Perceived strength of evidence supporting practices to prevent health care-associated infection: results from a national survey of infection prevention personnel.
BACKGROUND
Limited data exist describing the perceived strength of evidence behind practices to prevent common health care-associated infections (HAIs). We conducted a national survey of infection prevention personnel to assess perception of the evidence for various preventive practices. We were also curious whether lead infection preventionist certification in infection prevention and control (CIC) correlated with perceptions of the evidence.


METHODS
In 2009, we mailed surveys to 703 infection prevention personnel using a national random sample of US hospitals and all Veterans Affairs hospitals; the response rate was 68%. The survey asked the respondent to grade the strength of evidence behind prevention practices. We considered "strong" evidence as being 4 and 5 on a Likert scale. Multivariable logistic regression models assessed associations between CIC status and the perceived strength of the evidence.


RESULTS
The following practices were perceived by 90% or more of respondents as having strong evidence: alcohol-based hand rub, aseptic urinary catheter insertion, chlorhexidine for antisepsis prior to central venous catheter insertion, maximum sterile barriers during central venous catheter insertion, avoiding the femoral site for central venous catheter insertion, and semirecumbent positioning of the ventilated patient. CIC status was significantly associated with the perception of the evidence for several practices.


CONCLUSIONS
Successful implementation of evidence-based practices should consider how key individuals in the translational process assess the strength of that evidence.
Hospital Outcomes Program of Excellence (HOPE), VA Ann Arbor Healthcare System, Ann Arbor, MI, USA. saint@med.umich.edu
Sanjay
S
Saint
M Todd
MT
Greene
Russell N
RN
Olmsted
Vineet
V
Chopra
Jennifer
J
Meddings
Nasia
N
Safdar
Sarah L
SL
Krein
D003428:Cross Infection / Q000517:prevention & control*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D016357:Infection Control Practitioners; D011361:Professional Competence / Q000592:standards*; D011795:Surveys and Questionnaires; D014481:United States