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The increasing incidence of surgical site infections (SSIs) following caesarean sections highlights the necessity for updated protocols that address risk factors throughout the preoperative, intraoperative, and postoperative stages. Negative Pressure Wound Therapy (NPWT) and hydrocolloid dressings have demonstrated potential for improving wound management and reducing complications, particularly by enhancing dressing integrity. Nevertheless, the application of NPWT requires careful consideration and adherence to local trust guidelines to ensure both its safety and efficacy. [ABSTRACT FROM AUTHOR]

Background: Environmental cleaning and disinfection is the basis of the prevention of healthcare-acquired infections (HAIs). Aim: This study aimed to describe photon disinfection technologies (PDTs), report their impact on inactivating micro-organisms and preventing HAIs and to create recommendations for their implementation in hospital settings. Methods: An integrated literature review was completed to evaluate and report the impact of PDTs in hospital settings. The quality of 23 articles were assessed, their contents analysed and results reported according to the PICOT model. Findings: The microbiological impact of the PDT varied by micro-organism, settings and according to the used devices. It was crucial that environmental cleaning was completed before the disinfection. Conclusion: The implementation of PDT in the hospital setting requires inquiry from the viewpoints of microbiological, environmental, occupational, technical and human safety. To enhance the safe implementation of PDTs, the construction and use of evidence-based global standards for PDT are crucial. [ABSTRACT FROM AUTHOR]

While there is a lot of emphasis on the need for good infection prevention and control practices and acute care, the increasing complexity of patients being cared for in their own homes means that there is an increased risk for infection. Good practice is required by community nurses to minimise this risk. Patients' own homes can present particular challenges in complying with good practice and this article looks at some of the barriers to optimum infection prevention and control precautions in this setting. [ABSTRACT FROM AUTHOR]

The speed, severity and scale of the COVID-19 pandemic challenged infection prevention and control (IPC) efforts at hospitals worldwide. Dorset County Hospital NHS Foundation Trust in Dorchester had an established pandemic plan, which had been developed in response to the swine flu (H1N1) pandemic in 2009. However, the COVID-19 pandemic developed to a level that modern health care had not seen before and it remains the largest challenge for health care to date. This article outlines the experience of a rural district general hospital using digital solutions for infection prevention and control before and during the pandemic. The author will explore the experience of a hospital that implemented specialised clinical surveillance software, how it was applied to management and control of COVID-19 cases, and how the availability of that system allowed for continued focus on controlling other pathogens in the hospital environment, even at the height of the pandemic. [ABSTRACT FROM AUTHOR]

Background/Aims: Midwives play a key role in the prevention and control of infection. The identification of barriers and facilitators to guideline adherence is of paramount importance to improve compliance and ultimately patient care. This review's aim was to explore barriers and facilitators to midwives' infection prevention and control guideline adherence. Methods: This integrated review used the Whittemore and Knafl method to conduct a systematic search of eight databases for research carried out between 2015 and 2021. Data were analysed using the Braun and Clarke framework and reported using PRISMA guidelines. Results: Four themes were identified: 'compliance is infrastructure and resource dependent', 'recognising and working with what you have', 'midwives' fear and anxiety' and 'culture change: a mammoth challenge'. Midwifery experience of infection prevention and control guidelines adherence is affected by factors such as resource availability, guideline availability, healthcare systems, socioeconomic factors and midwives' personal influences. Conclusions: Education for midwives is crucial to improve adherence to infection prevention and control guidance. However, education from a behaviour change standpoint has been shown to be most effective and this should be incorporated into training programmes. [ABSTRACT FROM AUTHOR]

Patients in intensive care units (ICUs) are at a greater risk of developing hospital-acquired infections (HCAIs). Decontamination, which usually includes a regimen of body washing with an antimicrobial skin cleanser, is used to prevent HCAIs. Approaches can be: targeted, where carriers are identified and decontaminated; or universal, where all patients undergo a decontamination regimen. Universal rather than targeted decontamination is more effective at reducing infection rates and is more cost-effective. Decontamination in the ICU can lower HCAI rates across the entire hospital. Microbial resistance to chlorhexidine, however, which is the main active agent used for decontamination is increasing, and there are also adverse effects, leading to interest in octenidine as an alternative. This article explores the use of octenidine-containing single-use wash mitts in ICUs, which have been positively evaluated regarding antimicrobial activity, and ease and effectiveness of use. [ABSTRACT FROM AUTHOR]

