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美国各州卫生部门对养老院感染管理的支持程度各不相同。

Support of nursing homes in infection management varies by US State Departments of Health.

机构信息

Helene Fuld College of Nursing, New York, NY, USA.

RAND Corporation, Santa Monica, CA, USA.

出版信息

J Hosp Infect. 2020 Jun;105(2):258-264. doi: 10.1016/j.jhin.2020.02.007. Epub 2020 Feb 14.

Abstract

BACKGROUND

In many countries, healthcare-associated infections (HAIs) are problematic in long-term aged care living facilities. In the United States (US), HAIs occur frequently in nursing homes (NHs). Identifying effective practices for state Departments of Health (DOHs) to help NHs improve infection prevention and control and reduce HAIs is necessary.

AIM

As a first step, the objective was to systematically examine and catalogue the variations in state intentions and activities related to HAI prevention in NHs.

METHODS

An environmental scan of state DOH websites, HAI plans, and HAI state infographics was conducted. Data were collected on 16 items across three domains: (1) intentions to reduce HAIs in NHs, (2) actions to reduce HAIs in NHs, and (3) website usability.

FINDINGS

State infection control support for NHs varied widely. Most states (92%) mentioned NHs in their HAI plans and 76% included NHs in their infographic. Half has an HAI prevention advisory council, while one-third had a state HAI prevention collaborative. Only 57% of HAI plans that mentioned NHs included training materials on HAI reduction. The most common training available was on antibiotic stewardship.

CONCLUSION

Many US states have room for improvement in the support they provide NHs regarding infection prevention and control. Specific areas of improvement include: (1) increased provision of training materials on HAI reduction, (2) focusing training materials on common HAIs, and (3) NH engagement in collaboratives aimed at HAI reduction. More research is needed linking DOH activities to resident outcomes.

摘要

背景

在许多国家,长期护理养老机构的医疗保健相关感染(HAI)是一个问题。在美国,疗养院(NH)经常发生 HAI。确定州卫生部门(DOH)的有效实践,以帮助 NH 改善感染预防和控制并减少 HAI 是必要的。

目的

作为第一步,目标是系统地检查和分类与 NH 中 HAI 预防相关的州意图和活动的变化。

方法

对州 DOH 网站、HAI 计划和 HAI 州信息图进行环境扫描。在三个领域收集了 16 个项目的数据:(1)减少 NH 中 HAI 的意图,(2)减少 NH 中 HAI 的行动,和(3)网站可用性。

发现

州对 NH 的感染控制支持差异很大。大多数州(92%)在 HAI 计划中提到了 NH,76%将 NH 纳入了信息图。一半的州有 HAI 预防咨询委员会,而三分之一的州有州 HAI 预防合作。只有 57%提到 NH 的 HAI 计划包括关于 HAI 减少的培训材料。最常见的可用培训是关于抗生素管理。

结论

许多美国州在为 NH 提供感染预防和控制方面还有改进的空间。具体的改进领域包括:(1)增加 HAI 减少培训材料的提供,(2)将培训材料重点放在常见的 HAI 上,以及(3)NH 参与旨在减少 HAI 的合作。需要进行更多的研究,将 DOH 活动与居民结果联系起来。

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