Rosa R, Manzanillo K, Dinh H
… +3 more, Martinez OV, Somani J, Abbo LM
Am J Infect Control
· 2026 Jul · PMID 42401339
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BACKGROUND: The economic impact of different testing strategies for Candidozyma auris (C. auris) colonization in at risk patients on hospital admission has not been extensively described. We present cost-savings estimate...BACKGROUND: The economic impact of different testing strategies for Candidozyma auris (C. auris) colonization in at risk patients on hospital admission has not been extensively described. We present cost-savings estimates with different C. auris testing workflows. METHODS: This study was conducted across an integrated health system with a well-established two-step admission screening process. Test turnaround time (TAT), duration of isolation precautions, and costs were compared between performing a laboratory-developed PCR (LDT), utilizing a commercially available PCR kit (Kit), and sending samples to an off-site reference laboratory. Data for the LDT and the Kit were collected from March to September 2025, and a historical cohort was used for the off-site test (August 2019 to July 2021). RESULTS: A total of 2,407 patients underwent testing during the contemporary cohort, and 589 in the historical cohort. The median time from admission to PCR result was 27.0 hours for the LDT and the Kit, and 11 days for the off-site test. The highest cost-savings per year were estimated between $1,173,989.54 - $4,921,343.92 when performing the PCR Kit twice daily. DISCUSSION: Admission screening workflows for C. auris with rapid TAT can streamline operational implementation of infection prevention strategies while delivering cost-effective solutions for health systems.
Takayama N, Aminaka M, Sakaki H
… +4 more, Endo E, Shirai M, Toyoda A, Nishioka M
Am J Infect Control
· 2026 Jul · PMID 42398660
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BACKGROUND: Respiratory infection outbreaks often occur in long-term care (LTC) settings and can disrupt healthcare delivery, including admissions and visitation. METHODS: This study evaluated the cost-effectiveness of t...BACKGROUND: Respiratory infection outbreaks often occur in long-term care (LTC) settings and can disrupt healthcare delivery, including admissions and visitation. METHODS: This study evaluated the cost-effectiveness of the Concurrent Approach for Respiratory Epidemiological Surveillance and Symptom Screening (CARES), which integrates patient syndromic surveillance with staff and visitor symptom screening. We compared two 6-month periods in two wards of a single LTC hospital, including 202 patients (98 non-CARES; 104 CARES). Staff time was assessed using time-motion observations. Incremental effectiveness was measured as reductions in ward-level calendar days under facility-mandated admission suspension, defined as the temporary suspension of new admissions, and visitation restriction, defined as the temporary restriction of family and visitor access. RESULTS: Admission suspension decreased from 16 days in the non-CARES period to 0 days in the CARES period, and visitation restriction decreased from 23 days to 0 days. Incremental cost-effectiveness ratios were US $115.48 per day of admission suspension avoided and US $80.34 per day of visitation restriction avoided. DISCUSSION: CARES demonstrated operational efficiency and measurable benefits in maintaining healthcare access and patient-family interaction. CONCLUSIONS: CARES may be an economically feasible and practical strategy that helps preserve quality of life and supports sustainable infection prevention in LTC settings.
Am J Infect Control
· 2026 Jul · PMID 42386092
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BACKGROUND: Gynecologic surgical site infections (SSIs) are influenced by patient, procedural, environmental, and system-level risks. We evaluated an enterprise risk management-informed program for gynecologic SSIs preve...BACKGROUND: Gynecologic surgical site infections (SSIs) are influenced by patient, procedural, environmental, and system-level risks. We evaluated an enterprise risk management-informed program for gynecologic SSIs prevention in a tertiary hospital in Western China. METHODS: This single-center implementation study included all gynecologic surgical procedures except cesarean deliveries. SSIs included superficial incisional, deep incisional, and organ/space infections identified during hospitalization or within 30 days after surgery. A multidisciplinary team used the Committee of Sponsoring Organizations enterprise risk management (COSO-ERM) framework to conduct failure mode and effects analysis and implement staged infrastructure, process, and intelligence-feedback interventions. Semiannual SSI rates from 2022 to 2025 were analyzed descriptively, with rate ratios used for pre-post comparisons. RESULTS: During 2022-2025, 123 SSIs occurred after 10,954 gynecologic procedures. SSI rates increased from 1.15% in 2022 H1 to 1.76% in 2023 H2, then decreased to 0.64% in 2025 H2. Compared with 2022-2023, the SSI rate decreased from 1.39% to 0.86% during 2024-2025 (rate ratio, 0.62; 95% CI, 0.43-0.88; P =.008). CONCLUSIONS: A multidisciplinary risk management program was temporally associated with lower gynecologic SSI rates and may help hospitals translate surveillance findings into staged infection prevention actions.
