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{ "pk": 46582, "title": "National Survey on Infection Prevention and Control in United States Emergency Departments", "subtitle": null, "abstract": "<p><strong>Introduction:</strong> In the emergency care setting, implementation of infection prevention and control (IPC) practices can be challenging due to numerous factors including emergency department (ED) crowding and boarding of patients, high staff-turnover rates, and acuity of patient needs. Understanding how the unique nature of the ED environment impacts IPC implementation is essential to reducing healthcare-associated infections and to improving patient safety. In this study we aimed to assess ED leaders’ perceptions of IPC practices to identify areas for potential intervention and inform targeted process improvement initiatives.</p>\n<p><strong>Methods:</strong> Between January–July 2023, ED leaders across the United States were queried about their IPC practices using the National Emergency Department Inventories (NEDI)-USA survey, which is administered annually to all EDs in the US. An expanded survey was administered in a subset of EDs to assess healthcare personnel training for IPC, reported adherence to recommended practices and policies related to disinfection of reusable medical equipment and environment, use of personal protective equipment, hand hygiene practices, patient care space cleaning and disinfection, use of transmission-based precautions signage, risk perceptions of how healthcare personnel practice contributes to healthcare-associated infections and barriers to appropriate room cleaning.</p>\n<p><strong>Results:</strong> Of the 289 facilities surveyed, 159 (55%) responded, and among responding EDs, 67 (42%) reported seeing ≥ 40,000 patients in the prior year. Regarding healthcare personnel training, 84% (131/156) of ED leaders reported that ≥80% of their ED healthcare personnel were correctly trained in IPC procedures according to their hospital’s policies. Perception of healthcare personnel compliance with IPC practices, however, was lower. Although 75% (118/157) of EDs reported > 80% compliance with correct N95 respirator use, compliance with transmission-based precaution signage was identified as a significant gap, with 30% (47/159) of EDs reporting that they never, rarely, or only sometimes posted signs for patients who required them. Further, 69% (61/89) of EDs reported that they never, rarely, or only sometimes posted transmission-based precaution signs for patients in hallways or overflow treatment spaces.</p>\n<p><strong>Conclusion: </strong>This national survey found that ED leaders perceive that their healthcare personnel have a high level of knowledge of IPC policies and compliance with some, but not all, IPC policies in the ED. The overall high perceptions of compliance stand in contrast to prior published observations of poor IPC practice in ED settings, suggesting complex relationships between perception and practice that may impact patient safety outcomes. These findings can guide future targeted interventions to improve IPC compliance, reduce healthcare-associated infections, and improve patient safety in emergency settings.</p>", "language": "eng", "license": { "name": "Creative Commons Attribution 4.0", "short_name": "CC BY 4.0", "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.", "url": "https://creativecommons.org/licenses/by/4.0" }, "keywords": [ { "word": "infection prevention and control" }, { "word": "emergency department" }, { "word": "survey" }, { "word": "healthcare-associated infection" }, { "word": "Compliance" }, { "word": "nosocomial" }, { "word": "leadership" }, { "word": "hand hygiene" }, { "word": "portable medical equipment" }, { "word": "transmission-based precautions" }, { "word": "training" }, { "word": "Personal Protective Equipment" }, { "word": "crowding" }, { "word": "hallways" } ], "section": "Original Research (Limit 4000 words)", "is_remote": true, "remote_url": "https://escholarship.org/uc/item/0kw634fh", "frozenauthors": [ { "first_name": "Laya", "middle_name": "", "last_name": "Dasari", "name_suffix": "", "institution": "Massachusetts General Hospital, Center for Disaster Medicine, Department of Emergency Medicine, Boston, Massachusetts", "department": "" }, { "first_name": "Molly", "middle_name": "L", "last_name": "Paras", "name_suffix": "", "institution": "Massachusetts General Hospital, Division of Infectious Diseases, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts", "department": "" }, { "first_name": "Samantha", "middle_name": "L", "last_name": "Pellicane", "name_suffix": "", "institution": "Massachusetts General Hospital, Center for Disaster Medicine, Department of Emergency Medicine, Boston, Massachusetts", "department": "" }, { "first_name": "Eileen", "middle_name": "F", "last_name": "Searle", "name_suffix": "", "institution": "Massachusetts General Hospital, Center for Disaster Medicine, Department of Emergency Medicine, Boston, Massachusetts", "department": "" }, { "first_name": "Amy", "middle_name": "", "last_name": "Courtney", "name_suffix": "", "institution": "Infection Control, Mass General Brigham, Boston, Massachusetts", "department": "" }, { "first_name": "Julio", "middle_name": "", "last_name": "Ma Shum", "name_suffix": "", "institution": "Massachusetts General Hospital, Center for Disaster Medicine, Department of Emergency Medicine, Boston, Massachusetts", "department": "" }, { "first_name": "Krislyn", "middle_name": "M", "last_name": "Boggs", "name_suffix": "", "institution": "Emergency Medicine Network, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts", "department": "" }, { "first_name": "Janice", "middle_name": "A", "last_name": "Espinola", "name_suffix": "", "institution": "Emergency Medicine Network, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts", "department": "" }, { "first_name": "Ashley", "middle_name": "F", "last_name": "Sullivan", "name_suffix": "", "institution": "Emergency Medicine Network, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts", "department": "" }, { "first_name": "Carlos", "middle_name": "A", "last_name": "Camargo", "name_suffix": "Jr", "institution": "Harvard Medical School, Boston, Massachusetts; Emergency Medicine Network, Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts; Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts", "department": "" }, { "first_name": "Jeremiah", "middle_name": "D", "last_name": "Schuur", "name_suffix": "", "institution": "Lawrence General Hospital, Lawrence, Massachusetts; Tufts University School of Medicine, Boston, Massachusetts", "department": "" }, { "first_name": "Erica", "middle_name": "S", "last_name": "Shenoy", "name_suffix": "", "institution": "Massachusetts General Hospital, Division of Infectious Diseases, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Infection Control, Mass General Brigham, Boston, Massachusetts", "department": "" }, { "first_name": "Paul", "middle_name": "D", "last_name": "Biddinger", "name_suffix": "", "institution": "Massachusetts General Hospital, Center for Disaster Medicine, Department of Emergency Medicine, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Massachusetts General Hospital, Department of Emergency Medicine, Boston, Massachusetts", "department": "" } ], "date_submitted": "2025-03-07T16:37:26.448000+01:00", "date_accepted": "2025-08-27T16:50:04.933000+02:00", "date_published": "2025-11-27T05:54:00+01:00", "render_galley": null, "galleys": [ { "label": "PDF", "type": "pdf", "path": "https://journalpub.escholarship.org/westjem/article/46582/galley/43185/download/" } ] }