New Paper Calls for More Infection Control Surveillance, Standardization in the Emergency Department

Washington, DC, September 3, 2014

When researchers searched the literature to determineadherence rates for various infection prevention protocols in the emergencydepartment (ED), they discovered both a dearth of studies reporting EDpractices and a lack of standardization that rendered some studiesincomparable, according to a literature review published in the September issueof the American Journal of InfectionControl, the official publication of the Association forProfessionals in Infection Control and Epidemiology (APIC). 

A team of researchers from Columbia University performed aliterature review of the available medical literature to determine adherencerates in the ED for hand hygiene during routine patient care, aseptic techniqueduring the placement of central venous catheters and urinary catheters, urinarycatheter insertion guidelines, and rates of equipment contamination. Of the 853records they identified, 589 abstracts were screened, and ultimately 23 paperswere included in the study.

Of studies that reported hand hygiene rates, the use ofmultiple guidelines prevented meaningful comparisons, despite disparate ratesof compliance ranging from 7.7 percent to 89.7 percent. Four studies examinedthe appropriateness of urinary catheter insertions, with one finding that only69.7 percent of urinary catheters in the ED were warranted. Seven studiesexamined central venous catheter insertions and determined that video-basedonline training led to increased compliance. In only one study was aseptictechnique observed during urinary catheter insertion, and while 27 percentadherence was reported in one hospital and 58 percent in another, thesepercentages reflect aseptic technique during various procedures and not solelyurinary catheter insertion.

"To our knowledge, this is one ofthe first literature reviews detailing adherence rates with common infectionprevention practices in the ED setting," said lead author Eileen J. Carter, RN,BSN. "While this review adds new information about infection preventionpractices in the ED, there is clearly more to be learned, since EDs are a vitaland important component of our health care system."


Notes for Editors
"Common infection control practices in the emergency department:A literature review," by Eileen J. Carter, Stephanie M. Pouch, and Elaine L.Larson appears in the AmericanJournal of Infection Control, Volume 42, Issue 9 (September 2014).

Eileen J. Carter, RN, BSN (Corresponding Author)
School of Nursing, Columbia University, New York, NY
Stephanie M. Pouch,MD
College ofPhysicians and Surgeons, Columbia University, New York, NY
Elaine L. Larson,RN, PhD, FAAN, CIC
Mailman School of Public Health, Columbia University, NewYork, NY

About AJIC: American Journal of Infection Control AJIC: American Journal of InfectionControl ( covers key topics and issues ininfection control and epidemiology. Infection preventionists, includingphysicians, nurses, and epidemiologists, rely on AJIC for peer-reviewedarticles covering clinical topics as well as original research. As the officialpublication of APIC, AJIC is the foremost resourceon infection control, epidemiology, infectious diseases, quality management, occupationalhealth, and disease prevention. AJIC also publishes infection controlguidelines from APIC and the CDC. Published by Elsevier, AJIC is included inMEDLINE and CINAHL.

About APIC
 APIC's mission is to create a safer world through preventionof infection. The association's more than 15,000 members direct infectionprevention programs that save lives and improve the bottom line for hospitalsand other healthcare facilities. APIC advances its mission through patientsafety, implementation science, competencies and certification, advocacy, anddata standardization. Visit APIC online at Follow APIC onTwitter: and Facebook: information on what patients and families can do, visit APIC's InfectionPrevention and You website at

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Liz Garman
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