Current infection control practices used in Australian and New Zealand cystic fibrosis centers

BMC Pulm Med. 2020 Jan 17;20(1):16. doi: 10.1186/s12890-020-1052-y.

Abstract

Background: The 2013 update of the Infection Prevention and Control (IP&C) Guideline outlined recommendations to prevent the spread of CF respiratory pathogens. We aimed to investigate the current infection control practices used in Australian and New Zealand (NZ) CF centers.

Methods: Two online surveys were distributed to Australian and NZ CF centers regarding the uptake of selected IP&C recommendations. One survey was distributed to all the Medical Directors and Lead CF Nurses and the second survey was distributed to all the Lead CF Physiotherapists.

Results: The response rate was 60% (60/100) for medical/nursing and 58% (14/24) for physiotherapy. Over 90% (55/60) of CF centers followed CF-specific infection control guidelines and consistent infection control practices were seen in most CF centers; 76% (41/54) had implemented segregation strategies for ambulatory care and no CF centers housed people with CF in shared inpatient accommodation. However, the application of contact precautions (wearing gloves and apron/gown) by healthcare professionals when reviewing a CF person was variable between CF center respondents but was most often used when seeing CF persons with MRSA infection in both ambulatory care and hospital admission (20/50, 40% and 42/45, 93% of CF centers, respectively). Mask wearing by people with CF was implemented into 61% (36/59) of centers. Hospital rooms were cleaned daily in 79% (37/47) of CF centers and the ambulatory care consult rooms were always cleaned between consults (49/49, 100%) and at the end of the clinic session (51/51, 100%); however the staff member tasked with cleaning changed with 37% (18/49) of CF centers responding that CF multidisciplinary team (MDT) members cleaned between patients whereas at the end of the clinic session, only 12% (6/51) of the CF MDT cleaned the consult room.

Conclusions: Overall, Australian and NZ CF centers have adopted many recommendations from the IP&C. Although, the application of contact precautions was inconsistent and had overall a low level of adoption in CF centers. In ~ 25% of centers, mixed waiting areas occurred in the ambulatory care. Given the variability of responses, additional work is required to achieve greater consistency between centers.

Keywords: Cleaning; Contact precautions; Cross-infection; Cystic fibrosis; Infection control; Masks; Survey.

MeSH terms

  • Ambulatory Care*
  • Australia
  • Cystic Fibrosis / therapy*
  • Disinfection*
  • Guideline Adherence
  • Hospitalization*
  • Humans
  • Infection Control / methods*
  • Infection Control / standards
  • Masks
  • Methicillin-Resistant Staphylococcus aureus
  • New Zealand
  • Nurse Administrators
  • Organizational Policy
  • Patient Isolation
  • Patients' Rooms
  • Personal Protective Equipment*
  • Physical Therapists
  • Physician Executives
  • Physicians' Offices
  • Respiratory Protective Devices
  • Staphylococcal Infections / prevention & control
  • Surveys and Questionnaires