Catheter associated urinary tract infections (CAUTIs) are among the most common type of health care associated infections (HAIs) accounting for about 30% of infections in acute care facilities. Urinary tract infections(UTI) are infections involving any part of the urinary system and indwelling urinary catheters are usually potential channels for infections. Our facility is an acute care setting with population served comprising poor and medically underserved persons with high risk of infections. The objective of this study was to evaluate the potential effects of targeted verbal reminders with frontline staff on urinary catheter associated infection rates. All adult patients admitted into intensive and non-intensive units, and had Foley urinary catheter insertion from July to December 2016 were included in our study. We used the preceding six months (January to June 2016) to establish baseline data. The Infection Preventionist begun a 48-hour interval intense verbal campaign of engaging physicians and nurses on Foley necessity and exploring “alternatives” such as condom catheters and urinals. The primary variable was hospital-acquired CAUTI, which is a UTI in an admitted patient with Foley in place for greater than two calendar days on the date infection criteria was met . Data were derived from the National Healthcare Safety Network (NHSN) Surveillance from the Centers for Disease Control and Prevention (CDC), which is a widely, used HAI tracking system for hospitals in the United States. NHSN utilizes the standardized infection ratio (SIR), which is a statistic used to track HAI over time and compares the actual number of HAIs to the number of infections predicted using regression models for that facility. A baseline SIR of 3.158 with a p-value of 0.0285 (95% CI 1.157, 7.001) was established prior to intervention, which was statistically significant. Following intervention (July 2016), we noticed a downward trend and at the end of year, our SIR for second half was 0.815 with a p-value of 0.9460 (95% CI 0.041, 4.019), which was not statistically significant. The findings suggest that targeted communication with frontline staff in urinary catheter necessity and providing alternatives can significantly lead to a decrease in CAUTIs in acute care settings.

Background: The appropriate use of antivirals in the treatment of influenza remains an issue in the United States, alongside the over prescription of antibiotics. Many rapid influenza tests have poor sensitivity, resulting in a lack of clinician certainty in final diagnosis. Objective: Determine whether the use of a new, highly accurate point of care PCR test for influenza decreases guideline unsupported treatment of patients with influenza-like illness compared to patients who received usual care. Guideline unsupported care would include an antibiotic for a patient unlikely to have a bacterial infection, or use of oseltamivir more than 48 hours after the onset of symptoms. Methods: A quasi-experimental non-equivalent control groups design was set in three primary care clinics within a university health center. Patient population included 1265 university students presenting with a chief complaint of cough or two suspected influenza symptoms within 7 days. One group (n = 279) received care guided by a rapid point of care PCR test and the other (n = 986 received usual care). We used logistic regression to determine whether use of the rapid point of care PCR test was independently associated with the likelihood of receiving guideline supported treatment. Results: Overall, 196 of 1265 patients (15.5%) received guideline unsupported care. This was less common in the PCR group than in the usual care group (11.9% vs 16.4%, respectively). Crude analysis revealed a strong trend between guideline supported treatment and the use of the PCR test compared to usual care (OR 1.46, 95% CI 0.98 to 2.16). Five signs and symptoms were significantly different between the PCR and usual care groups with an absolute frequency difference of at least 10%: cough, myalgia, chills, fever, and duration of symptoms. A fully adjusted analysis for the clinic assignment, signs, and symptoms found that the association between use of the PCR test and a greater likelihood of guideline supported care was statistically significant (aOR 1.53, 95% CI 1.01 to 2.31). Conclusions: Use of a rapid point of care PCR test for influenza that increased diagnostic certainty was associated with reducing guideline unsupported treatment of patients with influenza-like illness.

Background. In recent decades, emerging infectious diseases (EIDs) have become more common, and health organizations have been called on to tackle EID outbreaks. As social and economic development worldwide have progressed markedly, average citizens have far more access to new information of all kinds. Compliance with guidelines issued by CDC–like health organizations could decrease in such circumstances. Supported by institutions like the U. S. Centers for Disease Control and Prevention (CDC), all citizens of this planet have a role in reducing risk of outbreaks and of their own potential EID infection. Objectives. The present study is intended to determine how citizens’ socioeconomic status (SES) and public health communications help explain citizens’ risk perception and actions taken during recent 2016 Zika virus (ZIKV) outbreaks. Methods. We used data from a nationally representative study conducted in March 2016 by the Associated Press–National Opinion Research Center to analyze American adult responses regarding ZIKV. Of the 1004 American adults who responded to the survey, 831 respondents who said they had heard or read some information about Zika prior to being contacted for the survey constituted the final sample. Results. We found that respondent risk perception and actions taken diminished as education level (b=-.29, p < .01 for risk perception and b=-.19, p < .01 for actions taken) and household income (b=-.05, p<.01 for action taken) rose. Risk perception was also found to mediate preventive actions’ associations. We argue that the direction found for the SES–ZIKV response relationship may stem from, notably, high-SES individuals whose cultural and economic capital empower them to question scientific claims about infection, developing “reflexive self-assessments” of ZIKV infection risk and determination on need for preventative behavior within their social networks, potentially altering others’ risk perception as well. Conclusions. To quell the global spread of emerging infectious diseases (EIDs) like ZIKV, health organizations worldwide must understand how SES contributes to ZIKV (and other future EIDs) risk perception and preventive action. A more compelling means of risk communication must be developed that takes into account the impact of these higher SES “risk assessments” on future outbreaks and infections.

Background. Along the US-Mexico border, women may be at higher risk of adverse pregnancy outcomes due to high unintended pregnancy rates and prevalence of Aedes species mosquitoes. This research assesses behavioral changes made in response to the threat of Zika among Healthy Start Border Alliance (HSBA) participants in 5 Healthy Start programs in San Diego-CA, Nogales-AZ, Anthony-NM, Las Cruces-NM, and Laredo-TX. Methods. In late 2016, we surveyed 327 pregnant and interconceptional women to assess preventive actions taken in relation to the threat of Zika; personal characteristics, knowledge of Zika and Zika information sources that women found helpful were also collected. Behavioral changes were grouped into 4 categories: accessing clinical services, reducing sexual risks, minimizing exposure to mosquitoes (i.e. wearing repellant or removing standing water), and avoiding travel to affected areas. We used chi-square tests and 95% confidence intervals to test for relationships between these preventive behaviors and other factors, including individual HSBA programs. Results. Among the 305 women who had heard of Zika, 63.9% (58.4-69.1) reported >1 behavioral change. Behavioral change was associated with age (p<.002) but not education or pregnancy status. Women who received helpful information from health care providers, the community or both, had greater odds of taking preventive action to reduce sexual risk (OR=5.0,1.5-17.2) and avoid travel (OR=4.7,1.9-11.6) compared to women who did not. Women who knew Zika could be transmitted sexually had greater odds than others of accessing clinical services, reducing sexual risk, and minimizing exposure to mosquitoes. Prevalence of behavioral change varied greatly across the 5 programs ranging from 30.8% in Anthony-NM to 79.5%. in Las Cruces-NM (p<.001). The odds of accessing clinical services in San Diego-CA was nearly 10 times that of Laredo-TX (OR=9.8, 1.1-85.4). Adjusted analyses are in progress. Conclusions. Most women who knew about Zika took action to minimize their risk. Educational efforts that focus on health care providers to reduce unintended pregnancy could also address Zika prevention. Further research is needed to better understand the variation across different Healthy Start programs.