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Am J Infect Control. 2013 Feb;41(2):100-6. doi: 10.1016/j.ajic.2012.10.007.

Perceived strength of evidence supporting practices to prevent health care-associated infection: results from a national survey of infection prevention personnel.

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Hospital Outcomes Program of Excellence (HOPE), VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.



Limited data exist describing the perceived strength of evidence behind practices to prevent common health care-associated infections (HAIs). We conducted a national survey of infection prevention personnel to assess perception of the evidence for various preventive practices. We were also curious whether lead infection preventionist certification in infection prevention and control (CIC) correlated with perceptions of the evidence.


In 2009, we mailed surveys to 703 infection prevention personnel using a national random sample of US hospitals and all Veterans Affairs hospitals; the response rate was 68%. The survey asked the respondent to grade the strength of evidence behind prevention practices. We considered "strong" evidence as being 4 and 5 on a Likert scale. Multivariable logistic regression models assessed associations between CIC status and the perceived strength of the evidence.


The following practices were perceived by 90% or more of respondents as having strong evidence: alcohol-based hand rub, aseptic urinary catheter insertion, chlorhexidine for antisepsis prior to central venous catheter insertion, maximum sterile barriers during central venous catheter insertion, avoiding the femoral site for central venous catheter insertion, and semirecumbent positioning of the ventilated patient. CIC status was significantly associated with the perception of the evidence for several practices.


Successful implementation of evidence-based practices should consider how key individuals in the translational process assess the strength of that evidence.

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