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- Ariadna Villanueva Arias [5]
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- Corporate Infection Control Department, Hamad Medical Corporation, Qatar [2]
- Infection Control Department, The Cuban Hospital. E-mail: [email protected] ORCID: https://orcid.org/0000-0001-7279-0062 [2]
- 1Infection Control Department, The Cuban Hospital, Hamad Medical Corporation, Dukhan, Qatar [1]
- 1The Cuban Hospital, Hamad Medical Corporation, Dukhan, Qatar [1]
- 2Department of Public Health, Supreme Council of Health, Doha, Qatar [1]
- 2Nursing Department, The Cuban Hospital, Hamad Medical Corporation, Dukhan, Qatar [1]
- 3Critical Care Unit, The Cuban Hospital, Hamad Medical Corporation, Dukhan, Qatar [1]
- 4Medical Administration, The Cuban Hospital, Hamad Medical Corporation, Dukhan, Qatar [1]
- Corporate Infection Control Department, Hamad Medical Corporation, Doha, Qatar [1]
- Infection Control Department, The Cuban Hospital, Hamad Medical Corporation, Doha, Qatar. E-mail: [email protected] ORCID: https://orcid.org/0000-0001-7279-0062 [1]
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Direct observation of hand hygiene can show differences in staff compliance: Do we need to evaluate the accuracy for patient safety?
Background: Direct observation of hand hygiene is the standard practice recommended by the World Health Organization to monitor its compliance. Objective: To evaluate the accuracy of hand hygiene observation performed by units' observers. Methods: A descriptive study was carried out in seven patient care units in a 75-bed community hospital in Qatar. Four trained nurses performed hand hygiene observation in May 2016 any day of the week and in different shifts following the same methodology as routine units' observers. Hand hygiene opportunities were registered including hand hygiene moments staff category and actions (handrubs hand washing missed hand hygiene and gloves without hand hygiene). Results: During January–May 2016 routine monitoring reported 25319 opportunities with a compliance of 89.2% and 91.6% for nurses 89.6% for physicians and 85.1% for ancillary staff. Trained external observers reported 815 opportunities and compliance of 54.7% with the highest compliance observed after blood and body fluid exposure (80.0%) and after patient contact (85.5%) and the lowest figures before patient contact (34.2%) and before aseptic procedure (34.0%). Conclusion: This study provides essential information about the accuracy of the monitoring procedure and the compliance of hand hygiene that requires immediate action to protect patients and staff from healthcare-associated infections.
Evaluation of the timeliness and completeness of communicable disease reporting: Surveillance in The Cuban Hospital, Qatar
Public health surveillance systems should be evaluated periodically and should involve an assessment of system attributes. Objective: Evaluate hospital-based surveillance of communicable diseases using the elements of timeliness and data quality. Method: Descriptive study was conducted of communicable diseases reported at The Cuban Hospital Qatar during January 2012 to December 2013. The completeness of notifications were assessed for contact number address place of work and date of symptom onset. Time between the symptoms onset and physician notification time between physician and Supreme Council of Health notification and time between physician notification and lab confirmation were calculated for each case. Analysis: Percentage of cases with documented essential information and 95% confidence interval (CI) were determined. Mean and standard deviation (SD) of time were calculated. Results: 1065 patients were reported 75% were male 80% non-qataries and 91.5% were group 1 (high priority) diseases. Symptom onset date was documented in 91.5% (95% CI 89.8; 93.2) of cases; contact number in 84.7% (82.5;86.8) with lower frequencies for address (68.1% 65.3;70.9) and place of work (60.5% 57.5;63.4). Diagnostic time for tuberculosis was 61.7 days (SD 93.0) acute hepatitis 18.5 days (SD 17.6) typhoid fever 17.0 days (SD 11.6 days) other diseases of sexual transmission 300.2 days chronic hepatitis 165 days and AIDS 154.5 days. The time of notification to the Supreme Council of Health for group 1 diseases was 1.2 days (SD 1.4). Conclusion: Our results show that the quality of essential data and timeliness is not sufficient to meet the needs of the health system. Additional studies should focus on the evaluation of time delay for diagnosis of high priority diseases.
