No studies in Japan have described the perceived strength of evidence supporting practices to prevent common healthcare‐associated infections and the actual use of these practices. In the current study, we conducted a nationwide survey of infection prevention personnel to assess perception of the evidence for various preventive practices and the regular use of these practices.
Between 1 April 2012 and 31 January 2013, we mailed surveys to lead infection preventionists at 971 hospitals across Japan. Our survey asked respondents to grade the strength of evidence to support a number of general infection prevention practices as well as practices specific to the prevention of catheter‐associated urinary tract infection (CAUTI), central line‐associated bloodstream infection (CLABSI) and ventilator‐associated pneumonia (VAP). Using a 5‐point Likert scale, we defined responses of 4 (strong) or 5 (very strong) as strong evidence. In addition, the survey asked about how frequently infection prevention practices were used in their hospitals, with responses of 4 (almost always) or 5 (always) representing regular use.
The response rate was 71% (685 hospitals). The following practices were perceived by 90% or more of respondents as having strong evidence: alcohol‐based hand rub (98%), aseptic urinary catheter insertion (96%), antimicrobial stewardship (96%), and maximum sterile barriers during central venous catheter insertion (92%). The perceived strength of the evidence was aligned with the evidence in several preventive practices (see Figure). Specifically, regular use of the following several practices was generally aligned with the perception of evidence: alcohol‐based hand rub, aseptic urinary catheter insertion, antimicrobial stewardship, and maximum sterile barriers during central venous catheter insertion. Regular use of many practices, however, was quite low despite a strong perception of evidence for the respective practices.
Although there appears to be a general awareness of the evidence of infection prevention recommendations, regular use of these practices is low in Japan. In addition to maintaining awareness of the evidence, strategies – such as devoting additional resources to infection control programs and promoting a strong organizational culture of safety – are needed to increase the appropriate use of practices to prevent healthcare‐associated infection in Japan.
To cite this abstract:Tokuda Y, Sakamoto F, Sakihama T, Greene M, Ratz D, Saint S. Low Regular Use of Practices to Prevent Healthcare‐Associated Infection Despite the High Degree of Perceived Strength of Evidence: A National Study in Japan. Abstract published at Hospital Medicine 2014, March 24-27, Las Vegas, Nev. Abstract 86. Journal of Hospital Medicine. 2014; 9 (suppl 2). https://www.shmabstracts.com/abstract/low-regular-use-of-practices-to-prevent-healthcareassociated-infection-despite-the-high-degree-of-perceived-strength-of-evidence-a-national-study-in-japan/. Accessed April 7, 2020.