Vacca ML, Ehly M, Leahy M
… +2 more, Flomenberg PR, Cook M
Am J Infect Control
· 2026 Jul · PMID 42386091
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A rare case of suspected occupational mpox infection occurred in a registered nurse who developed laboratory-confirmed disease despite strict adherence to full personal protective equipment (PPE) and isolation precaution...A rare case of suspected occupational mpox infection occurred in a registered nurse who developed laboratory-confirmed disease despite strict adherence to full personal protective equipment (PPE) and isolation precautions while caring for a suspected mpox patient. Retrospective review, staff interviews, and public health collaboration identified no clear breach in infection prevention practices, suggesting possible doffing-related or unrecognized exposure. This case highlights persistent transmission risk to healthcare workers and reinforces the importance of meticulous PPE removal and CDC-recommended self-monitoring.
Essani RR, Mehrali S, Mahmood SF
… +2 more, Virani NK, Papathanasoglou E
Am J Infect Control
· 2026 Jun · PMID 42379273
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BACKGROUND: Central line-associated bloodstream infections (CLABSIs) in lower-middle-income countries (LMICs) are a major cause of morbidity and mortality, particularly in patients admitted to intensive care units (ICUs)...BACKGROUND: Central line-associated bloodstream infections (CLABSIs) in lower-middle-income countries (LMICs) are a major cause of morbidity and mortality, particularly in patients admitted to intensive care units (ICUs). Despite the scale of this problem, few studies have explored healthcare provider and organizational factors contributing to CLABSIs in LMIC ICUs, and comprehensive literature syntheses remain scarce. OBJECTIVES: To synthesize the published literature on HCP-related, system-related, and resource-related factors associated with CLABSIs in ICUs of LMICs. METHODS: A scoping review was conducted using the JBI methodology. Four electronic databases (MEDLINE, EMBASE, CINAHL, and SCOPUS) were searched from 2011 to 2024 using predefined eligibility criteria based on the PCC framework. RESULTS: Of 897 articles identified, 30 met the inclusion criteria. Studies were predominantly from the Middle East and North Africa (50%, n=15) and South Asia (43%, n=13), with most using quantitative designs (93%, n=28). Three categories of factors associated with CLABSIs were identified: (1) HCP-related factors, including non-compliance with infection prevention practices, knowledge and training deficits, and technical skill gaps; (2) system-related factors, including weak governance, inadequate policy implementation, poor safety culture, and limited learning opportunities; and (3) resource-related factors, including staffing shortages, high workload, equipment and supply constraints, and financial limitations. CONCLUSION: This review identifies a critical gap in the literature: few studies examine CLABSI prevention from the perspective of healthcare providers in LMIC ICUs. Addressing the interconnected HCP, system, and resource-related barriers identified in this review is essential for developing effective, context-appropriate infection prevention strategies.
