Journal of Hospital Infection最新文献

{"title":"Escape room to enhance immediate and long-term healthcare workers' knowledge of multi-drug resistant organisms: a before-after study.","authors":"Bénédicte Perdrieux, Geoffrey Loison, Denis Verron, Clément Legeay","doi":"10.1016/j.jhin.2025.08.011","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.08.011","url":null,"abstract":"<p><p>Multidrug resistant organisms (MDRO) require specific infection control measures in healthcare settings. Escape rooms (ER) are used in healthcare education but remain unevaluated for MDRO training and poorly assessed for long-term knowledge retention. This study assessed the impact of an ER intervention on healthcare workers' (HCWs) MDRO knowledge over short and long-term. A prospective, single-center study was conducted in a French university hospital (May-December 2023). Nurses, nurse assistants, and medical fellows from 24 wards participated. An 11-item test was administered before, after, and three months post-intervention. The intervention consisted of a 60-minute escape room session with MDRO-related riddles and a debriefing. Univariate and multivariate analyses were performed to assess factors associated with better performance. Among 141 participants (52.5% nurses, 44.0% nurse assistants, 3.5% medical fellows), correct response rates increased from 53.3% pre-training to 74.9% post-training (p < 0.001). Nurses improved from 55.9% to 78.5%, and nurse assistants from 49.6% to 71.4%. Nurses were associated with better post-test scores. Retained knowledge at three months was significantly higher than pre-intervention test in 44 participants (71.3%, p < 0.001). Satisfaction was high (9.3/10). An ER can enhance nurses and nurse assistants' knowledge and retention of MDRO-related infection control measures. This gamified approach is not without challenges (time, equipment, logistics) but achieves great satisfaction among participants.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bolt-connected silver-coated external ventricular drains have a lower risk of infection compared with tunnelled antibiotic-impregnated catheters: a pilot study.","authors":"Raquel Gutiérrez-González, Teresa Mediavilla, Celia Ortega-Angulo, Teresa Kalantari, Alvaro Zamarron","doi":"10.1016/j.jhin.2025.08.014","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.08.014","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the risk of ventriculostomy-related infection (VRI) according to the type of external ventricular drain (EVD) used: bolt-connected silver-coated EVD (antimicrobial effect) vs. tunnelled antibiotic-impregnated EVD, and determine which catheter is superior. The secondary endpoint is to estimate the infection risk depending on the ventriculostomy duration.</p><p><strong>Methods: </strong>Prospective single-centre cohort study. All patients who underwent EVD placement between January 2022 and August 2024 were included. Infection was the primary endpoint. Cox regression analysis was used to determine the hazard ratio (HR) depending on the type of catheter, adjusting for possible confounding covariables. Kaplan-Meier curves were used to estimate the cumulative risk of infection.</p><p><strong>Results: </strong>90 procedures were analysed. The overall infection rate was 7.8%. A significantly higher infection risk was confirmed when tunnelled antibiotic-impregnated catheters were used compared to bolt-connected silver-coated drains after adjusting by the setting of the placement and duration of ventriculostomy (HR 7.61 [95% CI 1.30-44.38, p=0.024]). Placement of the device in the ICU was also independently associated with a higher risk of infection than in the operating room (HR 8.16 [95% CI 1.17-56.94, p=0.034]). The risk of VRI was 0% by day five, 1.6% by day 10, and 23.5% by day 30.</p><p><strong>Conclusions: </strong>Bolt-connected silver-coated catheters (antimicrobial coating and skull anchoring) were associated with an 88% lower risk of VRI than subcutaneous tunnelled antibiotic-impregnated catheters. Drain placement in the ICU was also associated with a higher risk of infection. The risk of VRI was 0% by day five and 1.6% by day 10.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Burden of Healthcare- Associated Viral Infections in Hospitalised Children.","authors":"Jaime Baxter, Anna Smielewska, Nichola Dwyer, Beatriz Larru","doi":"10.1016/j.jhin.2025.09.001","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.09.001","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-reported knowledge, practice and perceived usefulness of Care Bundles: A Pilot Survey among Italian Healthcare Professionals.","authors":"Valentina De Nicolò, Alessandra Sinopoli, Paola Santalucia, Maria Silvia Spinelli, Denise Rinaldo, Velia Bruno, Antonello Napoletano, Daniela Coclite","doi":"10.1016/j.jhin.2025.08.009","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.08.009","url":null,"abstract":"<p><strong>Background: </strong>Healthcare-associated infections (HAIs) are a global concern, with Italy reporting a 7.5% prevalence, one of the highest rates in Europe. They contribute to longer hospital stays, antimicrobial resistance, and annual costs exceeding EUR 7 billion across Europe. To address HAIs, WHO recommends infection prevention strategies, including Care Bundles (CBs), evidence-based interventions to improve patient safety. Despite their effectiveness, adoption of CBs in Italy remains low (20-25%).