Nursing and capstone (24 hours)

Criteria

Article 1

Article 2

Article 3

Article 4

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

Authors: John Gammon, Julian Hunt, Sharon Williams, Sharon Daniel, Sue Rees & Sian Matthewson.

Publisher: BMC Health Services Research

Working link: https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4126-x

Authors: Alexander Trusov, Jamilya Ismoilova, Tamara Tonkel, and Andrii Aleksandrin.

Publisher: HEALTH AFFAIRS

Working link: https://www.healthaffairs.org/doi/10.1377/hlthaff.2016.0050

Authors: Author N.Kentersa, T.Gottlieb, J.Hopman, S.Mehtar, M.L.SchweizereE.Tartari

Publisher: Elsevier

Link: https://www.sciencedirect.com/science/article/abs/pii/S0195670118302731

Authors:NikkiKenter, Elisabeth G.W.HuijskensPhD, MD, Sophie C.J. WitBS, Joostvan RosmalenPhDcAndreasVossPhD, MD.

Publisher: Elsevier

Link: https://www.sciencedirect.com/science/article/abs/pii/S0196655317306363

Article Title and Year Published

Infection prevention control and organisational patient safety culture within the context of isolation: study protocol.

Published: 08 May 2019

Infection Prevention And Control In TB Programs:

PUBLISHED:MARCH 2016

An international survey of cleaning and disinfection practices in the healthcare environment.

Published: 2018

Effectiveness of cleaning-disinfection wipes and sprays against multidrug-resistant outbreak strains

Published: 2017

Research Questions (Qualitative)/Hypothesis (Quantitative)

Ways in which engagement of health workers with IPC strategies and principles, shape and inform organizational patient safety culture within the context of isolation in surgical, medical and admission hospital settings; and vice-versa.

What are the causes of poor infection control of TB?

How poor infection prevention and control in congregate settings such as health facilities and prisons is a serious obstacle to advancing public health efforts worldwide and can have deadly consequences, as in the 2015 Ebola outbreak in West Africa.

Antimicrobial resistance has become an urgent global health priority. Basic hygiene practices and cleaning and disinfection of the hospital environment are key in preventing pathogen cross-transmission.

Hospital rooms play an important role in the transmission of several health care–associated pathogens. What is the action of different disinfectants available in the market?

Purposes/Aim of Study

To understand the meaning of IPC ‘ownership’ for health workers; the ways in which IPC is promoted, how IPC teams operate as new challenges arise, how their effectiveness is assessed and the positioning of IPC within the broader context of organizational patient safety culture, within hospital isolation settings.

To guide the National TB Control Program in revising national and regional policies for infection prevention and control at TB health care facilities and laboratories.

To our knowledge no studies have assessed the worldwide differences in cleaning and disinfection practices in healthcare facilities. The electronic survey described here was developed in order to evaluate differences in healthcare facility cleaning practices around the world.

The aim was to determine which product was most effective in simultaneous cleaning and disinfection of surfaces.

Design (Type of Quantitative, or Type of Qualitative)

Qualitative

Qualitative

Qualitative

Qualitative.

Setting/Sample

Two National Health Service (NHS) district general hospitals (DGHs) in Wales, in the UK.

Macheton National TB Hospital

Healthcare settings around the world

Not mentioned

Methods: Intervention/Instruments

Qualitative case studies within isolation settings at two National Health Service (NHS) district general hospitals (DGHs) in Wales, in the UK

In 2015, for the first time ever, TB cases among health workers throughout the country were systematically recorded and reported.

The International Society of Antimicrobial Chemotherapy (ISAC, formerly ISC), Infection Prevention and Control work group developed a survey with 30 multiple-choice questions.

Seven cleaning-disinfecting wipes and sprays based on different active ingredients were tested for their efficacy in removal of microbial burden and proteins. Efficacy was tested with known Dutch outbreak strains: vancomycin-resistant enterococci (VRE), Klebsiella pneumoniae OXA-48, or Acinetobacter baumannii.

Analysis

The data set, both MaPSaF and case studies data, will be stored electronically on a shared data base. A computer assisted qualitative data analysis software package will be utilized to manage and analyze data.

Successful infection prevention and control programs such as those implemented with Project HOPE’s technical expertise, in partnership with governments, donors, and other nongovernmental organizations, provide encouragement that TB can be eradicated when evidence-based practices are followed.

The questions were designed to assess the current cleaning practices in healthcare settings around the world.

Comparative analysis of results produced by different disinfectants.

Key Findings

Focusing on the relationship between IPC and patient safety culture within the context of isolation is both timely and particularly interesting.

As a result of its commitment to making TB infection prevention and control a priority, the Macheton TB Hospital was designated by the Tajikistan government as the national infection control demonstration site and training base.

A total of 110 healthcare professionals, representing 23 countries, participated in the online survey. In 96% of the facilities a written cleaning policy was present. Training of cleaning staff occurred in 70% of the facilities at the start of employment. Cleaning practices and monitoring of these practices varied.

