Amie Steel, Hope Foley, Kim Graham, Joanna Harnett, Jon Adams
Patient experiences of information-sharing and patient-centred care across the broad landscape of primary care practice and provision: a nationally representative survey of Australian adults
BMC primary care
children pediatric longterm care facilities pltcf represent highly vulnerable population infectious outbreaks occur frequently resulting significant morbidity mortality resource use purpose quasiexperimental trial using time series analysis assess impact 4year theoretically based behavioral intervention infection prevention practices clinical outcomes three pltcf 288 beds new york metropolitan area including 720 residents ages 1 day 26 years mean lengths stay 79336 months 5pronged behavioral intervention included explicit leadership commitment active staff participation work flow assessments training staff world health organization five moments hand hygiene hh electronic monitoring feedback hh frequency major outcomes hh frequency rates infections number hospitalizations associated infections outbreaks mean infection rates1000 patient days ranged 41104 preintervention 29100 postintervention mean hospitalizations1000 patient days ranged 2397 6498 intervention number outbreaks1000 patient days per study site ranged 924 pre 918 postintervention total 95 number casesoutbreak ranged 97324 total cases preintervention 591 postintervention 401 postintervention statistically significant increases hh trends occurred one three sites reductions infections two sites fewer hospitalizations sites significant varied changes numbers outbreaks casesoutbreak modest inconsistent improvements occurred clinically relevant outcomes sustainable improvements infection prevention pltcf require culture change increased staff involvement explicit administrative support meaningful timely behavioral feedback