209. Healthcare-Associated Infections: Knowledge, Training, and Practice of Resident Physicians
Session: Poster Abstract Session: Criticare, HAIs: Pneumonia and Chlorhexidine
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • RP survey ID week 2013.pdf (1.6 MB)
  • Background: Healthcare-associated infections (HAIs) lead to significant morbidity and mortality. Improving the knowledge and practice of resident physicians (RPs) helps reduce risk to patients.

    Methods: We administered a web-based survey to 194 RPs of 8 different specialty programs to evaluate knowledge and practice to prevent 4 HAIs. The 50 questions addressed preventing infection related to urinary catheters (UCs), central lines, ventilators, and surgical site. Each of the programs had additional questions specific to their specialty.

    Results: 183 (94.3%) RPs completed the survey. The mean SD reported hand hygiene by RPs was 85.3% 16.2%. Knowledge and practice varied depending on specialty and HAI type. RPs reported knowledge of the appropriate indications for urinary catheter (UC) use in 64/127 (50.4%), with 55/127 (43.3%) having formal training on placement and maintenance of UCs. Only 34/98 (34.7%) RPs would assess daily for UC necessity >70% of the time and 47/115 (40.9%) would evaluate patients for UC need at the time of transfer out of intensive care >70% of the time. Although 83/98 (84.7%) reported knowing the proper insertion technique of a central line, only 78/98 (79.6%) would use chlorhexidine-alcohol for antisepsis. 40/98 (40.8%) RPs would stop and call for help after 2 attempts for placing a central line, 37/98 (37.8%) after 3 attempts, and 10/98 (10.2%) after 4 or more attempts. For RPs who performed surgical procedures, only 47/76 (61.8%) reported formal training on antisepsis of operative site, and only 17/76 (22.4%) reported documenting competence under supervision before performing the procedure independently. Interestingly, 42/76 (55.3%) were responsible for the antisepsis preparation of operative site in >70% of the time. 41/104 (39.4%) RPs reported being formally trained on preventing pneumonia in the mechanically ventilated, but only 51/104 (49%) would evaluate patients for head of bed elevation >70% of the time.

    Conclusion: Evaluating RP knowledge and practice is an important step to identify target areas for improvement efforts. With gaps identified, we plan to address them for each residency program through education and reassess any changes over time.

    Mohamad Fakih, MD, MPH1, Steven Minnick, MD, MBA2, Karen Huggland, MS2, Raymond Hilu, MD3, Patricia Nouhan, MD4, Elango Edhayan, MD5, Douglas Ziegler, MD6, Mark Paschall, MD7, Michael Prysak, MD8, Stuart Wertheimer, DPM9 and Adonis Lorenzana, MD10, (1)Infection Prevention and Control, St. John Hospital and Medical Center, Grosse Pointe Woods, MI, (2)Medical Education, St John Hospital and Medical Center, Grosse Pointe Woods, MI, (3)Internal Medicine, St John Hospital and Medical Center, Grosse Pointe Woods, MI, (4)Emergency Medicine, St John Hospital and Medical Center, Detroit, MI, (5)Surgery, St John Hospital and Medical Center, Detroit, MI, (6)Pediatrics, St John Hospital and Medical Center, Detroit, MI, (7)Family Medicine, St John Hospital and Medical Center, Detroit, MI, (8)Obstetrics and Gynecology, St John Hospital and Medical Center, Detroit, MI, (9)Podiatry, St John Hospital and Medical Center, Detroit, MI, (10)Transitional Year, St John Hospital and Medical Center, Detroit, MI

    Disclosures:

    M. Fakih, None

    S. Minnick, None

    K. Huggland, None

    R. Hilu, None

    P. Nouhan, None

    E. Edhayan, None

    D. Ziegler, None

    M. Paschall, None

    M. Prysak, None

    S. Wertheimer, None

    A. Lorenzana, None

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