Frankston Hospital, Frankston, VIC Australia; The Bays Hospital, Mornington, VIC Australia; Monash University, Frankston, VIC Australia.
Frankston Hospital, Frankston, VIC Australia; The Bays Hospital, Mornington, VIC Australia; Calvary Public Hospital, ACT, Canberra, Australia.
Aust Crit Care. 2022 Jul;35(4):415-423. doi: 10.1016/j.aucc.2021.06.015. Epub 2021 Jul 9.
Clinical guidelines on infection control strategies in healthcare workers (HCWs) play an important role in protecting them during the severe acute respiratory syndrome coronavirus 2 pandemic. Poorly constructed guidelines that are incomprehensive and/or ambiguous may compromise HCWs' safety.
The objective of this study was to develop and validate a tool to appraise guidelines on infection control strategies in HCWs based on the guidelines published early in the coronavirus disease 2019 pandemic.
DESIGN, SETTING, AND OUTCOMES: A three-stage, web-based, Delphi consensus-building process among a panel of diverse HCWs and healthcare managers was performed. The tool was validated by appraising 40 international, specialty-specific, and procedure-specific guidelines along with national guidelines from countries with a wide range of gross national income.
Overall consensus (≥75%) was reached at the end of three rounds for all six domains included in the tool. The Delphi panel recommended an ideal infection control guideline should encompass six domains: general characteristics (domain 1), engineering recommendations (domain 2), personal protective equipment (PPE) use (domain 3), and administrative aspects (domain 4-6) of infection control. The appraisal tool performed well across the six domains, and the inter-rater agreement was excellent for the 40 guidelines. All included guidelines performed relatively better in domains 1-3 than in domains 4-6, and this was more evident in guidelines originating from lower income countries.
The guideline appraisal tool was robust and easy to use. Engineering recommendations aspects of infection control, administrative measures that promote optimal PPE use, and HCW wellbeing were generally lacking in assessed guidelines. This tool may enable health systems to adopt high-quality HCW infection control guidelines during the severe acute respiratory syndrome coronavirus 2 pandemic and may also provide a framework for future guideline development.
临床医护人员感染控制策略指南在保护医护人员免受严重急性呼吸综合征冠状病毒 2 型大流行的影响方面发挥着重要作用。构建不当、不全面且/或不明确的指南可能会危及医护人员的安全。
本研究旨在开发和验证一种工具，以根据在 2019 年冠状病毒病大流行早期发布的指南，评估医护人员感染控制策略指南。
设计、地点和结果：通过对一组不同的医护人员和医疗保健管理人员进行三轮在线德尔菲共识建立过程，进行了三个阶段的研究。该工具通过评估 40 项国际、专业特定和程序特定指南以及来自国民收入差异较大的国家的国家指南进行了验证。
该指南评估工具稳健且易于使用。感染控制的工程建议、促进最佳个人防护装备使用的行政措施以及医护人员的健康福利在评估的指南中普遍缺失。该工具可使卫生系统在严重急性呼吸综合征冠状病毒 2 型大流行期间采用高质量的医护人员感染控制指南，也可为未来的指南制定提供框架。