Du X, Guo H, Chen Y
… +6 more, Meng Q, Liu M, Lu X, Shi X, Liu C, Li L
Am J Infect Control
· 2026 Jun · PMID 42364880
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BACKGROUND: Healthcare-associated infections remain a global threat to patient safety, with contaminated environmental surfaces serving as important pathogen transmission vectors. Interventional radiology operating rooms...BACKGROUND: Healthcare-associated infections remain a global threat to patient safety, with contaminated environmental surfaces serving as important pathogen transmission vectors. Interventional radiology operating rooms are high-frequency blood exposure settings, yet quantitative contamination data remain scarce. This study applied a quantitative occult blood detection method to assess environmental blood contamination in interventional operating rooms. METHODS: A quantitative occult blood detection method (HGBTEST® WIPES with AI-based image analysis) measured hemoglobin residues at 142 sampling sites (44 operating tables, 37 C-arms, 61 other surfaces) across four operating rooms at a tertiary hospital. Contamination levels were graded using quartile-based thresholds. RESULTS: Environmental blood contamination was widespread (median: 62.21 μg/cm², IQR: 41.37-96.94; mean ± SD: 142.75 ± 337.77; range: 1.23-3026.98 μg/cm²). Operating tables showed the highest contamination (median: 71.19 μg/cm², IQR: 38.47-120.25), followed by other surfaces (median: 66.60 μg/cm², IQR: 46.09-101.02) and C-arms (median: 57.99 μg/cm², IQR: 39.42-67.54). CONCLUSION: This study reveals distribution patterns of environmental blood contamination in interventional radiology operating rooms and proposes three hypothetical contamination pathways. The Pareto distribution pattern suggests optimised resource allocation through targeted cleaning, while the proposed pathways indicate the necessity of differentiated prevention strategies for improving environmental quality.
Am J Infect Control
· 2026 Jun · PMID 42364879
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BACKGROUND: To examine rural-urban differences in vaccination against COVID-19 and influenza since the introduction of the COVID-19 vaccine. METHODS: Our analysis used the National Health Interview Survey from April 2021...BACKGROUND: To examine rural-urban differences in vaccination against COVID-19 and influenza since the introduction of the COVID-19 vaccine. METHODS: Our analysis used the National Health Interview Survey from April 2021-December 2023, including respondents ≥18 years. The outcome was past 12-month vaccination, categorized as vaccination against only influenza, only COVID-19, both, or neither. The primary exposure was rural-urban classification. Multinomial logistic regression modeled vaccination according to rural-urban classification with interaction terms between rural-urban classification and time (months). Another model added a binary control for the end of the public health emergency in May 2023 and its interaction between rural-urban classification. RESULTS: Over our study period, receipt of both vaccines decreased (42% to 28%). On multivariable regression, rural compared to urban respondents had a lower likelihood of receiving both vaccines (relative risk ratio:0.61; 95% confidence interval:0.52,0.71; p<0.001) as compared to receiving neither vaccine. Interaction terms showed that rural-urban differences in receipt of both vaccines did not vary over out study period (p=0.081). CONCLUSIONS: We found that receipt of both vaccines remained lower in rural compared to urban respondents since the end of the pandemic. Lower risk perceptions and self-efficacy in vaccination among rural areas during the pandemic, may have persisted.
Mieusement LMD, Eplett J, Chawla R
… +6 more, Williams V, Wood M, Rizvi A, Sriharan A, Candon HL, Leis JA
Am J Infect Control
· 2026 Jun · PMID 42362087
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BACKGROUND: Unnecessary use of non-sterile gloves (NSG) is associated with potential harms and waste. Despite campaigns aimed at reducing unnecessary NSG use, there is significant opportunity to develop targeted interven...BACKGROUND: Unnecessary use of non-sterile gloves (NSG) is associated with potential harms and waste. Despite campaigns aimed at reducing unnecessary NSG use, there is significant opportunity to develop targeted interventions to improve practice. METHODS: We performed a multi-facility observational study across acute care, rehabilitation, nursing home and chronic care. Trained observers were randomized to location and time to observe NSG use during patient care activities. The primary outcome was the proportion of all observations where NSGs were used, and the proportion that were considered unnecessary (e.g., touching intact skin, or performing activities where hand hygiene alone is sufficient). RESULTS: NSG were worn in 548 (63%) of observations and deemed unnecessary in 268 (49%, 95% CI; 44.7-53.1). The activities that contributed to the largest amount of unnecessary NSG use included mobilizing a patient (76/103, 74%), speaking to a patient (81/133, 61%), touching intact skin (48/93, 52%) and taking vital signs (20/37, 54%). Combined, these four clinical activities contributed to 66% (172/268) of all unnecessary NSG use and was consistent across all healthcare settings. CONCLUSIONS: Unnecessary NSG use remains pervasive across different healthcare sectors. A significant proportion of this waste could be eliminated by focusing on a few simple targeted practice changes.
