Hascic, Alen; Wolfensberger, Aline; Clack, Lauren; Schreiber, Peter W; Kuster, Stefan P; Sax, Hugo (2022). Documentation of adherence to infection prevention best practice in patient records: a mixed-methods investigation. Antimicrobial resistance and infection control, 11(1), p. 107. BioMed Central 10.1186/s13756-022-01139-2
|
Text
s13756-022-01139-2.pdf - Published Version Available under License Creative Commons: Attribution (CC-BY). Download (2MB) | Preview |
BACKGROUND
Healthcare-associated infections remain a preventable cause of patient harm in healthcare. Full documentation of adherence to evidence-based best practices for each patient can support monitoring and promotion of infection prevention measures. Thus, we reviewed the extent, nature, and determinants of the documentation of infection prevention (IP) standards in patients with HAI.
METHODS
We reviewed electronic patient records (EMRs) of patients included in four annual point-prevalence studies 2013-2016 who developed a device- or procedure-related HAI (surgical site infection (SSI), catheter-associated urinary tract infection (CAUTI), ventilator-associated infection (VAP), catheter-related bloodstream infection (CRBSI)). We examined the documentation quality of mandatory preventive measures published as institutional IP standards. Additionally, we undertook semi-structured interviews with healthcare providers and a two-step inductive (grounded theory) and deductive (Theory of Planned Behaviour) content analysis.
RESULTS
Of overall 2972 surveyed patients, 249 (8.4%) patients developed 272 healthcare-associated infections. Of these, 116 patients met the inclusion criteria, classified as patients with SSI, CAUTI, VAP, CRBSI in 78 (67%), 21 (18%), 10 (9%), 7 (6%), cases, respectively. We found documentation of IP measures in EMRs in 432/1308 (33%) cases. Documentation of execution existed in the study patients' EMRs for SSI, CAUTI, VAP, CRBSI, and overall, in 261/931 (28%), 27/104 (26%), 46/122 (38%), 26/151 (17%), and 360/1308 (28%) cases, respectively, and documentation of non-execution in 67/931 (7%), 2/104 (2%), 0/122 (0%), 3/151 (2%), and 72/1308 (6%) cases, respectively. Healthcare provider attitudes, subjective norms, and perceived behavioural control indicated reluctance to document IP standards.
CONCLUSIONS
EMRs rarely included conclusive data about adherence to IP standards. Documentation had to be established indirectly through data captured for other reasons. Mandatory institutional documentation protocols or technically automated documentation may be necessary to address such shortcomings in patient safety documentation.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology |
UniBE Contributor: |
Sax, Hugo Siegfried |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2047-2994 |
Publisher: |
BioMed Central |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
29 Aug 2022 13:59 |
Last Modified: |
05 Dec 2022 16:23 |
Publisher DOI: |
10.1186/s13756-022-01139-2 |
PubMed ID: |
36008823 |
Uncontrolled Keywords: |
Documentation Healthcare-associated infections Infection control Infection prevention Mixed-method research Prevalence study |
BORIS DOI: |
10.48350/172430 |
URI: |
https://boris.unibe.ch/id/eprint/172430 |
Actions (login required)
 |
Edit item |