FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Acta veterinaria Scandinavica2014; 56(1); 52; doi: 10.1186/s13028-014-0052-4

A pre- and post-intervention study of infection control in equine hospitals in Sweden.

Abstract: Detection of nosocomial methicillin-resistant Staphylococcus aureus infections in horses in Sweden has increased attention on infection control (IC) in equine hospitals. This study established baseline data on IC programmes within such settings, evaluated compliance with some IC procedures before and after an education intervention, and examined barriers to compliance.The study was carried out between 2008 and 2011 in four Swedish equine hospitals. Data on current IC of each hospital, purchase data on hand sanitisers and disposable gloves per patient, and direct observations of compliance with procedures were monitored pre- and post-intervention. The intervention comprised a lecture on common IC and a review of each hospital's current procedures. For comparison, retrospective purchase data were reviewed. A questionnaire on individual compliance, experiences and opinions of IC was issued to employees. Results: Three hospitals completed the study, while the fourth reported its IC procedures and completed the questionnaire. Actual numbers of procedures, content and level of documentation differed among the hospitals. Similarities were poor or absent IC implementation strategy, lack of active surveillance of compliance with procedures and no monitoring of such as nosocomial infections. Among the hospitals which completed the study, two reported pre-intervention observation of compliance, while all three reported post-intervention observations. The purchase data showed trends for changes over time, although not uniformly related to the intervention. One hospital demonstrated a significant post-intervention increase in compliance with glove procedures, accompanied by a non-significant post-intervention increase in purchases figures. Compliance with dress code and personal appearance was high in all three hospitals (92-100%), while compliance with hand hygiene procedures was generally poorer. Barriers to compliance cited in the questionnaire (data from four hospitals) included insufficient supplies of hygiene products, lack of readily accessible places for cleaning, insufficient knowledge and high workload. Conclusions: Potential for easily attainable improvements in IC, such as traceability of documents, implementation strategies and surveillance of efficacy, was revealed. Attention to hand hygiene implementation and improvement of logistics appeared important. Data on purchases per patient were readily available and therefore applicable for intra-hospital surveillance of IC trends over time.
Get Full Text
Publication Date: 2014-08-22 PubMed ID: 25146752PubMed Central: PMC4236551DOI: 10.1186/s13028-014-0052-4Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article
  • Research Support
  • Non-U.S. Gov't

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research examines infection control programs in Swedish equine hospitals, identifies barriers to compliance, and assesses how an education intervention could improve their practice. The researchers found that while there were structures for infection control, there were areas for improvement such as documentation traceability, implementation strategy, and surveillance.

Methodology of the Study

  • The study was conducted in four equine hospitals in Sweden between 2008 and 2011. It included collecting baseline data on existing infection control systems, observation of compliance before and after an intervention, and an evaluation of deterrents.
  • Examination comprised observing actual purchase data of sanitizers and disposable gloves per patient, compliance with infection control methods, and their post-intervention assessment.
  • The intervention involved a lecture on fundamental infection control measures as well as an evaluation of each hospital’s current procedures.
  • To ensure validity, retrospective purchase data were analyzed. Staff members were also given a questionnaire to assess their compliance, experiences, and viewpoints about infection control.

Study Findings

  • Regarding operational procedures, documentation content, and level, considerable differences and variations were identified amongst the hospitals. Shared issues amongst the hospitals included the absence or inadequate implementation of infection control strategies, a lack of compliance surveillance, and no monitoring of hospital-acquired infections.
  • Two hospitals reported observation of compliance even before the intervention, whereas all three showed compliance after the intervention.
  • Gloves purchase data showed a significant increase post-intervention, an indication of improved compliance with glove procedures.
  • However, compliance differed across different areas; dress code and personal appearance compliance were high in all three hospitals (between 92-100%) while hand hygiene practices were not as impressive.

Barriers to Compliance

  • From the staff questionnaires, several barriers to better compliance were outlined. They include insufficient supplies of hygiene products, inadequate easily accessible sanitation points, lack of knowledge, and high workload.

