2014 Theses Doctoral

Infection Prevention Practices and Crowding in the Emergency Department

Carter, Eileen Juliana

This dissertation evaluates quality of care in the emergency department (ED), specifically with regards to crowding and infection prevention practices. Chapter One provides an overview of crowding, hand hygiene practices, and catheter-associated urinary tract infection (CAUTI) prevention in the ED, identifies gaps in science regarding these areas, and specifies the aims of this dissertation. Chapter Two reports a systematic review of the relationship between ED crowding and patient outcomes. Chapter Three reports a literature review of ED healthcare worker compliance with common infection prevention protocols. Chapter Four uses data collected from a single-site observational study to examine the relationship between crowding and hand hygiene compliance. Chapter Five uses data from a nationwide qualitative study to describe facets of high-performing ED CAUTI prevention programs. Lastly, Chapter Six synthesizes dissertation findings, specifies the implications of results, and makes recommendations for further study.