Journal of Infection Prevention最新文献

{"title":"Investigation of healthcare-associated SARS-CoV-2 infection: Learning outcomes from an investigative process in the initial phase of the pandemic.","authors":"Isobel Ramsay,&nbsp;Katherine Sharrocks,&nbsp;Ben Warne,&nbsp;Nyarie Sithole,&nbsp;Pooja Ravji,&nbsp;Rachel Bousfield,&nbsp;Nick Jones,&nbsp;Clare E Leong,&nbsp;Mohamed Suliman,&nbsp;Rachel Tsui,&nbsp;Michelle S Toleman,&nbsp;Christine Moody,&nbsp;Richard Smith,&nbsp;James Whitehorn,&nbsp;Theodore Gouliouris,&nbsp;Florentina Penciu,&nbsp;Christian Hofling,&nbsp;Chris Cunningham,&nbsp;David A Enoch,&nbsp;Elinor Moore","doi":"10.1177/17571774221092553","DOIUrl":"https://doi.org/10.1177/17571774221092553","url":null,"abstract":"<p><strong>Background: </strong>Healthcare-associated (HCA) SARS-CoV-2 infection is a significant contributor to the spread of the 2020 pandemic. Timely review of HCA cases is essential to identify learning to inform infection prevention and control (IPC) policies and organisational response.</p><p><strong>Aim: </strong>To identify key areas for improvement through rapid investigation of HCA SARS-CoV-2 cases and to implement change.</p><p><strong>Methods: </strong>Cases were identified based on date of first positive SARS-CoV-2 PCR sample in relation to date of hospital admission. Cases were reviewed using a structured gap analysis tool to identify key learning points. These were discussed in weekly multidisciplinary meetings to gain consensus on learning outcomes, level of harm incurred by the patient and required actions. Learning was then promptly fed back to individual teams and the organisation.</p><p><strong>Findings: </strong>Of the 489 SARS-CoV-2 cases admitted between 10^th March and 23^rd June 2020, 114 suspected HCA cases (23.3%) were reviewed; 58/489 (11.8%) were ultimately deemed to be HCA. Five themes were identified: individual patient vulnerability, communication, IPC implementation, policy issues and organisational response. Adaptations to policies based on these reviews were completed within the course of the initial phase of the pandemic.</p><p><strong>Conclusion: </strong>This approach enabled timely learning and implementation of control measures and policy development.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":" ","pages":"197-205"},"PeriodicalIF":1.2,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9117956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40416876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lessons from the COVID-19 epidemic in Hubei, China: Perspectives on frontline nursing.","authors":"Janita Pak Chun Chau,&nbsp;Suzanne Hoi Shan Lo,&nbsp;Jie Zhao,&nbsp;Laveeza Butt,&nbsp;Ravneet Saran,&nbsp;Simon Kwun Yu Lam,&nbsp;David R Thompson","doi":"10.1177/17571774221092558","DOIUrl":"https://doi.org/10.1177/17571774221092558","url":null,"abstract":"<p><strong>Background: </strong>The emergence of COVID-19 has been an ordeal for nurses worldwide. It is crucial to understand their experiences at the frontline, attempt to allay their concerns, and help inform future pandemic response capabilities.</p><p><strong>Aims: </strong>To explore nurses' lived experiences at the frontline in order to identify and address their concerns and help enhance future responses to infectious disease outbreaks.</p><p><strong>Methods: </strong>A qualitative study was carried out. Semi-structured interviews were conducted with 60 registered nurses who came to Hubei from different parts of China to care for patients with COVID-19. Interviews were audio-recorded and transcribed verbatim for thematic analysis.</p><p><strong>Results: </strong>Six major themes emerged: emotional turmoil due to personal and professional concerns, quality issues with personal protective equipment and associated physical discomfort, witnessing and managing patient distress, readiness of emergency response mechanisms in the health system, collective community awareness and preparedness, and heightened professional pride and confidence in future epidemic control.</p><p><strong>Discussion: </strong>Nurses were placed in challenging and unfamiliar situations to deal with unexpected and unpredictable events which caused considerable psychological and physical distress. Support in the form of government edicts, hospital management policies, community generosity and collegiality was highly welcomed by the nurses. Policy makers and managers should ensure that nurses are provided with the support and resources necessary for dealing with large-scale infectious disease outbreaks. Priority should be given to risk assessment, infection prevention and control, and patient and staff health and safety.