Background: Hand hygiene is considered the simplest and most cost-effective method of infection prevention. Regular observation and feedback on hand hygiene compliance are key strategies for its enhancement. This study evaluated the effectiveness of hand hygiene surveillance, including direct observation and feedback, by comprehensively analyzing the reported hand hygiene compliance within the Korean National Healthcare-Associated Infections Surveillance System from 2019 to 2022. Methods: Participating medical institutions included general hospitals and hospitals with infection control departments that consented to participate. Hand hygiene surveillance was conducted using direct observation. Collected data, including healthcare workers, clinical areas, hand hygiene moments, and hand hygiene compliance, were recorded to calculate hand hygiene compliance rates. Additionally, the volume of alcohol-based hand sanitizers used per patient per day was investigated as an indirect indicator of hand hygiene compliance. The study was conducted from July 2019 to December 2022. Results: Hand hygiene compliance increased from 87.2% in Q3 2019 to 89.9% in 2022. Nurses and medical technologists showed the highest compliance rates, whereas doctors showed the lowest compliance rates. Intensive care units excelled in compliance, whereas emergency de partments lagged. Compliance was highest after patient contact and lowest when the patient’s surroundings were touched. Larger hospitals consumed more alcohol-based hand sanitizers than smaller hospitals did. Conclusion This study confirmed an improvement in hand hygiene compliance through sustained surveillance, indicating its contribution not only to preventing infection transfer within healthcare facilities but also to fostering a culture of hand hygiene in the country.

Purpose: The purpose of this study was to develop an infection control education program (ICEP) for infection control practitioners (ICPs) in long-term care hospitals (LTCH) and to test the effectiveness of the program. Methods: The ICEP was developed based on the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model. Focus group interviews, Borich needs assessment, and location of focus models were used to assess educational needs. To test the effectiveness of the developed ICEP program, one-group pretest-posttest design was used. Participants were 269 ICPs working at LTCH. Knowledge, skills, awareness, self-efficacy, and teaching efficacy on infection control were measured before and after the program using questionnaires. A paired t-test was performed to analyze the data. Results: Compared to pre-test, there was a significant improvement in knowledge (47.07±10.22 vs, 76.99±0.88, p<.001) and skills (32.11±12.48 vs. 62.11±14.08, p<.001). Awareness of infection control, self-efficacy, and teaching efficacy were also significantly improved. Conclusion We developed an ICEP for ICPs working at LTCH. Based on the results of this study, the ICEP is effective in improving infection control knowledge, skills, self-efficacy, and teaching efficacy for the ICPs. It is suggestive to provide an ICEP to improve hospital infection control activities.

PURPOSE: The purpose of this study was to investigate the status of infection control in long-term care facilities in Korea and educational needs of nurses in charge of infection control. METHODS: This was a descriptive study. A self-reported questionnaire was provided to the nurses in charge of infection control in 250 hospitals with long-term care. 209 nurses answered to the questionnaire. Data were collected from September 30 to November 7, 2016. Data were analyzed using SPSS/WIN 18.0, and the educational needs were analyzed by applying the Borich Needs Assessment Model. RESULTS: Only 17.4% of the hospitals had infection control departments, and only 1.0% of the hospitals had nurses who were fully-in-charge of infection control. Regarding the educational needs on infection control, level of knowledge was statistically significantly lower in all 50 items compared to the importance. Specifically, educational demand on air and water quality management, construction and infection control, indicator management, and infectious disease management were also high. CONCLUSION: The results of this study showed that organization and manpower were needed for effective infection control of long-term care facilities in Korea. In addition, it was deemed necessary to develop and applicate infection control education programs as reflected on the scores obtained in the educational needs on infection control.
Communicable Diseases ; Education ; Infection Control* ; Korea* ; Long-Term Care* ; Needs Assessment ; Water Quality

PURPOSE: The purpose of this study was to describe the status of infection control nurses (ICNs) and their activities, and to identify the factors affecting the level of infection control activities. Methods: Data were collected from 199 hospitals from June 24 to July 26, 2016. The structured questionnaires included status of infection control nurses, type and level of infection control activities. METHODS: Data were collected from 199 hospitals from June 24 to July 26, 2016. The structured questionnaires included status of infection control nurses, type and level of infection control activities. RESULTS: Most participating hospital were advanced general hospital (20.1%) and general hospital (67.8%). Among the hospitals, 86.4% had an infection control department (ICD). The average hospital work experience of ICNs was 14.62 years, and their average infection control career was for 4.94 years. Among the ICNs, 85.6% worked in full time and the average number of beds per ICN was 311.21. There were significant differences in the existence of ICD, infection control activities including surveillance, outbreak investigation, negative pressure room, hand hygiene monitoring, disinfection, and sterilization according to hospital size. The level of infection control activities was higher with more number of ICNs, ICN employment as full time, and healthcare institution accreditation status. The explanatory power was 37.5%. CONCLUSION: These results of this study which reflect infection control status of healthcare facilities with more than 150 beds in 2016 will provide baseline data to establish infection control system in small to medium sized hospitals after the Middle East Respiratory Syndrome outbreak in 2015.
Accreditation ; Coronavirus Infections ; Delivery of Health Care ; Disinfection ; Employment ; Hand Hygiene ; Health Facility Size ; Hospitals, General ; Infection Control ; Korea ; Sterilization