Conclusions and Recommendations

  • The research brought to the fore the potential for improving infection control in equine hospitals, specifically in areas of document traceability, strategy implementation, effectiveness surveillance.
  • Hand hygiene implementation and improvement of logistics were also identified as crucial areas for attention.
  • The data on purchases per patient were readily available and hence applicable for internal hospital tracking of infection control trends over time.

Cite This Article

APA
Bergström K, Grönlund U. (2014). A pre- and post-intervention study of infection control in equine hospitals in Sweden. Acta Vet Scand, 56(1), 52. https://doi.org/10.1186/s13028-014-0052-4

Publication

Acta veterinaria Scandinavica
ISSN: 1751-0147
NlmUniqueID: 0370400
Country: England
Language: English
Volume: 56
Issue: 1
Pages: 52

Researcher Affiliations

Bergström, Karin
  • Department of Animal Health and Antimicrobial Strategies, National Veterinary Institute, Uppsala, SE 750 89, Sweden. karin.bergstrom@sva.se.
Grönlund, Ulrika

    MeSH Terms

    • Animals
    • Horses
    • Hospitals, Animal / standards
    • Infection Control / standards
    • Reference Standards
    • Sweden

    References

    This article includes 28 references
    1. Yezli S, Li H. Antibiotic resistance amongst healthcare-associated pathogens in China.. Int J Antimicrob Agents 2012 Nov;40(5):389-97.
      doi: 10.1016/j.ijantimicag.2012.07.009pmc: PMC7135469pubmed: 22999767google scholar: lookup
    2. Dallap Schaer BL, Aceto H, Rankin SC. Outbreak of salmonellosis caused by Salmonella enterica serovar Newport MDR-AmpC in a large animal veterinary teaching hospital.. J Vet Intern Med 2010 Sep-Oct;24(5):1138-46.
      doi: 10.1111/j.1939-1676.2010.0546.xpubmed: 20584143google scholar: lookup
    3. van Duijkeren E, Moleman M, Sloet van Oldruitenborgh-Oosterbaan MM, Multem J, Troelstra A, Fluit AC, van Wamel WJ, Houwers DJ, de Neeling AJ, Wagenaar JA. Methicillin-resistant Staphylococcus aureus in horses and horse personnel: an investigation of several outbreaks.. Vet Microbiol 2010 Feb 24;141(1-2):96-102.
      doi: 10.1016/j.vetmic.2009.08.009pubmed: 19740613google scholar: lookup
    4. Garcia-Alvarez L, Dawson S, Cookson B, Hawkey P. Working across the veterinary and human health sectors.. J Antimicrob Chemother 2012 Jul;67 Suppl 1:i37-49.
      doi: 10.1093/jac/dks206pubmed: 22855878google scholar: lookup
    5. Steneroden KK, Van Metre DC, Jackson C, Morley PS. Detection and control of a nosocomial outbreak caused by Salmonella newport at a large animal hospital.. J Vet Intern Med 2010 May-Jun;24(3):606-16.
      doi: 10.1111/j.1939-1676.2010.0484.xpubmed: 20337913google scholar: lookup
    6. Bereket W, Hemalatha K, Getenet B, Wondwossen T, Solomon A, Zeynudin A, Kannan S. Update on bacterial nosocomial infections.. Eur Rev Med Pharmacol Sci 2012 Aug;16(8):1039-44.
      pubmed: 22913154
    7. Hartmann FA, Trostle SS, Klohnen AA. Isolation of methicillin-resistant Staphylococcus aureus from a postoperative wound infection in a horse.. J Am Vet Med Assoc 1997 Sep 1;211(5):590-2.
      pubmed: 9290826
    8. Smith BP. Evolution of equine infection control programs.. Vet Clin North Am Equine Pract 2004 Dec;20(3):521-30, v.
      doi: 10.1016/j.cveq.2004.07.002pubmed: 15519815google scholar: lookup
    9. Weese JS, Rousseau J, Willey BM, Archambault M, McGeer A, Low DE. Methicillin-resistant Staphylococcus aureus in horses at a veterinary teaching hospital: frequency, characterization, and association with clinical disease.. J Vet Intern Med 2006 Jan-Feb;20(1):182-6.
      doi: 10.1892/0891-6640(2006)20[182:MSAIHA]2.0.CO;2pubmed: 16496939google scholar: lookup
    10. Morley PS. Evidence-based infection control in clinical practice: if you buy clothes for the emperor, will he wear them?. J Vet Intern Med 2013 May-Jun;27(3):430-8.
      doi: 10.1111/jvim.12060pubmed: 23517451google scholar: lookup
    11. Morley PS, Anderson ME, Burgess BA, Aceto H, Bender JB, Clark C, Daniels JB, Davis MA, Hinchcliff KW, Johnson JR, McClure J, Perkins GA, Pusterla N, Traub-Dargatz JL, Weese JS, Whittem TL. Report of the third Havemeyer workshop on infection control in equine populations.. Equine Vet J 2013 Mar;45(2):131-6.
      doi: 10.1111/evj.12000pubmed: 23368775google scholar: lookup
    12. Bergström K, Aspan A, Landén A, Johnston C, Grönlund-Andersson U. The first nosocomial outbreak of methicillin-resistant Staphylococcus aureus in horses in Sweden.. Acta Vet Scand 2012 Feb 8;54(1):11.
      doi: 10.1186/1751-0147-54-11pmc: PMC3348035pubmed: 22316072google scholar: lookup
