Six Moments of Infection Prevention in Injection Drug Use: An Educational Toolkit for Clinicians
Six Moments of Infection Prevention in Injection Drug Use: An Educational Toolkit for Clinicians
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DOI：
10.1093/ofid/ofab631
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发表时间：
2022-02-01
影响因子：
4.2
通讯作者：
Branch-Elliman, Westyn
中科院分区：
文献类型：
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作者：
Harvey, Leah;Boudreau, Jacqueline;Branch-Elliman, Westyn
背景 注射吸毒相关的细菌和病毒感染正在增加。扩大获得减少危害服务的机会，例如安全注射教育，是有效的预防策略。然而，这些策略的采用程度有限。需要新的工具来提高提供者的能力，以促进这些循证干预措施的传播。方法“注射毒品使用中感染预防的六个时刻”提供者教育工具是使用全球而非特定病原体的感染预防框架开发的，强调除病毒病原体外还预防侵入性细菌和真菌感染。该工具的有效性通过一项简短的配对前/后调查进行了测试，该调查评估了提供者对减少伤害的知识和态度。结果 75 名受访者完成了配对调查。在基线时，17 名受访者 (22.6%) 表示他们之前没有接受过减少伤害方面的培训，28 名受访者 (37.3%) 表示在为注射吸毒者 (PWID) 提供咨询时感到不适。 60 名受访者 (80.0%) 表示他们从未将患者转介至注射器服务计划 (SSP)；其中，73.3% 的人表示缺乏对 SSP 位置的了解，40.0% 的人表示不知道从哪里获取有关 SSP 的信息。培训结束后，66 名受访者 (88.0%) 表示他们对注射吸毒者教育感到更加自在 (P < .0001)，65 名受访者 (86.6%) 表示他们计划在自己的实践中使用六时刻模型，100% 的受访者表示他们将来会考虑将患者转介给 SSP。结论 六个时刻模型强调了采取全球方法预防感染和减少伤害的重要性。这种教育干预措施可以作为降低吸毒者发病率和死亡率的一系列实施策略的一部分。
Background Injection drug use-associated bacterial and viral infections are increasing. Expanding access to harm reduction services, such as safe injection education, are effective prevention strategies. However, these strategies have had limited uptake. New tools are needed to improve provider capacity to facilitate dissemination of these evidence-based interventions. Methods The "Six Moments of Infection Prevention in Injection Drug Use" provider educational tool was developed using a global, rather than pathogen-specific, infection prevention framework, highlighting the prevention of invasive bacterial and fungal infections in additional to viral pathogens. The tool's effectiveness was tested using a short, paired pre/post survey that assessed provider knowledge and attitudes about harm reduction. Results Seventy-five respondents completed the paired surveys. At baseline, 17 respondents (22.6%) indicated that they had received no prior training in harm reduction and 28 (37.3%) reported discomfort counseling people who inject drugs (PWID). Sixty respondents (80.0%) reported they had never referred a patient to a syringe service program (SSP); of those, 73.3% cited lack of knowledge regarding locations of SSPs and 40.0% reported not knowing where to access information regarding SSPs. After the training, 66 (88.0%) reported that they felt more comfortable educating PWID (P < .0001), 65 respondents (86.6%) reported they planned to use the Six Moments model in their own practice, and 100% said they would consider referring patients to an SSP in the future. Conclusions The Six Moments model emphasizes the importance of a global approach to infection prevention and harm reduction. This educational intervention can be used as part of a bundle of implementation strategies to reduce morbidity and mortality in PWID.