title: Exploring the influence of enforcing infection control directives on the risk of developing healthcare associated infections in the intensive care unit: a retrospective study.
abstract: BACKGROUND
  Although strict adherence to infection control strategies is recognised as the simplest and most cost effective method to prevent the spread of healthcare associated infections (HAIs), measurement of the direct impact that such adherence may have on the risk of developing such infections has always been a challenge.
  
  
  OBJECTIVE
  The purpose of this study was to compare the risk of HAIs before and during the SARS outbreak. Such comparison is intended to provide a surrogate measure of the influence that strict enforcement of infection control strategies during the SARS outbreak may have had on the risk of HAIs.
  
  
  METHODS
  A retrospective chart review was conducted on the medical records of 400 intensive care patients who were admitted to the ICU three months before and during the 2003 SARS outbreak.
  
  
  RESULTS
  The rate of HAIs was higher in the pre-SARS period than the SARS period. Specifically, 61.7% of all reported infections were diagnosed in the pre-SARS period. The rate of HAIs in the pre-SARS period was 14.5% as opposed to 9% during the SARS period. Adjusted logistic regression analysis suggested that the odds of HAIs were 2.2 times higher in the pre-SARS period as compared to the SARS period (OR=2.2; 95%CI=1.08-4.49).
  
  
  CONCLUSIONS
  Our findings suggest that strict enforcement of infection control strategies may have a positive impact on the efforts to minimise the risk of HAIs. These findings carry a clinical significance that shall not be ignored with regard to our overall efforts to minimise the risk of developing HAIs in the ICU.
authors: University of Windsor, Faculty of Nursing, 401 Sunset, Health Education Center, and Hotel Dieu Grace Hospital, Room 328, Windsor, Ontario N9B 3P4, Canada. melmasri@uwindsor.ca
authors: Maher M
authors: MM
authors: El-Masri
authors: Margaret Peggy
authors: MP
authors: Oldfield
mesh_terms: D003428:Cross Infection / Q000209:etiology / Q000517:prevention & control*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D017053:Infection Control / Q000592:standards*; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D045169:Severe Acute Respiratory Syndrome / Q000517:prevention & control / Q000635:transmission