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A comparison of infection control program resources, activities, and antibiotic resistant organism rates in Canadian acute care hospitals in 1999 and 2005: pre- and post-severe acute respiratory syndrome.

https://arctichealth.org/en/permalink/ahliterature154889
Source
Am J Infect Control. 2008 Dec;36(10):711-7
Publication Type
Article
Date
Dec-2008
Author
Dick E Zoutman
B Douglas Ford
Author Affiliation
Department of Pathology and Molecular Medicine, Queen's University and Infection Control Service, Kingston General Hospital, Kingston, Ontario, Canada. zoutmand@kgh.kari.net
Source
Am J Infect Control. 2008 Dec;36(10):711-7
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Analysis of Variance
Bed Occupancy - statistics & numerical data
Canada - epidemiology
Clostridium difficile
Cross Infection - epidemiology
Data Collection
Enterococcus
Health Resources - organization & administration
Hospital Bed Capacity - statistics & numerical data
Hospitals - statistics & numerical data
Humans
Infection Control - methods - organization & administration
Infection Control Practitioners - organization & administration - statistics & numerical data
Logistic Models
Methicillin-Resistant Staphylococcus aureus
Population Surveillance
Severe Acute Respiratory Syndrome - epidemiology
Staphylococcal Infections - epidemiology
Vancomycin Resistance
Abstract
The Resources for Infection Control in Hospitals (RICH) project assessed infection control programs and rates of antibiotic-resistant organisms (AROs) in Canadian acute care hospitals in 1999. In the meantime, the severe acute respiratory syndrome (SARS) outbreak and the concern over pandemic influenza have stimulated considerable government and health care institutional efforts to improve infection control systems in Canada.
In 2006, a version of the RICH survey similar to the original RICH instrument was mailed to infection control programs in all Canadian acute care hospitals with 80 or more beds. We used chi(2), analysis of variance, and analysis of covariance analyses to test for differences between the 1999 and 2005 samples for infection control program components and ARO rates.
72.3% of Canadian acute care hospitals completed the RICH survey for 1999 and 60.1% for 2005. Hospital size was controlled for in analyses involving AROs and surveillance and control intensity levels. Methicillin-resistant Staphylococcus aureus (MRSA) rates increased from 1999 to 2005 (F = 9.4, P = .003). In 2005, the mean MRSA rate was 5.2 (standard deviation [SD], 6.1) per 1000 admissions, and, in 1999, it was 2.0 (SD, 2.9). Clostridium difficile-associated diarrhea rates trended up from 1999 to 2005 (F = 2.9, P = .09). In 2005, the mean Clostridium difficile-associated diarrhea rate was 4.7 (SD, 4.3), and, in 1999, it was 3.8 (SD, 4.3). The proportion of hospitals that reported having new nosocomial vancomycin-resistant Enterococcus (VRE) cases was greater in 2005 than in 1999 (chi(2) = 10.5, P = .001). In 1999, 34.5% (40/116) of hospitals reported having new nosocomial VRE cases, and, in 2005, 61.0% (64/105) reported new cases. Surveillance intensity index scores increased from a mean of 61.7 (SD, 18.5) in 1999 to 68.1 (SD, 15.4) in 2005 (F = 4.1, P = .04). Control intensity index scores trended upward slightly from a mean of 60.8 (SD, 14.6) in 1999 to 64.1 (SD, 12.2) in 2005 (F = 3.2, P = .07). Infection control professionals (ICP) full-time equivalents (FTEs) per 100 beds increased from a mean of 0.5 (SD, 0.2) in 1999 to 0.8 (SD, 0.3) in 2005 (F = 90.8, P
Notes
ReprintIn: Can J Infect Control. 2009 Summer;24(2):109-1519697536
PubMed ID
18834747 View in PubMed
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The confidentiality of patient and physician information in pharmacy prescription records.

