We conducted a retrospective cohort study about the incidence of catheter-associated urinary tract infections (CAUTI) and a survey on appropriate urinary catheter use in a single acute care hospital. This study included 606 patients who underwent catheter placement after admission and were managed in general wards from April 2017 to December 2018. CAUTI occurred in 19 patients, with an incidence rate of 4.1/1000 device days. The univariate analysis revealed "chronic heart failure," "bedridden," "prolonged catheter use," and "open irrigation" as causal risk factors for CAUTI. In the survey of catheter use, only 43.4% of catheters were placed for the appropriate reasons. After the catheter placement, the rate of appropriate use decreased weekly to 38.1%, 35.9%, 34.3%, and 33.3%. CAUTI developed in 3 out of 11 patients after open irrigation (p < 0.01). After removing the catheter, voiding support was not appropriately provided to 30 patients (38.0%) and 26 patients required catheters again. Fourteen patients were discharged without catheter removal. To reduce CAUTI, health care teams need to improve implementation of care bundles, such as adherence to catheter insertion protocol, shortening catheter placement, maintaining a closed system, introduction of portable bladder scanner, and strengthening a urinary support team.

This study examined the relationship between workplace support, role acceptance, and work motivation of infection control link nurses. Workplace support was to mean support from nurse managers and certified infection control nurses. This study targeted link nurses who belonged to facilities with 300 or more beds and had certified nurses in infection control. A total of 3018 link nurses were questioned and surveyed. We received 1479 responses, out of which 950 were valid. Descriptive statistics and univariate analysis analyzed the relationship among basic attributes, workplace support, role acceptance, and work motivation. In addition, multiple regression analyses were conducted with basic attributes and workplace support subscale scores as explanatory variables and role acceptance and work motivation subscale scores as the objective variables. Evaluative and instrumental support from the head nurse, evaluative and informational support from a certified infection control nurse over 40, and one year of experience as a link nurse influenced role satisfaction. Evaluative support from the head nurse, informational support from a certified infection control nurse, at least 15 years of nursing experience, and >17 years of experience in the department were the influencing factors for role evaluation. Influencing factors for motivation toward the current job were informational support from certified infection control nurses, >2 years of experience as a link nurse, and motivation. The nurse manager's evaluative support, certified infection control nurse's informational support, age over 40, and motivation influenced future motivation toward work. The workplace support provided by head nurses and certified infection control nurses differed in their impact on role acceptance and workplace motivation of infection control link nurses. This suggests that it is important for both to provide the necessary support.

Recent increases in adolescent and adult rates of pertussis and transmission to newborns and infants at risk for severe infection have become problematic. In 2018, adsorbed diphtheria-purified pertussis-tetanus combined vaccine (DPT vaccine, TRIBIK^®) was reissued in Japan due to the need for booster pertussis vaccinations among adolescents and adults. Although DPT vaccinations have been administered to healthcare workers to prevent pertussis in some medical facilities, the current implementation status in pediatric medical facilities is unclear. Therefore, we conducted a questionnaire survey regarding experiences with nosocomial pertussis infection and the status of DPT vaccination for healthcare workers. The subjects were 36 Japanese pediatric medical facilities registered with the Japanese Association of Children's Hospitals and Related Institutions (JACHRI), and we received responses from 35 facilities. The survey results show that 37% (17/35) of facilities had experienced pertussis infection in healthcare workers necessitating antibiotic prophylaxis for numerous other healthcare workers. Only 17% (6/25) of facilities had administered DPT vaccination for healthcare workers. The targets for DPT vaccination depended on the facility. DPT vaccination of pediatric healthcare workers should contribute to the prevention of nosocomial pertussis. There is a very strong need to define targets for vaccination.

Postoperation, patients with renal transplants are in an immunosuppressive state. Under immunosuppression, oral lesions such as rodents and periodontal disease sometimes become infection foci and when they become severe they develop cerebral abscesses and have a poor prognosis. Therefore, treating oral lesions in patients with renal transplants is extremely important. In our department, in the case of living-donor renal transplantation, which is a scheduled operation, the presence or absence of oral lesions is examined by dental and oral surgery before transplantation and treatment including tooth extraction is performed. Check the status of the treatment in dental and oral surgery when renewing the transplant registration, perform transplantation if there is no problem at the time of cadaveric renal transplantation, and consult Maxillofacial Surgery if treatment is insufficient before transplantation. Lesions can become infection foci, so perform transplantation after treatment to the extent possible. Even after transplantation, immunosuppressive and antihypertensive agents may cause gingival thickening, mouth ulcers, and reservoir and periodontal disease, which may become foci of infection if left untreated. Therefore, in our department, we regularly request Maxillofacial Surgery consults for oral examinations of patients after transplantation. We have an otolaryngology examination for the oral cavity and throat in some cases.

In this study, many of the cadaveric renal transplant patients and their waiting patients in our department were insufficiently treated for oral lesions before transplantation. A patient who wishes to have a renal transplant and has severe periodontal disease must avoid or postpone the renal transplant. After the renal transplant, infections such as cerebral abscesses could develop. To prevent infectious diseases, it is extremely important to confirm the presence or absence of oral lesions before and after renal transplantation to prevent infectious diseases.

[Purpose] This study examined the knowledge and techniques regarding infection measures while considering reinforcement needed from the care staff of a special elderly nursing home. It also aimed to develop a guide for infection measures based on the obtained information. [Methods] We conducted an expression inventory survey through mail to assess knowledge of infection measures at a special elderly nursing home from December 2020 to March 2021. We analyzed the proportional difference in the number of infection measures using a person in charge who expected reinforcement from the care staff of the special elderly nursing home. The Chi-square test conducted item analysis. [Results] The survey enrolled 299 people. The average years of experience regarding infection measures were 6.8 years (±5.51: SD). The item with a significant difference was influenza, a norovirus infection, and COVID-19. The items "characteristics and knowledge," "correspondence at the normal and preventive understanding" were all "correspondence when suspected it." Moreover, regarding COVID-19, the item of "attachment and detachment of personal protector method" increased the "healthcare of the staff" and "three secrets avoidance behaviors except for working hours." Using these, we created the contents of the guide. [Conclusion] The technique and knowledge regarding the infection measures that needed reinforcement was common among the care staff dealing with influenza, a norovirus infection. We developed a guide on the infection measures with illustrations to improve understanding.

This study aimed to clarify the cognitive, emotional, and behavioral inclinations of doctors at Hospital A in situations where hand hygiene compliance is required and to examine future issues. A Personal Attitude Construct (PAC) analysis was conducted on five doctors, and the results were qualitatively and descriptively analyzed. Experience and guesswork influenced the decision to perform hand hygiene, and there was a lack of sufficient hand hygiene education and a system for group efforts. Prompting by others, posters, and rubbing alcohol hand sanitizer led to the recall of hand hygiene. To promote hand hygiene among doctors, it is necessary to set up hand hygiene reminders, develop role models among doctors, create a system that allows doctors to participate in hand hygiene promotion activities, provide sufficient hand hygiene education, and take an approach that fits doctors' interests.