BACKGROUND: This study was performed to improve the working competencies of novice infection control nurses (ICNs) and thereby prevent healthcare associated infection. We developed and implemented an education program and then evaluated its effectiveness. METHODS: The education program was developed by conducting a literature review and four expert group discussions. The program was implemented twice, and included 3 days of lectures and 1 day of practice in Seoul and Pusan, for 157 ICNs with less than 3 years of experience. The knowledge of the participants before and after the educational program and overall satisfaction were measured. Data were analyzed using the SPSS WIN 18.0 program. RESULTS: The education program consisted of 12 lectures and 2 practices in total. The post-program knowledge score increased to 77.99 compared to 45.91 prior to participating in the program (P<.001). The scores for overall satisfaction, knowledge acquirement, and usefulness in field practice were 9.05, 8.97, and 9.01, respectively. The overall satisfaction was higher for the practice component (9.37) than the lectures (9.00). There were significant differences in surveillance knowledge according to age (F=3.94, P=.021), hospital career (F=3.71, P=.027), hospital type (F=5.36, P=.006), and hospital size (F=6.19, P=.003); and there were significant differences in hand hygiene knowledge according to age (F=4.14, P=.018) and hospital type (F=4.84, P=.009). However, there was no difference in overall satisfaction with the program. CONCLUSION: To enhance working competencies and professionalism, education programs considering the characteristics and needs of the ICNs must be developed. Moreover, professional training courses are needed to nurture ICNs in small hospitals.
Busan ; Cross Infection ; Education* ; Hand Hygiene ; Health Facility Size ; Infection Control* ; Lectures ; Professionalism ; Seoul

PURPOSE: This study was done to investigate the status of disinfection and sterilization in healthcare facilities. METHOD: A survey of 193 Korean healthcare facilities was conducted from February 8 to March 7, 2013. Data were analyzed using descriptive statistics, chi2 test, Fisher's exact test, one-way ANOVA, Scheffe with SPSS WIN 18.0. RESULTS: Of the healthcare facilities 93.2% had specific guidelines for disinfection/sterilization, but only 47.9% had a committee on disinfection/sterilization for decision-making, less than half (42.7%) conducted regular monitoring of actual practices, while 83.9% had established procedures for recovery in case of problems with the disinfection process and 89.0% kept records and archives of disinfection practices. Cleaning process, selection of chemical disinfectants and process of disinfection and sterilization were found to be inadequate in some healthcare facilities. Perception score for adequacy of medical instruments was 8.10, environmental disinfection was 7.20, and sterilizer management was 8.45 out of a possible 10. CONCLUSION: Compared to larger institutions, smaller healthcare facilities had less effective disinfection and sterilization management systems, while some facilities showed inadequate practices for medical equipment and general sterilization. Better academic and state-level support is recommended for smaller facilities in order to establish a better system-wide management system.
Delivery of Health Care* ; Disinfectants ; Disinfection* ; Sterilization*

BACKGROUND: The purpose of this study is to know the healthcare-associated infection (HAI)s in small and medium sized hospitals, less than 400 beds. METHODS: We had web based surveillance for HAIs in 27 hospitals from August to October 2010. The surveillance performed in 1-2 ICUs and 1 general ward in each hospitals by CDC definition. And for the multi-drug resistant organisms (MDROs), we reviewed all of blood culture results. RESULTS: We identified 319 HAIs among 269,436 patients days. The HAIs rate was 1.18 (CI 1.05-1.32)/1,000 patient-days. Urinary tract infection was the most common HAI (52.4%) in this study followed by pneumonia (18.9%), blood-stream infections (14.2%), surgical site infection (7.9%), and others (6.6%). There were 76.5% of device associated infections in UTI, 46.7% in BSI, and 18.3% in pneumonia. The rate of HAIs in ICU was higher than that of in general ward (4.6 vs 0.9/1,000 patient-days). However, the indwelling catheter associated urinary tract infection rate was lower in ICU (2.6 vs 4.4/1,000 device days). There were no significant differences in central line-associated blood stream infection rate (1.5 vs 1.8) and ventilator-associated pneumonia rate (3.0 vs 0.0). The common microorganisms found in HAIs were Escherichia coli (19.8%), Staphylococcus aureus (13.1%), and Pseudomonas aeruginosa (12.7%). Moreover, 90.9% of S. aureus were resistant to methicillin, and 38.2% of P. aeruginosa and 44.4% of Acinetobacter baumannii were resistant to imipenem. Total of 66 MDROs were isolated from blood culture and the result shows that the MRSA was 84.6% (56 case), carbapenmen-resistant Acinetobacter spp. was 10.6% (7 case), and vancomycin-resistant enterococci was 4.6% (3 case). CONCLUSION: The characteristics of HAIs in small and medium sized hospitals will be contributed to the decision making of governance policy for infection control and to provide comparable data for these hospitals.
Acinetobacter ; Acinetobacter baumannii ; Catheters, Indwelling ; Centers for Disease Control and Prevention (U.S.) ; Decision Making ; Escherichia coli ; Humans ; Imipenem ; Infection Control ; Methicillin ; Methicillin-Resistant Staphylococcus aureus ; Patients' Rooms ; Pneumonia ; Pneumonia, Ventilator-Associated ; Pseudomonas aeruginosa ; Rivers ; Staphylococcus aureus ; Urinary Tract Infections