https://arctichealth.org/en/permalink/ahliterature181323
Source
CMAJ. 2004 Mar 2;170(5):815-6
Publication Type
Article
Date
Mar-2-2004
Author
Dick E Zoutman
B Douglas Ford
Assil R Bassili
Author Affiliation
Department of Pathology and Molecular Medicine, Queen's University, 76 Stuart Street, Kingston, Ontario K7L 2V7, Canada. zoutman@cliff.path.queensu.ca
Source
CMAJ. 2004 Mar 2;170(5):815-6
Date
Mar-2-2004
Language
English
Publication Type
Article
Keywords
Access to Information - legislation & jurisprudence
Canada
Confidentiality - legislation & jurisprudence
Disclosure - legislation & jurisprudence
Drug Prescriptions
Humans
Informed Consent - legislation & jurisprudence
Medical Records Systems, Computerized - legislation & jurisprudence
Pharmacy
Physician-Patient Relations
Notes
Cites: JAMA. 2000 Jan 19;283(3):373-8010647801
Cites: J Law Med Ethics. 1997 Summer-Fall;25(2-3):98-110, 8211066504
Cites: CMAJ. 2000 Oct 31;163(9):1146-811079059
Cites: CMAJ. 2002 Aug 20;167(4):393-612197705
Cites: BMJ. 2003 Feb 15;326(7385):37312586673
Cites: CMAJ. 2003 Jul 8;169(1):5, 712847016
Cites: CMAJ. 1998 Oct 20;159(8):997-10169834730
Comment In: CMAJ. 2004 Sep 28;171(7):711-2; author reply 71215451823
PubMed ID
14993178 View in PubMed
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A cross-Canada survey of infection prevention and control in long-term care facilities.

https://arctichealth.org/en/permalink/ahliterature152643
Source
Am J Infect Control. 2009 Jun;37(5):358-63
Publication Type
Article
Date
Jun-2009
Author
Dick E Zoutman
B Douglas Ford
Jim Gauthier
Author Affiliation
Department of Pathology and Molecular Medicine, Queen's University and Infection Control Service, Kingston General Hospital, 76 Stuart Street, Kingston, Ontario, Canada. zoutmand@kgh.kari.net
Source
Am J Infect Control. 2009 Jun;37(5):358-63
Date
Jun-2009
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Canada
Cross Infection - epidemiology - prevention & control
Data Collection
Hospital Bed Capacity - statistics & numerical data
Humans
Infection control - methods - standards
Infection Control Practitioners - organization & administration - statistics & numerical data
Long-Term Care
Middle Aged
Organizational Policy
Questionnaires
Residential Facilities - statistics & numerical data
Abstract
Residents in long-term care facilities (LTCFs) are at considerable risk for developing infections. This is the first comprehensive examination of infection control programs in Canadian LTCFs in almost 20 years.
A survey designed to assess resident and LTCF characteristics; personnel, laboratory, computer, and reference resources; and surveillance and control activities of infection prevention and control programs was sent in 2005 to all eligible LTCFs across Canada.
One third of LTCFs (34%, 488/1458) responded. Eighty-seven percent of LTCFs had infection control committees. Most LTCFs (91%) had 24-hour care by registered nurses, and 84% had on-site infection control staff. The mean number of full-time equivalent infection control professionals (ICPs) per 250 beds was 0.6 (standard deviation [SD], 1.0). Only 8% of ICPs were certified by the Certification Board of Infection Control and Epidemiology. Only one fifth of LTCFs had physicians or doctoral level professionals providing service to the infection control program. The median surveillance index score was 63 out of a possible 100, and the median control index score was 79 of 100. Influenza vaccinations were received by 93.0% (SD, 11.3) of residents in 2004.
To bring infection control programs in Canadian LTCFs up to expert suggested resource and intensity levels will necessitate considerable investment. More and better trained ICPs are essential to providing effective infection prevention and control programs in LTCFs and protecting vulnerable residents from preventable infections.
PubMed ID
19217188 View in PubMed
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Evaluation of hospital and patient factors that influence the effective administration of surgical antimicrobial prophylaxis.

