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Abstract
Objective
To assess healthcare facilities’ level of readiness to respond to an HAI
outbreak, the Florida Department of Health in Pinellas County (DOH-Pinellas)
conducted an HAI outbreak tabletop exercise (TTX) on June 6, 2017. Other benefits
of
this TTX were to provide opportunities for collaborative learning, building
community partnerships and evaluation of HAI preparedness activities in Pinellas
County healthcare facilities.
Introduction
One in twenty-five patients in acute care hospitals develop at least one health care
associated infection (HAI); this resulted in approximately 75,000 preventable deaths
in 2011. Risk factors associated with developing HAIs include older patients,
serviced at a large hospital, central catheter placement, receiving medical
ventilation, and placement in a critical care unit. In Pinellas County, individuals
65 years of age and older comprise approximately 24% of the total population.
Methods
A line list of contact information for all long-term care facilities in Pinellas
County was obtained from the DOH–Pinellas Environmental Health Program. An
invitation to the TTX was sent to 234 health care and assisted living facilities.
Of
those invited, 35 individuals attended the TTX on June 6, 2017. The methods used to
facilitate discussion included the four scenarios that addressed different stages
of
an outbreak investigation and a “force decision-making” framework.
Following the course, a twelve-question evaluation was distributed. The first seven
questions were based on a five-point Likert scale assessing the course’s
impact on knowledge and tabletop learning environment. The other five were
open-ended and asked participants to elaborate on what they learned and provide
feedback regarding the strengths and areas for improvement of the TTX.
Results
Exercise participants included infection control practitioners, safety officers,
nursing supervisors, facility managers and epidemiologists from hospitals, assisted
living and skilled nursing facilities, hospice, rehabilitation centers and health
departments. Of the 35 participants, 30 completed the course evaluation for a
completion rate of 86%. For questions addressing HAI knowledge, participants
strongly agreed that the tabletop exercise enhanced their understanding of infection
control guidelines for HAIs. The question that received the lowest score of 4.3 was
the perception that “I was able to develop tools for my agency’s
infection control guidelines.” In the open-ended questions, themes regarding
HAI knowledge, resources, response and policies were frequently mentioned, in
addition to confusion over the health department’s role and available
resources during an HAI outbreak.
Conclusions
Participation and feedback during the TTX substantiated the importance of increased
collaboration across organizations and opportunities for training on HAI outbreak
response. Participants identified a need for an open forum to discuss best practices
for HAI control and surveillance methods to help guide preparedness and response
efforts. To address this need, DOH-Pinellas will create a HAI coalition which would
aim to improve understanding of each facility’s role in responding to an HAI
outbreak.
ISDS Annual Conference Proceedings 2018. This is an Open Access
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