BACKGROUND: This study aimed to examine the underreporting rate and related factors after needlestick injuries among healthcare workers (HCWs) in small- or medium-sized hospitals. METHODS: Convenience sampling was conducted for 1,100 HCWs in 12 small- or medium-sized hospitals with less than 500 beds. From October 1 to November 30, 2010, data were collected using self-report questionnaire that was developed by researcher. The response rate for the study was 98.3% (982 HCWs). Data were analyzed using Statistical Package for the Social Sciences (SPSS) Win 12.0. RESULTS: The reports showed that 239 HCWs (24.3%) sustained needlestick injuries within the last year. The under-reporting rate after a needlestick injury was 67.4% (161/239), and underreporting rates varied across the hospitals and ranged from 46.2% to 85.7%. The major reasons for underreporting after needlestick injuries were the assumption that no blood-borne pathogens existed in the source patient (62.8%), annoyance (17.9%), and no knowledge about the reporting procedure (6.0%). Multiple logistic regression analysis showed that the suggestion by colleagues to report the injury, the number of needlestick injuries, and the needle type were independently related to the underreporting of needlestick injuries. CONCLUSION: The underreporting rate of needlestick injuries in small- or medium-sized hospitals was similar to that in large-sized hospitals, and this finding confirmed that the suggestion by colleagues to report the injury was the most significant factor influencing the injury-report rate. Thus, creating an environment that encourages HCWs to report injuries is considered the most important method to decrease the underreporting rate of needlestick injuries in small- and medium-sized hospitals.
Blood-Borne Pathogens ; Delivery of Health Care ; Humans ; Logistic Models ; Needles ; Needlestick Injuries ; Occupational Exposure ; Risk Management ; Social Sciences ; Surveys and Questionnaires

PURPOSE: The purpose of this study was to examine the under-reporting rate and related factors after blood and body fluid (BBF) exposure among hospital employees. METHODS: Fifteen hundred employees were conveniently sampled from ten university and acute care hospitals. The survey questionnaire consisted of 37 items. Data were collected from September 10 to November 30, 2008. RESULTS: The survey response rate was 88.7%. The 47.9% (638/1,331) of hospital employees were exposed to BBF and the mean number of exposure was 4.7+/-5.942 within the previous year. Under-reporting rate after BBF exposure was 69.4% (443/638). By multi-variate logistic regression analysis, the exposure number, exposure type, infectious disease and hospital were independently related to the under-reporting of BBF among hospital employees. CONCLUSION: The Under-reporting Rate After Being Exposed To Blood And Body Fluids Was Relatively High. To Address This Problem, Educational Programs Are Needed To Decrease The Under-reporting Rate For Healthcare Workers. Further, It Might Be Helpful If Other Factors Related To Under-reporting Be Investigated In Future Studies.
Blood-Borne Pathogens ; Body Fluids ; Communicable Diseases ; Delivery of Health Care ; Logistic Models ; Occupational Exposure ; Risk Management

PURPOSE: The purpose of this study is to investigate the predisposing factors for nipple confusion by using questionnaires. METHODS: From October, 2005 to October, 2006, we performed a survey on guardians of neonates who had been admitted to the nursery at Dongguk University Medical Center and were discharged 10 to 14 days before the survey. We reviewed their medical records retrospectively. The neonates were categorized into two groups; nipple-unconfused group and nipple- confused group. RESULTS: There were 71 neonates in the nipple-unconfused group and 29 neonates in the nipple-confused group. In the nipple-confused group, 12 neonates (41.4%) had nipple-suckling experience before admission, whereas in the nipple-unconfused group, 54 neonates (76.1%) had nipple-suckling experience before admission; showing a difference that was statistically significant (P=0.001). Regarding to breast-feeding experience before admission, 11 neonates (37.9%) had experience in the nipple-confused group, whereas 49 neonates (69.0%) had in the nipple-unconfused group. This also showed a statistically significant difference (P=0.004). However, the relationship between the duration of breast-feeding prior to hospitalization was not different (P=0.151). CONCLUSION: In this study, we believe that the suckling experience and the breast-feeding of neonates before admission may be factors affecting the development of nipple confusion. This study particularly revealed that neonates who had only nipple suckling experience, regardless of breast-feeding, had less nipple confusion. Thus, allowing neonates enough time to make an attempt at nipple suckling may be helpful to prevent nipple confusion.
Academic Medical Centers ; Breast Feeding ; Hospitalization ; Humans ; Infant, Newborn ; Medical Records ; Nipples ; Nurseries ; Retrospective Studies