DOI QR코드

DOI QR Code

Development of Evidence-based Guidelines for Nursing Home's Infection Control in Korea

한국형 노인요양시설 근거중심 감염관리 가이드라인 개발

  • Received : 2018.05.09
  • Accepted : 2018.07.30
  • Published : 2018.08.31

Abstract

Purpose: The purpose of this study was to develop evidence-based guidelines for infection control in nursing homes in Korea (ENIK). Methods: Three steps were planned for the development which were developing a draft and testing the content validity. First, the draft was based on evidence and developed through focus group interviews with nurses in nursing homes, a comprehensive review of international guidelines and literature, and systematic reviews of interventions for infection control and outbreaks in long-term care facilities. Clinical applicability was established through reviews of nursing records and job assignments in one nursing home. The final step consisted of experts evaluating the content validity. The ENIK was revised to fit Korean nursing homes. Results: The ENIK consisted of recommendations in 9 compositions and a one-page practical algorithm. The principles of infection control were presented by statements and specific strategies were recommended in resident care programs. The infection control practical algorithm was organized into 3 steps: screening at admission, prevention, and control at the early stage. The practice to control infection was composed of a 5-step process. Conclusion: The ENIK will contribute to improving the competency of infection control practice because it provides standardized practice and is tailored to Korean nursing homes.