Howard-Anderson J, Dotto VR, Gottlieb LB
… +11 more, Grooms L, Holder C, Reif L, Johnson K, Gent J, Love K, Regina R, Murphy DJ, Jacob JT, Kraft CS, Mumma JM
Am J Infect Control
· 2026 Jun · PMID 42349659
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BACKGROUND: During the COVID-19 pandemic, central line-associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) increased substantially across U.S. hospitals. METHODS: We perf...BACKGROUND: During the COVID-19 pandemic, central line-associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) increased substantially across U.S. hospitals. METHODS: We performed qualitative analyses of free-text contributing factors reported in apparent cause analyses (ACAs) of CLABSIs and CAUTIs occurring August 2020-August 2022 within an academic healthcare system in Atlanta, GA. We developed a framework for classifying contributing factors in terms of critical infection prevention tasks as well as issues affecting these tasks. RESULTS: We reviewed 350 CLABSI ACAs with 602 contributing factors and 240 CAUTI ACAs with 405 contributing factors. The framework comprised nine CLABSI-specific and seven CAUTI-specific tasks, and 11 issues affecting tasks for both infection types. The tasks most frequently implicated in CLABSIs were patient bathing (29%) and central line dressing maintenance (23%); in CAUTIs, the most frequent tasks were urinary catheter care (37%) and the assessment of catheter necessity (32%). Although these tasks were affected by nearly every issue, documentation gaps and knowledge or skills deficits were particularly prevalent, with the latter being the primary issue for some infrequently reported tasks (e.g., drawing blood from central lines and use of bowel management systems). CONCLUSIONS: This task-issue framework links infection prevention tasks to systemic issues that undermine their performance and may help quality improvement teams monitor trends and design targeted interventions to strengthen CLABSI and CAUTI prevention.
Ben-Amram H, Azrad M, Michael Y
… +3 more, Edelshtein S, Peretz A, Agay-Shay K
Am J Infect Control
· 2026 Jun · PMID 42349658
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BACKGROUND: Hospitalization reasons may reflect vulnerability and influence risks of hospital-acquired infections (HAI) and resistant infections (HARI). AIM: To evaluate the association between hospitalization reasons an...BACKGROUND: Hospitalization reasons may reflect vulnerability and influence risks of hospital-acquired infections (HAI) and resistant infections (HARI). AIM: To evaluate the association between hospitalization reasons and the risk of HAI and HARI. METHODS: We analyzed 17,240 adult admissions (2020-2022). Reasons were coded using ICD-9 diagnostic categories. HAI/HARI were identified by antibiotic susceptibility testing. Generalized linear models assessed crude and adjusted associations. RESULTS: Infections occurred in 322 patients (1.9%). Compared with tissue, skeleton and nervous system disorders, adjusted HAI risk was higher for endocrine, metabolic and immunity disorders (OR=3.1; 95.0% CI: 1.8 - 5.3; P <.001), neoplasms (OR=2.3; 95.0% CI: 1.3 - 4.0, P =.002), genitourinary disorders (OR=2.4; 95.0% CI: 1.0 - 3.8, P =.020), circulatory and blood disorders (OR=1.9; 95.0% CI: 1.2 - 3.0, P =.002) and digestive disorders (OR=1.7; 95.0% CI: 1.1 - 2.4, P =.004). Circulatory and blood disorders also increased HARI risk (OR=3.0; 95.0% CI: 1.5 - 6.1, P =.002). Respiratory disorders showed the strongest associations for both outcomes (HAI: OR=5.0; 95.0% CI: 3.4 - 7.4, P <.001, HARI: OR=6.5; 95.0% CI: 3.4 - 12.2, P <.001). CONCLUSIONS: Identifying high-risk groups based on hospitalization reason may guide tailored infection control and targeted surveillance, potentially reducing the clinical burden of HAI and HARI.
