The present research involved the implementation / evaluation of several approaches to optimising antibiotic use and infection control. The first study reported within this thesis aimed at assessing the impact of an antibiotic policy on reducing high-risk antibiotic usage in hospital practice and the associated incidence rates of MRSA and C. difficile infection (CD!). There was a significant decrease in high-risk antibiotic use within the three studied hospitals as a result of the policy. MRSA and CD! incidence rates were monitored in one of the hospitals and both rates decreased significantly. The next study reported in the thesis focused on the influence of antibiotic prescribing in primary care on the incidence rates of ESBL-producing bacteria detected in patients who were hospitalised. It was clearly shown that previous exposure in primary care to fluoroquinolones and cephalosporins (second and third generation) were independently associated with ESBL detection in hospital. Moving to the wound infection area, an interrupted timeseries analysis was performed to examine the impact of infection control practices on rates of post-caesarean surgical site infection (SSI). In this work, there was a significant drop in the incidence rate of SSIs after the introduction of the main intervention in the study (use of ChloraPrep® skin disinfectant). In the final experimental chapter, the aim was to evaluate changes in the incidence of central venous catheter-related bloodstream infection (CRBSI when switching from mechanical-valve needleless connector use to the use of split-septum needle less connectors in an intensive care unit. A reduction in the CRBSI incidence rate was identified after this switch took place. Overall, the work presented in this thesis adds evidence which supports guidelines on controlling antibiotic use and healthcare acquired infections. The findings will help inform future new services and practices that will enhance healthcare quality and patient safety.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:695214 |
| Date | January 2016 |
| Creators | Alnajjar, Munther Saleh Numan A. |
| Publisher | Queen's University Belfast |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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