Optimizing infection control and antimicrobial stewardship bedside discussion: a scoping review of existing evidence on effective healthcare communication in hospitals

Bonaconsa, Candice; Mbamalu, Oluchi; Surendran, Surya; George, Anu; Mendelson, Marc; Charani, Esmita

doi:10.1016/j.cmi.2023.12.011

Clinical Microbiology and Infection

2024

DOI: 10.1016/j.cmi.2023.12.011

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Optimizing infection control and antimicrobial stewardship bedside discussion: a scoping review of existing evidence on effective healthcare communication in hospitals

Candice Bonaconsa,

Oluchi Mbamalu,

Surya Surendran

et al.

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2024

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Cited by 3 publications

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Empirical antimicrobials in the intensive care unit

De Bus,

Arvaniti,

Sjövall

2024

Intensive Care Med

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Empirical antimicrobials in the intensive care unit

De Bus,

Arvaniti,

Sjövall

2024

Intensive Care Med

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Co-design of a nurse handover tool to optimise infection control and antimicrobial stewardship in a low resource setting intensive care unit: A nurse led collaboration

Bonaconsa,

van den Bergh,

Charani

et al. 2024

Wellcome Open Res

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Background The quality of intensive care unit (ICU) nursing handover impacts patient safety, including infection prevention and control (IPC) and antimicrobial stewardship (AMS) practices. We report a co-designed quality improvement study using a visual, structured nurse handover tool in a low resource setting. Methods The study was conducted with clinical nurses in an 8-bed medical ICU at a tertiary hospital in South Africa. Using a participatory action research (PAR) framework and visual participatory methods, the handover tool development had three phases: data collection, journal club, and co-design. To engage busy nurses and create real-time discussions and input, 7-minute focussed sessions in the ICUs using large-scale graphics to facilitate were used. Qualitative data were thematically analysed. Results Between September – October 2022, baseline data were collected from 16 handovers (46 patient discussions over 4 hours). The tool was co-designed through 18 contact sessions involving 31 nurses (April–June 2023). Variation was observed in patterns of handover structure (sequence of what was presented) and content (type and the level of detail of information provided). An evidence-based visual tool was co-designed to identify and manage key patient care risk factors. The tool included a structured section to report on IPC and AMS. Nurses reported the visual prompts to be beneficial to ensuring consistent inclusion of critical information in handovers. Conclusions An innovative approach involving ICU nurses in co-designing a visual handover tool resulted in a structured method for systematically reporting patient care risk factors, body systems, IPC, and AMS. Implementation and dissemination in this unit, and expansion to other units, is underway to promote sustainable change in nursing clinical practices.

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Infection Prevention and Control Strategies According to the Type of Multidrug-Resistant Bacteria and Candida auris in Intensive Care Units: A Pragmatic Resume including Pathogens R0 and a Cost-Effectiveness Analysis

Fanelli,

Pistidda,

Terragni

et al. 2024

Antibiotics

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Multidrug-resistant organism (MDRO) outbreaks have been steadily increasing in intensive care units (ICUs). Still, healthcare institutions and workers (HCWs) have not reached unanimity on how and when to implement infection prevention and control (IPC) strategies. We aimed to provide a pragmatic physician practice-oriented resume of strategies towards different MDRO outbreaks in ICUs. We performed a narrative review on IPC in ICUs, investigating patient-to-staff ratios; education, isolation, decolonization, screening, and hygiene practices; outbreak reporting; cost-effectiveness; reproduction numbers (R0); and future perspectives. The most effective IPC strategy remains unknown. Most studies focus on a specific pathogen or disease, making the clinician lose sight of the big picture. IPC strategies have proven their cost-effectiveness regardless of typology, country, and pathogen. A standardized, universal, pragmatic protocol for HCW education should be elaborated. Likewise, the elaboration of a rapid outbreak recognition tool (i.e., an easy-to-use mathematical model) would improve early diagnosis and prevent spreading. Further studies are needed to express views in favor or against MDRO decolonization. New promising strategies are emerging and need to be tested in the field. The lack of IPC strategy application has made and still makes ICUs major MDRO reservoirs in the community. In a not-too-distant future, genetic engineering and phage therapies could represent a plot twist in MDRO IPC strategies.

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Optimizing infection control and antimicrobial stewardship bedside discussion: a scoping review of existing evidence on effective healthcare communication in hospitals

Cited by 3 publications

References 78 publications

Empirical antimicrobials in the intensive care unit

Empirical antimicrobials in the intensive care unit

Co-design of a nurse handover tool to optimise infection control and antimicrobial stewardship in a low resource setting intensive care unit: A nurse led collaboration

Infection Prevention and Control Strategies According to the Type of Multidrug-Resistant Bacteria and Candida auris in Intensive Care Units: A Pragmatic Resume including Pathogens R0 and a Cost-Effectiveness Analysis

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