of HAIs in a Russian ICU. | To provide an overview of the Italian situation of healthcare-associated infections and antimicrobial use in long-term care facilities. | To provide an overview of strategies to prevent healthcare-associated infections. |
| Design (Type of Quantitative, or Type of Qualitative)
|
Narrative Review | Prospective observational cohort study. | Cross-sectional study. | Narrative review. |
| Setting/Sample
|
N/A
|
The study was conducted in the neuro-ICU department at the Burdenko National Medical Research Center of Neurosurgery (NSI) in Moscow, Russia. The sample consisted of 2038 high-risk patients who required more than 48 hours of care in the neurosurgical ICU. | 33 long-term care facilities in Italy. | N/A |
| Methods: Intervention/Instruments
|
Literature review
|
The study implemented an infection prevention and control program inspired by the results of the European HELICS-ICU program. The program included three key components: education, infection prevention measures, and surveillance. Data was collected prospectively on a daily basis and entered into the NSI electronic health record system. | Data was collected using a standardized questionnaire. | Literature review. |
| Analysis
|
The study analyzed the literature available on healthcare-associated infections in geriatric patients. | Survival analysis was used to compare patients with and without HAIs | Descriptive statistics. | Literature review. |
| Key Findings
|
Geriatric patients are at an increased risk of healthcare-associated infections. | Implementing an infection control and prevention program decreased the incidence of healthcare-associated infections and antibiotic resistance in the Russian neuro-ICU. | Prevalence of healthcare-associated infections and antimicrobial use in long-term care facilities in Italy was high. | Effective strategies in preventing healthcare-associated infections include hand hygiene, personal protective equipment, decolonization and cleaning protocols, and surveillance and monitoring. |
| Recommendations
|
HAI rates can be reduced by ensuring appropriate hand hygiene, wearing PPE, having suitable isolation strategies, sterilization, and disinfection, appropriate antibiotic prophylaxis, minimizing invasive procedures to reduce the risk of endogenous infections, infection surveillance to identify and control outbreaks, improvement of healthcare practices, and continuing education for healthcare workers. | Implement an evidence-based infection control and prevention (IPC) program in neuro-ICUs to reduce the incidence of healthcare-associated infections (HAIs).
Consider expanding IPC initiatives, potentially paired with a robust antimicrobial stewardship program, in resource-limited settings as a feasible and cost-effective opportunity to achieve meaningful reductions in antibiotic resistance and HAI incidence. |
long-term care facilities should implement policies and procedures to prevent and control HAIs, and optimize antimicrobial use.
Further research to understand the reasons for the high prevalence is also recommended. |
Healthcare facilities should prioritize infection prevention and control by implementing evidence-based strategies, such as hand hygiene, the use of personal protective equipment, decolonization and cleaning protocols, and surveillance and monitoring. They should regularly review and update their infection prevention and control policies and procedures, and healthcare workers should be trained on these policies and procedures. |
| Explanation of How the Article Supports EBP/Capstone Project
|
It highlights HAIs as a problem among geriatric patients. | It shows that standard precautions such as infection prevention and control can prevent HAIs. | The article indicates how critical it is to develop strategies to reduce HAIs. | The article shows that standard precautions such as infection prevention and control can prevent HAIs. |
| Criteria | Article 5 | Article 6 | Article 7 | Article 8 |
| Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
|
Héquet, D., Kessler, S., Rettenmund, G., Lemmenmeier, E., Qalla-Widmer, L., Gardiol, C., Münzer, T., Schlegel, M., Petignat, C., & Kohler, P. (2021). Healthcare-associated infections and antibiotic use in long-term care residents from two geographical regions in Switzerland. Journal of Hospital Infection, 117, 172-178. https://doi.org/10.1016/j.jhin.2021.08.018 | Lee, M., Lee, G., Lee, S., & Park, Y. (2019). Effectiveness and core components of infection prevention and control programmes in long-term care facilities: A systematic review. Journal of Hospital Infection, 102(4), 377-393. https://doi.org/10.1016/j.jhin.2019.02.008 | Ripabelli, G., Salzo, A., Mariano, A., Sammarco, M. L., & Tamburro, M. (2019). Healthcare-associated infections point prevalence survey and antimicrobials use in acute care hospitals (PPS 2016–2017) and long-term care facilities (HALT-3): A comprehensive report of the first experience in Molise region, central Italy, and targeted intervention strategies. Journal of Infection and Public Health, 12(4), 509-515. https://doi.org/10.1016/j.jiph.2019.01.060 | Damani, N. (2019). Prevention of healthcare associated infections. Manual of Infection Prevention and Control, 233-304. https://doi.org/10.1093/med/9780198815938.003.0007
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| Article Title and Year Published
|
Healthcare-associated infections and antibiotic use in long-term care residents from two geographical regions in Switzerland. Published in 2021. | Effectiveness and core components of infection prevention and control programmes in long-term care facilities: A systematic review. Published in 2019. | Healthcare-associated infections point prevalence survey and antimicrobials use in acute care hospitals (PPS 2016–2017) and long-term care facilities (HALT-3): A comprehensive report of the first experience in Molise region, central Italy, and targeted intervention strategies
Published: 2019. |
Prevention of healthcare associated infections. Manual of Infection Prevention and Control, 233-304.