</p><p><strong>Aim: </strong>This pilot survey aimed to test the feasibility of a large-scale study on healthcare workers' knowledge and use of CBs in high-risk wards.</p><p><strong>Methods: </strong>The study took place from October to November 2024. An anonymous online questionnaire, developed according to CHERRIES and CROSS standards, investigated demographics, knowledge, use, and barriers/facilitators to CB implementation, as well as feedback on the tool. Participants-physicians and nursing/obstetric staff from various specialties-were recruited through Scientific Societies and Professional Associations.</p><p><strong>Findings: </strong>A total of 753 healthcare professionals completed the questionnaire (73.5% response rate). Most respondents were from northern regions (43.6%). Nearly half of physicians (49%) were unfamiliar with CBs, though 90% of them expressed interest in training. Among those familiar with CBs, only 57% reported applying them. Anaesthetists and surgeons showed greater awareness than orthopaedists. While 64% of nurses noticed CBs, 53% of obstetricians were unaware, and only 23% of the latter group used them in practice.</p><p><strong>Conclusion: </strong>The survey highlights gaps in the knowledge and application of CBs across professional groups, emphasizing the need for targeted strategies to enhance adoption in clinical practice.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of the cost-impact of sepsis care bundles.","authors":"Elyse Ladbrook, Stephane Bouchoucha, Jo McDonall, Anastasia F Hutchinson","doi":"10.1016/j.jhin.2025.08.006","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.08.006","url":null,"abstract":"<p><p>The use of evidence-based sepsis bundles to minimise variation in clinical management of sepsis, improve health outcomes, and associated costs, is well supported in current literature, particularly within high-acuity acute care settings. However, there is limited research evaluating sepsis bundle implementation in subacute, residential aged care facilities (RACF) and broader acute care environments. The aim of this systematic review was to evaluate studies reporting financial outcomes associated with use/implementation of sepsis care bundles across acute and subacute healthcare organisations, and RACF. Electronic searches of the Cochrane database, as well as CINAHL Complete and MEDLINE Complete (via the EBSCOHost platform) were conducted between January 2000 to July 2025. Studies were screened and evaluated by two independent researchers. Twelve studies were identified for inclusion, of these 58.33% (n = 7) utilised an established economic evaluation methodology and five studies (41.67%) outlined the cost impact of sepsis bundle implementation. Results highlighted heterogeneity in reported cost outcomes, sepsis definitions, with limited patient level data and evaluation. Despite heterogeneity of findings, the results of this review indicate clinical and economic effectiveness associated with sepsis bundle implementation in the acute care setting. Sepsis bundle implementation was associated with decreased hospital and/or patient costs in 66.7% of studies. Further research is required to evaluate the economic impact of sepsis bundles beyond the acute care environment, including subacute and RACF, in paediatric and adult populations. In addition, greater attention towards cross-jurisdictional standardisation of cost-impact evaluation methods is needed to facilitate performance benchmarking and meta-analysis of outcomes.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Hospital Cleaning Effectiveness Using Fluorescence: A Proof-of-Concept Study and Comparison to ATP Testing.","authors":"Sarah Fieldhouse, Benhur Bakhtiari Bastaki, Andrea Ledgerton, Paul Clarke, Trystan Lewis","doi":"10.1016/j.jhin.2025.08.008","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.08.008","url":null,"abstract":"<p><p>Visual inspections are used to assess hospital cleanliness as visible contamination may present health risks and influence perceptions of care quality. Problematically, many contaminants are invisible to the naked eye, limiting the reliability of visual checks. Many invisible substances, however, fluoresce - emit visible light after absorbing electromagnetic radiation. Portable torches can detect fluorescent substances 'in situ', offering a potential method to enhance cleaning practices. This study has evaluated fluorescence as a tool for identifying general invisible contamination after hospital cleaning. Visibly clean surfaces in seven single-occupancy patient rooms and two six-bed wards across two NHS hospitals were examined using a portable high-intensity blue and UV light torch. Adenosine triphosphate levels in fluorescent and non-fluorescent areas were taken as a recognised cleaning monitoring tool and statistically analysed using Wilcoxon Signed-Rank tests. Fluorescent contamination that was invisible to the naked eye was found on every surface. ATP Relative Light Unit (RLU) levels were statistically different (higher) in fluorescent substances compared to non-fluorescent (p ≤ 0.05) with large effect sizes on patient chairs, bed frames, overbed tables, bedside units, and pillows, but not toilets, sinks, or commodes. The mean RLU measurement was 161 in fluorescent areas compared to 33 RLU in the control areas. Fluorescence detected alternative contamination which could present toxic risk to humans, possibly cleaning fluid and/or drug contaminated residue, which frequently contain fluorescent constituents. This was an important finding since relying solely on ATP detection may overlook significant contamination risks. Further work to evaluate the method as a cleaning aid is encouraged.