Practical Model of Infection Prevention and Control in Intensive Care Units for Iran
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Abstract
Background and Objectives: Nosocomial infections, especially in intensive care units as well as increased mortality and costs associated with them are considered as one of the major health problems in the communities so that successful control of them requires awareness on their problems in the hospitals and a precise planning. This study was conducted to "provide a model for prevention and control of nosocomial infections in intensive care units".
Methods and Materials: This qualitative study was conducted through purposeful sampling strategy on 21 healthcare providers selected via purposive sampling from various medical subgroups, including: anesthesiologist, nurse manager, supervisors, faculty members, head nurses, and hospital managers. The data were collected using semi-structured interviews and conventional content analysis method was used for data analysis. In the second phase, a comparative study of the situation of our country and targeted countries was conducted and in the third phase a practical model is designed.
Results: The results of qualitative content analysis using conventional approach in the field of staff's experiment regarding the model of prevention and control of nosocomial infections in intensive care units, revealed 3 main themes: "barriers (human factors, environmental factors, personal factors and complexity)", "facilitating factors (organizational, external and internal stimuli) ", and "concepts of the model (effectiveness of infection control training process in ICU, the systematic nature of the process of infection control, public hospital management, resource management and organizational leadership)". After a comparative study, the applied model of control and prevention of nosocomial infection in the ICU was designed with seven models, including standards (caring-curing and structural), monitoring and supervision, education and training, logistic resources, modern technologies, translation and knowledge transfer and evidence-based practice.
Conclusion: Identifying the barriers and facilitating factors of nosocomial infection control and the use of especial measures in ICU promote the patient's safety and enhance the quality of care. Prevention of these infections requires a comprehensive and integrated controlling program. This model can be applied to resolve existing gaps and cause maximum integrity between the concepts.
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References
I. Darvishpoor K, Rezaei Manesh MR. Prevalence of nosocomial infections and microbial causes in Torbat heydariyeh 9dey educational and clinical hospital in 2012 and 2013. Iranian Journal of Medical Microbiology. 2016;10(1):93-6.
II. Mobaien AR, Amirhasani S, Nekoei A, Moghimbeigi E, Nekoei B. Study of nosocomial urinary tract infections in the ICUs of Hamadan Besat and Ekbatan Hospitals during the 1387-89 Period. J Adv Med Biomed Res. 2012;20(79):94-102.
III. Mohammadnejad E, Abbaszadeh A, Soori H, Afhami S. Prevention and control of nosocomial infections proceeding in intensive care units: A content analysis study. Acta Medica Mediterranea. 2016;32:1295.
IV. Shakib P, Lavakhamseh H, Mohammadi B. The prevalence of nosocomial infection in ICU, Besat Hospital, Sanandaj City, Iran. 2014.
V. Trubiano JA, Padiglione AA. Nosocomial infections in the intensive care unit. Anaesthesia & Intensive Care Medicine. 2015;16(12):598-602.
VI. Amini M, Sanjary L, Vasei M, Alavi S. Frequency evaluation of the nosocomial infections and related factors in Mostafa Khomeini Hospital" ICU" based on" NNI" system. JAUMS. 2009;7(1):9-14.
VII. Allah-Bakhshian A, Moghaddasian S, Zamanzadeh V, Parvan K, Allah-Bakhshian M. Knowledge, attitude, and practice of ICU nurses about nosocomial infections control in teaching hospitals of Tabriz. Iran journal of nursing. 2010;23(64):17-28.
VIII. Dehghani K, Nasiriani K, Mousavi T. Investigating intensive care unit nurses' performance and its adjusting with standard. SSU_Journals. 2014;21(6):808-15.
IX. Kalantarzadeh M, Mohammadnejad E, Ehsani SR, Tamizi Z. Knowledge and practice of nurses about the control and prevention of nosocomial infections in emergency departments. Archives of clinical infectious diseases. 2014;9(4).
X. Bagheri P. The review systematic and meta analysis of prevalence and causes of nosocomial infection in Iran. Iranian Journal of Medical Microbiology. 2015;8(4):1-12.
XI. Ding J-G, Sun Q-F, Li K-C, Zheng M-H, Miao X-H, Ni W, et al. Retrospective analysis of nosocomial infections in the intensive care unit of a tertiary hospital in China during 2003 and 2007. BMC infectious diseases. 2009;9(1):1-6.
XII. Majumdar SS, Padiglione AA. Nosocomial infections in the intensive care unit. Anaesthesia & intensive care medicine. 2012;13(5):204-8.
XIII. Chandramathi K, Padmavathi P, Rajeswari S. Hypertonic Saline Nebulized Suctioning for Tracheostomy Patients. International Journal of Nursing Critical Care. 2019;5(2):9-15.