Published in 2019. |
| Research Questions (Qualitative)/Hypothesis (Quantitative)
|
What is the prevalence of HAIs and antibiotic use in long-term care residents from two different geographical regions in Switzerland. | How effective are infection prevention and control programs in long-term care facilities and what are their core components? | What is the prevalence of HAIs and antimicrobial use in acute care hospitals and long-term care facilities in the Molise region of central Italy, and what potential areas are suitable for targeted intervention strategies? | What are the different types of HAIs and what measures can be implemented to reduce their risk in healthcare facilities? |
| Purposes/Aim of Study | Investigating the prevalence of HAIs and antibiotic use in long-term care residents from two geographical regions in Switzerland, and to identify possible risk factors and trends. | To identify the effectiveness and core components of infection prevention and control programs in long-term care facilities, and to provide recommendations for improvement. | To conduct a point prevalence survey of HAIs and antimicrobial use in acute care hospitals and long-term care facilities in the Molise region of central Italy, and to identify potential areas for targeted intervention strategies. | To provide information about various strategies and measures that can be implemented to reduce the risk of HAIs in healthcare facilities |
| Design (Type of Quantitative, or Type of Qualitative)
|
Cross-sectional study. | Systematic review. | Cross-sectional observational design. | N/A |
| Setting/Sample
|
Residents in Long-term care facilities in two regions in Switzerland.
|
Review of articles from various settings and samples, including long-term care facilities and residents. | Molise region of central Italy, and the sample consisted of patients in acute care hospitals and long-term care facilities. | N/A |
| Methods: Intervention/Instruments
|
Data were collected through a standardized questionnaire and medical chart review. | A systematic search of various databases, and included studies published between 2000 and 2018. The studies were evaluated for quality and data were extracted and analyzed. | Use of a point prevalence survey to collect data on HAIs and antimicrobial use. Data was collected through interviews with patients and health care staff, examination of medical records, and observation of infection control practices. | N/A |
| Analysis
|
Data were analyzed using descriptive statistics, chi-squared test, and logistic regression. | Data was analyzed using a qualitative synthesis of the findings. | Descriptive statistics, including frequencies, percentages, and means.
|
N/A |
| Key Findings
|
HAIs were high in long-term care residents, with urinary tract infections being the most common type. Antibiotic use was also found to be high, with broad-spectrum antibiotics being the most commonly prescribed. | iInfectionprevention and control programs in long-term care facilities can effectively reduce the rate of healthcare-associated infections. Core components of effective programs included staff education and training, infection surveillance and reporting, and a system for managing outbreaks. | HAIs were more prevalent in long-term care facilities than in acute care hospitals. The study also found that there was a high level of antimicrobial use in both types of facilities | Many key measures can be implemented in healthcare facilities to prevent and control HAIs. |
| Recommendations
|
Reduce antibiotic use in these facilities, and promote the use of more targeted and appropriate antibiotics. | Long-term care facilities should implement comprehensive infection prevention and control programs, focusing on staff education and training, infection surveillance and reporting, and a system for managing outbreaks. | Implementation of infection control strategies in these facilities to reduce the prevalence of HAIs.
Further research. |
Implement evidence-based guidelines and protocols to reduce the risk of HAIs.
A multifaceted approach, including infection control measures, surveillance systems, and education and training for healthcare professionals. Emphasis on hand hygiene, environmental cleaning and vaccination as a measure to prevent HAIs |
| Explanation of How the Article Supports EBP/Capstone
|
The article highlights the need to address HAIs as a problem among elderly patients. | The article indicates that standard precautions such as infection prevention and control are effective for controlling HAIs. | The article indicates how HAIs are high in long-term facilities and affect elderly patients. | The article indicates measures necessary for the prevention and control of HAIs. |