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Reducing healthcare-associated infections in an ambulatory dialysis unit: Identification and alignment of work system factors.

MedStar author(s):

Citation: American Journal of Infection Control. 42(10 Suppl):S284-90, 2014 Oct.PMID: 25239723Institution: MedStar Health Research Institute | MedStar Institute for InnovationDepartment: National Center for Human Factors in HealthcareForm of publication: Journal ArticleMedline article type(s): Journal Article | Research Support, U.S. Gov't, P.H.S.Subject headings: *Catheter-Related Infections/ep [Epidemiology] | *Catheter-Related Infections/pc [Prevention & Control] | *Cross Infection/ep [Epidemiology] | *Cross Infection/pc [Prevention & Control] | *Infection Control/mt [Methods] | Ambulatory Care Facilities | Bacteremia/ep [Epidemiology] | Communicable Diseases | Cross Infection/ec [Economics] | Data Collection | Guideline Adherence | Hospital Departments | Hospitals | Humans | Life Style | Quality Improvement | Renal Dialysis/ae [Adverse Effects]Local holdings: Available online from MWHC library: 1995 - presentISSN:

0196-6553

Name of journal: American journal of infection controlAbstract: BACKGROUND: Patients undergoing hemodialysis have experienced a 43% increase in rate of hospitalization due to infection during the past 20 years. Research in other industries has shown that safe systems are achieved by considering the entire system to enable performance specifications to be met.CONCLUSIONS: Inconsistent compliance with interventions is hypothesized to be due to organizational and external environment factors.Copyright � 2014 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.METHOD: A sociotechnical systems framework was applied through the Macroergonomic Analysis and Design method to evaluate a 54-chair ambulatory dialysis unit to decrease healthcare-associated infections. Fifty-seven system discrepancies across 6 healthcare-associated infection risk factors were identified. A multicomponent intervention was developed to address 44 of the variances across 4 of the risk factors.RESULTS: Access-related bloodstream infections and access site infections did not improve. Bacterial surface contamination decreased. Process measures for the individual components of the intervention demonstrated varying adherence to the intervention.All authors: Benda N, Clark L, Hardwick MJ, Lewis VRDigital Object Identifier:

http://dx.doi.org/10.1016/j.ajic.2014.05.016

Date added to catalog: 2016-01-13

Holdings ( 1 )
Title notes ( 6 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article		Available		25239723

Available online from MWHC library: 1995 - present

BACKGROUND: Patients undergoing hemodialysis have experienced a 43% increase in rate of hospitalization due to infection during the past 20 years. Research in other industries has shown that safe systems are achieved by considering the entire system to enable performance specifications to be met.

CONCLUSIONS: Inconsistent compliance with interventions is hypothesized to be due to organizational and external environment factors.Copyright � 2014 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

METHOD: A sociotechnical systems framework was applied through the Macroergonomic Analysis and Design method to evaluate a 54-chair ambulatory dialysis unit to decrease healthcare-associated infections. Fifty-seven system discrepancies across 6 healthcare-associated infection risk factors were identified. A multicomponent intervention was developed to address 44 of the variances across 4 of the risk factors.

RESULTS: Access-related bloodstream infections and access site infections did not improve. Bacterial surface contamination decreased. Process measures for the individual components of the intervention demonstrated varying adherence to the intervention.

English