Infection prevention practices in the Netherlands: results from a National Survey

Area of Science:

• Healthcare-associated infection (HAI) prevention
• Infection control practices
• Epidemiology

Background:

• Healthcare-associated infections (HAIs) remain a significant concern in acute care settings.
• Standardized prevention practices are crucial for reducing the incidence of catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and Clostridioides difficile infection (CDI).
• Assessing the adoption of these recommended practices is essential for quality improvement initiatives.

Purpose of the Study:

• To evaluate the extent of adoption of recommended practices for preventing four major HAIs in Dutch acute care hospitals.
• To identify variations in the implementation of CAUTI, CLABSI, VAP, and CDI prevention strategies.
• To pinpoint areas for improvement in infection prevention protocols within the Netherlands.

Main Methods:

• A survey was conducted among infection prevention teams in all acute care hospitals in the Netherlands between July and October 2017.
• The survey instrument, adapted from the 'Translating Healthcare-Associated Infection Prevention Research into Practice' (TRIP) questionnaire, assessed the regular use of specific prevention practices.
• Descriptive statistics were employed to analyze reported practices and hospital characteristics.

Main Results:

• A response rate of 65.3% (47 out of 72 hospitals) was achieved.
• High adoption rates were reported for CLABSI (95.4% surveillance) and CDI (77.3% surveillance) prevention practices, with over 80% of hospitals using most recommended CDI strategies.
• While practices like aseptic technique for CAUTI (95%) and selective decontamination for VAP (84%) showed good uptake, specific CAUTI (intermittent catheterization 65.8%, stop-orders 62.2%) and CLABSI (avoidance of femoral site 65.9%) practices, along with antiseptic-impregnated devices (≤5%), were less consistently applied.

Conclusions:

• Dutch hospitals demonstrate strong adherence to recommended practices for preventing CLABSI and CDI.
• There is a notable opportunity for enhancing the implementation of specific evidence-based practices for CAUTI and VAP prevention.
• Targeted interventions are needed to improve the consistent use of all recommended strategies across Dutch acute care facilities.