Impact of the COVID-19 pandemic on the incidence, etiology, and antimicrobial resistance of healthcare-associated infections in a critical care unit in Western Qatar
Background: Healthcare-associated infections (HAIs) in critical patients affect the quality and safety of patient care and increase patient morbidity and mortality. During the COVID-19 pandemic an increase in the incidence of HAIs particularly device-associated infections (DAIs) was reported worldwide. In this study we aimed to estimate the incidence of HAIs in an intensive care unit (ICU) during a 10-year period and compare HAI incidence during the preCOVID-19 and COVID-19 periods.Methods: A retrospective observational study of HAIs in the medical–surgical ICU at The Cuban Hospital was conducted. DAIs included central line-associated bloodstream infections (CLABSI) catheter-associated urinary tract infections (CAUTI) and ventilator-associated pneumonia (VAP). Data included the annual incidence of HAIs etiology and antimicrobial resistance using definitions provided by the Centers for Disease Control and Prevention except for other respiratory tract infections (RTIs).Results: 155 patients with HAI infections were reported from which 130 (85.5%) were identified during the COVID-19 period. The frequencies of DAIs and non-DAIs were higher during the COVID-19 period except for Clostridium difficile infections. Species under Enterobacter Klebsiella and Pseudomonas dominated in both periods and higher frequencies of Acinetobacter Enterococcus Candida Escherichia coli Serratia marcescens and Stenotrophoma maltophila were noted during COVID-19 period. Device utilization ratio increased to 10.7% for central lines and 12.9% for ventilators while a reduction of 15% in urinary catheter utilization ratio was observed. DAI incidence was higher during the COVID-19 pandemic with risks for CLABSI VAP and CAUTI increased by 2.79 (95% confidence interval 0.93–11.21; p < 0.0050) 15.31 (2.53–625.48) and 3.25 (0.68–31.08) respectively.Conclusion: The incidence of DAIs increased during the pandemic period with limited evidence of antimicrobial resistance observed. The infection control program should evaluate strategies to minimize the impact of the pandemic on HAIs.
Ten-year incidence and impact of coronavirus infections on incidence, etiology, and antimicrobial resistance of healthcare-associated infections in a critical care unit in Western Qatar
Background: Healthcare-associated infections (HAI) in critical patients affect the quality and safety of patient care as they impact morbidity and mortality. During the COVID-19 pandemic an increase in the incidence rate was reported worldwide. We aim to describe the incidence of HAI in the intensive care unit (ICU) during a 10-year follow-up period and compare the incidence during the pre-COVID-19 and COVID-19 periods.
Methods: A retrospective observational study of HAI in the medical-surgical ICU at The Cuban Hospital was conducted. The data collected include the annual incidence of HAI its etiology and antimicrobial resistance using the Centers for Disease Control and Prevention definitions except for other respiratory tract infections (RTIs).
Results: A total of 155 patients had HAI of which 130 (85.5%) were identified during COVID-19. The frequency of device-associated infections (DAI) and non-DAI was higher during COVID-19 except for Clostridium difficile infections. Etiology was frequently related to species of Enterobacter Klebsiella and Pseudomonas in both periods and a higher frequency of Acinetobacter Enterococcus Candida Escherichia coli Serratia marcescens and Stenotrophomonas maltophilia was noted during the COVID-19 period. Device utilization ratio increased by 10.7% for central lines and 12.9% for ventilators while a reduction of 15% in urinary catheter utilization ratio was observed. DAI incidence was higher during the COVID-19 with a 2.79 higher risk of infection (95% CI: 0.93–11.21; p < 0.0050) 15.31 (2.53–625.48) and 3.25 (0.68–31.08) for CLABSI VAP and CAUTI respectively.
Conclusion: The incidence of DAI increased during the pandemic period as compared to the pre-pandemic period and limited evidence of the impact on antimicrobial resistance was observed. The infection control program should evaluate strategies to minimize the impact of pandemics on HAI.
Catheter-associated urinary tract infection and urinary catheter utilization ratio over 9 years, and the impact of the COVID-19 pandemic on the incidence of infection in medical and surgical wards in a single facility in Western Qatar
Introduction: Catheter-associated urinary tract infection (CAUTI) is a frequently reported healthcare-associated infection in critical and non-critical patients. Limited data are available about CAUTI incidence in non-critical patients. We aim to describe the incidence of CAUTI over 9 years and evaluate the impact of the pandemic on the incidence in non-critical acute care patients.
Methods: A retrospective observational study of CAUTI in medical-surgical and maternity wards was carried out at a public hospital in the west of the State of Qatar. Data collected included the annual CAUTI incidence (per 1000 device days) urinary catheter utilization ratio (UC-UR) etiology and antimicrobial resistance.
Results: 115238 patient days and 6681 urinary catheters (UC) days were recorded over the study period and 9 and 4 CAUTI were confirmed in medical-surgical and maternity wards respectively. The infection rate was 1.9 per 1000 UC days and the UC-UR was 0.06. The CAUTI rate was higher in medical-surgical wards over the COVID-19 period (2.4 × 1000 UC days) in comparison with the non-COVID-19 period (1.7 × 1000 UC days) (RR 1.46; 1.12–1.80). However in the maternity ward the result was 0 and 2.5 × 1000 UC days during these periods respectively. No differences were observed in the infection rate among periods for all patients (RR 1.06; 0.81–1.31). Multidrug-resistant organisms were identified in 7 patients and non-multidrug-resistant in 6 cases.
Conclusion: The study findings describe a lower CAUTI risk over 9 years in non-critical acute care patients. The impact of COVID-19 on the CAUTI risk is mainly related to medical patients who had previously been admitted to critical care. The infection control program should consider these data as a benchmark for quality improvement.