Infection Control Matters

C. difficile and One Health with Prof Tom Riley

We discuss One Health in this episode with Professor Tom Riley, using C.difficile as the example of explaining why the concept of One Health is so important.
 
Tom is a Fellow of the Royal College of Pathologists, the Australian Society for Microbiology, the American Academy of Microbiology, the Society for Healthcare Epidemiology of America and the Faculty of Science of the Royal College of Pathologists of Australasia, and has published over 400 book chapters and refereed publications.

Saving time and increasing IPC efficiency using Robotic Process Automation

This week, Martin talks to Jincy Jerry, Assistant Director of Nursing in Infection Prevention and Control at the Mater Misericordiae University Hospital, Dublin, Ireland. Jincy is a pioneer in the use of Robotic Process Automation in clinical settings within Irish Healthcare. Robotic process automation (RPA) is a software technology that makes it easy to build, deploy, and manage software robots that emulate humans actions interacting with digital systems and software. In 2021, the project received Prix Hubert Tuor Innovation Academy Award at the 6th International Conference on Prevention and Infection Control (ICPIC), in Geneva.
We discuss the potential and actual benefits, including the freeing up of hours of IP time as well as the use of AI (Artificial Intelligence) in the infection prevention world.
 
A review paper on this topic can be found here:
Piaggio, D., M. Zarro, S. Pagliara, M. Andellini, A. Almuhini, A. Maccaro & L. Pecchia (2023) The use of smart environments and robots for infection prevention control: A systematic literature review. Am J Infect Control, 10.1016/j.ajic.2023.03.005. https://www.ncbi.nlm.nih.gov/pubmed/36924997

A CLEEN study chat and a rude interruption!

In this podcast, we talk about the CLEEN and I-CLEEN studies. These are a RCT and quasi-experimental genomics study aiming to determine the effect of additional cleaning of shared medical equipment of the frequency of healthcare associated infections.  We also make phone call mid podcast...
A shout out to all the team involved in this project, including being wonderfully coordinated by Dr Kate Browne and with great support from Georgia Matterson.  Full details on the website below.
Link to study website: https://cleenstudy.com/
Link to study protocol: https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-023-07144-z
This project is funded by a National Health and Medical Research Council Emerging Leadership Investigator grant (Prof Brett Mitchell, (GNT2008392)).

Surgical site infection, quality improvement and patient involvement with Sinéad Horgan

In this episode, Martin Kiernan talks to Sinèad Horgan, Director of Nursing South/South West Hospital Group, and School of Nursing and Midwifery, College of Medicine and Health, University College Cork in Ireland. We discuss a journey towards surgical site sueveillance and quality improvement and her recent papers on this topic. We discuss knowledge, attitudes, gaining engagement, buy-in and the importance of patient involvement in SSI prevention.
Papers discussed include:
Horgan S, et al. Healthcare professionals' knowledge and attitudes of surgical site infection and surveillance: A narrative systematic review. Nurse Educ Pract. 2023;69:103637.  HTTPS://doi:10.1016/j.nepr.2023.103637
Horgan S, et al. Impact of a quality improvement intervention on the incidence of surgical site infection in patients undergoing colorectal surgery: Pre-test-post-test design. J Clin Nurs. 2023.  HTTPS://doi:10.1111/jocn.16690
Troughton R, et al. Understanding determinants of infection control practices in surgery: the role of shared ownership and team hierarchy. Antimicrob Resist Infect Control. 2019;8:116.  https://doi:10.1186/s13756-019-0565-8

Implementation of HAP Prevention - not what you do but the way that you do it

In this episode, we discuss a paper in the Lancet Infectious Disease about preventing non-ventilator associate pneumonia including the determinants of implementationsuccess. Brett and Martin chat with Dr Aline Wolfensberger and Professor Hugo Sax, authors of this paper about this important work.
Link to paper: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(22)00812-X/fulltext
 
Dr Aline Wolfensberger is a medical doctor, certified in Internal Medicine and in Infectious Diseases and Hospital Epidemiology. She works at the Department of Infectious Diseases and Hospital Epidemiology of the University Hospital Zurich with Professor Hugo Sax. Prof Hugo Sax is a Swiss ID physician who worked for the last 20 years as a leader in infection prevention and control.
 
 

Have gloves and gowns had their day?

Brett Mitchell talks to Dr Sarah Browning and Professor Josh Davis about a recent paper in Infection, Disease and Health - "Have gloves and gowns had their day?" The evidence for gloves and gowns is discussed, as well as results from a recent survey into their use in Australia and New Zealand.
Sarah is an infectious disease physician and Director of Infection Prevention and Control at the Hunter New England (HNE) Health District in NSW, Australia. Josh is infectious disease physician and a clinical trialist, also based at HNE and the Hunter Medical Research Institute.
 
A link to the article: https://www.idhjournal.com.au/article/S2468-0451(23)00030-5/fulltext
Reference:
Browning, S., Davis, J. S., & Mitchell, B. G. (2023). Have gloves and gowns had their day? An Australian and New Zealand practice and attitudes survey about contact precautions for MRSA and VRE colonisation. Infection, Disease & Health. DOI: 10.1016/j.idh.2023.03.006

Surveillance and Antimicrobial Stewardship in long-term care facilities

In this episode Phil talks to A/Prof Noleen Bennett* about the state of surveillance and antimicrobial stewardship and what her research has discovered in this area. Noleen also tells about an exciting project she is leading called NISPAC, a streamlined infection and antimicrobial use surveillance system for Australian Residential Aged Care Facilities.
*Associate Professor Noleen Bennett. Infection Control Consultant, Victorian Healthcare Associated Infection Surveillance Coordinating Centre and the National Centre for Antimicrobial Stewardship.
 
