ABSTRACT
PURPOSE: The safety of care professionals and patients is paramount while caring for people with infectious diseases, including those with confirmed or suspected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19). Existing policies and protocols for donning and doffing personal protective equipment (PPE) are primarily for institutional settings such as hospitals, not for home visits for patient care. We describe a protocol for donning and doffing PPE in home settings. METHODS: We used an iterative, rapid-prototyping approach to develop the protocol. A small workgroup created preliminary drafts, drawing on hospital-based protocols and modifying them, while undertaking simulations. Wider input was solicited via 2 webinars; 1 regional (Hamilton, Ontario) with palliative clinicians, and 1 national (Canada) with varying professions. We also consulted a group of infectious disease experts. A "how-to" video accompanies the protocol. RESULTS: Twelve versions of the protocol were produced, with major changes occurring within the first 6 versions. A national webinar mid-development provided further validation and minor modifications. Subsequent versions involved minor changes. The protocol has 4 phases: (1) Preparing, (2) Entering the Home, (3) Leaving the Home, and (4) After the Visit and Reprocessing. In addition to PPE-related equipment, the protocol requires additional materials including 2 pails for transporting supplies, plastic bags, hand sanitizer, disinfectant wipes, and printed easy-to-use checklists. CONCLUSIONS: This protocol addresses gaps in COVID-19-related guidelines, specifically the process of donning and doffing PPE during home visits while supplementing jurisdictional PPE guidelines and protocols.Appeared as Annals "Online First" article.
Subject(s)
COVID-19/prevention & control , Health Personnel , Pandemics/prevention & control , Personal Protective Equipment , Humans , Infection Control/methods , SARS-CoV-2ABSTRACT
BACKGROUND: Pathogens may be transmitted in hospitals via patients' own hands, but little is known about the facilitators and barriers of hand hygiene among inpatients. This study aimed to assess the hand hygiene knowledge, attitudes, and practices of adult inpatients at 5 hospitals. METHODS: The study consisted of a cross-sectional survey distributed followed by structured interviews with randomly selected inpatients. Qualitative data were analyzed independently by 2 researchers using the Theoretical Domains Framework. RESULTS: A total of 268 surveys were completed, with 66.4% of patients reporting always performing hand hygiene after toileting and 49.2% before eating. The majority of patients (74.6%) stated that they did not want to receive more information about hand hygiene while in the hospital. Key themes identified from 23 interviews include knowledge; environmental context and resources; memory, attention, and decision processes; and social influences. CONCLUSIONS: Self-reported patient hand hygiene rates are suboptimal and there are knowledge gaps among patients as to when to perform hand hygiene, but patients are not receptive to receiving traditional educational interventions. Future interventions to improve patient hand hygiene should focus on other behavior change domains, including environmental context and resources (eg, access to hand sanitizer at the bedside), memory, attention, and decision processes (eg, posters or other reminders), and social influences (eg, role modeling).
Subject(s)
Cross Infection/prevention & control , Hand Hygiene , Health Knowledge, Attitudes, Practice , Inpatients/psychology , Patient Acceptance of Health Care/psychology , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Qualitative ResearchABSTRACT
Infection prevention and control audits are an important element in the achievement of a health care setting's patient safety goals. The successful audit can result in enhanced partnerships between infection control professionals and other departments and services in the organization, implement change and lead to continuing improvement in outcomes for patients/residents and staff. In this first part of the audit process, the preparation leading up to the actual administration of the audit is described.
Subject(s)
Communicable Disease Control/methods , Infection Control/methods , Medical Audit/methods , Communicable Disease Control/standards , Humans , Infection Control/standards , Medical Audit/standardsABSTRACT
Many hospitals and long-term care facilities in North America currently permit animals to visit with their patients; however, the development of relevant infection control and prevention policies has lagged, due in large part to the lack of scientific evidence regarding risks of patient infection associated with animal interaction. This report provides standard guidelines for animal-assisted interventions in health care facilities, taking into account the available evidence.