The onset of the COVID-19 pandemic highlighted the importance of infection prevention and control (IPC), and accentuated the need for better health and safety measures to protect both healthcare professionals and their patients. In this article, Francesca Ramadan provides an overview of IPC measures for community nurses, such as hand hygiene and personal protective equipment, along with the safe management of care equipment and the care environment. [ABSTRACT FROM AUTHOR]

Since the beginning of the novel coronavirus disease pandemic (COVID-19), inadvertent exposure of hospitalised patients and healthcare workers has been a major concern. Patients in inpatient settings with mental illnesses have also been impacted by the restrictions the pandemic has caused, with many having experienced the confines and loss of liberties that COVID-19 has brought. This article identifies the infection prevention and control measures required in a mental health setting during an outbreak of COVID-19. The focus is on the challenges of working in a mental health setting and identifies the difficulties in containing the infection within this ill-designed built environment and includes the additional pressures of managing this complex and diverse group of patients. Current guidance on outbreak measures is given with particular attention applied to the patients, the practices and the environment. [ABSTRACT FROM AUTHOR]

Aims: The aims of this study were to explore the experience and psychological impact of sustaining a sharps injury within a nursing student population in the UK. Design: A qualitative approach was taken, using two methods to gather data, namely a Twitter chat and interviews. Methods: A Twitter chat was orchestrated to investigate the experiences of sharps injury with nursing students and registered nurses nationwide (n=71). Interviews were conducted with nursing students from a university in the UK who had sustained a sharps injury (n=12) to discover their experiences and the impact of the injury. Findings were then synthesised and examined. Results: Some nursing students reported psychological impacts after sustaining the sharps injury, which affected both their professional and personal life. The qualitative findings were synthesised into eight themes. Conclusion: Sharps injuries can have many psychological impacts on the individual nursing student and necessary support should be available. [ABSTRACT FROM AUTHOR]

Careful attention to detail and adherence to procedure guidelines when inserting and managing intravascular catheters has decreased the incidence of catheter-related bloodstream infections (CRBSIs). In order to limit these, health professionals must understand the underlying microbiology. Biofilms can explain the clinical findings most often seen with CRBSIs, yet they are poorly understood within medicine. Bacteria growing on solid surfaces such as a catheter are predominantly in biofilm phenotype, with a group of genes active that allow the bacteria to be tolerant to antiseptics and antibiotics by producing a self-secreted protective matrix. It is unclear whether it is planktonic seeding or small fragments of biofilm breaking off into the bloodstream that eventually results in the acute infection. The literature identifies four routes for microbes to adhere to a catheter and start biofilm formation: catheter contact, catheter insertion, catheter management and non-catheter-related sources. Routine clinical culture methods are inadequate to fully identify microbes producing catheter biofilm and/or bloodstream infection, therefore DNA methods may be required to diagnose CRBSIs. Treatment is removal and reinsertion of the catheter in a different site when possible. However, antibiofilm strategies can be employed to try to salvage the catheter. The use of high-dose antiseptics or antibiotics for long durations inside the catheter and hub (antibiotic/antiseptic lock) can suppress biofilm enough to reduce the seeding of the blood below a level where the patient’s immune system can prevent bloodstream infection. [ABSTRACT FROM AUTHOR]

Infection control is the responsibility of all nurses, but, traditionally, it has been seen as a priority only in hospitals. Infection control does not stop when a patient is discharged home, but should be practiced wherever clinical care takes place. Community nurses face a unique challenge as they work in patients' homes, and they must manage infection control in that unique environment. This article looks at practical ways to maintain infection control in patients' homes. It covers hand hygiene and personal protective equipment (PPE), including the five moments of hand hygiene, appropriate hand hygiene, the use of all PPE and when gloves are required and when they are not. It also discusses managing clinical equipment, both that taken into the home and that left with a patient, including decontamination, safe storage of sharps and waste management. It touches upon what can be done in a patient's home to reduce the risk of contamination, as well as infectious disease management, including specimens and wound infection management. Lastly, it talks about cross-infection and why staff health is also important. [ABSTRACT FROM AUTHOR]

