JaHyun Kang

Cost-Effectiveness Analysis of Active Surveillance Screening for Methicillin-Resistant Staphylococcus aureus in an Academic Hospital Setting

OBJECTIVE To evaluate the cost-effectiveness of 3 alternative active screening strategies for methicillin-resistant Staphylococcus aureus (MRSA): universal surveillance screening for all hospital admissions, targeted surveillance screening for intensive care unit admissions, and no surveillance screening. DESIGN Cost-effectiveness analysis using decision modeling. METHODS Cost-effectiveness was evaluated from the perspective of an 800-bed academic hospital with 40,000 annual admissions over the time horizon of a hospitalization. All input probabilities, costs, and outcome data were obtained through a comprehensive literature review. Effectiveness outcome was MRSA healthcare-associated infections (HAIs). One-way and probabilistic sensitivity analyses were conducted. RESULTS In the base case, targeted surveillance screening was a dominant strategy (ie, was associated with lower costs and resulted in better outcomes) for preventing MRSA HAI. Universal surveillance screening was associated with an incremental cost-effectiveness ratio of

Relative frequency of health care-associated pathogens by infection site at a university hospital from 1980 to 2008

14,955 per MRSA HAI. In one-way sensitivity analysis, targeted surveillance screening was a dominant strategy across most parameter ranges. Probabilistic sensitivity analysis also demonstrated that targeted surveillance screening was the most cost-effective strategy when willingness to pay to prevent a case of MRSA HAI was less than

Use of personal protective equipment among health care personnel: Results of clinical observations and simulations

71,300. CONCLUSION Targeted active surveillance screening for MRSA is the most cost-effective screening strategy in an academic hospital setting. Additional studies that are based on actual hospital data are needed to validate this model. However, the model supports current recommendations to use active surveillance to detect MRSA.

Economic Analysis of Universal Active Surveillance Screening for Methicillin-Resistant Staphylococcus aureus : Perspective Matters

BACKGROUND We describe the relative frequency of health care-associated pathogens by infection site over 29 years using hospital-wide surveillance data from a large academic hospital. METHODS Comprehensive hospital-wide surveillance was provided by trained infection preventionists using Centers for Disease Control and Prevention definitions. Five 5-year blocks and one 4-year block were created for each site: bloodstream infections (BSI), urinary tract infections (UTI), respiratory tract infections (RTI), and surgical site infections (SSI). The blocks of relative frequency of health care-associated pathogens were compared by χ(2) analysis, and trends for each pathogen were estimated by regression analysis. RESULTS At least 1 pathogen was isolated from 28,208 (83.5%) of 33,797 health care-associated infections (HAI). Staphylococcus aureus, coagulase-negative staphylococci (CoNS), Enterococcus species, and Clostridium difficile and other anaerobes significantly increased, whereas Escherichia coli, Pseudomonas aeruginosa, Klebsiella species, Enterobacter species, and other streptococci significantly decreased in the relative proportion of pathogens during the study period. By infection site, results showed significant increasing trends of S aureus in UTI, RTI, and SSI; CoNS in BSI and SSI; Candida in SSI; and Enterococcus in BSI and UTI. CONCLUSION Significant changes in relative frequency of health care-associated pathogens by infection site occurred over the 29-year period. These findings have implications for implementation of infection prevention strategies.

Preventing Catheter-Associated Urinary Tract Infections: Hospital Location of Catheter Insertion

