VA improving infection control, but there's room for improvement, study finds

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The reported use of 12 infection prevention practices increased in Veterans Affairs hospitals between 2005 and 2017, but there is room for improvement in key infection control areas, according to a study published in JAMA Network Open.

Between 2005 and 2017, infection preventionists were surveyed at all VA hospitals every four years. The surveys assessed infection control practices to curb common healthcare-associated infections. Researchers examined responses to 320 surveys.

They found that reported use of 12 infection-prevention practices increased:

For catheter-associated urinary tract infections:

• Use of alternatives to urinary catheters

For central line–associated bloodstream infection:

• Maximal sterile barrier precautions during insertion
• Antimicrobial dressing with chlorhexidine

For ventilator-associated pneumonia:

• Use of semirecumbent positioning
• Antimicrobial mouth rinse
• Subglottic secretion drainage
• Selective digestive tract decontamination
• Use of silver-coated endotracheal tubes

For Clostridioides difficile infection:

• Contact precautions
• Use of private rooms or cohorting
• Soap and water hand hygiene
• Terminal disinfection

But the study also found areas of improvement with regard to use of infection prevention practices, including the lack of adoption of several practices that could help reduce catheter-associated urinary tract infections and the continued use of microbiologic testing for healthcare-associated infections that could contribute to overuse of antibiotics.

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