The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH; Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH; Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH.
The Center for the Advancement of Team Science, Analytics, and Systems Thinking in Health Services and Implementation Science Research (CATALYST), College of Medicine, The Ohio State University, Columbus, OH.
Am J Infect Control. 2021 May;49(5):536-541. doi: 10.1016/j.ajic.2020.09.001. Epub 2020 Sep 24.
Prevention of healthcare-associated infections (HAIs) is critical to reduce preventable deaths and healthcare costs. Variable success with HAI prevention efforts has suggested that management practices are critical to support clinical infection prevention practices. This study examined hospital leaders' management practices around the prevention of catheter-associated urinary tract infections (CAUTIs) and central line-associated bloodstream infections (CLABSIs) to identify actions that leaders can take to promote HAI prevention efforts.
We conducted interviews with 420 key informants, including managers and frontline staff, in 18 hospitals across the United States. Interviewees were asked about management practices supporting HAI prevention. We analyzed interview transcripts using rigorous qualitative methods to understand how management practices were operationalized in infection prevention efforts.
Across hospitals and interviewees, three management practices were characterized as important facilitators of HAI prevention: (1) engagement of executive leadership; (2) information sharing; and (3) manager coaching. We found that visible executive leadership, efficient communication, and frequent opportunities to provide and promote learning from feedback were perceived to promote and sustain HAI prevention efforts.
Our findings provide insight into management practices for leaders that support successful HAI prevention. In practice, these tactics may need to be adjusted to accommodate the current restrictions caused by the COVID-19 pandemic, in order to maintain HAI prevention efforts as a priority.
预防医疗保健相关感染（HAIs）对于减少可预防的死亡和医疗保健成本至关重要。HAI 预防工作的成功程度不一，这表明管理实践对于支持临床感染预防实践至关重要。本研究调查了医院领导在预防导管相关尿路感染（CAUTIs）和中心静脉相关血流感染（CLABSIs）方面的管理实践，以确定领导可以采取哪些行动来促进 HAI 预防工作。
我们对美国 18 家医院的 420 名关键信息提供者（包括管理人员和一线工作人员）进行了访谈。受访者被问及支持 HAI 预防的管理实践。我们使用严格的定性方法分析访谈记录，以了解管理实践在感染预防工作中的实施情况。
在不同的医院和受访者中，有三种管理实践被认为是 HAI 预防的重要促进因素：（1）行政领导的参与；（2）信息共享；（3）经理指导。我们发现，可见的行政领导、高效的沟通以及提供和促进从反馈中学习的频繁机会被认为可以促进和维持 HAI 预防工作。
我们的研究结果为支持成功的 HAI 预防的领导者提供了管理实践方面的见解。在实践中，这些策略可能需要根据 COVID-19 大流行带来的当前限制进行调整，以维持 HAI 预防工作作为优先事项。