XIV. Rabirad N, Nejad EM, Hadizadeh MR, Begjan J, Ehsani SR. The prevalence of TB in HIV patients and risk factor with frequent referral (Iran, 2009-10). Iranian Red Crescent Medical Journal. 2013;15(1):58.
XV. Mohammad Nejad E, Jafari S, Mahmoodi M, Begjani J, Roghayyeh Ehsani S, Rabirad N. Hepatitis B virus antibody levels in high-risk health care workers. Hepat Mon. 2011 ;11(8):662-3.
XVI. Abdollahi A. Comparison of patient-collected and lab technician-collected nasopharyngeal and oropharyngeal swabs for detection of COVID-19 by RT-PCR. Iranian journal of pathology. 2020;15(4):313.
XVII. Ghadmgahi F, Zighaimat F, Ebadi A, Houshmand A. Knowledge, attitude and self-efficacy of nursing staffs in hospital infections control. Journal Mil Med. 2011;13(3):167-72.
XVIII. Bikmorady A, Mardani D, Soltanian A, Khatiban M. The impact of educational evidence-based hand washing program on knowledge, attitude, and adherence of intensive care unit nurses. Scientific Journal of Hamadan Nursing & Midwifery Faculty. 2013;21:5-13.
XIX. Cheraghi MA, Nejad EM, Begjani J, Rabirad N, Ehsani SR, Kaji MA. Knowledgeand attitudes of nurses regarding HIV/AIDS (Tehran–2010). Iran J Clin Infect Dis. 2011;6(3):121-3.
XX. Ehsani SR, Mohammadnejad E, Hadizadeh MR, Mozaffari J, Ranjbaran S, Deljo R, et al. Epidemiology of needle sticks and sharp injuries among nurses in an Iranian teaching hospital. Archives of Clinical Infectious Diseases. 2012;8(1):27-30.
XXI. Neuendorf KA, Kumar A. Content analysis. The international encyclopedia of political communication. 2015:1-10.
XXII. Walker LO, Avant KC. Strategies for theory construction in nursing: Pearson/Prentice Hall Upper Saddle River, NJ; 2005.
XXIII. Bailey RR. Modeling the Epidemiologic and Economic Impacts of Nosocomial Infection Prevention Strategies: University of Pittsburgh; 2011.
XXIV. Siron S, Dagenais C, Ridde V. What research tells us about knowledge transfer strategies to improve public health in low-income countries: a scoping review. International journal of public health. 2015;60(7):849-63.
XXV. Bull S, Roberts N, Parker M. Views of ethical best practices in sharing individual-level data from medical and public health research: A systematic scoping review. Journal of Empirical Research on Human Research Ethics. 2015;10(3):225-38.
XXVI. Titler MG. The evidence for evidence-based practice implementation. Patient safety and quality: An evidence-based handbook for nurses. 2008.
XXVII. Kvernbekk T. The concept of evidence in evidence‐based practice. Educational Theory. 2011;61(5):515-32.
XXVIII. Curtis K, Fry M, Shaban RZ, Considine J. Translating research findings to clinical nursing practice. Journal of clinical nursing. 2017;26(5-6):862-72.
XXIX. Tingen MS, Burnett AH, Murchison RB, Zhu H. The importance of nursing research. Journal of Nursing Education. 2009;48(3):167-70.
XXX. Collins AS. Preventing health care–associated infections. Patient safety and quality: An evidence-based handbook for nurses. 2008.
XXXI. Van Graan AC, Williams MJ, Koen MP. Professional nurses' understanding of clinical judgement: A contextual inquiry. health sa gesondheid. 2016;21:280-93.
XXXII. Pratt R, Pellowe C, Wilson J, Loveday H, Harper P, Jones S, et al. epic2: National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. Journal of Hospital infection. 2007;65:S1-S59.
XXXIII. .Loveday HP, Wilson JA, Pratt RJ, Golsorkhi M, Tingle A, Bak A, et al. epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. Journal of Hospital infection. 2014;86:S1-S70.
XXXIV. Mehta Y, Gupta A, Todi S, Myatra S, Samaddar D, Patil V, et al. Guidelines for prevention of hospital acquired infections. Indian journal of critical care medicine: peer-reviewed, official publication of Indian Society of Critical Care Medicine. 2014;18(3):149.
XXXV. McKibben L, Horan T, Tokars JI, Fowler G, Cardo DM, Pearson ML, et al. Guidance on public reporting of healthcare-associated infections: recommendations of the Healthcare Infection Control Practices Advisory Committee. American journal of infection control. 2005;33(4):217-26.
XXXVI. Allegranzi B, Pittet D. Role of hand hygiene in healthcare-associated infection prevention. Journal of Hospital infection. 2009;73(4):305-15.
XXXVII. Haque M, Sartelli M, McKimm J, Bakar MA. Health care-associated infections–an overview. Infection and drug resistance. 2018;11:2321.