Educational intervention to improve infection prevention and control practices in four companion animal clinics in Switzerland

The Journal of hospital infection(2023)

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摘要
Background: Infection prevention and control (IPC) practices vary among companion animal clinics, and outbreaks with carbapenemase-producing Enterobacterales (CPE) have been described.Aim: To investigate the effect of an IPC intervention (introduction of IPC protocols, IPC lectures, hand hygiene campaign) in four companion animal clinics.Methods: IPC practices, environmental and hand contamination with antimicrobial -resistant micro-organisms (ARM) and hand hygiene (HH) were assessed at baseline, and 1 and 5 months after the intervention.Results: Median IPC scores (% maximum score) improved from 57.8% (range 48.0-59.8%) to 82.9% (range 81.4-86.3%) at 1-month follow-up. Median cleaning frequency assessed by fluorescent tagging increased from 16.7% (range 8.9-18.9%) to 30.6% (range 27.8-52.2%) at 1-month follow-up and 32.8% (range 32.2-33.3%) at 5-month follow-up. ARM con-tamination was low in three clinics at baseline and undetectable after the intervention. One clinic showed extensive contamination with ARM including CPE before and after the intervention (7.5-16.0% ARM-positive samples and 5.0-11.5% CPE-positive samples). Mean HH compliance improved from 20.9% [95% confidence interval (CI) 19.2-22.8%] to 42.5% (95% CI 40.4-44.7%) at 1-month follow-up and 38.7% (95% CI 35.7-41.7%) at 5-month follow-up. Compliance was lowest in the pre-operative preparation area at baseline (11.8%, 95% CI 9.3-14.8%) and in the intensive care unit after the intervention (28.8%, 95% CI 23.3-35.1%). HH compliance was similar in veterinarians (21.5%, 95% CI 19.0-24.3%) and nurses (20.2%, 95% CI 17.9-22.7%) at baseline, but was higher in veterinarians (46.0%, 95% CI 42.9-49.1%) than nurses (39.0%, 95% CI 36.0-42.1%) at 1-month follow-up.Conclusion: The IPC intervention improved IPC scores, cleaning frequency and HH com-pliance in all clinics. Adapted approaches may be needed in outbreak situations.& COPY; 2023 The Authors. Published by Elsevier Ltd on behalf of The Healthcare Infection Society. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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关键词
Antimicrobial resistance,IPC,Hand hygiene,CPE,Carbapenemase-producing,Enterobacterales,Outbreak,Infection
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