Leadership and management for infection prevention and control. What do we have and what do we need?

Gould, D.J. et al. The Journal of Hospital Infection. Published online: 16 July 2016

chess-316658_960_720Leadership is widely considered to be vital for infection prevention and control (IPC).1 Its purpose is to maintain progress reducing risks of healthcare-associated infections especially those caused by antimicrobial-resistant organisms, and to achieve continuous quality improvement.2 But given its importance there is little rigorous research on effective leadership for IPC. While there is indirect evidence that IPC experts and clinicians working at the frontline of patient care can assume leadership, almost nothing has been written about IPC leadership at senior level.

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Infection prevention and control in the paediatric setting: the challenges

Winzor, G. & Cooke, R.P.D. Journal of Hospital Infection. Published online: 27 July 2016
Infection prevention and control (IPC) practices within the paediatric setting pose many unique challenges which are often linked to a lack of paediatric specific research. The short report in this issue of the JHI by Araujo da Silva et al1 highlights a lack of quality studies and practice recommendations for paediatric IPC.
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Assessment of a multimodal intervention for the prevention of catheter-associated urinary tract infections

Ternavasio-de la Vega, H.G. et al. The Journal of Hospital Infection. Published online: July 25 2016

Background and objectives: Catheter-associated urinary tract infections (CAUTIs) represent an important health care burden. We assessed the effectiveness of an evidence-based multimodal multidisciplinary intervention intended to improve outcomes by reducing the use of urinary catheters (UCs) and minimizing the incidence of CAUTIs in the Internal Medicine department of a university hospital.

Material and methods: A multimodal intervention was developed, including training sessions, urinary catheterization reminders, surveillance systems, and mechanisms for staff feedback of results. The frequency of UC use and incidence of CAUTIs were recorded in 3-month periods before (P1) and during the intervention (P2).

Results: The catheterization rate decreased significantly during P2 (27.8% vs. 16.9%; relative risk [RR]: 0.61; 95% confidence interval [95% CI]: 0.57-0.65). We also observed a reduction in CAUTI risk (18.3 vs. 9.8%; RR: 0.53; 95% CI: 0.30-0.93); a reduction in the CAUTI rate per 1000 patient-days (5.5 vs. 2.8; incidence ratio [IR]: 0.52; 95% CI: 0.28-0.94); and a non-significant decrease in the CAUTI rate per 1000 catheters-days (19.3 vs. 16.9; IR: 0.85; 95% CI: 0.46-1.55).

Conclusions: The multimodal intervention was effective in reducing the catheterization rate and the frequency of CAUTIs.

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A Comprehensive Review of Common Respiratory Infections Encountered in Urgent and Primary Care

Beam, C. et al. Journal of Emergency Nursing. Published online: July 21 2016

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Image shows digitally colorized electron micograph of influenza virions 

Concern about antibiotic overuse has become heightened as bacterial resistance to antibiotics continues to increase. Patients experiencing respiratory symptoms frequently present to urgent/emergent care settings such as fast-track emergency care departments and primary care retail settings with the expectation that they will be prescribed antibiotics.

The Centers for Disease Control and Prevention (CDC) reports that approximately 2 million people will become ill with bacteria that are resistant to at least one antibiotic, approximately 23,000 people die as a direct result of these infections, and many others die as a result of complications related to antibiotic-resistant infections.

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Meningococcal disease programme information

Public Health England | 19 July 2016

PHE has published ‘Meningococcal ACWY Immunisation Programme for Adolescents: Information for health care professionals‘. Originally published in July 2015 this document has been updated and includes details on: the purpose of the programme, who the vaccine is recommended for; when vaccines will be available to order and how to administer the vaccine.

Measles vaccination advice for young adults

Measles cases continue to be confirmed in teenagers and young adults across England. | Public Health England

Public Health England (PHE) is advising young adults to ensure they have received two doses of MMR vaccine. .

Measles can be more severe in teenagers and adults and some may need hospital treatment. Measles is also extremely infectious and summer events like music festivals and fairs where people are mixing closely with each other provide the ideal place for the infection to spread.

The vaccine also protects against other serious illnesses including mumps. Anyone who is unsure of their vaccination status should contact their GP practice to make an appointment.

Dr Gayatri Amirthalingam, measles expert for PHE, explains the importance of being immunised against measles:

NICE guidance: sepsis

B0006171 Streptococcal pyrogenic exotoxin A1

Image shows Streptococcus pyogenes. This is a bacterial superantigen capable of causing toxic shock. Source: K R Acharya, Wellcome Images // CC BY-NC-ND 4.0

NICE has published new guidance Sepsis: recognition, diagnosis and early management (NG51). This guideline covers the recognition, diagnosis and early management of sepsis for all populations. The guideline committee identified that the key issues to be included were: recognition and early assessment, diagnostic and prognostic value of blood markers for sepsis, initial treatment, escalating care, identifying the source of infection, early monitoring, information and support for patients and carers, and training and education.

The UK Sepsis Trust will support release of the NICE Clinical Guideline on sepsis with tools and resources including screening and action tools to aid with early identification and management of sepsis in children and adults (including in pregnancy) across community-based, prehospital and acute clinical environments.

Related: NICE pathway: Sepsis