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":" ","pages":"206-213"},"PeriodicalIF":1.2,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9082098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40416877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 contact tracing in the hospitals located in the North Denmark region: A retrospective review.","authors":"Dorte Fromberg,&nbsp;Nina Ank,&nbsp;Hans L Nielsen","doi":"10.1177/17571774221107754","DOIUrl":"https://doi.org/10.1177/17571774221107754","url":null,"abstract":"<p><strong>Background: </strong>The Department of Infection Control, at our University Hospital conducted contact tracing of COVID-19 positive patients and staff members at all hospitals in the North Denmark Region.</p><p><strong>Aim: </strong>To describe the contact tracing performed during the COVID-19 pandemic in the Region and its outcomes.</p><p><strong>Methods: </strong>Data from each contact tracing were collected prospectively during 14 May 2020-26 May 2021. Data included information about the index case (patient or hospital staff member), presentation (asymptomatic vs symptomatic), probable source of transmission (community-acquired or hospital-acquired), number of close contacts and if any of these were SARS-CoV-2 PCR-test positive.</p><p><strong>Findings: </strong>362 contact tracing were performed. A total of 573 COVID-19 positive cases were identified among 171 (30%) patients and 402 (70%) staff members. 192 (34%) of all cases were tested due to symptoms of COVID-19, whereas two-third were tested for other reasons including outbreak and systematic screening tests. A total of 1575 close contacts were identified, including 225 (14%) patients and 1350 (86%) staff members. 100 (6%) close contacts, including 24 patients and 76 staff members, were infected with SARS-CoV-2, of which 33 (43%) staff members was positive at day 0 i.e. the same day as being identified as close contacts.</p><p><strong>Discussion: </strong>We found a three to one of close contacts to each index case, but only 6% became SARS-CoV-2 positive, with a surprisingly high number of those identified at day 0. Our data confirm that regular testing of patients and staff will identify asymptomatic carriers and thereby prevent new cases.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":" ","pages":"228-234"},"PeriodicalIF":1.2,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9207588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40416875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A COVID-19 outbreak among migrants in a hosting facility in Greece, April 2020.","authors":"Kassiani Mellou,&nbsp;Kassiani Gkolfinopoulou,&nbsp;Anastasia Andreopoulou,&nbsp;Aikaterini Tsekou,&nbsp;Kalliopi Papadima,&nbsp;Konstantinos Stamoulis,&nbsp;Athanasios Kossyvakis,&nbsp;Andreas Mentis,&nbsp;Helena C Maltezou","doi":"10.1177/17571774221092568","DOIUrl":"https://doi.org/10.1177/17571774221092568","url":null,"abstract":"<p><p>In April 2020, a coronavirus disease 2019 outbreak was identified among migrants/refugees in Greece. Overall, 155 of 450 hosted migrants and two of 46 employees were infected (attack rates: 34.4% and 4.3%, respectively). The mean age of infected migrants was 24.9 years (3 days-68 years). In addition, 177 community contacts were tested negative. Cases were cohorted in separate rooms from people tested negative. Surfaces were cleaned and disinfected daily. The implementation of measures for the containment of the outbreak was challenging due to language barriers and lack of space for cohorting. At that time, there was no official recommendation to the general population regarding the use of masks or other personal protective equipment. Extensive testing of vulnerable populations and building trust in order to report symptoms and comply with the recommendations are essential.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":" ","pages":"235-238"},"PeriodicalIF":1.2,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9389273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40416878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of patient delay among pulmonary tuberculosis patients in Northeast Thailand.","authors":"Kampanart Chaychoowong,&nbsp;Roger Watson,&nbsp;David I Barrett","doi":"10.1177/17571774221094164","DOIUrl":"https://doi.org/10.1177/17571774221094164","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary tuberculosis (PTB) is a major health problem in Thailand. Delay in getting treatment is an important factor which may worsen the disease and increase TB transmission.