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National Survey of Practices to Prevent Healthcare-Associated Infections in Thailand: The Role of Safely Culture and Collaboratives

Published online by Cambridge University Press:  02 January 2015

Anucha Apisarnthanarak ,
M. Todd Greene ,
Edward H. Kennedy ,
Thana Khawcharoenporn ,
Sarah Krein  and
Sanjay Saint
Anucha Apisarnthanarak*
Affiliation:
Division of Infectious Diseases, Thammasat University Hospital, Pathumthani, Thailand
M. Todd Greene
Affiliation:
University of Michigan Health System, Ann Arbor, Michigan Department of Veterans Affairs/University of Michigan Patient Safety Enhancement Program, Ann Arbor, Michigan
Edward H. Kennedy
Affiliation:
Department of Veterans Affairs/University of Michigan Patient Safety Enhancement Program, Ann Arbor, Michigan
Thana Khawcharoenporn
Affiliation:
Division of Infectious Diseases, Thammasat University Hospital, Pathumthani, Thailand
Sarah Krein
Affiliation:
University of Michigan Health System, Ann Arbor, Michigan Department of Veterans Affairs/University of Michigan Patient Safety Enhancement Program, Ann Arbor, Michigan Center for Clinical Management Research, Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
Sanjay Saint
Affiliation:
University of Michigan Health System, Ann Arbor, Michigan Department of Veterans Affairs/University of Michigan Patient Safety Enhancement Program, Ann Arbor, Michigan Center for Clinical Management Research, Department of Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan
*
Division of Infectious Diseases, Thammasat University Hospital, Pathumthani, Thailand12120 ([email protected])
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Abstract

Objective.

To evaluate hospital characteristics and practices used by Thai hospitals to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP), the 3 most common types of healthcare-associated infection (HAI) in Thailand.

Design.

Survey.

Setting.

Thai hospitals with an intensive care unit and 250 or more hospital beds

Methods.

Between January 1, 2010, and October 31, 2010, research nurses collected data from all eligible hospitals. The survey assessed hospital characteristics and practices to prevent CAUTI, CLABSI, and VAP. Ordinal logistic regression was used to assess relationships between hospital characteristics and use of prevention practices.

Results.

A total of 204 (80%) of 256 hospitals responded. Most hospitals (93%) reported regularly using alcohol-based hand rub. The most frequently reported prevention practice by infection was as follows: for CAUTI, condom catheters in men (47%); for CLABSI, avoiding routine central venous catheter changes (85%); and for VAP, semirecumbent positioning (84%). Hospitals with peripherally inserted central catheter insertion teams were more likely to regularly use elements of the CLABSI prevention bundle. Greater safety scores were associated with regular use of several VAP prevention practices. The only hospital characteristic associated with increased use of at least 1 prevention practice for each infection was membership in an HAI collaborative.

Conclusions.

While reported adherence to hand hygiene was high, many of the prevention practices for CAUTI, CLABSI, and VAP were used infrequently in Thailand. Policies and interventions emphasizing specific infection prevention practices, establishing a strong institutional safety culture, and participating in collaboratives to prevent HAI may be beneficial.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 33 , Issue 7 , July 2012 , pp. 711 - 717
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2012

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