Am J Infect Control
· 2026 Jun · PMID 42320825
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BACKGROUND: Implementation science and sentiment analysis may help understand determinants of physician perspectives on infection prevention and control (IPC), with an aim to guide future IPC education efforts. METHODS:...BACKGROUND: Implementation science and sentiment analysis may help understand determinants of physician perspectives on infection prevention and control (IPC), with an aim to guide future IPC education efforts. METHODS: Mobile ethnography was employed between May and June 2024. Thirty English-speaking U.S. physicians of various specialties completed 3-7 mobile journal entries over a 15-day period. The prompts asked questions related to IPC knowledge, feelings about IPC in their facilities, and daily challenges and successes. De-identified journal entries were analyzed using the Theoretical Domains Framework (TDF) to identify relevant determinants. Sentiment analysis was done on all coded journal entries to identify which frameworks correlate with positive physician sentiments. RESULTS: Of 30 physicians recruited, 25 finished all 7 journal entries. The domains "environmental context" (25.1%) and "social and professional role and identity" (20.3%) were the most frequently coded. The two domains with the most positive sentiment score were "beliefs about capabilities" and "skills" (+4.84 and +4.19, respectively) and the two domains with the lowest sentiment score were "emotion" and "reinforcement" (-5.56 and -1.39, respectively). CONCLUSIONS: Strong IPC programs require clinical environments that support IPC practices and recognize physicians as healthcare leaders. IPC education must include specific information on the implications of not adhering to IPC protocols for both patients and healthcare professionals.
Wilson GM, Ray C, Jacob RL
… +10 more, Vivo A, Jackson R, Cooper R, Nwankpa C, Kota SM, Hicks N, Jones M, Pfeiffer C, Klutts JS, Evans CT
Am J Infect Control
· 2026 Jun · PMID 42314876
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BACKGROUND: Placing patients on contact precautions (CP) reduces the spread of infection. VA Bug Alert (VABA) was developed to notify VA infection control staff of new patients with MDRO colonization or infection. This s...BACKGROUND: Placing patients on contact precautions (CP) reduces the spread of infection. VA Bug Alert (VABA) was developed to notify VA infection control staff of new patients with MDRO colonization or infection. This study examined the link between VABA use and CP initiation. METHODS: Patients who had an MDRO-positive culture were included. Medical chart reviews were conducted on 660 admissions for evidence of a CP order. Logistic regression determined the likelihood of patients being placed into CP within 24 hours of admission. Kaplan-Meier survival analysis assessed whether VABA utilization was associated with a shorter time to CP. RESULTS: The final analysis included 659 admissions. Half of the patients were placed into CP within 24 hours of admission. High VABA use had a 69% increased likelihood of being placed into contact precautions within 24 hours compared to low. Kaplan-Meier analysis showed that patients at facilities in the highest tertile of VABA use had faster time to CP (median 2.1 hours) than those in the lower tertiles (median 6.3 hours) (p = 0.036). CONCLUSIONS: VABA use is associated with earlier and more rapid placement into CP, demonstrating the alert system's effectiveness in rapidly identifying MDRO patients to reduce the spread of infection.
