Search

Background Ward closure is a method of controlling hospital-acquired infectious diseases outbreaks and is often coupled with other practices. However, the value and efficacy of ward closures remains uncertain. Purpose To understand the current practices and perceptions with respect to ward closure for hospital-acquired infectious disease outbreaks in acute care hospital settings across Canada. Methods A Web-based environmental scan survey was developed by a team of infection prevention and control (IPC) experts and distributed to 235 IPC professionals at acute care sites across Canada. Data were analyzed using a mixed-methods approach of descriptive statistics and thematic analysis. Results A total of 110 completed responses showed that 70% of sites reported at least 1 outbreak during 2013, 44% of these sites reported the use of ward closure. Ward closure was considered an “appropriate,” “sometimes appropriate,” or “not appropriate” strategy to control outbreaks by 50%, 45%, and 5% of participants, respectively. System capacity issues and overall risk assessment were main factors influencing the decision to close hospital wards following an outbreak. Discussion Results suggest the use of ward closure for containment of hospital-acquired infectious disease outbreaks in Canadian acute care health settings is mixed, with outbreak control methods varying. The successful implementation of ward closure was dependent on overall support for the IPC team within hospital administration.

General purpose To provide information from a review of literature about economic evaluations of preventive strategies for pressure injuries (PIs). Target audience This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. Learning objectives/outcomes After participating in this educational activity, the participant should be better able to:1. Identify the purpose and methods used for this study.2. Compare costs and effectiveness related to preventative strategies for PIs. Abstract BACKGROUND: Pressure injuries (PIs) are a common and resource-intensive challenge for acute care hospitals worldwide. While a number of preventive strategies have the potential to reduce the cost of hospital-acquired PIs, it is unclear what approach is the most effective. Objective The authors performed a narrative review of the literature on economic evaluations of preventive strategies to survey current findings and identify important factors in economic assessments. Data sources Ovid, MEDLINE, NHS Economic Evaluation Databases, and the Cochrane Database of Systematic ReviewsSELECTION CRITERIA: Potentially relevant original research articles and systematic reviews were considered. Data extraction Selection criteria included articles that were written in English, provided data on cost or economic evaluations of preventive strategies of PIs in acute care, and published between January 2004 and September 2015. Data were abstracted from the articles using a standardized approach to evaluate how the items on the Consolidated Health Economic Evaluation Reporting Standards checklist were addressed. Data synthesis The searches identified 192 references. Thirty-three original articles were chosen for full-text reviews. Nineteen of these articles provided clear descriptions of interventions, study methods, and outcomes considered. Conclusions Limitations in the available literature prevent firm conclusions from being reached about the relative economic merits of the various approaches to the prevention of PIs. The authors' review revealed a need for additional high-quality studies that adhere to commonly used standards of both currently utilized and emerging ways to prevent hospital-acquired PIs.

The purpose of this pilot study was to explore the feasibility of implementing a new electronic transfer of care (TOC) tool. The study was conducted in a Canadian tertiary care center. Brief survey instruments were completed by acute care physicians, community-based physicians, and patients to assess providers' perspectives on the usability of the novel electronic tool. The units of analysis were physician and patient perceptions. Mixed methods were used including descriptive statistical analyses and qualitative thematic analysis. Twenty-eight unique acute care physicians completed 100 electronic TOC summaries, and 44 unique community-based physicians rated quality and pertinence of the summaries. Twenty-two patients responded to a follow-up telephone call. The novel TOC communication tool was generally well received by physicians and patients, and it is now being evaluated in a large-scale clinical trial assessing hard clinical outcomes. The information presented herein provides a template for assessment of such information system innovations.

Objective: Missing medical equipment in health care settings decrease productivity, increase spending to replace losses, and potentially endanger patient safety. By documenting and investigating the causes of these incidents, strategies to prevent future occurrences can be developed.Methods: As an example of this approach, we describe the inadvertent disposal of an expensive medical device during a randomized controlled trial (RCT) conducted within a medical facility. The incident was carefully documented and investigated shortly after it occurred. This information was used to develop targeted interventions to prevent further occurrences.Results: The device was a mattress overlay connected to a computer monitor that generated a continuous pressure image for use by nursing staff in the prevention of pressure injuries. An Environmental Services staff member disposed of one of these devices when the room of an enrolled patient was cleaned following their transfer to another unit. Miscommunication (or a misunderstanding of communicated information) and lack of awareness were identified as the main causes of this error.Discussion: By using the loss as a learning opportunity, the investigation of the incident led to strategies for preventing future occurrences. These included frequent training sessions for staff and improvements in signage. A detailed, factual and timely investigation of the events around the loss of armamentarium coupled with analysis on how to prevent future occurrences should be considered for all incidents involving high cost equipment.Conclusions: A standardized, non-judgmental approach to documenting and investigating the causes of costly equipment loss can lead to strategies for improved asset management and the prevention of further incidents of this nature.