The low to very low quality of the evidence of studies included in this review provides insufficient evidence to determine with certainty which interventions are most effective in changing professional behaviour and in what contexts. However, interventions that may be worth further study are educational interventions involving more than one active element and that are repeatedly administered over time, and interventions employing specialised personnel, who are focused on an aspect of care that is supported by evidence e.g. dentists/dental auxiliaries performing oral care for VAP prevention.
Evaluating the efficacy of the infection control liaison nurse in the hospital.
The infection control liaison nurse (ICLN) is a nurse in the ward, appointed to participate in education for infection control, and to liaise between the ward and the infection control nurse (ICN). The efficacy of ICLNs was evaluated when a guideline on urinary catheter care was introduced in a 1000-bed hospital in Hong Kong. The 27 public wards were divided randomly into a test (24 wards) and control group (three wards), and ICLNs were appointed in the test group by the nursing administration. For education, the ICN conducted in-service lectures for both groups, while in the test group, the ICLNs also conducted tutorials for all ward nurses. Before and after the education programme, prevalence surveys were conducted to detect incorrect practices on urinary catheter care. Three practices were evaluated: the securing of catheters, presence of kinking and the use of urinary bags with a drainage spigot. Before education, the percentage of incorrect practices in the test groups was 63%, which was comparable to the 68% of the control group (P = 0.40, chi 2 = 0.71). After education, the percentage of incorrect practices in the test group (36%) was significantly lower than the 48% in the control group (P less than 0.05, chi 2 = 4.25). This indicates that ICLNs can indeed enhance the education programme for infection control.