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Effectiveness and core components of infection prevention and control programmes in long-term care facilities: a systematic review
Journal of Hospital Infection ( IF 6.9 ) Pub Date : 2019-02-19 , DOI: 10.1016/j.jhin.2019.02.008
M.H. Lee , G.A. Lee , S.H. Lee , Y-H. Park

Background

Infection prevention and control (IPC) is a measure to prevent healthcare-associated infections in healthcare settings. There is limited evidence of the effectiveness of IPC programmes in long-term care facilities (LTCFs).

Aim

To review and analyse the effectiveness and the components of IPC programmes in LTCFs for older adults.

Methods

Electronic databases (PubMed, EMBASE, CINAHL and Cochrane CENTRAL) were searched systematically for English-language articles assessing IPC interventions in LTCFs, published over the last decade (2007–2016). The components of IPC programmes were analysed based on the World Health Organization (WHO) manuals for improving IPC activities. Two reviewers independently assessed the quality of studies using the Cochrane risk-of-bias tool and the risk-of-bias assessment tool for non-randomized studies.

Findings

Seventeen studies met the eligibility criteria; 10 studies were randomized trials (58.8%) and the others were non-randomized trials to examine the impact of IPC programmes on infection and/or performance outcomes of healthcare workers. None of the included studies implemented all of the WHO core components. Behavioural change strategies using education, monitoring and feedback were reported to be successful interventions for reducing the threat of healthcare-associated infections. Generally, studies using four or more elements of the WHO multi-modal strategy reported significant reductions in infection rates.

Conclusions

There is some evidence for the effectiveness of IPC interventions using education, monitoring, feedback and four or more elements of the WHO multi-modal strategy to control healthcare-associated infections in LTCFs.



中文翻译:

长期护理机构感染预防和控制计划的有效性和核心组成部分:系统回顾

背景

感染预防和控制(IPC)是一种在医疗机构中预防与医疗相关的感染的措施。很少有证据表明IPC计划在长期护理机构(LTCF)中的有效性。

目的

审查和分析针对老年人的LTCF中IPC计划的有效性和组成部分。

方法

系统地搜索了电子数据库(PubMed,EMBASE,CINAHL和Cochrane CENTRAL),以评估过去十年(2007-2016年)发表的评估IPC在LTCF中的干预措施的英文文章。根据世界卫生组织(WHO)手册对IPC计划的组成部分进行了分析,以改善IPC的活动。两位审稿人使用Cochrane偏倚风险工具和非随机研究偏倚风险评估工具独立评估了研究质量。

发现

十七项研究符合资格标准;10项研究是随机试验(58.8%),其他是非随机试验,以检查IPC计划对医护人员感染和/或绩效结局的影响。纳入的研究均未实施世卫组织的所有核心组成部分。据报道,使用教育,监测和反馈的行为改变策略是减少医疗保健相关感染威胁的成功干预措施。通常,使用世卫组织多式联运战略的四个或更多要素的研究报告,感染率显着降低。

结论

有证据表明,使用教育,监测,反馈和WHO多模式策略的四个或更多个要素来控制LTCF的医疗保健相关感染,IPC干预是有效的。

更新日期:2019-07-18
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