https://arctichealth.org/en/permalink/ahliterature174325
Source
Infect Control Hosp Epidemiol. 2005 May;26(5):478-85
Publication Type
Article
Date
May-2005
Author
Bruce R R Turnbull
Dick E Zoutman
Mui Lam
Author Affiliation
Department of Community Health & Epidemiology, Queen's University, Kingston, Ontario, Canada. bruce.turnbull@i3magnifi.com
Source
Infect Control Hosp Epidemiol. 2005 May;26(5):478-85
Date
May-2005
Language
English
Publication Type
Article
Keywords
Aged
Antibiotic Prophylaxis - adverse effects - standards - utilization
Cohort Studies
Female
Hospitals, Teaching - organization & administration
Humans
Male
Middle Aged
Ontario
Patients
Surgical Wound Infection - prevention & control
Abstract
To analyze and model the patient and healthcare system factors that may interfere with the appropriate administration of surgical antimicrobial prophylaxis.
Between 1994 and 1998, surgical-site surveillance data were collected prospectively for a cohort of eligible surgical patients. For all cases, and each individual procedure (cardiothoracic, colonic, gynecologic, orthopedic, or vascular), forward stepwise multiple logistic regression was applied to relate key hospital and patient factors to an effective first prophylactic dose (ie, appropriate administration time, dose, route, and drug).
A 450-bed, tertiary-care teaching hospital in Canada.
A total of 4,835 patients admitted for surgical procedures who required antimicrobial prophylaxis.
Factors positive for an effective first prophylactic dose for all cases were when an order was written (OR, 19.7; CI95, 9.1-42.7; P
PubMed ID
15954487 View in PubMed
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The pandemic influenza planning process in Ontario acute care hospitals.

https://arctichealth.org/en/permalink/ahliterature146597
Source
Am J Infect Control. 2010 Feb;38(1):3-8
Publication Type
Article
Date
Feb-2010
Author
Dick E Zoutman
B Douglas Ford
Matt Melinyshyn
Brian Schwartz
Author Affiliation
Department of Pathology and Molecular Medicine, Queen's University and Infection Control Service, Kingston General Hospital, Kingston, Ontario, Canada. zoutmand@kgh.kari.net
Source
Am J Infect Control. 2010 Feb;38(1):3-8
Date
Feb-2010
Language
English
Publication Type
Article
Keywords
Disaster Planning - statistics & numerical data
Disease Outbreaks - prevention & control
Emergency Service, Hospital - organization & administration
Health Planning - statistics & numerical data
Health Services Research
Hospitals
Humans
Infection Control - organization & administration - statistics & numerical data
Influenza, Human - epidemiology - prevention & control - therapy
Ontario - epidemiology
Organizational Policy
Regional Health Planning - methods
Abstract
There will be little time to prepare when an influenza pandemic strikes; hospitals need to develop and test pandemic influenza plans beforehand.
Acute care hospitals in Ontario were surveyed regarding their pandemic influenza preparedness plans.
The response rate was 78.5%, and 95 of 121 hospitals participated. Three quarters (76.8%, 73 of 95) of hospitals had pandemic influenza plans. Only 16.4% (12 of 73) of hospitals with plans had tested them. Larger (chi(2) = 6.7, P = .01) and urban hospitals (chi(2) = 5.0, P = .03) were more likely to have tested their plans. 70.4% (50 of 71) Of respondents thought the pandemic influenza planning process was not adequately funded. No respondents were "very satisfied" with the completeness of their hospital's pandemic plan, and only 18.3% were "satisfied."
Important challenges were identified in pandemic planning: one quarter of hospitals did not have a plan, few plans were tested, key players were not involved, plans were frequently incomplete, funding was inadequate, and small and rural hospitals were especially disadvantaged. If these problems are not addressed, the result may be increased morbidity and mortality when a virulent influenza pandemic hits.
PubMed ID
20022406 View in PubMed
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The relationship between hospital infection surveillance and control activities and antibiotic-resistant pathogen rates.

