The Relationship between Hospital Infection Surveillance and Control Activities and Antibiotic Resistant Pathogen Rates

Objective: The purpose of the study was to examine the relationship of surveillance and control activities in Canadian hospitals with rates of nosocomial methicillin-resistant S. aureus (MRSA), C. difficile associated diarrhea (CDAD), and vancomycin-resistant Enterococcus (VRE). Methods: Surveys were sent to Infection Control programs in hospitals that participated in an earlier survey of infection control practices in Canadian acute care hospitals. Results: One hundred and twenty of 145 (82.8%) hospitals responded to the survey. The mean MRSA rate was 2.0 (SD 2.9) per 1,000 admissions, the mean CDAD rate was 3.8 (SD 4.3), and the mean VRE rate was 0.4 (SD 1.5). Multiple stepwise regression analysis found hospitals that reported infection rates by specific risk groups (r = - 0.27, p < 0.01) and that kept attendance records of infection control teaching activities (r = - 0.23, p < 0.01) were associated with lower MRSA rates. Multiple stepwise regression analysis found larger hospitals (r = 0.25, p < 0.01) and hospitals where infection control committees or staff had the direct authority to close a ward or unit to further admissions due to outbreaks (r = 0.22, p < 0.05) were associated with higher CDAD rates. Multiple logistic regression analysis found larger hospitals (OR = 1.6, CI 1.2 - 2.0, p = 0.003) and teaching hospitals (OR = 3.7, CI 1.2 - 11.8, p = 0.02) were associated with the presence of VRE. Hospitals were less likely to have VRE when infection control staff frequently contacted physicians and nurses for reports of new infections (OR = 0.5, CI 0.3 - 0.7, p = 0.02) and there were in-service programs for updating nursing and ancillary staff on current infection control practices (OR = 0.2, CI 0.1 - 0.7, p = 0.01). Conclusions: Surveillance and control activities were associated with MRSA and CDAD rates and the presence of VRE. Surveillance and control activities might be especially beneficial in large and teaching hospitals.

Preservice Elementary Teachers’ Beliefs toward Mathematics and Mathematics Teaching

As they began their one-year teacher education program 138 elementary school teacher candidates completed a questionnaire designed to measure their beliefs concerning the nature of mathematics, measured on a scale from absolutist to fallibilist, and their beliefs concerning effective mathematics instruction, measured on a scale from traditional to constructivist. Interviews were conducted with volunteer questionnaire participants, with selection based on the questionnaire results and using two sets of criteria. Study 1. involved 8 teacher candidates showing distinct absolutist or fallibilist views of mathematics and individual interviews explored participants' beliefs concerning the use of information and communication technology, particularly interactive whiteboards (IWB), in the teaching and learning of mathematics. Participants with absolutist beliefs about the nature of mathematics tended to focus on the IWB as a presentation tool, while those with fallibilist beliefs appreciated the use of the IWB to support student exploration. Study 2. involved 8 teacher candidates with apparently misaligning absolutist beliefs concerning the nature of mathematics and constructivist beliefs concerning teaching. Interviews exploring participants' favoured instructional approaches, particularly those involving the use of manipulatives, showed that constructivist views involved essentially surface beliefs and that in fact manipulatives would be employed to support traditional direct instruction.