title: Promoting best practices for control of respiratory infections: collaboration between primary care and public health services.
abstract: OBJECTIVE
  To determine the effectiveness of a short-term intervention to promote best practices for control of respiratory infections in primary care physicians' offices.
  
  
  METHODS
  Before-after observational study.
  
  
  METHODS
  Family physicians' offices in Ottawa, Ont.
  
  
  METHODS
  General practitioners and office staff.
  
  
  METHODS
  Four infection-control practices (use of masks, alcohol-based hand gel, and signs, and asking patients to sit at least 1 m apart in the waiting room) were observed, and 2 reported infection-control practices (disinfecting surfaces and use of hand-gel dispensers in examining rooms) were audited before the intervention and 6 weeks after the intervention.
  
  
  METHODS
  Percentage of patients asked to use masks and alcohol-based hand gel, number of relevant signs, and percentage of patients asked to sit at least 1 m away from other patients. Percentage of surfaces disinfected and percentage of physicians using hand-gel dispensers in examining rooms.
  
  
  RESULTS
  Of 242 practices invited, 53 agreed to participate (22% response rate), and within those practices, 143/151 (95%) physicians participated. Signs regarding respiratory infection control measures increased from 15.4% to 81.1% following the intervention (P < .001). At least 1 patient with cough and fever was given a mask in 17% of practices before the intervention; during the observation period after the intervention, at least 1 patient was given a mask in 66.7% of practices (P < .001). Patients were instructed to use alcohol-based hand gel in 24.5% of practices before the intervention and in 79.2% of practices after it (P < .001). Instruction to sit at least 1 m from others in the waiting area was given in 39.6% of practices before the intervention and in 52.8% of practices following the intervention (P < .001). Before the intervention, the percentage of practices using all 4 audited primary prevention measures was 3.8%; after the intervention, 52.8% of practices were using them (P < .001), demonstrating a 49% increase in adoption of best practices.
  
  
  CONCLUSIONS
  A multifaceted intervention by public health nurses successfully promoted best practices for control of respiratory infections in primary care offices. Collaboration between public health services and primary care can promote best practices and warrants further study and development in areas of common interest.
authors.affiliation: Department of Family Medicine, University of Ottawa, Ontario, Canada. whogg@uottawa.ca
authors.forename: William
authors.initials: W
authors.lastname: Hogg
authors.forename: Patricia
authors.initials: P
authors.lastname: Huston
authors.forename: Carmel
authors.initials: C
authors.lastname: Martin
authors.forename: Raphael
authors.initials: R
authors.lastname: Saginur
authors.forename: Adriana
authors.initials: A
authors.lastname: Newbury
authors.forename: Eileen
authors.initials: E
authors.lastname: Vilis
authors.forename: Enrique
authors.initials: E
authors.lastname: Soto
mesh_terms: D000438:Alcohols; D002170:Canada; D005194:Family Practice / Q000592:standards* / Q000639:trends; D005260:Female; D005782:Gels; D006235:Hand Disinfection; D019538:Health Care Surveys; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007400:Interprofessional Relations; D008297:Male; D008397:Masks / Q000706:statistics & numerical data; D009819:Office Visits; D010353:Patient Education as Topic; D010824:Physicians' Offices; D011322:Primary Prevention / Q000379:methods*; D011481:Protective Clothing / Q000706:statistics & numerical data; D011637:Public Health Nursing / Q000592:standards* / Q000639:trends; D011787:Quality of Health Care; D012141:Respiratory Tract Infections / Q000517:prevention & control* / Q000628:therapy
chemical_list: D000438:Alcohols; D005782:Gels