</p><p><strong>Objective: </strong>This study aimed to investigate the duration and predictors of patient delay among PTB patients in Northeast Thailand.</p><p><strong>Methods: </strong>A cross-sectional study was undertaken using a structured questionnaire in nine districts in Nakhon Ratchasima Province from July to September 2018. The duration between the first symptom onset and the first visit to a health facility was determined, with a period of greater than 30 days defined as patient delay. Multiple logistic regression was used to identify predictors of the delay.</p><p><strong>Results: </strong>300 PTB patients participated in the survey, with patient delay identified in 39% of respondents. The median duration of the delay was 35 days among participants overall. Through multivariate analysis, primary education, upper secondary education, previous TB knowledge, TB recognition, TB stigmatisation, weight loss, self-treatment, the number of visits with health providers and using a motorcycle to travel to the hospital were significant predictors of patient delay.</p><p><strong>Discussion: </strong>Knowledge needs to be provided to people to increase their recognition and minimise stigmatisation of TB. Education about TB screening needs to be revised and delivered to health providers to increase and improve TB detection processes.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":"23 5","pages":"222-227"},"PeriodicalIF":1.2,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393596/pdf/10.1177_17571774221094164.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10123836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gap between self-evaluation and actual hand hygiene compliance among health-care workers.","authors":"Hideharu Hagiya,&nbsp;Ryosuke Takase,&nbsp;Yosuke Sazumi,&nbsp;Yoshito Nishimura,&nbsp;Hiroyuki Honda,&nbsp;Fumio Otsuka","doi":"10.1177/17571774221094160","DOIUrl":"https://doi.org/10.1177/17571774221094160","url":null,"abstract":"<p><p>Hand hygiene (HH) compliance among health-care workers has not satisfactorily improved despite multiple educative approaches. Between October 2019 and February 2020, we performed a self-evaluation test and a direct observation for the compliance of the 5 Moments for Hand Hygiene program advocated by the World Health Organization at two Japanese hospitals. Average percentages of self-evaluated HH compliance were as follows: (i) 76.9% for \"Before touching a patient,\" (ii) 85.8% for \"Before clean/aseptic procedures,\" (iii) 95.9% for \"After body fluid exposure/risk,\" (iv) 84.0% for \"After touching a patient,\" and (v) 69.2% for \"After touching patient surroundings.\" On the other hand, actual HH compliance was 11.7% for \"Before touching a patient\" and 18.0% for \"After touching a patient or patient surroundings.\" The present study demonstrated a big gap between self-evaluation and actual HH compliance among nurses working at hospitals, indicating the need of further providing the education in infection prevention.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":"23 5","pages":"239-242"},"PeriodicalIF":1.2,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393601/pdf/10.1177_17571774221094160.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10123840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Free online genome analyses reveal multiple strains in the beginning of a hospital outbreak of <i>Enterobacter hormaechei</i> carrying <i>bla</i> _OXA-436 carbapenemase gene.","authors":"Michael Kemp,&nbsp;Magnus G Jespersen,&nbsp;Annette Toft,&nbsp;Anette Holm","doi":"10.1177/17571774221107293","DOIUrl":"https://doi.org/10.1177/17571774221107293","url":null,"abstract":"<p><p>Free online tools for bacterial genome analyses are available for local infection surveillance at hospitals. The tools do not require bioinformatic expertise and provide rapid actionable results. Within half a year carbapenemase producing <i>Enterobacter cloacae</i> was reported in clinical samples from three patients who had been hospitalized at the same ward. The aim of this outbreak investigation was to characterize and compare genomes of the isolated bacteria in order to determine molecular evidence of hospital transmission. The three isolates and two isolates reported as susceptible to carbapenems were locally analyzed by whole genome sequencing (WGS). Draft genome assembly, species identification, phylogenetic analyses, typing, resistance gene determination, and plasmid analyses were carried out using free online tools from the Center for Genomic Epidemiology (CGE). Genome analyses identified all three suspected outbreak isolates as <i>E. hormaechei</i> carrying <i>bla</i> _OXA-436 gene. Two of the suspected outbreak isolates were closely related, while one was substantially different from them. Horizontal transfer of plasmid may have taken place in the ward. Detailed knowledge on the genomic composition of bacteria in suspected hospital outbreaks can be obtained by free online tools and may reveal transfer of resistance genes between different strains in addition to dissemination of specific clones.