Healthcare-associated infections are a significant reason for readmission to hospital post-discharge to the community. In this paper, the authors describe some of the key findings from a programme of work conducted in a home care agency (community care organisation) in the US. A survey was conducted to explore home care nurses' knowledge, attitudes and beliefs around infection control (n=415); 400 nurse-patient visits were observed, and 50 nurses were interviewed about their infection control practices. Nurses reported high compliance with infection control practices. However, the overall average adherence rate to observed hand hygiene practices was 45.6%. Interview data provided valuable insights into specific challenges faced by nurses in a home care setting. This study provides insights that can be used to enhance infection control practice in community care in the UK. [ABSTRACT FROM AUTHOR]

Over the past 9 months, hand hygiene has been highlighted as one of the key elements in the prevention of the spread of COVID-19, and health professionals know that hands play a key role in the transmission of infection. People with chronic kidney disease are particularly susceptible to healthcare-associated infections, so everyone coming into contact with these vulnerable people needs to be able to perform the relevant hand hygiene procedures correctly and appropriately to protect patients and themselves [ABSTRACT FROM AUTHOR]

Infections caused by Gram-negative bacteria continue to be on the rise, despite efforts by the Government and health service to curb their numbers. Most of these infections arise in the community. The case for targeting community-onset healthcare-associated infections is stark and requires a shift in focus from traditionally providing increased efforts in the hospital setting to a diversion of attention to the community. This article describes the challenges faced with increasing Gram-negative bloodstream infections and explores measures being taken to reduce transmission. As recent guidance has highlighted a proliferation within the community setting this article particularly focuses on a three-point plan for primary care. The strategies laid out are to reduce urinary tract infections, improve hydration and control antibiotic usage. Adopting these strategies will assist in reducing infection and targeting efforts where they are needed most. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus that causes the new disease COVID-19. Symptoms range from mild to severe with a higher incidence of severe cases in patients with risk factors such as older age and comorbidities. COVID-19 is mainly spread through the inhalation of respiratory droplets from coughing or sneezing or via contact with droplet-contaminated surfaces. Paramedics should be aware that some aerosol-generating procedures may put them at a higher risk of contracting the virus via possible airborne transmission. Use of remote triage clinical assessment is likely to increase as a result of the pandemic. There is no curative drug treatment for the virus and some medications may exacerbate its effects or make patients more susceptible to it. Evidence and guidelines are evolving on SARS-CoV-2 and COVID-19. Paramedics should keep up to date with the latest clinical guidance from their employers. [ABSTRACT FROM AUTHOR]

Home nursing is evolving towards more invasive care. Nevertheless, no national data are available on the prevalence of HAI in this setting. The aim of this pilot study is to explore the Flemish home care setting as a first step toward a national surveillance program. A survey, focused on patient characteristics and HAI, was conducted between 7 May and 20 July 2018 on 711 Flemish patients. Most of the patients (74%) are 65 years or older and half of them had a form of comorbidity. Assisting with personal hygiene and wound care were the most frequent services delivered by home care nurses. A comparison of the prevalence of infections diagnosed by a physician or applying uniform criteria (ECDC), revealed a similar prevalence of skin and soft tissue infections (9% vs. 8.5%) and urinary tract infections (4% vs. 4.5%). A positive MDRO-screening was found in 6% of the patients. This pilot study is a first step towards a standardized national surveillance in home care to collect information on the prevalence of HAI and it reveals several interesting facts and study pitfalls for this setting. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance is on the rise. As more infections are becoming resistant to antibiotic treatment, it would benefit practice nurses to be aware of the effective measures they can use to prevent the spread of infection, explains Naomi Fleming When micro-organisms are exposed to an antimicrobial, more susceptible organisms succumb, leaving behind those resistant to the antimicrobial. They can then pass on resistance to their offspring. The use and misuse of antimicrobials has increased the number and types of resistant organisms. As a result, standard treatments become ineffective and infections persist and may spread. Infection prevention and control (IPC) is key to reducing demand for antimicrobial use and reducing the acquisition of antimicrobial resistance. Poor IPC can increase the spread of drug-resistant infections. Interventions such as effective hand hygiene and vaccination have significant potential to limit opportunities for drug-resistant strains to emerge. Effective leadership is vital and nurses are central to promoting IPC, leading on IPC compliance and ensuring uptake of vaccination in primary care. [ABSTRACT FROM AUTHOR]

