Cultura

Whole-Of-Hospital Infection Control: A Holistic Review Of Multidisciplinary Medical Department Practices And Patient Safety Impacts

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Mudawi Mohammed Awaji Alwani, Salma Abdullah Bedah Alshahrani, Ashwag Saad Mesfer Alshahrani, Abdullah Hassan Jaber Zubayd, Aedh Abdullah Abdulrahman Alshahrani
Hamzah Hussain Mofareh Almalki, Hamoud Abdullah Abdurahman Alshahrani, Saleem Salem Ali Algathlan, Hanadi Abdullah Abdulaziz Alhadhir, Ahmed Mohammed Mohammed Asiri

Abstract

Healthcare-associated infections (HAIs) remain a major challenge to patient safety, care quality, and health system sustainability worldwide. While infection prevention and control (IPC) programs have traditionally focused on isolated clinical practices or single departments, growing evidence highlights the limitations of fragmented approaches. This review adopts a whole-of-hospital perspective to examine how coordinated practices across all medical and support departments contribute to effective infection control and improved patient safety outcomes. Using an integrative review methodology, relevant studies published in recent years were synthesized to explore multidisciplinary roles, organizational structures, and system-level enablers of hospital-wide IPC. The findings demonstrate that effective infection control is driven by the alignment of clinical care, diagnostics, medication management, environmental services, workforce training, governance mechanisms, and digital surveillance systems. Hospitals implementing integrated, multidisciplinary IPC frameworks consistently report reductions in HAIs, improved antimicrobial stewardship, enhanced safety culture, and better patient outcomes. The review underscores the importance of leadership commitment, shared accountability, and data-driven coordination in sustaining infection prevention efforts. This holistic synthesis provides a conceptual and practical foundation for healthcare leaders seeking to strengthen hospital-wide infection control strategies and advance patient safety.

Keywords : Infection prevention and control; Healthcare-associated infections; Multidisciplinary collaboration; Patient safety; Hospital systems; Quality of care; Integrated healthcare delivery.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty