Ongoing Projects >>>
Understanding the Role of Physician Attire on Patient Perception: A Prospective Survey
This study aims to assess the influence of physician attire on patient satisfaction and specific patient perceptions including physician knowledge, sense of trust, level of caring and feeling of comfort provided by their physician. This study is being conducted in several inpatient units, outpatient clinics, and ophthalmology clinics throughout the United States as well as in Italy, Japan, and Switzerland.
Italian Hand Hygiene
This study aimed to assess hand hygiene adherence after two infectious disease units merged. This was a follow-up study to one conducted in 2013 on the rates of hand hygiene adherence in these same units before the merger. This follow-up study was conducted by University of Michigan Resident, Christopher Petrilli, MD,
Completed Projects
World Health Organization
Dr. Saint and his team worked with colleagues at the World Health Organization to develop materials for the WHO SAVE LIVES: Clean Your Hands campaign - “No action today: no cure tomorrow – make the WHO 5 Moments for Hand Hygiene part of protecting your patients from resistant germs.” (http://www.who.int/gpsc/5may/EN_PSP_GPSC1_5May_2014/en/) For this event on May 5th, 2014, Dr. Saint helped develop a hand hygiene poster – based on the WHO 5 Moments of Hand Hygiene – but targeted specifically for insertion and care of a urinary catheter to prevent catheter-associated urinary tract infections. This poster – “My 5 Moments for Hand Hygiene: Focus on caring for a patient with a Urinary Catheter” - highlighted the tasks involved with urinary catheter use that would prompt hand hygiene, either before or after the task. The poster was translated into 4 languages – English, French, Spanish, and Portuguese.
Prevention of Hospital Infections by Interventions & Training (PROHIBIT)
The aim of PROHIBIT is to understand existing guidelines and practices to prevent healthcare associated infections (HAI) in European hospitals, identify factors that enable and prevent compliance with best practices, and test the effectiveness of interventions of known efficacy. The project will employ a mixed-methods approach combining the strengths of qualitative research, survey methods, observational and experimental designs. First, we will systematically review current guidelines on prevention of the most common HAIs within the EU, as well as schemes for surveillance and public reporting. Next, we will conduct a large-scale survey of what is actually being done in European hospitals, determining factors, and how these relate to bloodstream infection rates. The project will then focus on catheter-related bloodstream infection (CRBSI), a highly transmissable and reliably measured HAI, in a selected sample of European hospitals. In-depth interviews of healthcare staff and direct observation will be used to measure compliance with key prevention practices. A randomized effectiveness trial using a stepped wedge design will be conducted in intensive care units to determine the uptake and impact of 2 interventions (WHO hand hygiene protocol and so-called catheter bundle) on CRBSI as well as clinical and utlilization outcomes. The information will be synthesized to develop recommendations for the EU, policy makers, managers and medical professionals to prevent HAI. Dissemination will include instructional workshops and on-line training materials.
National Survey of Practices to Prevent Healthcare-Associated Infections in Thailand
Catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI) and ventilator-associated pneumonia (VAP) are the three most common healthcare-associated infections (HAIs) in Thailand. We conducted a national survey to evaluate current practices used by hospitals across Thailand to prevent these HAIs.
National Survey of Practices to Prevent Healthcare-Associated Infections in the United Kingdom
Similarly to the Thai study, we conducted a national survey to evaluate current practices used by hospitals across the UK to prevent CAUTI, CLABSI and VAP. I-AASC researchers are currently tabulating results from this survey. Measures of particular interest include hospital characteristics (particularly those related to infection control); opinions of the senior infection control nurse about improving infection prevention/control; and hospital systems for and reported use of practices to prevent CAUTI, CLABSI, and VAP. A potential further direction for study may include relationships between different hospital characteristics and reported rates of preventive practice usage.
Observational study of hand hygiene in Tuscany
In 2005, Tuscany, a region in central Italy, initiated a campaign to improve hand hygiene that focused on raising awareness and educating health care workers. We assessed hand hygiene rates approximately 3 years after the campaign was initiated in 5 units of 2 hospitals in Florence, Italy, the capital of Tuscany. We conducted a 3-month observational study in 2008 to assess hand hygiene adherence of doctors and nurses. External observers were used to assess the hand hygiene adherence of doctors and nurses before patient contact. A total of 665 doctor-patient observations and 1147 nurse-patient observations were made. The overall rates of hand hygiene adherence observed were similar to those found when Tuscany initiated a hand hygiene campaign 3 years earlier. Focusing on overall rates may be misleading, however, because substantial variability existed between units. Furthermore, these rates come only from the "first moment" (before touching the patient) and can only be compared with rates from studies using the same approach.
Subsequently, we assessed the longer term sustainability of the previously described intervention. Direct observation was used to assess hand hygiene compliance for both doctors and nurses in the emergency department. The overall effects of the intervention were sustained over a 1-year period, although a marked difference was observed between nurses and doctors.
Subsequently, we assessed the longer term sustainability of the previously described intervention. Direct observation was used to assess hand hygiene compliance for both doctors and nurses in the emergency department. The overall effects of the intervention were sustained over a 1-year period, although a marked difference was observed between nurses and doctors.