For all bacteria, ready-to-use cleaning-disinfecting products reduced the microbial count with a log10 reduction >5 with a 5-minute exposure time, with the exception of a spray based on hydrogen peroxide. Omitting the aforementioned hydrogen peroxide spray, there were no significant differences between use of a wipe or spray in bacterial load reduction. Using adenosine triphosphate (ATP) measurements, a significant difference in log10 relative light units (RLU) reduction between various bacteria (P ≤ .001) was observed.

Recommendations

It is imperative to understand the ways in which IPC strategies, principles and innovations are implemented and operate on the ground as new challenges arise and threats of antimicrobial resistance increases, and of the positioning of IPC within the broader context of organizational patient safety culture, within hospital isolation settings.

Activities should scaled up across the nation, and fifteen national TB representatives from Uzbekistan, Kazakhstan, and Kyrgyzstan are being trained in infection prevention and control methods, practices, and mentoring by leading international experts.

Development of guideline recommendations for cleaning and disinfection could improve practices and set minimum standards worldwide.

Future research should use the now available testing standards.

Explanation of How the Article Supports EBP/Capstone Project

This articles support my EBP project since it informs me how organizational culture affects infection prevention and control (IPC)

The highlights the benefits of infection control programs.

The survey enabled assessment and recognition of widely differing global practices in approaches to environmental cleaning and disinfection.

Because it is based on the analysis of various disinfectants introduced to the market.

Criteria

Article 5

Article 6

Article 7

Article 8

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

Author: Dayane de MeloCosta,

Lillian Kelly de Oliveira, LopesPhD,

HonghuaHuPhD

Publisher: Elsevier

Link: https://www.sciencedirect.com/science/article/abs/pii/S0196655317306326

Beatrice Casini ,Anna Righi ,Nunzio De Feo ,Michele Totaro ,Serena Giorgi ,Lavinia Zezza ,Paola Valentini ,Enrico Tagliaferri ,Anna Laura Costa ,Simona Barnini ,Angelo Baggiani ,Pietro Luigi Lopalco ,Paolo Malacarne andGaetano Pierpaolo Privitera.

Publisher: Int. J. Environ. Res. Public Health.

Link: https://www.mdpi.com/1660-4601/15/10/2305

Author: Beatrice Casini, Benedetta Tuvo, Michele Totaro, Francesco Aquino, Angelo Baggiani, and Gaetano Privitera.

Publisher: Pathogens

Link: https://www.mdpi.com/2076-0817/7/3/71?utm_source=TrendMD&utm_medium=cpc&utm_campaign=Pathogens_TrendMD_0

Authors: Aires G. Santos-Junior, Adriano M. Ferreira, Oleci P. Frota, Marcelo A. Rigotti, Larissa da S. Barcelos, Alvaro Francisco Lopes de Sousa,,* Denise de Andrade, Odanir G. Guerra, and Mara C. R. Furlan.

Publisher: Open Nurs J.

Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5876921/

Article Title and Year Published

Alcohol fixation of bacteria to surgical instruments increases cleaning difficulty and may contribute to sterilization inefficacy.

Published: 2017

Improving Cleaning and Disinfection of High-Touch Surfaces in Intensive Care during Carbapenem-Resistant Acinetobacter baumannii Endemo-Epidemic Situations.

Published: 2018

Evaluation of the Cleaning Procedure Efficacy in Prevention of Nosocomial Infections in Healthcare Facilities Using Cultural Method Associated with High Sensitivity Luminometer for ATP Detection.

Published: 2018

Effectiveness of Surface Cleaning and Disinfection in a Brazilian Healthcare Facility

Published: 2018

Research Questions (Qualitative)/Hypothesis (Quantitative)

Extended water soak or drying times increased the attachment of soil to instruments.

Alcohol exposure increased the attachment of soil to instruments.

Alcohol exposure and extended soak or drying times before cleaning increases cleaning difficulty and should be discouraged.

What is the effectiveness and residual disinfectant activity of disposable pre-impregnated wipes (Modified Operative Protocol, MOP) in reducing environmental bioburden versus a two-step Standard Operative Protocol (SOP) in a 12-bed Intensive Care Unit?

The microbial evaluation of surfaces is useful for monitoring the effectiveness of cleaning and disinfection practices.

Failures in the processes of cleaning and disinfecting health service surfaces may result in the spread and transfer of pathogens that are often associated with healthcare-related infections and outbreaks.

Purposes/Aim of Study

There was a comparison of the effect of air drying, prolonged soaking in water, and alcohol treatment on cleaning difficulty of contaminated forceps.

Evaluating why high-touch surfaces cleaning and disinfection require the adoption of effective and proper executed protocols, especially during carbapenem-resistant Acinetobacter baumannii (CRAB) endemo-epidemic situations.

The aim of the study was to evaluate cleaning procedure efficacy in reducing bacterial contamination and the specific nosocomial multi-resistant pathogens, using cultural methods, associated with a high-sensitive luminometer for ATP detection.

To assess the effectiveness of environmental surface cleaning and disinfection in a hospital clinic.

Design (Type of Quantitative, or Type of Qualitative)

Qualitative

Qualitative.