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":"23 5","pages":"243-247"},"PeriodicalIF":1.2,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393603/pdf/10.1177_17571774221107293.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10123841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Staff views need to be at the centre of electronic hand hygiene monitoring system development.","authors":"Katie-Rose Cawthorne,&nbsp;Richard P D Cooke","doi":"10.1177/17571774221092530","DOIUrl":"https://doi.org/10.1177/17571774221092530","url":null,"abstract":"We read with great interest Kelly et al.’s qualitative study of healthcare worker (HCW) perceptions of an electronic hand hygiene monitoring system (EMS) (2021). It is excellent to read of a successful implementation of a new innovative approach to hand hygiene (HH) monitoring in a busy NHS hospital. Though the qualitative analysis (from the 11 frontline HCWs interviewed) demonstrated mixed opinions, this study does provide cautious optimism about the longterm adoption of EMS technology by NHS staff. This should encourage other Infection Prevention and Control (IPC) teams to evaluate the impact of EMS technology in their own clinical practice. As demonstrated in this study, staff members recognise the importance of embracing change and the opportunities that EMS technology can bring in improving HH compliance and reducing healthcare-associated infections (HCAI). We therefore commend the authors’ initiative in wishing to seek HCW views of an implemented EMS. For any HH initiative to be effective, staff must be at the centre of the innovation process, and must be assured that they have ownership and control of the process. However, a limitation of this study is that interviews were restricted to a small group of nursing staff and healthcare assistants. As medical staff are well recognised to have low rates of HH compliance, (Pittet et al., 2000) it would have been useful to explore the perspectives of this staff group. A large staff survey which analysed 1200 responses across two acute NHS trusts (Cawthorne and Cooke, 2020) indicates that all staff groups take HH seriously, have concerns about direct observation (DO) audits and are generally supportive of new technological innovations. As part of a team of innovators working in an acute specialist NHS trust, we are taking a very different approach to EMS development compared to the system used by Kelly et al. and other current commercial applications. Our approach, Hy-genie (Cawthorne et al., 2022), has been underpinned by extensive staff consultations which is why the theme of exploring staff acceptability of how feedback is delivered is so critically important. As highlighted by Kelly et al., their chosen EMS may ‘monitor how effective we are but doesn’t make us more effective’. Many EMS, including the one used in their study, measure HH compliance, that is, HH opportunities taken against total HH opportunities available (HHOA). This means that EMSmust accurately be able to capture all HHOA. A concern raised in this study was that HCWsmay disagree with the EMSwhen recognising an HHOA. Thus, some HCWs found the EMS to undermine their own clinical judgement on when HH should be performed (‘I haven’t touched any patients but I have been in their bed space which says I should gel but I haven’t touched anyone’). In the development of our own EMS, we have sought an alternative approach to overcome this technical challenge. Rather than measuring HH compliance, our EMS simply measures HH frequency. It is","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":"23 5","pages":"248-249"},"PeriodicalIF":1.2,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393604/pdf/10.1177_17571774221092530.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10132908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical interns' views on the strategies for reducing antibiotic misuse in the hospitals-what guidelines do they follow?","authors":"Kai Sing Sun, Tai Pong Lam, Tak Hon Chan, Kwok Fai Lam, Kit Wing Kwok, Hoi Yan Chan, Pak Leung Ho","doi":"10.1177/17571774221094154","DOIUrl":"10.1177/17571774221094154","url":null,"abstract":"<p><strong>Objectives: </strong>Although the topic of antibiotic misuse is taught in medical schools, interns (fresh medical graduates) still encounter barriers to appropriate antibiotic prescription when they practice in hospitals under supervision. The impact of teaching in medical school, antibiotics stewardship program (ASP), and prescription guidelines was uncertain. This study explored the medical interns' views on antibiotic use and resistance, and their perceived enablers to appropriate antibiotic prescription.