Implementierungsstrategien für Hygienemaßnahmen

Welche Hygienemaßnahmen sind erfolgreich? – Diejenigen, die umgesetzt sind! Am Beispiel der Katheter-assoziierten Sepsis zeigt dieser Beitrag, wie Projekte zur Qualitätsverbesserung und Patientensicherheit in Krankenhäusern implementiert werden können, und was dabei zu beachten ist. Dabei werden verschiedene Modelle der Implementierungswissenschaft erläutert und beispielhaft angewendet.

Schlüsselwörter

Krankenhaushygiene - Hygiene - Strategien - Implementierung - Hygienefachkraft - Consolidated Framework for Implementation Research - CFIR - Expert Recommendations for Implementing Change, ERIC

Publication History

Article published online:
13 August 2024

• Literatur

• 1 Suetens C, Latour K, Karki T. et al. Prevalence of healthcare-associated infections, estimated incidence and composite antimicrobial resistance index in acute care hospitals and long-term care facilities: results from two European point prevalence surveys, 2016 to 2017. Euro Surveill 2018; 23: 1800516
• 2 NRZ. Deutsche nationale Punkt-Prävalenzerhebung zu nosokomialen Infektionen und Antibiotika-Anwendung. 2023
• 3 Martone WJ, Gaynes RP, Horan TC. et al. National Nosocomial Infections Surveillance (NNIS) semiannual report, May 1995. A report from the National Nosocomial Infections Surveillance (NNIS) System. Am J Infect Control 1995; 23: 377-385
• 4 National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control 2004; 32: 470-485
• 5 Rosenthal VD, Duszynska W, Ider BE. et al. International Nosocomial Infection Control Consortium (INICC) report, data summary of 45 countries for 2013–2018, Adult and Pediatric Units, Device-associated Module. Am J Infect Control 2021; 49: 1267-1274
• 6 Geffers C, Schwab F, Behnke M. et al. No increase of device associated infections in German intensive care units during the start of the COVID-19 pandemic in 2020. Antimicrob Resist Infect Control 2022; 11: 67
• 7 Zingg W, Sax H, Inan C. et al. Hospital-wide surveillance of catheter-related bloodstream infection: from the expected to the unexpected. J Hosp Infect 2009; 73: 41-46
• 8 Zingg W, Cartier V, Inan C. et al. Hospital-wide multidisciplinary, multimodal intervention programme to reduce central venous catheter-associated bloodstream infection. PLoS One 2014; 9: e93898
• 9 Pronovost P, Needham D, Berenholtz S. et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 2006; 355: 2725-2732
• 10 Gawande A. The checklist manifesto. New York, NY: Metropolitan Books; 2009
• 11 Bion JF, Dixon-Woods M. Keystone, matching Michigan, and bacteremia zero. Crit Care Med 2014; 42: e383-e384
• 12 Palomar M, Alvarez-Lerma F, Riera A. et al. Impact of a national multimodal intervention to prevent catheter-related bloodstream infection in the ICU: the Spanish experience. Crit Care Med 2013; 41: 2364-2372
• 13 Dixon-Woods M, Leslie M, Tarrant C. et al. Explaining Matching Michigan: an ethnographic study of a patient safety program. Implement Sci 2013; 8: 70
• 14 Dixon-Woods M, Bosk CL, Aveling EL. et al. Explaining Michigan: developing an ex post theory of a quality improvement program. Milbank Q 2011; 89: 167-205
• 15 van der Kooi T, Sax H, Pittet D. et al. Prevention of hospital infections by intervention and training (PROHIBIT): results of a pan-European cluster-randomized multicentre study to reduce central venous catheter-related bloodstream infections. Intensive Care Med 2018; 44: 48-60
• 16 Rabin BA, Brownson RC, Haire-Joshu D. et al. A glossary for dissemination and implementation research in health. J Public Health Manag Pract 2008; 14: 117-123
• 17 Klein KJ, Sorra JS. The challenge of innovation implementation. Acad Manag Rev 1996; 21: 1055-1080
• 18 Davidoff F, Batalden P, Stevens D. et al. Publication guidelines for improvement studies in health care: evolution of the SQUIRE Project. Ann Intern Med 2008; 149: 670-676
• 19 Dopson S, Fitzgerald L. The active role of context. In: Dopson S, Fitzgerald L. Knowledge to action? Evidence-based health care in context. Oxford, UK: Oxford University Press; 2006: 223
• 20 Szymczak JE. Beyond barriers and facilitators: the central role of practical knowledge and informal networks in implementing infection prevention interventions. BMJ Qual Saf 2018; 27: 763-765
• 21 Clack L, Zingg W, Saint S. et al. Implementing infection prevention practices across European hospitals: an in-depth qualitative assessment. BMJ Qual Saf 2018; 27: 771-780
• 22 Curran GM. Implementation science made too simple: a teaching tool. Implement Sci Commun 2020; 1: 27
• 23 Damschroder LJ, Aron DC, Keith RE. et al. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci 2009; 4: 50
• 24 Damschroder LJ, Reardon CM, Widerquist MAO. et al. The updated Consolidated Framework for Implementation Research based on user feedback. Implement Sci 2022; 17: 75
• 25 Zingg W, Holmes A, Dettenkofer M. et al. Hospital organisation, management, and structure for prevention of health-care-associated infection: a systematic review and expert consensus. Lancet Infect Dis 2015; 15: 212-224
• 26 Saint S, Kowalski CP, Banaszak-Holl J. et al. How active resisters and organizational constipators affect health care-acquired infection prevention efforts. Jt Comm J Qual Pat Saf 2009; 35: 239-246
• 27 Greenhalgh T, Robert G, Macfarlane F. et al. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q 2004; 82: 581-629
• 28 Saint S, Kowalski CP, Banaszak-Holl J. et al. The importance of leadership in preventing healthcare-associated infection: results of a multisite qualitative study. Infect Control Hosp Epidemiol 2010; 31: 901-907
• 29 Elder NC, Brungs SM, Nagy M. et al. Intensive care unit nurses' perceptions of safety after a highly specific safety intervention. Qual Saf Health Care 2008; 17: 25-30
• 30 Hofstede G, Hofstede GJ, Minkov M. Cultures and organisations: software of the mind. New York; NY: McGraw-Hill;: 2010
• 31 Waltz TJ, Powell BJ, Chinman MJ. et al. Expert Recommendations for Implementing Change (ERIC): protocol for a mixed methods study. Implement Sci 2014; 9: 39
• 32 Powell BJ, Waltz TJ, Chinman MJ. et al. A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project. Implement Sci 2015; 10: 21
• 33 Powell BJ, McMillen JC, Proctor EK. et al. A compilation of strategies for implementing clinical innovations in health and mental health. Med Care Res Rev 2012; 69: 123-157
• 34 Waltz TJ, Powell BJ, Fernandez ME. et al. Choosing implementation strategies to address contextual barriers: diversity in recommendations and future directions. Implement Sci 2019; 14: 42
• 35 Zingg W, Mutters NT, Harbarth S. et al. Education in infection control: A need for European certification. Clin Microbiol Infect 2015; 21: 1052-1056
• 36 Trivedi KK, Schaffzin JK, Deloney VM. et al. Implementing strategies to prevent infections in acute-care settings. Infect Control Hosp Epidemiol 2023; 44: 1232-1246
• 37 Brusaferro S, Cookson B, Kalenic S. et al. Training infection control and hospital hygiene professionals in Europe, 2010: agreed core competencies among 33 European countries. Euro Surveill 2014; 19: 20985