This article describes the management of an outbreak of multidrug-resistant Acinetobacter baumannii (MDR-Ab) at an acute NHS Foundation Trust. The outbreak affected two respiratory wards and the initial outbreak lasted 9 months, with the first patient (index case) being identified in April 2015 and the final, tenth case, in September 2015. The outbreak was declared closed in January 2016, but a further two cases were identified in July and August 2016. Of the 12 identified patients, eight were colonised with the bacterium and four were infected. The four infections were of the respiratory tract with MDR-Ab, of identical variable number tandem repeat, isolated from sputum in all cases. All 12 patients were decolonised and this continued throughout the outbreak. Some negative rescreening results were achieved. At the time of the outbreak, decolonisation using octenidine had not been reported in any guidelines. The sensitivity of MDR-Ab to octenidine was microbiologically tested and antibacterial action of octenidine against this organism was demonstrated. The use of octenidine appeared to be one element in helping to control this testing situation. This report seeks to demonstrate not only the complexity of managing and containing an outbreak of MDR-Ab but also how, with the use of a range of effective infection prevention measures, the spread of this pathogen can be successfully controlled. It is hoped that this article will increase awareness among healthcare providers and infection prevention and control (IPC) teams of the threat posed by this organism in the healthcare environment. [ABSTRACT FROM AUTHOR]

Surgical site infection (SSI), which can range from superficial infection to life-threatening problems, puts extra strain on healthcare resources and can have a significant impact on patient quality of life. The majority of SSIs are preventable, with different members of the multidisciplinary team (MDT) playing their part at every stage of the patient journey from preoperative assessment to post-discharge follow up. Effective communication and cooperation between members of the MDT is key. This article provides an overview of the input at different stages along the patient journey. [ABSTRACT FROM AUTHOR]

The notion of ‘isolation’ in infectious diseases refers to the possibility of people known or suspected to be infected from the wider population, and has historically been used to control and prevent the spread of infectious diseases. Isolation practices in healthcare settings evolved over the 20th century resulting in a focus on the disruption of known routes of potential transmission. There was renewed attention to infection prevention and control (IPC) in the UK at the turn of the 20th century after high-profile reports acknowledged the importance of IPC as a key indicator of high-quality clinical care, and the impact of healthcare-acquired infections. There has been a shift away from isolation wards towards isolation in single rooms on general wards. For infections that are spread by the airborne, droplet or contact routes, placing the patient in single-room isolation is considered to be an important component of transmission-based precautions (TBPs). However, in practice isolation is complex and a number of challenges are involved in implementing IPC procedures. [ABSTRACT FROM AUTHOR]

Aim: to identify the most effective suctioning technique for the prevention of ventilator-associated pneumonia. Background: ventilator-associated pneumonia is an important hospital-acquired infection associated with increased mortality and morbidity. Method: a rapid review included an electronic database search of articles published between January 2009 and March 2016. The quality of the seven included studies was appraised and data were subjected to tabular and narrative syntheses. Results: closed suction systems have no clear advantage over open suction, but may better prevent late-onset ventilator-associated pneumonia. Subglottic secretion drainage reduces ventilator-associated pneumonia incidence. Conclusion: open versus closed suction combined with subglottic secretion drainage requires ongoing research. Alongside this, policy guidance, education, behavioural and managerial strategies must be implemented. [ABSTRACT FROM AUTHOR]

Prevention is the best option in the treatment and management of central venous stenosis (CVS)--a complication of the use of central venous catheters. Johann Nicholas, Ritika Rana, Helen Spooner and Diane O'Hara discuss how the implementation of enhanced infection prevention protocols made a significant difference in avoiding CVS in a single-centre study. [ABSTRACT FROM AUTHOR]

The article investigates infection prevention and control practice of phlebotomy for blood grouping samples for up to 60 personnel in one setting, a regular occurrence within a military training establishment, with potential for infectious transmission. Topics include risks associated with transmission of blood-borne viruses (BBV) and comparison of existing practice with evidence-based practice. Also mentioned are recommendations to improve practice and the 1951 Lewin's framework for change.