Further information:
NISPAC
VICNISS 
An evaluation of influenza, pneumococcal and herpes zoster vaccination coverage in Australian aged care residents, 2018 to 2022
Infection prevention quality indicators in aged care: ready for a national approach
Skin and soft tissue infections and current antimicrobial prescribing practices in Australian aged care residents

Outbreaks you didn’t know that you had - the joy of whole genome sequencing

In this episode recorded at the 2023 SHEA Spring Meeting in Seattle, Martin talks to Associate Professor Alex Sundermann about his work on sequencing all isolates from local healthcare settings and the discoveries that this enables. Healthcare infections due to previous admissions, endoscopes, even pseudo-outbreaks are all laid bare by this approach. Some recent papers from the group are listed below:
1. Sundermann AJ, et al. Two artificial tears outbreak-associated cases of XDR Pseudomonas aeruginosa detected through whole genome sequencing-based surveillance. medRxiv. 2023.
https://doi:10.1101/2023.04.11.23288417 2. Sundermann AJ, et al. Sensitivity of National Healthcare Safety Network definitions to capture healthcare-associated transmission identified by whole-genome sequencing surveillance. Infect Control Hosp Epidemiol. 2023:1-3. https://doi:10.1017/ice.2023.52 3. Branch-Elliman W, et al. The future of automated infection detection: Innovation to transform practice (Part III/III). Antimicrob Steward Healthc Epidemiol. 2023;3(1):e26. https://doi:10.1017/ash.2022.333 4. Sundermann AJ, et al. Whole-genome sequencing surveillance and machine learning for healthcare outbreak detection and investigation: A systematic review and summary. Antimicrob Steward Healthc Epidemiol. 2022;2(1):e91. https://doi:10.1017/ash.2021.241 5. Sundermann AJ, et al. Whole-Genome Sequencing Surveillance and Machine Learning of the Electronic Health Record for Enhanced Healthcare Outbreak Detection. Clin Infect Dis. 2022;75(3):476-482. https://doi:10.1093/cid/ciab946 6. Sundermann AJ, et al. Outbreak of Pseudomonas aeruginosa Infections from a Contaminated Gastroscope Detected by Whole Genome Sequencing Surveillance. Clin Infect Dis. 2021;73(3):e638-e642. https://doi:10.1093/cid/ciaa18877. Kumar P, et al. Method for Economic Evaluation of Bacterial Whole Genome Sequencing Surveillance Compared to Standard of Care in Detecting Hospital Outbreaks. Clin Infect Dis. 2021;73(1):e9-e18. https://doi:10.1093/cid/ciaa512 8. Sundermann AJ, et al. Automated data mining of the electronic health record for investigation of healthcare-associated outbreaks. Infect Control Hosp Epidemiol. 2019:1-6. https://doi:10.1017/ice.2018.343

Staff opinions of automated hand hygiene monitoring

In this second discussion of an abstract presented at the SHEA Spring meeting 2023 in Seattle, Martin talks to MPH candidate Olivia Hess about her work on staff opinions of automated hand hygiene monitoring. Olivia works as a member of Dr Gonzalo Bearman's group at VCU Health (Virginia Commonwealth University) in Richmond, Virginia. We discuss staff attitudes to the technology and it's utility, which are almost universally negative.
Some recent papers on automated hand hygiene monitoring:
M. A. Tremblay, et al. 2022 Investigation of Individual Nurses' Relative Hand Hygiene Performance Using an Anonymous Automated Electronic Hand Hygiene Monitoring System and a Nursing Assignment Schedule Am J Infect Control https://10.1016/j.ajic.2022.05.026
V. Mouajou, et al. 2022 Hand hygiene compliance in the prevention of hospital-acquired infections: a systematic review J Hosp Infect 119 33-48 https://10.1016/j.jhin.2021.09.016
K. J. McKay, et al. 2022 Healthcare workers' experiences of video-based monitoring of hand hygiene behaviours: a qualitative study Am J Infect Control https://10.1016/j.ajic.2022.03.010
D. J. Durant, et al. 2020 Adoption of electronic hand hygiene monitoring systems in New York state hospitals and the associated impact on hospital-acquired C. difficile infection rates Am J Infect Control 48 7 733-739 https://10.1016/j.ajic.2020.04.005
And thanks to Marco Bo Hansen for reminding us of this recent paper
A. R. Knudsen, et al. 2023 Individual hand hygiene improvements and effects on healthcare-associated infections: A long-term follow-up study using an electronic hand hygiene monitoring system J Hosp Infect In Press https://10.1016/j.jhin.2023.02.017

Human factors and cleaning in the perioperative setting

In this episode recorded at the 2023 SHEA Spring Meeting in Seattle, Martin talks to abstract presenter Dr Lamia Alam about the work of a Johns' Hopkins group on a systematic review of human factors relating to cleaning in the Operating Room. We discuss the abstract presented at the meeting and also previous work in human factors and environmental service workers from this group that are particular favourites of Martin's (detailed below).
Relevant papers:
1. A. Xie, et al. 2018 Improving Daily Patient Room Cleaning: An Observational Study Using a Human Factors and Systems Engineering Approach IISE Transactions on Occupational Ergonomics and Human Factors 6 3-4 178-191 https://10.1080/24725838.2018.1487348
2. C. Rock, et al. 2016 Using a Human Factors Engineering Approach to Improve Patient Room Cleaning and Disinfection Infect Control Hosp Epidemiol 37 12 1502-1506 https://10.1017/ice.2016.219