    13. Bergström K, Nyman G, Widgren S, Johnston C, Grönlund-Andersson U, Ransjö U. Infection prevention and control interventions in the first outbreak of methicillin-resistant Staphylococcus aureus infections in an equine hospital in Sweden.. Acta Vet Scand 2012 Mar 8;54(1):14.
      doi: 10.1186/1751-0147-54-14pmc: PMC3325856pubmed: 22401493google scholar: lookup
    14. Weese JS. Barrier precautions, isolation protocols, and personal hygiene in veterinary hospitals.. Vet Clin North Am Equine Pract 2004 Dec;20(3):543-59.
      doi: 10.1016/j.cveq.2004.07.006pmc: PMC7135499pubmed: 15519817google scholar: lookup
    15. Traub-Dargatz JL, Dargatz DA, Morley PS, Dunowska M. An overview of infection control strategies for equine facilities, with an emphasis on veterinary hospitals.. Vet Clin North Am Equine Pract 2004 Dec;20(3):507-20, v.
      doi: 10.1016/j.cveq.2004.07.004pubmed: 15519814google scholar: lookup
    16. Sax H, Clack L, Touveneau S, Jantarada Fda L, Pittet D, Zingg W. Implementation of infection control best practice in intensive care units throughout Europe: a mixed-method evaluation study.. Implement Sci 2013 Feb 19;8:24.
      doi: 10.1186/1748-5908-8-24pmc: PMC3584730pubmed: 23421909google scholar: lookup
    17. Shea A, Shaw S. Evaluation of an educational campaign to increase hand hygiene at a small animal veterinary teaching hospital.. J Am Vet Med Assoc 2012 Jan 1;240(1):61-4.
      doi: 10.2460/javma.240.1.61pubmed: 22171756google scholar: lookup
    18. Nakamura RK, Tompkins E, Braasch EL, Martinez JG Jr, Bianco D. Hand hygiene practices of veterinary support staff in small animal private practice.. J Small Anim Pract 2012 Mar;53(3):155-60.
      doi: 10.1111/j.1748-5827.2011.01180.xpubmed: 22309291google scholar: lookup
    19. Smith JR, Packman ZR, Hofmeister EH. Multimodal evaluation of the effectiveness of a hand hygiene educational campaign at a small animal veterinary teaching hospital.. J Am Vet Med Assoc 2013 Oct 1;243(7):1042-8.
      doi: 10.2460/javma.243.7.1042pubmed: 24050573google scholar: lookup
    20. Erasmus V, Daha TJ, Brug H, Richardus JH, Behrendt MD, Vos MC, van Beeck EF. Systematic review of studies on compliance with hand hygiene guidelines in hospital care.. Infect Control Hosp Epidemiol 2010 Mar;31(3):283-94.
      doi: 10.1086/650451pubmed: 20088678google scholar: lookup
    21. Rupp ME, Fitzgerald T, Puumala S, Anderson JR, Craig R, Iwen PC, Jourdan D, Keuchel J, Marion N, Peterson D, Sholtz L, Smith V. Prospective, controlled, cross-over trial of alcohol-based hand gel in critical care units .. Infect Control Hosp Epidemiol 2008 Jan;29(1):8-15.
      doi: 10.1086/524333pubmed: 18171181google scholar: lookup
    22. Traore O, Hugonnet S, Lübbe J, Griffiths W, Pittet D. Liquid versus gel handrub formulation: a prospective intervention study.. Crit Care 2007;11(3):R52.
      doi: 10.1186/cc5906pmc: PMC2206398pubmed: 17477858google scholar: lookup
    23. Boyce JM, Cooper T, Dolan MJ. Evaluation of an electronic device for real-time measurement of alcohol-based hand rub use.. Infect Control Hosp Epidemiol 2009 Nov;30(11):1090-5.
      doi: 10.1086/644756pubmed: 19775238google scholar: lookup
    24. Boyce JM. Measuring healthcare worker hand hygiene activity: current practices and emerging technologies.. Infect Control Hosp Epidemiol 2011 Oct;32(10):1016-28.
      doi: 10.1086/662015pubmed: 21931253google scholar: lookup
    25. Eckmanns T, Bessert J, Behnke M, Gastmeier P, Ruden H. Compliance with antiseptic hand rub use in intensive care units: the Hawthorne effect.. Infect Control Hosp Epidemiol 2006 Sep;27(9):931-4.
      doi: 10.1086/507294pubmed: 16941318google scholar: lookup
    26. Chen LF, Carriker C, Staheli R, Isaacs P, Elliott B, Miller BA, Anderson DJ, Moehring RW, Vereen S, Bringhurst J, Rhodes L, Strittholt N, Sexton DJ. Observing and improving hand hygiene compliance: implementation and refinement of an electronic-assisted direct-observer hand hygiene audit program.. Infect Control Hosp Epidemiol 2013 Feb;34(2):207-10.
      doi: 10.1086/669084pmc: PMC3622086pubmed: 23295569google scholar: lookup
    27. Haas JP, Larson EL. Measurement of compliance with hand hygiene.. J Hosp Infect 2007 May;66(1):6-14.
      doi: 10.1016/j.jhin.2006.11.013pubmed: 17276546google scholar: lookup
    28. Sax H, Allegranzi B, Uçkay I, Larson E, Boyce J, Pittet D. 'My five moments for hand hygiene': a user-centred design approach to understand, train, monitor and report hand hygiene.. J Hosp Infect 2007 Sep;67(1):9-21.
      doi: 10.1016/j.jhin.2007.06.004pubmed: 17719685google scholar: lookup

