Pan European Networks - Horizon 2020 - page 187

Guideline review
Zingg then presented the activities and results of the PROHIBIT project.
He discussed the first work package, the ‘Systematic review of guidelines
in Europe’, as outlined in his presentation slides to delegates: “What we
have seen across Europe is a large variation in scope, update and quality
among many documents. We also identified that much of this guidance
was absolutely not user friendly and was difficult to retrieve, which
definitely works against the use of guidelines.”
Zingg added that at “the end of the day”, it is important to have
documents that are used in “daily practice”. Another finding delivered to
delegates was that some guidelines are not being suitably followed, and
the speaker informed the audience that “less than 70% of hospitals
implemented national recommendations”.
“When we looked at hospitals having a national guideline or not having
a national guideline for the prevention of bloodstream infections, we saw
that for some of the recommendations there is no difference between
those countries.
“Whether you have national guidelines or do not have national guidelines,
hospitals still establish the best practice standards which are published
in the literature. Evidence-based or the adoption of evidence-based best
practice may precede the provision of not having national documents.”
Infection control
Zingg then turned his attention to the second work package, defined as
a ‘European-wide questionnaire about organisation and activity of
infection control’ in his onscreen presentation. “More than 300 European
hospitals provided data about the organisation of infection control. We
have seen that a median of the hospitals in Europe have established one
infection control nurse per 250 beds. In a way, this is good news, but it’s
only half the hospitals,” he said.
findings. The investigation assessed healthcare-
associated infections and antimicrobial use in
acute care hospitals.
“At any given time in a hospital in Europe, you
would find an average of 6% of the patients
having healthcare-associated infections …
with quite some variation across the countries,”
he said. This variation is between 2.3 and
10.8% among the countries analysed.
“Healthcare-associated infections can be
prevented by best practice procedures, rather
than by technology,” Zingg told delegates.
“There is no magical device you can use and
implement in a hospital to solve the problem,
and that makes the whole implementation and
the whole tackling and prevention so difficult.
“But best practice is not a standalone. In a
recent systematic review which was initiated by
the ECDC… they came up with guidance of ten
key components and identified several factors
that contribute to improving healthcare or to the
problem of healthcare-associated infections.”
Study findings
Zingg then detailed some of the key findings of
the ECDC review, including “having well-staffed
infection control”, “ward occupancy that does
not exceed the capacity for which a ward or
hospital was defined” and “reducing the use of
school and agency nurses in hospitals”.
Workload, “access to materials and best
equipment” and using “guidelines wisely” were
also important.
“In the context of a multimodal education
strategy,” Zingg said, “we have to involve
frontline workers in education and training and
we have to organise audits in order to be sure
of what we implement and what we want to
have or to see. That means the reduction of
healthcare-associated infections … and
those practices that lead to this prevention are
really established.”
Encouraging surveillance and “active feedback”
in hospitals were also defined as important, as
were infection control programmes as a
“multimodal” and “comprehensive” strategy.
Individual “champions” would also “help
improve practices”, and the study found it
important to realise “a positive organisational
culture” in hospitals.
H O R I Z O N 2 0 2 0 P R O J E C T S : P O R TA L
I S S U E S I X
187
H E A L T H : D I S E A S E R E S E A R C H
More than 300
European hospitals
provided data to
the PROHIBIT
project survey
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