This article describes a literature review of published evidence on infection prevention and control in central venous access device (CVAD) care conducted by a novice researcher (lead author) under the supervision of her lecturer (second author). It includes details of the search as well as of the analysis which led to the selection and critical appraisal of a selected article identified and, importantly, discussion of the limitations and lessons learned by the novice researcher with her experimental approach. Infection control is paramount within nursing practice as a result of the number of healthcare-associated infections, which are preventable if evidence-based practice is followed and when trust protocols are informed by evidence. The question posed by the author prior to undertaking the literature search related to whether the use of sterile gloves for CVADs reduces infections in the oncology patient population compared with the use of non-sterile gloves. The question was formulated using the PICO (Population, Intervention, Comparison, Outcome) process and relevant literature was located using CINAHL and MEDLINE databases. The results of the review demonstrated no significant difference in infection rates using sterile or non-sterile gloves when handling CVADs but further research in this area is needed to validate the findings. [ABSTRACT FROM AUTHOR]

Hand hygiene is one of the most effective measures for preventing infections. The annual NHS staff survey in England provides national and local data on how staff feel about working in the NHS. It also provides staff with the opportunity to give their views on the availability of hand-washing materials. The infection prevention and control team at an NHS trust decided a review was required on this issue. This review assessed the availability of hand-washing materials and alcohol handrub on wards and at ward entrances. Three community buildings and 31 wards were reviewed. The audit results showed the availability of hand-washing materials was good in 30 out of 34 areas. Staff on both wards and in the community buildings highlighted what other materials were required for hand hygiene, and steps were made to provide these. The audit allowed hand-hygiene practices to be benchmarked across the trust and increased staff awareness of improving hand hygiene. As a result of this audit, the hand-hygiene compliance score increased from 80% to 95%. [ABSTRACT FROM AUTHOR]

Any health professional providing care and treatment should first do no harm. With many serious infections affecting hospitals, patients can be fearful. Education and competency processes specific to vascular access devices (VADs) ensure staff have knowledge of the pathophysiology of infection, basic aseptic techniques for cannulation, device management, methods of flushing, assessing device functions, and dressing and securement techniques (Coopersmith et al, 2002; Centers for Disease Control and Prevention (CDC), 2011; Infusion Nurses Society (INS), 2011; Pratt et al, 2007). However, knowledge in these areas is often taken for granted and it is assumed that health professionals are applying such knowledge in practice. Staff education is effective in reducing infection and complications (Coopersmith et al, 2002). Through teaching the Clean, Assess and Clear model, which applies to intravenous access, patient assessment and flushing catheters until clear, the basics of safe intravenous care can be consistently understood and applied, and competency assessed (Moureau, 2012). Education on the principles of aseptic technique is a necessary for all nurses and doctors to establish a culture of safety in all healthcare settings. Establishing consistent, simple and clear health professional education on the care and maintenance of intravenous devices, in compliance with guidelines and recommendations, is necessary to achieve the best outcomes (CDC, 2011; INS, 2011). [ABSTRACT FROM AUTHOR]

For the first time in 10 years, there has been a fall in the number of diagnoses of sexually transmitted infections (STIs) in England; new diagnoses fell by 1%. Infection rates continue to grow among gay men and other men who have sex with men. Men who have sex with men are at more risk of developing an STI than other men in the population. This article considers the overall trends and diagnoses of STIs in England. A focus in particular on men who have sex with men is provided with an emphasis on lymphogranuloma venereum. Data is presented in order to provide the nurse with an overview of trends and the burden of STIs on this group of people; STIs are still on the increase in men who have sex with men. This article makes recommendations for action and emphasises the important role of the nurse in making men who have sex with men a priority for targeted HIV and STI prevention and health promotion work. [ABSTRACT FROM AUTHOR]

Community nurses provide care to patients in a variety of settings, for example health centres, community hospitals, patients' homes, residential and nursing homes. Administering subcutaneous injections to patients in the community is an everyday activity for many nurses in clinical practice. Many problems related to being 'sharps safe' are common to both community nurses and hospital staff. The majority of subcutaneous injections administered in the community are for patients with diabetes. Reducing needlestick injuries after the administration of subcutaneous injections in the community remains paramount to all NHS staff. This article provides information on what national standards to employ when administrating subcutaneous injections and what safety practices should be undertaken for good sharps management. Staff administering subcutaneous injections in the community need to ensure that they are updated on the latest developments in safety needle devices in order to prevent needlestick injuries and provide safe, effective and individualised care for their patients. [ABSTRACT FROM AUTHOR]