</p><p><strong>Methods: </strong>Two focus groups were conducted among medical interns with rotation experiences in different public hospitals of Hong Kong. The identified themes about attitudes to antibiotic resistance and enablers to appropriate antibiotic prescription were further examined by a questionnaire survey with 77 respondents.</p><p><strong>Results: </strong>The interns had lower preferences for tackling antibiotic resistance as they feared of delayed prescriptions. Guidelines provided by international evidence-based clinical resources and the interns' working hospitals were stronger enablers to appropriate antibiotic use than education materials from schools and the government. Qualitative findings revealed that the interns were aware of the existing ASP but doubted its effectiveness as it failed to get the prescribers' attention. They followed guidelines in their wards but perceived guidelines from local health authorities user-unfriendly. Knowledge from medical school was not very applicable. Varying prescribing practices between hospitals and the densely placed hospital beds made it difficult to prevent the spread of antimicrobial resistance.</p><p><strong>Conclusions: </strong>Minimizing delayed prescription is of a higher priority than tackling antibiotic resistance in medical interns' perspective. Interventions should target guidelines in hospitals and simplify the interface of local guidelines.</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":"23 5","pages":"214-221"},"PeriodicalIF":0.9,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9393602/pdf/10.1177_17571774221094154.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10132910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowledge and compliance to prevention of central line-associated blood stream infections among registered nurses in Jordan.","authors":"Abd Alrahman Matlab,&nbsp;Mahmoud Ogla Al-Hussami,&nbsp;Maha Alkaid Albqoor","doi":"10.1177/17571774211066778","DOIUrl":"https://doi.org/10.1177/17571774211066778","url":null,"abstract":"<p><strong>Background: </strong>Central line-associated bloods tream infections (CLABSIs) are among the most common healthcare-associated infections (HAIs).</p><p><strong>Aims: </strong>To assess the rates of CLABSIs and to investigate predictors of knowledge and compliance of registered nurses to central venous catheters (CVCs) maintenance care bundle in intensive care units (ICUs).</p><p><strong>Methods: </strong>A cross-sectional correlational design was used. A convenient sample of 114 registered nurses was selected from three hospitals in Jordan. Nurses' knowledge and compliance were measured by previously established measures and an observational checklist developed according to the Center for Disease Control and Prevention (CDC).</p><p><strong>Findings: </strong>The rate of CLABSI was the lowest in the hospital that applies the CVC bundle of care. Nurses' knowledge about CLABSI prevention practices was significantly correlated with their compliance to CVCs maintenance care bundle. Nurses' knowledge differed bytheirage, income, experience in ICU, and nurse-to-patient ratio, and in multiple regressions, age was the single predictor of knowledge of CLABSI prevention. Significant differences were also found in nurses' compliance to the CVC care bundle according to the hospital and nurse-to-patient ratio. The nurse-to-patient ratio was the single significant predictor, and it attenuated the effect of age and income on nurse's compliance to the CVC care bundle.</p><p><strong>Conclusion: </strong>This study indicated the need to expand the application of the CVC maintenance care bundle in hospitals. Programs that target promoting nurses' knowledge about CLABSI prevention and compliance to CVC care need to consider some factors, such as nurses' age and the circumstances of their work (nurse-to-patient ratio).</p>","PeriodicalId":16094,"journal":{"name":"Journal of Infection Prevention","volume":"23 4","pages":"133-141"},"PeriodicalIF":1.2,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10226055/pdf/10.1177_17571774211066778.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10298415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}