    Citations

    This article has been cited 3 times.
    1. Wierup M, Allard Bengtsson U, Vågsholm I. Biosafety considerations and risk reduction strategy for a new veterinary faculty building and teaching hospital in Sweden. Infect Ecol Epidemiol 2020 Jun 4;10(1):1761588.
      doi: 10.1080/20008686.2020.1761588pubmed: 32864050google scholar: lookup
    2. Bortolami A, Williams NJ, McGowan CM, Kelly PG, Archer DC, Corrò M, Pinchbeck G, Saunders CJ, Timofte D. Environmental surveillance identifies multiple introductions of MRSA CC398 in an Equine Veterinary Hospital in the UK, 2011-2016. Sci Rep 2017 Jul 14;7(1):5499.
      doi: 10.1038/s41598-017-05559-8pubmed: 28710350google scholar: lookup
    3. Sani Kaware M, Ibrahim MI, Shafei MN, Hairon SM, Abdullahi AU. Impact of an educational intervention on nurses' perception of handoff process in public hospitals in Katsina, Nigeria: a cluster-randomized trial. BMC Nurs 2025 May 17;24(1):555.
      doi: 10.1186/s12912-025-03202-wpubmed: 40382622google scholar: lookup
    Subscribe to our newsletter
    Join 99,727 horse owners like you who receive our email updates on horse health and nutrition.