March 01, 2013
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Strong evidence perceived to support most infection prevention practices

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Most infection prevention personnel said they believed that there was strong evidence to support common practices used to prevent health care-associated infections, according to study data published in the American Journal of Infection Control.

Among the practices perceived to have strong evidence were alcohol-based hand rubs, aseptic urinary catheter insertion and the use of chlorhexidine for antisepsis before central venous catheter insertion.

“Since infection preventionists play a key role in preventing health care-associated infections, it makes sense that they are aware of the evidence base underlying the various practices to prevent infection,” Sanjay Saint, MD, MPH, George Dock Collegiate Professor of Internal Medicine at the University of Michigan Medical School, told Infectious Disease News. “It was comforting to discover that most infection preventionists generally appear to know which practices to implement and which ones to avoid.”

Sanjay Saint, MD 

Sanjay Saint

Saint and colleagues administered a survey to 703 infection prevention personnel at US hospitals, with a response rate of 68%. The survey respondents were asked to rate the strength of the evidence supporting infection prevention practices.

Regarding general infection prevention practices, most respondents said they believed that there was strong evidence for hand hygiene with alcohol-based hand wash and antimicrobial stewardship programs. For the prevention of catheter-associated urinary tract infections, most said the aseptic insertion technique and timely removal of the catheter had strong supporting evidence.

For the prevention of central line-associated bloodstream infections, the use of chlorhexidine for antisepsis before insertion, maximum sterile barriers during insertion and avoiding the femoral site had strong evidence. Practices believed to have strong evidence for the prevention of ventilator-associated pneumonia included semirecumbent positioning, sedation vacation, antimicrobial mouth rinse and subglottic secretion drainage.

“Hospitals may rely even more on the recommendations of their infection preventionists since they appear to be keeping track of which practices prevent infection and thereby enhance patient safety,” Saint said. “But once a hospital has decided to use a particular practice, the heavy lifting begins, since actually implementing that practice may prove challenging.”

Saint said it would be interesting to see how other health care workers, including hospital epidemiologists, bedside nurses, front-line physicians and mid-level managers, would perceive the strength of the evidence that underlies infection prevention practices.

Disclosure: Saint reports no relevant financial disclosures.