TY  - BOOK
AU  - Benda, Natalie
AU  - Clark, Lindsey
AU  - Hardwick, Matthew J
AU  - Lewis, Vicki R
TI  - Reducing healthcare-associated infections in an ambulatory dialysis unit: Identification and alignment of work system factors
SN  - 0196-6553
KW  - *Catheter-Related Infections/ep [Epidemiology]
KW  - *Catheter-Related Infections/pc [Prevention & Control]
KW  - *Cross Infection/ep [Epidemiology]
KW  - *Cross Infection/pc [Prevention & Control]
KW  - *Infection Control/mt [Methods]
KW  - Ambulatory Care Facilities
KW  - Bacteremia/ep [Epidemiology]
KW  - Communicable Diseases
KW  - Cross Infection/ec [Economics]
KW  - Data Collection
KW  - Guideline Adherence
KW  - Hospital Departments
KW  - Hospitals
KW  - Humans
KW  - Life Style
KW  - Quality Improvement
KW  - Renal Dialysis/ae [Adverse Effects]
KW  - MedStar Health Research Institute
KW  - MedStar Institute for Innovation
KW  - National Center for Human Factors in Healthcare
KW  - Journal Article
KW  - Research Support, U.S. Gov't, P.H.S
N1  - Available online from MWHC library: 1995 - present
N2  - 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
UR  - http://dx.doi.org/10.1016/j.ajic.2014.05.016
ER  -