Variability in practice patterns regarding protective isolation measures after heart transplantation: A secondary analysis of the international BRIGHT study - 09/01/20
for the BRIGHT study team
Résumé |
Background |
Infection control is a cornerstone of post-heart transplantation (HTx) in-hospital management when immunosuppression is highest. The use of protective isolation persists despite its questionable effectiveness. We describe and compare practice patterns internationally and assessed correlates of protective isolation.
Methods |
Using the BRIGHT-study data, a cross-sectional intercontinental study, we assessed 12 protective isolation measures in 4 continents, 11 countries, and 36 HTx centers. Data were summarized descriptively, as appropriate. Comparisons between countries and continents and association testing between center characteristics and number of isolation measures used were also explored by general linear modeling.
Results |
A total of 89% (32/36) of HTx centers used protective isolation measures with an average of 4.5 protective isolation measures per center (SD, 2.6; range 1-10). Most often applied were disinfecting high-touch surfaces (n = 27/34; 79.4%), use of private room (n = 27/36; 75.0%), and changing linen daily (n = 25/36; 69.4%). Least applied were wearing a cap (n = 6/35; 17.1%) and high-efficiency particulate air filtration (N = 5/32; 15.6 %). Larger centers and those with dedicated beds for HTx applied more isolation measures.
Conclusions |
Protective isolation measures are still widely applied within heart transplant centers across the world persists notwithstanding its doubtful effectiveness. Future clinical guidelines for heart transplant management should include a statement of the need for strict adherence to standard infection prevention measures.
Le texte complet de cet article est disponible en PDF.Key Words : Infection control, International comparison, Standard precaution measures, Immunosuppression, Disinfection, Private room
Plan
| The BRIGHT Study team consists of: Marisa G. Crespo-Leiro (Complexo Hospitalario Universitario A Coruña (CHUAC), CIBERCV, INIBIC, Universidade da Coruña (UDC), La Coruña, Spain); Sandra Cupples (US Department of Veterans Affairs, Veterans Health Administration, Washington DC, USA); Paolo De Simone (Azienda Ospedaliero‐Universitaria Pisana, Ospedale Cisanello, Pisa, Italy); Albert Groenewoud (Astellas Pharma Europe Ltd, UK); Christiane Kugler (Hannover Medical School, Hannover, Germany); Linda Ohler (George Washington University, Washington DC, USA); Johan Van Cleemput (University Hospitals Leuven, Leuven, Belgium); Alain Jean Poncelet (Cliniques Universitaires Saint‐Luc, Brussels, Belgium); Laurent Sebbag (Hôpital Louis Pradel, Lyon, France); Magali Michel (Hôpital Nord Laennec, Nantes, France); Andrée Bernard (Hôpital Universitaire Pitié‐Salpêtrière, Paris, France); Andreas Doesch (University Hospital Heidelberg, Heidelberg, Germany); Ugolino Livi (University Hospital Udine, Udine, Italy); Luciano Potena (University of Bologna, Bologna, Italy); Vicens Brossa-Loidi (Hospital de Sant Pau, Barcelona, Spain); Javier Segovia-Cubero (Hospital Puerta de Hierro, Madrid, Spain); Luis Almenar-Bonet (Hospital Universitari i Politècnic La Fe de Valencia, Valencia, Spain); Carmen Segura Saint-Gerons (Hospital Univeritario Reina Sofia, Córdoba, Spain); Paul Mohacsi (University Hospital of Bern, Bern, Switzerland); Eva Horvath (University Hospital Zurich, Zurich, Switzerland); Cheryl Riotto (Papworth Hospital, Cambridge, UK); Gareth Parry (Freeman Hospital, Newcastle, UK); Ashi Firouzi (Royal Brompton & Harefield NHS Foundation Trust, London, UK); Stella Kozuszko (Toronto General Hospital, Toronto, Canada); Haissam Haddad (University of Ottawa Heart Institute, Ottawa, ON, Canada); Annemarie Kaan (St Paul's Hospital, Vancouver, BC, Canada); Grant Fisher (London Health Sciences Centre, London, ON, Canada); Tara Miller (Duke University Hospital, Durham, NC, USA); Maureen Flattery (Virginia Commonwealth University Health System, Richmond, VA, USA); Kristin Ludrosky/Nancy Albert (Cleveland Clinic, OH, USA); Bernice Coleman (Cedars-Sinai Medical Center, Los Angeles, CA, USA); Jacqueline Trammell & Flavio Epstein (Kaiser Permanente Santa Clara Medical Center, Santa Clara, CA, USA); Katherine St. Clair, Andrew Kao (St. Luke's Hospital, Kansas City, MO, USA); Maria Molina (Hospital of the University of Pennsylvania, Philadelphia, PA, USA); Karyn Ryan Canales (Ochsner Medical Center, New Orleans, LA, USA); Samira Scalso de Almeida (Hospital Israelita Albert Einstein, São Paulo & Hospital Municipal Vila Santa Catarina - Ministerio da Saude PROAD/-SUS, São Paulo, Brazil); Bartira de Aguiar Roza,Paulista School of Nursing, Federal University of Sao Paulo, São Paolo, Brazil; Andrea Cotait Ayoub (Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil); Fernanda Barone (Instituto do Coração da Universidade de São Paulo, São Paulo Brazil); Michelle Harkess (St. Vincent's Hospital, Sydney, Australia); Joanne Maddicks-Law (The Prince Charles Hospital, Brisbane, Australia). |
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| Conflicts of interest: None to report. |
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| Author contributions: E.A. and C.D. are joint first authors. F.D. and S.D.G. are joint last authors. |
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