Infectious Disease

Taking infection prevention recommendations ‘from paper to bedside’

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Disclosures:
Trivedi owns Trivedi Consults. Please see the article for all other authors’ relevant financial disclosures.

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Key takeaways:

  • A new chapter of a compendium for infection prevention guidance teaches hospitals how to implement the guidance.
  • It is intended for a wide audience — including infection prevention and control teams.

Experts published new recommendations focused on helping hospitals implement evidence-based infection prevention recommendations into practice.

Implementing Strategies to Prevent Infections in Acute Care Settings is a new section of a compendium first published in 2008 by the Society for Healthcare Epidemiology of America, the Infectious Diseases Society of America, the Association for Professionals in Infection Control and Epidemiology, the American Hospital Association , and The Joint Commission.

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The recommendations included in the new section — which was also published in Infection Control & Hospital Epidemiology — account for the different conditions found within each facility.

We spoke with Kavita K. Trivedi, MDa medical epidemiologist for the Alameda County Public Health Department in San Leandro, California, about the new section.

Healio: What prompted the guidance?

Trivedi: This new section is a natural companion to the compendium because it is a compilation of practical tools to successfully implement best practices from the compendium. It’s a way to take the compendium from paper to bedside in order to improve practices for patient safety.

Healio: What does the new guidance cover, where is it published and who is it intended for?

Trivedi: This new chapter summarizes more than nine models for implementing compendium recommendations for preventing common health care-associated infections. It is meant to help bridge the “knowing-doing” gap, a term that describes why health care practices often diverge from published evidence to prevent infections that harm patients. It is published in Infection Control & Hospital Epidemiology, and the intended audience is wide, including infection prevention and control teams, public health personnel, health care epidemiologists and specialty groups.

Healio: What are some of the major concepts and frameworks?

Trivedi: A menu of frameworks is presented with application in infection prevention and control, as well as antibiotic stewardship. The complexity of health care systems makes it difficult for health care teams to implement best practices in infection prevention. Understanding factors that promote and hinder adoption within a given setting is an important step to identifying the best framework to deploy in that setting.

Healio: How can the guidance be used by facilities to help implement evidence-based infection prevention recommendations into practice?

Trivedi: Studies in implementation science make it clear that identifying effective interventions is a necessary first step before transferring them into real-world settings in an intentional process. Here we provide the reader with the resources to think about implementation and evaluate the contextual determinants of behavior in order to design more successful, customized interventions for their setting.

Healio: What are some reasons one facility’s approach may not be reproducible at another facility?

Trivedi: Spending time listening and exploring your context, including local factors such as operational support, informatics resources, familiarity and experience, willingness to change and safety is of tremendous value. People are seldom eager to change.

Healio: What is the overall take home message of the guidance?

Trivedi: Five medical societies have published a guidance for operationalizing strategies for infection prevention in acute care settings that account for conditions within the facility, including the culture and communications style of teams, hospital policies, resources available, leadership support and staff buy-in. Implementation of best practices must be well thought out, and this new chapter can provide ways in which to operationalize the recommendations in the compendium.

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