Keywords

References

  1. Australian Government Department of Health. (2013, April). Infection prevention and control in residential and community aged care. Canberra: National Health and Medical Research Council.
  2. Bang, H. L., & Park, Y. H. (2013). Development of evidence-based dysphagia nursing care protocol for nursing home residents. Korean Society of Muscle and Joint Health, 20(1), 31-42. https://doi.org/10.5953/JMJH.2013.20.1.31
  3. Castle, N., Wagner, L., Ferguson, J., & Handler, S. (2014). Hand hygiene deficiency citations in nursing homes. Journal of Applied Gerontology, 33(1), 24-50. https://doi.org/10.1177/0733464812449903
  4. Choi, S. Y. (2009). Characteristics and risk factors of healthcare-associated infections in Korean nursing homes. Unpublished master's thesis, Seoul National University, Seoul.
  5. Flanagan, E., Cassone, M., Montoya, A., & Mody, L. (2016). Infection control in alternative health care settings: An update. Infectious Disease Clinics of North America, 30(3), 785-804. https://doi.org/10.1016/j.idc.2016.05.001
  6. Harrison, M. B., Legare, F., Graham, I. D., & Fervers, B. (2010). Adapting clinical practice guidelines to local context and assessing barriers to their use. Canadian Medical Association Journal, 182(2), E78-E84. https://doi.org/10.1503/cmaj.081232
  7. Herzig, C. T., Stone, P. W., Castle, N., Pogorzelska-Maziarz, M., Larson, E. L., & Dick, A. W. (2016). Infection prevention and control programs in US nursing homes: Results of a national survey. Journal of the American Medical Directors Association, 17(1), 85-88. https://doi.org/10.1016/j.jamda.2015.10.017
  8. High, K. P., Juthani-Mehta, M., & Quagliarello, V. J. (2010). Infectious diseases in the nursing home setting: Challenges and opportunities for clinical investigation. Clinical Infectious Diseases, 51(8), 931-936. https://doi.org/10.1086/656411
  9. Hwang, I., Kim, H., Son, Y., Jeong, H., Kim, M., Lee, S., et al. (2017). Rate of antimicrobial resistant urinary pathogens and associated risk factor in older adults living in long-term care facilities in Seoul. Korean Journal of Family Practice, 7(6), 864-869. https://doi.org/10.21215/kjfp.2017.7.6.864
  10. Hyun, H. J., Chang, A. K., Yu, S. J., & Park, Y. H. (2012). Comparison of comprehensive health status and health-related quality of life between institutionalized older adults and community dwelling older adults. Korean Academy of Community Health Nursing, 23(1), 40-50. https://doi.org/10.12799/jkachn.2012.23.1.40
  11. Kim, Y. A., Lee, J. Y., Kim, H. S., & Hwan, J. H. (2011). A comparison of nursing problems identified through RAI-FC and by nurses caring for nursing home residents. Journal of Korean Gerontological Nursing, 13(1), 58-68.
  12. Kim, Y. J., & Park, J. S. (2017). Survey on infection control status and perceived importance of ICP(infection control practitioner) in long term care hospital. Journal of the Korea Academia-Industrial Cooperation Society, 18(7), 466-475. https://doi.org/10.5762/KAIS.2017.18.7.466
  13. Lee, T. W., & Chung, J. (2010). Structural factors influencing the quality management activities in nursing homes. Journal of Korean Academy of Nursing Administration, 16(2), 162-171. https://doi.org/10.11111/jkana.2010.16.2.162
  14. Loeb, M., Brazil, K., Lohfeld, L., McGeer, A., Simor, A., Stevenson, K., et al. (2005). Effect of a multifaceted intervention on number of antimicrobial prescriptions for suspected urinary tract infections in residents of nursing homes: Cluster randomised controlled trial. BMJ, 331(7518), 669. https://doi.org/10.1136/bmj.38602.586343.55
  15. Ministry of Health and Welfare. (2017, June). 2017 Welfare facilities for the elderly. Sejong: Author.
  16. Ministry of the Interior and Safety. (2017, September 4). At the end of August 2017, the number of residents 51,175,000. Retrieved January 15, 2018, from http://www.mois.go.kr/frt/bbs/type010/commonSelectBoardArticle.do?bbsId=BBSMSTR_000000000008&nttId=59453
  17. Montoya, A., Cassone, M., & Mody, L. (2016). Infections in nursing homes: Epidemiology and prevention programs. Clinics in Geriatric Medicine, 32(3), 585-607. https://doi.org/10.1016/j.cger.2016.02.004
  18. National Health Insurance Service. (2016, April). 2015 Evaluation of long-term care facilities. Wonju: Author.
  19. Nicolle, L. E. (2014). Infection prevention issues in long-term care. Current Opinion in Infectious Diseases, 27(4), 363-369. https://doi.org/10.1097/qco.0000000000000071
  20. Park, E. J., Lim, Y. J., Cho, B. H., Sin, I. J., & Kim, S. O. (2011). A Survey on performance of infection control by workers in nursing homes for the elderly. Journal of Korean Gerontological Nursing, 13(2), 79-90.
  21. Park, E. J., Seo, J. H., Jung, Y., Yun, S. M., & Lee, N. G. (2017). Quality care strategy for long-term care hospitals and nursing homes- Focusing on patient (resident) safety. Sejong: Korea Institute for Health and Social Affairs.
  22. Schweon, S. J., Edmonds, S. L., Kirk, J., Rowland, D. Y., & Acosta, C. (2013). Effectiveness of a comprehensive hand hygiene program for reduction of infection rates in a long-term care facility. American Journal of Infection Control, 41(1), 39-44. https://doi.org/10.1016/j.ajic.2012.02.010
  23. Scottish Intercollegiate Guidelines Network. (2015, November). SIGN 50: A guideline developers' handbook. Edinburgh: Scottish Intercollegiate Guidelines Network.
  24. Shin, H. J. (2016, October 19). Long-term care facilities, defenseless in the backward disease 'scabies'. Korea Times, p. 12. Retrieved January 15, 2018 from http://www.hankookilbo.com/v/da66f46d26e04b7a8db2f2737514601e
  25. Smith, P. W., Bennett, G., Bradley, S., Drinka, P., Lautenbach, E., Marx, J., et al. (2008). SHEA/APIC Guideline: Infection prevention and control in the long-term care facility. American Journal of Infection Control, 36(7), 504-535. https://doi.org/10.1016/j.ajic.2008.06.001
  26. Stone, N. D., Ashraf, M. S., Calder, J., Crnich, C. J., Crossley, K., Drinka, P. J., et al. (2012). Surveillance definitions of infections in long-term care facilities: Revisiting the McGeer criteria. Infection Control and Hospital Epidemiology, 33(10), 965-977. https://doi.org/10.1086/667743
  27. Straus, S. E., Richardson, S., Glasziou, P., & Haynes, B. (2005). Evidence-based medicine: How to practice and teach it. Edinburgh, UK: Elsevier Churchill Livingstone.
  28. Stuart, R. L., Kotsanas, D., Webb, B., Vandergraaf, S., Gillespie, E. E., Hogg, G. G., et al. (2011). Prevalence of antimicrobial-resistant organisms in residential aged care facilities. Medical Journal of Australia, 195(9), 530-533. https://doi.org/10.5694/mja11.10724
  29. Suetens, C. (2012). Healthcare-associated infections in European long-term care facilities: How big is the challenge? Eurosurveillance, 17(35), 20259. https://doi.org/10.2807/ese.17.35.20259-en
  30. Yu, C. W., Kuo, H. M., Chun, H. M., Hung, L. T., & Lau, Y. J. (2015). The use of a nursing home in central bundle care reduces the effectiveness of urinary tract infection. Journal of Microbiology, Immunology and Infection, 48(2), S96. https://doi.org/10.1016/j.jmii.2015.02.339