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aseptic technique in clinical nursing settings: a scoping review.","authors":"Hannah Kent, Sonja Dawson, Joanne Lewis, Brett Mitchell","doi":"10.1016/j.jhin.2025.08.007","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.08.007","url":null,"abstract":"<p><strong>Introduction: </strong>Aseptic technique forms a component of Standard Precautions and is a foundational concept in nursing practice. The application of that standard appears to vary between context and nurse. The variation of principles and application between facilities and individuals may reflect the current disparity in evidence-based literature. The purpose of this scoping review is to map the current literature and to seek clarification of key concepts and definitions of asepsis and aseptic technique in relation to clinical nursing.</p><p><strong>Method: </strong>A systematic search was conducted in alignment with JBI guidelines and PRISMA-ScR for scoping reviews. Electronic databases MEDLINE and CINAHL were searched using a combination of Medical Subject Headings (MeSH) and free-text terms. Studies published between 1st January 2004 and 31st December 2024 were included. Studies were screened in Covidence. One reviewer screened the titles and abstracts, with a second checking a random sample. Two reviewers conducted full text reviews. Data extraction was undertaken using a pre-specified database.</p><p><strong>Findings: </strong>2812 studies were initially identified, with 31 articles included in the review following the screening and full-text review. Half of the included papers originated from three countries, the UK (6), USA (5), and Australia (4). Many papers do not define asepsis or aseptic technique, and there are notable variations in the terminology used to apply aseptic technique.</p><p><strong>Conclusion: </strong>This scoping review highlights the variation in the definitions, principles, and application of aseptic technique in clinical nursing settings across evidence-based literature. It will inform a larger planned program of research.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health system drivers of antimicrobial resistance: a qualitative exploration of implications for infection prevention and control in hospitals and long-term care facilities in Merseyside.","authors":"Yussif Alhassan, Maria Moore, Kirsten A Duda, Fabrice E Graf, Stacy Todd, Joseph M Lewis, Nicholas Feasey, Miriam Taegtmeyer","doi":"10.1016/j.jhin.2025.08.004","DOIUrl":"https://doi.org/10.1016/j.jhin.2025.08.004","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) transmission is shaped by a complex interplay of health system factors, many of which remain underexplored or insufficiently addressed. This study investigates concrete systemic transmission drivers in hospitals and long-term care facilities (LTCFs) for older adults in Merseyside, UK.</p><p><strong>Methods: </strong>Qualitative data were collected through semi-structured interviews with 37 purposively selected participants across hospitals, LTCFs, community settings, and ambulance services. Interviews were informed by the WHO Health System Building Blocks framework and explored AMR transmission pathways and drivers, barriers to infection prevention and control (IPC) practices, and intervention strategies. Thematic analysis was conducted using NVivo 12.</p><p><strong>Results: </strong>Three key perceived transmission points were identified: prolonged waits in overcrowded hospital areas, inter-facility transfers, and shared spaces within LTCFs and hospital wards. Contributing systemic AMR drivers included inadequate infrastructure, fragmented communication during care transitions, staff turnover, training gaps. Less recognised yet significant risks included the lack of consistent cleaning teams across wards; generic IPC guidelines ill-suited to specific care contexts; and weak administrative oversight of environmental hygiene. While AMR screening was widely recognised as problematic, its cost-effectiveness and clinical utility remain unclear. Communication failures during transfers emerged as an immediately addressable issue, while infrastructure deficits and workforce instability posed more persistent, systemic challenges.</p><p><strong>Conclusion: </strong>Addressing AMR in care settings requires a context-specific, multi-component approach prioritising effective infection risk communication at care interfaces, tailored IPC protocols, and stable staffing. While long-term investment in infrastructure, screening and workforce is essential, immediate progress is possible through low-resource measures such as improved infection risk information systems and context-specific IPC guidelines.</p>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transmission of Staphylococcus aureus from an outpatient to an inpatient: implications for infection control.","authors":"E S Tanriverdi, Y Yakupogullari, F Memisoglu, B Otlu","doi":"10.1016/j.jhin.2025.08.005","DOIUrl":"10.1016/j.jhin.2025.08.005","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A ‘SWIFT’ response to wound healing","authors":"M. Rochon ,&nbsp;G. Bond-Smith","doi":"10.1016/j.jhin.2025.04.006","DOIUrl":"10.1016/j.jhin.2025.04.006","url":null,"abstract":"","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"163 ","pages":"Pages 108-109"},"PeriodicalIF":3.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}