University of Michigan Medical School, Ann Arbor, MI, USA; Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA.
University of Michigan Medical School, Ann Arbor, MI, USA; VA Ann Arbor Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
Am J Infect Control. 2022 Sep;50(9):975-980. doi: 10.1016/j.ajic.2022.06.011. Epub 2022 Jun 17.
A 2014 study assessed infection prevention (IP) practices in Thai hospitals for catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP). This study compares current IP practices to results obtained in 2014.
Between February 1, 2021 and August 31, 2021, we resurveyed Thai hospitals regarding practices to prevent CAUTI, CLABSI, and VAP. We also assessed COVID-19 impact and healthcare worker burnout and coping strategies. We distributed 100 surveys to a convenience sample of infection preventionists.
Response rate: 100%. One-third (31%) of hospitals reported excellent leadership support for infection control (ie, responses of "good" or "excellent" to one survey question). Some prevention practices increased between 2014 vs 2021 (CAUTI: catheter reminder/stop-order/nurse-initiated discontinuation [50.0% vs 70.0%, P < .001]; condom catheters [36.3% vs 51.0%, P = .01]; ultrasound bladder scanner [4.7% vs 12.0%, P = .03]; CLABSI: chlorhexidine gluconate insertion site antisepsis [73.6% vs 85.0%, P = .03]; maximum sterile barrier precautions [63.2% vs 80.0%, P = .003]; VAP: selective digestive tract decontamination [26.9% vs 40.0%, P = .02]). Antimicrobial catheter use decreased since 2014 (10.4% vs 3.0%, P < .001). Many other practices remain suboptimal. COVID-19 challenges: staff shortages (71%), financial hardships (67%). Only 46% of infection preventionists felt safe working during COVID-19.
More national strategic support is needed for IP programs to prevent CAUTI, CLABSI, VAP and healthcare worker well-being in Thailand during the COVID-19 pandemic.
2014 年的一项研究评估了泰国医院预防导管相关性尿路感染（CAUTI）、中心静脉导管相关性血流感染（CLABSI）和呼吸机相关性肺炎（VAP）的感染预防（IP）实践。本研究将当前的 IP 实践与 2014 年的结果进行了比较。
2021 年 2 月 1 日至 8 月 31 日，我们对泰国医院预防 CAUTI、CLABSI 和 VAP 的实践进行了重新调查。我们还评估了 COVID-19 的影响以及医护人员的倦怠和应对策略。我们向感染预防专家发放了 100 份调查问卷。
回复率为 100%。三分之一（31%）的医院报告称，感染控制的领导层支持非常出色（即对一个调查问题的回答为“良好”或“优秀”）。一些预防措施在 2014 年至 2021 年之间有所增加（CAUTI：导管提醒/停止医嘱/护士自行中断[50.0%比 70.0%，P <.001]； condom 导管[36.3%比 51.0%，P =.01]；超声膀胱扫描仪[4.7%比 12.0%，P =.03]；CLABSI：葡萄糖酸洗必泰皮肤消毒剂[73.6%比 85.0%，P =.03]；最大无菌屏障预防措施[63.2%比 80.0%，P =.003]；VAP：选择性消化道去污染[26.9%比 40.0%，P =.02]）。自 2014 年以来，抗菌导管的使用减少（10.4%比 3.0%，P <.001）。许多其他措施仍然不理想。COVID-19 的挑战：人员短缺（71%），财务困难（67%）。只有 46%的感染预防专家在 COVID-19 期间感到工作安全。
在 COVID-19 大流行期间，泰国需要更多的国家战略支持，以改善 IP 项目，预防 CAUTI、CLABSI、VAP 和医护人员的健康。