Qualitative, meta- analysis

Quantitative

Setting/Sample

Haltsted-mosquito forceps

Sampling was performed before each procedure and at 0.5, 2.5, 4.5 and 6.5 h after (560 sites)

Hospital in North-West Tuscany, Italy.

560 surface samples were collected,

Nursing ward with 45 beds. A total of 80 samples from 5 high-touch surfaces.

Methods: Intervention/Instruments

Haltsted-mosquito forceps were contaminated with only Staphylococcus aureus. Instruments were air-dried for 10 (control), 75, or 240 minutes, soaked in water, or air dried then treated with ethanol or isopropanol for 10 seconds. All instruments were prewashed for 15 minutes. Forceps contaminated with blood and S aureus or Pseudomonas aeruginosa were dried and then sprayed or wiped with ethanol, and prewashed..

Five high-touch surfaces were cleaned and disinfected either according to the SOP (alcohol-based cleaning and chlorine-based disinfection) or using quaternary ammonium compounds-based disposable wipes (MOP).

Surface contamination was analyzed using cultural methods and ATP detection, performed with a high-sensitivity luminometer. The values 100 CFU/cm2 and 40 RLU/cm2 were considered as the threshold values for medium-risk category areas, while 250 CFU/cm2 and 50 RLU/cm2 were defined for the low-risk category ones. Air quality was evaluated using active and passive sampling microbiological methods and particle count (0.3 μm–10 μm) detection.

The study was conducted in a nursing ward with 45 beds. A total of 80 samples from five high-touch surfaces were evaluated before and after cleaning and disinfection, using the following methods: visual inspection, adenosine triphosphate bioluminescence assay, aerobic colony count, Staphylococcus aureus colony count, and evaluation of resistance to methicillin.

Analysis

Bacterial viability and soiling were determined by standard plate culture and crystal violet staining, respectively

Total viable count (TVC) was evaluated according to Italian hygiene standard (<50 CFU/24 cm2). Clinical and environmental CRAB strains isolated were genotyped

To evaluate surface cleanliness, both the standard stamp agar method (stamp method) and the adenosine triphosphate (ATP) bioluminescence for ATP detection were applied in this study, as described by.

The data analysis used nonparametric comparative and correlative tests to observe any differences in the pre- and post- cleaning and disinfection results for the surfaces assessed.

Key Findings

Soaking or spraying instruments with alcohol significantly reduced viable bacterial numbers, but significantly increased soil attached to forceps, as did air drying. Wiping instruments with alcohol had little effect on bacterial viability, but increased cleaning difficulty. Soaking in water for 75 or 240 minutes increased cleaning difficulty perhaps due to bacterial attachment to forceps.

On non-electromedical surfaces the difference between TVC before procedure and at each of the following times was significant only for the MOP (p < 0.05, Wilcoxon test). Using the MOP, only 7.4% (10/135) of sites showed TVC >50 CFU/24 cm2 (hygiene failures) versus 18.9% (25/132) after SOP (p < 0.05, Fisher’s Exact test). On infusion pumps a higher number of hygiene failures was observed after the SOP (7/44, 15.9%) compared with the MOP (4/45, 8.9%). Genotyping highlighted a common source of infection

From a total of 560 samples analyzed, all the samples were negative for the research into S. aureus, P. aeruginosa, Aspergillus spp. and enterobacteria. We investigated these parameters according to the hygienic standards proposed by ISPESL 2009 guidelines. Before cleaning, the mean microbial values were 32 ± 56 CFU/cm2 in the low-risk area and 25 ± 40 CFU/cm2 for the low- and medium-risk environments. The percentages of samples that resulted over the threshold were 3% and 13%, respectively. After cleaning, the average values were: 2 ± 3 CFU/cm2 and 7 ± 11 CFU/cm2, with a reduction of the samples above the threshold at 1% and 5%, respectively. The reduction rates recorded were 92% for the ambulatory care unit and 98.3% for the wound care

Effective cleaning and disinfection had a significant effect on only two surfaces when measured for the presence of adenosine triphosphate, the inner bathroom door handle (p=0.007) and the toilet bowl (p=0.01). When evaluated for Staphylococcus aureus colony count, the toilet flush handle also demonstrated a significant effect (p=0.04).

Recommendations

Treating contaminated instruments with alcohol, allowing them to dry, or allowing them to soak in water for prolonged period increases cleaning difficulty and should be discouraged.

The use of disposable wipes by in-house auxiliary nurses may represent a more effective alternative to standard cleaning and disinfection procedure performed by outsourced cleaning services, showing effectiveness in reducing microbial contamination and residual disinfection activity up to 6.5 h.

The effectiveness of cleaning and disinfection of the surfaces tested was not satisfactory. An educational intervention is recommended for the cleaning and disinfection staff and the nursing team at the healthcare facility.

The effectiveness of cleaning and disinfection of the surfaces tested was not satisfactory. An educational intervention is recommended for the cleaning and disinfection staff and the nursing team at the healthcare facility.

Explanation of How the Article Supports EBP/Capstone

Provides criteria of instrument decontamination.

Provide analysis and recommendation of infection control programs.

Address infection control programs

Address infection control programs