Srikanth S, Ching PR, Rittmann B
… +5 more, Pedersen L, Wooten R, Olkonen T, Cooper K, Doll M
Am J Infect Control
· 2026 Jun · PMID 42314875
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INTRODUCTION: Hand hygiene (HH) performance in our facility declined during the COVID-19 pandemic and failed to return to baseline despite a widespread education campaign and increased HH rounding. To better understand p...INTRODUCTION: Hand hygiene (HH) performance in our facility declined during the COVID-19 pandemic and failed to return to baseline despite a widespread education campaign and increased HH rounding. To better understand provider perceptions and inform future interventions, we conducted a survey examining self-evaluation of HH performance. METHODS: The survey assessed perceived HH performance relative to peers, opportunities for improvement, factors causing variation in personal HH practice (workload/acuity, time of day, and patient characteristics), and burnout using a validated, single-item scale. Surveys were conducted in-person with clinical providers on high-performing and lower-performing units. Non-clinical staff were excluded. Self-perception of performance was compared against other variables using the Kruskal-Wallis test, using SAS 9.4, Cary, NC. RESULTS: One hundred surveys were completed. The majority of those surveyed believed themselves to be in the top quartile of HH performers (87%). The actual HH compliance measured on these 4 units for 1/2024-11/2024 was 65% based on 7,436 directly-observed opportunities. No one selected bottom quartiles. There was no difference in perceived performance by unit (P = .4006), years of experience (P = .9679), or burnout (P = .2621). CONCLUSION: HH performance was perceived to be better than average by the majority of inpatient healthcare providers surveyed, despite data from these units indicating opportunities. Further improvement in HH will be difficult without efforts to move perception closer to reality for individual healthcare providers.
Roghmann MC, O'Hara LM, Mayoryk S
… +5 more, Robinson GL, Lydecker AD, French I, Paszkiewicz G, Johnson JK
Am J Infect Control
· 2026 Jun · PMID 42314874
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BACKGROUND: Nursing home residents have a high prevalence of multidrug-resistant organism (MDRO) colonization. CDC guidance recommends enhanced barrier precautions (EBP) for residents with novel or targeted MDROs and res...BACKGROUND: Nursing home residents have a high prevalence of multidrug-resistant organism (MDRO) colonization. CDC guidance recommends enhanced barrier precautions (EBP) for residents with novel or targeted MDROs and residents with indwelling medical devices or wounds, regardless of MDRO status. The guidance permits facilities to apply EBP to residents colonized with additional MDROs, as appropriate. METHODS: This study reports on prospective admission surveillance cultures collected during a trial evaluating EBP in 4 Maryland nursing homes. Our objective was to assess effectiveness of EBP indications for identifying residents with MDRO colonization. We collected clinical characteristics and surveillance cultures from the anterior nares and inguinal skin to estimate MDRO colonization prevalence. RESULTS: Among 580 mostly short-stay residents, 31% had one or more EBP indication; 21% had a MDRO history; 13%, a medical device; and 9%, a chronic wound. Surveillance cultures detected MDRO colonization in 21% of residents. Only 1 resident had carbapenemase-producing Gram-negative bacilli; no residents had Candidozyma auris. Only 25% of residents with MDRO history were culture-positive, and 25% of MDRO-colonized by culture residents had a MDRO history. CONCLUSIONS: MDRO history was the most common indication for EBP among short-stay residents. Novel or targeted MDROs were rare and most with MDRO history were not MDRO culture-positive. MDRO history poorly identified current MDRO-culture positive residents and may not be an effective EBP indication. GOV STUDY NUMBER: NCT03319368.
