A Blogger's Return: Relishing the Wave of Infection Prevention Science
- A systematic review/meta-analysis examining whether evidence supports use of cefazolin for surgical prophylaxis in hysterectomy. The authors noted a significantly higher SSI risk with cefazolin vs. cefoxitin or cefotetan (risk ratio, 1.7; 95% CI, 1.04–2.77; p = 0.03) and highlighted numerous limitations with the existing clinical studies.
- A human factors analysis of PPE doffing that identified 103 failure modes with PPE removal (including issues related to the person, the place, the equipment, and the training).
- An analysis of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey data to examine if placement in isolation adversely affected the patient experience (while isolation patients noted worse experience in the general ranking of overall care and in aspects of staff responsiveness, experience was similar in all other domains).
- A thoughtful commentary on defining antimicrobial never events that include inappropriate surgical prophylaxis, use of antibiotics for viral URI, and use of antibiotics for asymptomatic bacteriuria (as my hospital uses a Patient Harm Index of raw events for our quality goals, I love this concept, as it gives antibiotic stewardship some clear measures that fall into that framework).
- Another nice analysis illustrating that claims-based billing code data are not useful to assess infection rates (this time: SSI) when compared to NHSN surveillance gold standard. Use to rank hospital quality is even stickier, as illustrated by the finding that 65% of hospitals in the best quartile by claims data were ranked in worse quartiles by NHSN data.
And there are so many more excellent studies and manuscripts, so check it out (and keep pushing the IP evidence base forward)!