Using bottleneck analysis to examine the implementation of standard precautions in hospitals.

• Bottleneck analysis was used to examine hospitals' standard precaution implementation. • Service providers' improper use of protection equipment was the primary bottleneck. • High workload and misperceptions contributed to incompliance of standard precaution. • Secondary bottlenecks included diffi...

Descripción completa

Detalles Bibliográficos
Publicado en:American Journal of Infection Control Vol. 48; no. 7; pp. 751 - 757
Autores principales: Lin, Chunqing, Li, Li, Chen, Liang, Pan, Yunjiao, Guan, Jihui
Formato: research tables/charts Journal Article
Publicado: Elsevier B.V. Jul2020
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=144204111&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 144204111
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        01966553
        44Q
      jtl: American Journal of Infection Control
      issn: 01966553
      maglogo: N
    pubinfo:
      dt: Jul2020
      vid: 48
      iid: 7
      pid: 467
      pub: Elsevier B.V.
      place: New York, New York
    artinfo:
      ui:
        144204111
        144204111
        144204111
        10.1016/j.ajic.2019.12.003
        144204111
      ppf: 751
      ppct: 6
      formats:
      tig:
        atl: Using bottleneck analysis to examine the implementation of standard precautions in hospitals.
      aug:
        au:
          Lin, Chunqing
          Li, Li
          Chen, Liang
          Pan, Yunjiao
          Guan, Jihui
        affil: Semel Institute for Neuroscience and Human Behavior, Center for Community Health, The University of California at Los Angeles, Los Angeles, CA
      sug:
        subj:
          Infection Control Standards
          Occupational Exposure Prevention and Control
          Implementation Science
          Cross Infection
          Human
          Personal Protective Equipment
          Inventories
          Recycling
          Financial Management
          Budgets
          Workload
          Handwashing
          Sharps Disposal
          China
          Hospitals, Public
          Stratified Random Sample
          Male
          Female
          Adult
          Health Facility Administrators
          Physicians
          Nurses
          Descriptive Statistics
          Middle Age
          Funding Source
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: • Bottleneck analysis was used to examine hospitals' standard precaution implementation. • Service providers' improper use of protection equipment was the primary bottleneck. • High workload and misperceptions contributed to incompliance of standard precaution. • Secondary bottlenecks included difficulties in finance, recycling, and procurement. Service providers are often inadequately compliant with standard precaution protocols. This study used bottleneck analysis to identify the weakest link in standard precaution implementation and its associated challenges in hospitals. Bottleneck analysis was conducted in 12 hospitals in Fujian Province, China. In each hospital, a focus group was organized among the key informants to illustrate the sequential steps of standard precaution implementation graphically. The level of difficulty and the specific challenges associated with each step were discussed. The sequential activities of standard precaution implementation generally start with making budget for personal protection equipment (PPE), followed by procurement, storage/inventory, in-hospital distribution, in-department distribution, usage/monitoring, and recycling of PPE. Service providers' improper use of PPE was the primary bottleneck. The reasons for improper use of PPE included high workload, time constraints, the sense of wearing PPE would interfere with clinical judgment, and various misconceptions. Making financial planning, recycling, and procurement of PPE were the secondary bottlenecks. Bottleneck analysis is useful to illustrate workflow in healthcare systems and pinpoint constraints in standard precaution implementation. Institutional changes, including targeted provider training, adjustment of providers' workloads, and allocation of budget, are suggested strategies to address the identified bottlenecks in standard precaution.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N