Am J Infect Control
· 2026 Jun · PMID 42309368
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BACKGROUND: Ambulatory medical assistants (MAs) and certified medical assistants (CMAs) receive less guidance from subject matter expert educators (SMEEs) than hospital nurses, increasing reliance on informal skills tran...BACKGROUND: Ambulatory medical assistants (MAs) and certified medical assistants (CMAs) receive less guidance from subject matter expert educators (SMEEs) than hospital nurses, increasing reliance on informal skills transfer and perpetuating risks. METHODS: A quasi-experiential study with single group, pre-post intervention across 19 skills fairs, with standardized content, grounded in adult learning theory and high-reliability principles. 528 CMAs/MAs reviewed hand hygiene (HH), point-of-care testing (POCT), and intramuscular (IM) vaccination with SMEEs, using inquiry-driven methods. RESULTS: Infection prevention (IP) knowledge improved significantly post-intervention for HH (55.2% vs 15.8%), POCT (70.4% vs 23.8%), and IM vaccination (82.2% vs 33.6%). Self-confidence increased from 63% to 81% post-intervention. Participants rated the fair positively (4.9/5), and qualitative feedback was favourable (71.4%). SMEEs also identified deviations from safe IP practices in HH, needle selection, and patient instructions for POCT. CONCLUSIONS: A psychologically safe, hands-on skills fair significantly improved ambulatory CMA/MA knowledge and confidence while uncovering latent patient safety risks. Despite limitations related to short term knowledge assessment and real world application, findings support routine experiential skills fair as a high-impact strategy to review best practices and strengthen ambulatory IP and patient safety techniques.
Trudeau KT, Frith J, Furmanek S
… +3 more, Chandler TR, Sikes KL, Forton M
Am J Infect Control
· 2026 Jun · PMID 42303071
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BACKGROUND: Infection prevention and control training is vital to keeping patients and healthcare workers safe. Simulation is an established tool for healthcare education but novel to the context of infection prevention...BACKGROUND: Infection prevention and control training is vital to keeping patients and healthcare workers safe. Simulation is an established tool for healthcare education but novel to the context of infection prevention and control. Experiential learning theory supports the use of simulations to create experiences adults can learn from. The Kentucky Infection Prevention Training Center (KyIP) sought to fill this gap with infection prevention simulations and conduct a program evaluation. METHOD: To provide hands-on training in a location convenient for the learners, KyIP piloted mobile simulation training for Infection Prevention. RESULTS: Of 247 learners trained, 72 completed the survey, yielding a 29% response rate. Compared to a benchmark rate of 85%, nearly all respondents reported they will use the information they learned in the simulation (99%, P = .001), found the simulation to be impactful (96%, P = .008), and reported an increase in confidence (89%, P = .224). DISCUSSION: Mobile simulation training for infection prevention is useful and impactful to the learner. Further studies are needed to determine effects on behavior change and infection rates. CONCLUSIONS: These findings suggest that mobile simulation may serve as a scalable model for infection prevention training across diverse healthcare settings.
Am J Infect Control
· 2026 Jun · PMID 42297048
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BACKGROUND: Compliance with surgical antimicrobial prophylaxis (SAP) remains suboptimal worldwide, particularly regarding appropriate timing and duration. Inappropriate practices, including early administration and prolo...BACKGROUND: Compliance with surgical antimicrobial prophylaxis (SAP) remains suboptimal worldwide, particularly regarding appropriate timing and duration. Inappropriate practices, including early administration and prolonged prophylaxis, contribute to antimicrobial resistance and increased health care costs. To evaluate the impact of a multidisciplinary intervention, including the implementation of a preoperative antibiotic room, on SAP compliance and its sustainability over time. METHODS: This quasi-experimental pre-post study was conducted in a tertiary care hospital between 2022 and 2025. The intervention included establishing a preoperative antibiotic administration area, standardizing workflow processes, and providing regular education and feedback to surgical teams. SAP compliance was assessed according to national and international guidelines. RESULTS: Overall SAP compliance improved significantly from 15.4% in the pre-intervention period to 56.1% in the sustainability period. Early antibiotic administration decreased from 68.2% to 20.1%, while prolonged prophylaxis (> 24 hours) declined from 45.5% to 25.8%. Improvements were consistent across surgical procedures and sustained over time. CONCLUSIONS: A structured multidisciplinary approach, including a dedicated preoperative antibiotic room and continuous feedback mechanisms, significantly improves SAP compliance. This model represents an effective and scalable strategy for enhancing guideline adherence and optimising antimicrobial use in surgical settings, with sustained improvement over time.