Impact of certified infection preventionists in acute care settings: A systematic review.

BACKGROUND: Health care-associated infection (HAI) is a common adverse event affecting patient safety. This review aims to (1) establish evidence for the impact of certified infection prevention and control (CIC) specialists on infection prevention and patient safety in acute care settings and (2) summarize study design and statistical modeling used for impact assessment to inform future studies. METHODS: We searched and reviewed full-text, quantitative studies assessing the impact of CIC. The studies used empirical data published in English between January 2000 and April 2021 in PubMed, PsycINFO, and EMBASE. We identified 8 articles for data extraction and analysis. All eight studies used a cross-sectional design and had a quality rating of good to high based on the Johns Hopkins Nursing Evidence-Based Practice rating scales. RESULTS: CIC infection preventionists (IPs) may have a stronger understanding than other practitioners of the evidence for certain infection prevention practices and are more likely to recommend implementing them in the hospitals where they work, especially when the lead IP is certified. The association between CIC and HAI rates was inconsistent in our results. DISCUSSION AND CONCLUSIONS: Further studies are needed to explore the impact of CIC IPs on HAI rates.

Statins use and COVID-19 outcomes in hospitalized patients.

BACKGROUND: There is an urgent need for novel therapeutic strategies for reversing COVID-19-related lung inflammation. Recent evidence has demonstrated that the cholesterol-lowering agents, statins, are associated with reduced mortality in patients with various respiratory infections. We sought to investigate the relationship between statin use and COVID-19 disease severity in hospitalized patients. METHODS: A retrospective analysis of COVID-19 patients admitted to the Johns Hopkins Medical Institutions between March 1, 2020 and June 30, 2020 was performed. The outcomes of interest were mortality and severe COVID-19 infection, as defined by prolonged hospital stay (≥ 7 days) and/ or invasive mechanical ventilation. Logistic regression, Cox proportional hazards regression and propensity score matching were used to obtain both univariable and multivariable associations between covariates and outcomes in addition to the average treatment effect of statin use. RESULTS: Of the 4,447 patients who met our inclusion criteria, 594 (13.4%) patients were exposed to statins on admission, of which 340 (57.2%) were male. The mean age was higher in statin users compared to non-users [64.9 ± 13.4 vs. 45.5 ± 16.6 years, p <0.001]. The average treatment effect of statin use on COVID-19-related mortality was RR = 1.00 (95% CI: 0.99-1.01, p = 0.928), while its effect on severe COVID-19 infection was RR = 1.18 (95% CI: 1.11-1.27, p <0.001). CONCLUSION: Statin use was not associated with altered mortality, but with an 18% increased risk of severe COVID-19 infection.

The Global Health Security Index is not predictive of vaccine rollout responses among OECD countries.

OBJECTIVE: This study sought to evaluate the utility of the Global Health Security (GHS) index in predicting the launch of COVID-19 vaccine rollout by Organization for Economic Cooperation and Development (OECD) member countries. METHODS: Country-level data on the preparedness to respond to infectious disease threats through vaccination rollout were collected using the GHS index. OECD member countries were rank-ordered based on the percentage of their populations fully vaccinated against COVID-19. Rank-ordering was conducted from the lowest to the highest, with each country assigned a score ranging from 1 to 33. Spearman's rank correlation between the GHS index and the percentage of the population that is fully vaccinated was also performed. RESULTS: Israel, ranked 34th in the world on the GHS index for pandemic preparedness, had the highest percentage of the population that was fully vaccinated against COVID-19 within 2 months of the global vaccine rollout. The Spearman rank correlation coefficient between GHS index and the percentage of population fully vaccinated was -0.1378, with a p-value of 0.43. CONCLUSION: The findings suggest an absence of correlation between the GHS index rating and the COVID-19 vaccine rollout of OECD countries, indicating that the preparedness of OECD countries for infectious disease threats may not be accurately reflected by the GHS index.