HighlightsAmong 130 simulations, contamination occurred in 79.2% during the doffing process.Despite feedback, contaminations still occurred in 82% of 22 follow‐up simulations.Devising better personal protective equipment education and protocols is necessary to ensure health care personnel safety. Background Very little is known about how health care personnel (HCP) actually use personal protective equipment (PPE). Methods The clinical PPE practices of 50 HCP from selected units at the University of Pittsburgh Medical Center (UPMC) Presbyterian Hospital were videotaped with HCP consent. For 2 PPE simulation sessions (simple and full‐body sets), 82 HCP were recruited throughout the UPMC system. Simulation practices were videotaped and examined using fluorescent powder with ultraviolet lighting. All participants completed an electronic survey. For a follow‐up evaluation simulation, 12 HCP were recruited among simulation participants. Results Among 130 total sessions from 65 participants, contamination occurred in 79.2% of simulations during the doffing process with various PPE items: simple set (92.3%) and full‐body set (66.2%). Among 11 follow‐up evaluation participants, contaminations still occurred in 82% after receiving individual feedback, but the overall contamination level was reduced. Using the contamination information gained during the simulation analysis, 66% of potential contamination was estimated for the clinical observation. Concerns and barriers in PPE use from HCP survey responses were as follows: time‐consuming, cumbersomeness, and PPE effectiveness. Conclusions Although HCP knew they were being videotaped, contamination occurred in 79.2% of the PPE simulations. Devising better standardized PPE protocols and implementing innovative PPE education are necessary to ensure HCP safety.

Difficulties in using personal protective equipment: Training experiences with the 2015 outbreak of Middle East respiratory syndrome in Korea

Infection Control & Hospital Epidemiology / Volume 36 / Issue 01 / January 2015, pp 14 16 DOI: 10.1017/ice.2014.25, Published online: 05 January 2015 Link to this article: http://journals.cambridge.org/abstract_S0899823X14000257 How to cite this article: JaHyun Kang, Kenneth J. Smith, Cindy L. Bryce and Carlene A. Muto (2015). Economic Analysis of Universal Active Surveillance Screening for Methicillin-Resistant Staphylococcus aureus: Perspective Matters. Infection Control & Hospital Epidemiology, 36, pp 14-16 doi:10.1017/ice.2014.25 Request Permissions : Click here

Survey on Influenza Vaccination Noncompliance among Nursing Students

Infection Control & Hospital Epidemiology / Volume 33 / Issue 10 / October 2012, pp 1057 1058 DOI: 10.1086/667771, Published online: 02 January 2015 Link to this article: http://journals.cambridge.org/abstract_S0195941700031842 How to cite this article: David J. Weber, JaHyun Kang, Vickie M. Brown, Emily E. Sickbert-Bennett and William A. Rutala (2012). Preventing Catheter-Associated Urinary Tract Infections: Hospital Location of Catheter Insertion. Infection Control & Hospital Epidemiology, 33, pp 1057-1058 doi:10.1086/667771 Request Permissions : Click here

Changes in the incidence of health care–associated pathogens at a university hospital from 2005 to 2011

HighlightsIll‐fitting sizes were the most common obstacle observed among female healthcare personnel.Unstandardized and evolving protocols produced anxiety and confusion in healthcare personnel.The more personal protective equipment items involved, the more complex the doffing order became. &NA; This study aimed to evaluate practical barriers to personal protective equipment (PPE) use found through health care personnel (HCP) training sessions held during and after the 2015 Middle East respiratory syndrome outbreak in Korea. Difficulties observed were ill‐fitting sizes, anxiety, confusion from unstandardized protocols, doubts about PPE quality and effectiveness, and complexity of using several PPE items together. Further research to generate robust evidence and repeated HCP trainings are necessary to ensure HCP and patient safety in future outbreaks.

Survey of North Carolina Hospital Policies Regarding Visitor Use of Personal Protective Equipment for Entering the Rooms of Patients under Isolation Precautions

Infection Control & Hospital Epidemiology / Volume 35 / Issue 10 / October 2014, pp 1316 1317 DOI: 10.1086/678076, Published online: 16 January 2015 Link to this article: http://journals.cambridge.org/abstract_S0195941700094510 How to cite this article: JaHyun Kang, Sandra J. Engberg and Carlene A. Muto (2014). Survey on Inuenza Vaccination Noncompliance among Nursing Students. Infection Control & Hospital Epidemiology, 35, pp 1316-1317 doi:10.1086/678076 Request Permissions : Click here