Patient Care Processes and Infection Prevention: An Innovative Mixed Methods Approach to Minding Our Knowledge and Practice Gaps

Emily Chasco, PhD is an Assistant Research Scientist with the Engagement, Integration, and Implementation Core at the Institute for Clinical and Translational Science, University of Iowa. She also has a WOC appointment with the Center for Access and Delivery Research and Evaluation (CADRE) and the Veterans Rural Health Resource Center–Iowa City at the Iowa City VA Health Care System. As a medical anthropologist and health and behavioral sciences researcher, Dr. Chasco has extensive experience in interdisciplinary health research and expertise in qualitative and ethnographic methods. She currently collaborates as a qualitative methodologist on research, quality improvement, evaluation, and implementation projects, including studies on HIV and other infectious disease, infection prevention, rural health, and healthcare access and utilization.

Dr. Loreen Herwaldt is a professor of Internal Medicine at the University of Iowa Carver College of Medicine and a Professor of Epidemiology in the University of Iowa College of Public Health. She served as the hospital epidemiologist at the University of Iowa Hospitals and Clinics for > 20 years. She currently does infectious diseases consults and continues to do research on healthcare-associated infections. She has investigated clusters of infections and she has studied the epidemiology of several organisms that cause healthcare-associated infections, including staphylococci and Legionella. Her recent work has addressed risk factors for and prevention of surgical site infections (SSI) and healthcare workers’ risk of self-contamination while removing personal protective equipment. She currently is the principal investigator (PI) for the University of Iowa’s CDC Prevention Epicenter grant and she is the project PI for 2 of the 7 projects. One of these studies is the POTENT randomized stepped-wedge multicenter trial of intranasal povidone iodine for preventing SSI after orthopedic procedures for lower extremity fractures. She was recently awarded a CDC Strengthening Healthcare Infection Prevention and Control and Improving Patient Safety in the United States Cooperative Agreement. During 1999-2000, she took developmental leave to study narratives of illness and interview authors to learn about their experiences of getting healthcare for illnesses, injuries, and disabilities. In 2008, the University of Iowa Press published her book Patient Listening: A Doctor’s Guide, which grew out of the interviews she conducted with the authors. In 2012, she received the Society for Healthcare Epidemiology of America’s mentor scholar award. In 2016, she received the University of Iowa Graduate College’s Outstanding Faculty Postdoctoral Mentor Award and in 2022 she received the University of Iowa’s May Brodbeck Distinguished Achievement for Faculty Award.

Jaqueline Pereira da Silva, MS, PhD, is a postdoctoral research scholar in the Department of Internal Medicine at the University of Iowa Carver College of Medicine. She is an experienced human factors engineer with expertise in human performance in complex systems, cognitive engineering and decision making, and workplace safety. She has worked for many years as an industrial engineer in different multinational corporations on a wide variety of interdisciplinary projects in the areas of product development, manufacturing processes, and engineering software usage policy and education. For the past seven years she has been collaborating with a multidisciplinary team on infection prevention and control and patient safety research. She applies human factors engineering to identify risk factors and challenges healthcare providers face when attempting to comply with safety protocols during patient care, including hand hygiene and PPE use and removal.

Patient Care Processes and Infection Prevention: An Innovative Mixed Methods Approach to Minding Our Knowledge and Practice Gaps

This session will update participants about ongoing CDC-funded infection prevention research at the University of Iowa. Effective hand hygiene and personal protective equipment (PPE) use by healthcare personnel can prevent self-contamination and decrease transmission of pathogens. Using an approach informed by human factors engineering and ethnography, Drs. Loreen Herwaldt, Emily E. Chasco, and Jaqueline Pereira da Silva will describe the results of their studies investigating healthcare personnel’s hand hygiene practices, PPE use, and interactions with fomites in simulated and real-world acute and long-term care setting with the goals to improve PPE design, decrease environmental and self-contamination, and better integrate hand hygiene and PPE use into patient care activities.

At the conclusion of this training, participants will be able to:

  • Describe the benefits of interdisciplinary approaches to infection prevention research.
  • Describe factors that can compromise the effectiveness of PPE and increase the risk of self-contamination.
  • Identify barriers and facilitators to hand hygiene and PPE use in acute care settings.
  • Summarize challenges for PPE use related to the COVID-19 pandemic.
  • Describe infection prevention challenges in acute versus long-term care settings.