A clean and tidy environment provides the right setting for good patient care. It is fundamental in preventing and/or controlling the spread of healthcare-associated infections (HCAI). Cleanliness is an essential component for the comfort and dignity of patients, particularly those for whom a hospital is home for any length of time. Patients spend a lot of their time in bed so it is important for them to be provided with well maintained and clean mattresses. Beds, and especially the mattresses, should be cleaned and inspected regularly so patients know they are being cared for in a clean and safe environment. To prolong the life of the mattress and reduce infection risks, inspections for damage and contamination must take place on a regular basis. Assessment criteria for the audit of a mattress can include a visual inspection, a cover permeability test and a foam support surface test. These assessments will ensure the mattress is compliant with current standards and identify whether or not they require condemning. Mattress care can be improved by adopting unified good practices that can be standardized and audited regularly. [ABSTRACT FROM AUTHOR]

Acinetobacter baumannii infection is responsible for a wide range of infections, including pneumonia, bacteraemia, meningitis, wound infections, and urinary tract infections. During June 2010, two patients on an intensive care unit in an acute hospital in the UK had multi-resistant A. baumannii identified in samples obtained from a variety of specimens. A further case was identified 31 days following confirmation of the first outbreak. The investigation and management of this outbreak included the introduction of enhanced infection prevention and control precautions; the establishment of an Outbreak Control Team; epidemiological investigations; and the decontamination of equipment and the environment. Isolate typing by the Health Protection Agency Centre for Infections laboratory confirmed the three cases had identical A. baumannii strains: European clone II lineage encoded with an OXA-51-type carbapenemase. This suggests that there was a patient-to-patient spread of multi-resistant A. baumannii. [ABSTRACT FROM AUTHOR]

Infection prevention and control measures have been recognized as effective in minimizing the risk of infection from peripheral intravenous (IV) cannulas. However, this relies on health professionals' compliance with guidelines for the care of patients with IV catheters and at times it may be that practice is inconsistent with guidelines. This article discusses the care required for peripheral cannulas and shows how implementing the high-impact interventions can improve peripheral IV catheter care on insertion and its management afterwards. [ABSTRACT FROM AUTHOR]

A recent report by the Department of Health, Clostridium Difficile Infection: How to deal with the problem -- a board to ward approach, is a revised set of guidelines based on best practice and key recommendations for the NHS to ensure the control of Clostridium difficile infection (CDI). It takes into account a national framework for clinical governance which did not previously exist, a framework that gives significant weight to infection control as a matter of patient safety, and highlights that all clinicians have a personal responsibility for infection prevention and control. It puts the onus on Trust management and PCTs to ensure that measures are in place to prevent and manage CDI according to best evidence. However, the report fails to explain how these measures will have an impact on finance and resources on an already burdened system. The author explains how much of the report is comparable with the one published in 1994, and highlights many of its limitations within the busy hospital setting. Reducing CDI is achievable, as many hospitals are showing large reductions in their CDI rates. Healthcare workers must be applauded for their success in reducing CDI, but there is more to be done. [ABSTRACT FROM AUTHOR]

Infection prevention and control measures have been recognized as effective in minimizing the risk of infection from peripheral intravenous (IV) cannulas. However, this relies on health professionals' compliance with guidelines for the care of patients with IV catheters and at times it may be that practice is inconsistent with guidelines. This article discusses the care required for peripheral cannulas and shows how implementing the high-impact interventions can improve peripheral IV catheter care on insertion and its management afterwards. [ABSTRACT FROM AUTHOR]

Community nurses provide care to patients in a variety of settings; for example, health centres, community hospitals, patients' homes, and residential and nursing homes. Administering intramuscular (IM) injections to patients in the community is an everyday activity for many nurses in clinical practice. A great deal of problems related to being 'sharps safe' are common to both community nurses and hospital staff. There had been a reported six needlestick injuries (NSIs) from community clinics administering depot IM injections, which required a review. An audit of practice was undertaken in clinics administering depot injections. The audit was undertaken to monitor compliance in sharps management and investigated how community nurses were administering IM injections. The review highlighted a lack of resources, gaps in knowledge and training deficits. The infection prevention and control nurses worked hard to improve practices and procedures. After a year, there had been a significant reduction in NSIs. [ABSTRACT FROM AUTHOR]