https://arctichealth.org/en/permalink/ahliterature176371
Source
Am J Infect Control. 2005 Feb;33(1):1-5
Publication Type
Article
Date
Feb-2005
Author
Dick E Zoutman
B Douglas Ford
Author Affiliation
Queen's University and Infection Control Service, Kingston General Hospital, Kingston, Ontario, Canada. zoutman@cliff.path.queensu.ca
Source
Am J Infect Control. 2005 Feb;33(1):1-5
Date
Feb-2005
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Clostridium difficile
Cross Infection - epidemiology - microbiology
Data Collection
Enterococcus
Hospitals - statistics & numerical data
Humans
Infection Control - methods
Methicillin Resistance
Regression Analysis
Staphylococcus aureus
Vancomycin Resistance
Abstract
Antibiotic-resistant pathogen rates are rising in Canada and the United States with significant health and economic costs. The examination of the relationship of surveillance and control activities in hospitals with rates of nosocomial methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile -associated diarrhea (CDAD), and vancomycin-resistant Enterococcus (VRE) may identify strategies for controlling this growing problem.
Surveys were sent to infection control programs in hospitals that participated in an earlier survey of infection control practices in Canadian acute care hospitals.
One hundred twenty of 145 (82.8%) hospitals responded to the survey. The mean MRSA rate was 2.0 (SD 2.9) per 1000 admissions, the mean CDAD rate was 3.8 (SD 4.3), and the mean VRE rate was 0.4 (SD 1.5). Multiple stepwise regression analysis found that hospitals that reported infection rates by specific risk groups ( r = -0.27, P
PubMed ID
15685127 View in PubMed
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The state of infection surveillance and control in Canadian acute care hospitals.

https://arctichealth.org/en/permalink/ahliterature184252
Source
Am J Infect Control. 2003 Aug;31(5):266-72; discussion 272-3
Publication Type
Article
Date
Aug-2003
Author
Dick E Zoutman
B Douglas Ford
Elizabeth Bryce
Marie Gourdeau
Ginette Hébert
Elizabeth Henderson
Shirley Paton
Author Affiliation
Department of Pathology, Queen's University and Infection Control Service, Kingston General Hospital, Kingston, Ontario, Canada.
Source
Am J Infect Control. 2003 Aug;31(5):266-72; discussion 272-3
Date
Aug-2003
Language
English
Publication Type
Article
Keywords
Acute Disease
Canada - epidemiology
Cross Infection - epidemiology - prevention & control
Data Collection
Drug resistance
Hospitals - standards
Humans
Infection Control - organization & administration
Organizational Policy
Sentinel Surveillance
Abstract
Nosocomial infections and antibiotic-resistant pathogens cause significant morbidity, mortality, and economic costs. The infection surveillance and control resources and activities in Canadian acute care hospitals had not been assessed in 20 years.
In 2000, surveys were mailed to infection control programs in all Canadian hospitals with more than 80 acute care beds. The survey was modeled after the US Study on the Efficacy of Nosocomial Infection Control instrument, with new items dealing with resistant pathogens and computerization. Surveillance and control indices were calculated.
One hundred seventy-two of 238 (72.3%) hospitals responded. In 42.1% of hospitals, there was fewer than 1 infection control practitioner per 250 beds. Just 60% of infection control programs had physicians or doctoral professionals with infection control training who provided services. The median surveillance index was 65.6/100, and the median control index was 60.5/100. Surgical site infection rates were reported to individual surgeons in only 36.8% of hospitals.
There were deficits in the identified components of effective infection control programs. Greater investment in resources is needed to meet recommended standards and thereby reduce morbidity, mortality, and expense associated with nosocomial infections and antibiotic-resistant pathogens.
PubMed ID
12888761 View in PubMed
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7 records – page 1 of 1.