Herzig Carolyn T A, Stone Patricia W, Castle Nicholas, Pogorzelska-Maziarz Monika, Larson Elaine L, Dick Andrew W
Center for Health Policy, Columbia University School of Nursing, New York, NY.
Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, PA.
J Am Med Dir Assoc. 2016 Jan;17(1):85-8. doi: 10.1016/j.jamda.2015.10.017.
The objectives of this study were to (1) obtain a national perspective of the current state of nursing home (NH) infection prevention and control (IPC) programs and (2) examine differences in IPC program characteristics for NHs that had and had not received an infection control deficiency citation.
A national cross-sectional survey of randomly sampled NHs was conducted and responses were linked with Certification and Survey Provider Enhanced Reporting (CASPER) and NH Compare data.
Surveys were completed and returned by 990 NHs (response rate 39%) between December 2013 and December 2014.
The person in charge of the IPC program at each NH completed the survey.
The survey consisted of 34 items related to respondent demographics, IPC program staffing, stability of the workforce, resources and challenges, and resident care and employee processes. Facility characteristics and infection control deficiency citations were assessed using CASPER and NH Compare data.
Most respondents had at least 2 responsibilities in addition to those related to infection control (54%) and had no specific IPC training (61%). Although many practices and processes were consistent with infection prevention guidelines for NHs, there was wide variation in programs across the United States. Approximately 36% of responding facilities had received an infection control deficiency citation. NHs that received citations had infection control professionals with less experience (P = .01) and training (P = .02) and were less likely to provide financial resources for continuing education in infection control (P = .01).
The findings demonstrate that a lack of adequately trained infection prevention personnel is an important area for improvement. Furthermore, there is a need to identify specific evidence-based practices to reduce infection risk in NHs.
本研究的目的是:(1)从全国范围了解疗养院感染预防与控制(IPC)项目的现状;(2)检查收到和未收到感染控制缺陷引用的疗养院在IPC项目特征方面的差异。
对随机抽取的疗养院进行全国性横断面调查,并将回复与认证和调查提供者强化报告(CASPER)以及疗养院比较数据相关联。
2013年12月至2014年12月期间,990家疗养院完成并返回了调查问卷(回复率39%)。
每家疗养院负责IPC项目的人员完成了调查。
该调查包括34个项目,涉及受访者人口统计学、IPC项目人员配备、劳动力稳定性、资源与挑战以及居民护理和员工流程。使用CASPER和疗养院比较数据评估机构特征和感染控制缺陷引用情况。
大多数受访者除了与感染控制相关的职责外,至少还有两项职责(54%),并且没有接受过特定的IPC培训(61%)。尽管许多做法和流程符合疗养院感染预防指南,但美国各地的项目存在很大差异。约36%的回复机构收到了感染控制缺陷引用。收到引用的疗养院的感染控制专业人员经验较少(P = 0.01)且培训较少(P = 0.02),并且不太可能为感染控制继续教育提供资金资源(P = 0.01)。
研究结果表明,缺乏训练有素的感染预防人员是一个需要改进的重要领域。此外,有必要确定具体的循证做法以降低疗养院的感染风险。