A new approach to infection prevention: A pilot study to evaluate a hand hygiene ambassador program in hospitals and clinics

Background: Discontinuation of contact precautions for methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococci (VRE) have failed to show an increase in associated transmission or infections in adult healthcare settings. Pediatric experience is limited. Objective: We evaluated the impact of discontinuing contact precautions for MRSA, VRE, and extended-spectrum β-lactamase–producing gram-negative bacilli (ESBLs) on device-associated healthcare-associated infections (HAIs). Methods: In October 2018, contact precautions were discontinued for children with MRSA, VRE, and ESBLs in a large, tertiary-care pediatric healthcare system comprising 2 hospitals and 620 beds. Coincident interventions that potentially reduced HAIs included blood culture diagnostic stewardship (June 2018), a hand hygiene education initiative (July 2018), a handshake antibiotic stewardship program (December 2018) and multidisciplinary infection prevention rounding in the intensive care units (November 2018). Compliance with hand hygiene and HAI prevention bundles were monitored. Device-associated HAIs were identified using standard definitions. Annotated run charts were used to track the impact of interventions on changes in device-associated HAIs over time. Results: Average hand hygiene compliance was 91%. Compliance with HAI prevention bundles was 81% for ventilator-associated pneumonias, 90% for catheter-associated urinary tract infections, and 97% for central-line–associated bloodstream infections. Overall, device-associated HAIs decreased from 6.04 per 10,000 patient days to 3.25 per 10,000 patient days after October 2018 (Fig. 1). Prior to October 2018, MRSA, VRE and ESBLs accounted for 10% of device-associated HAIs. This rate decreased to 5% after October 2018. The decrease in HAIs was likely related to interventions such as infection prevention rounds and handshake stewardship. Conclusions: Discontinuation of contact precautions for children with MRSA, VRE, and ESBLs were not associated with increased device-associated HAIs, and such discontinuation is likely safe in the setting of robust infection prevention and antibiotic stewardship programs.Funding: NoneDisclosures: None

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The impact of a multimodel approach to designing a new orthopedic department

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1345 ◽

2020 ◽

pp. 1-6

Author(s):

Elad Keren ◽

Abraham Borer ◽

Lior Nesher ◽

Tali Shafat ◽

Rivka Yosipovich ◽

...

Keyword(s):

Hand Hygiene ◽

Antibiotic Stewardship ◽

Infection Prevention ◽

Tertiary Care ◽

Surgical Site Infections ◽

Antibiotic Use ◽

Prevention Measures ◽

Orthopedic Department ◽

Before And After ◽

The Impact

Abstract Objective: To determine whether a multifaceted approach effectively influenced antibiotic use in an orthopedics department. Design: Retrospective cohort study comparing the readmission rate and antibiotic use before and after an intervention. Setting: A 1,000-bed, tertiary-care, university hospital. Patients: Adult patients admitted to the orthopedics department between January 2015 and December 2018. Methods: During the preintervention period (2015–2016), 1 general orthopedic department was in operation. In the postintervention period (2017–2018), 2 separate departments were created: one designated for elective “clean” surgeries and another that included a “complicated wound” unit. A multifaceted strategy including infection prevention measures and introducing antibiotic stewardship practices was implemented. Admission rates, hand hygiene practice compliance, surgical site infections, and antibiotic treatment before versus after the intervention were analyzed. Results: The number of admissions and hospitalization days in the 2 periods did not change. Seven-day readmissions per annual quarter decreased significantly from the preintervention period (median, 7 days; interquartile range [IQR], 6–9) to the postintervention period (median, 4 days; IQR, 2–7; P = .038). Hand hygiene compliance increased and surgical site infections decreased in the postintervention period. Although total antibiotic use was not reduced, there was a significant change in the breakdown of the different antibiotic classes used before and after the intervention: increased use of narrow-spectrum β-lactams (P < .001) and decreased use of β-lactamase inhibitors (P < .001), third-generation cephalosporins (P = .044), and clindamycin (P < .001). Conclusions: Restructuring the orthopedics department facilitated better infection prevention measures accompanied by antibiotic stewardship implementation, resulting in a decreased use of broad-spectrum antibiotics and a significant reduction in readmission rates.

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Standardized aseptic dressing change procedure: Optimizations and adherence in a prospective pre- and postintervention cohort study

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.200 ◽

2021 ◽

pp. 1-6

Author(s):

Meike M. Neuwirth ◽

Swetlana Herbrandt ◽

Frauke Mattner ◽

Robin Otchwemah

Keyword(s):

Hand Hygiene ◽

Infection Prevention ◽

Process Analysis ◽

Trauma Surgery ◽

Hand Disinfection ◽

Work Surface ◽

Hygiene Measures ◽

Iterative Improvement ◽

Dressing Change ◽

Change Concept

Abstract Background: The “HygArzt” project investigated the effectiveness of hygiene measures introduced by an infection prevention link physician (PLP). Objective: To investigate whether the introduction of a standardized aseptic dressing change concept (ADCC) by a PLP can increase hand hygiene adherence and adherence to specific process steps during an aseptic dressing change (ADC) in a trauma surgery and orthopedic department. Methods: We defined 4 required hand disinfection indications: (1) before the preparation of ADC equipment, (2) immediately before the ADC, (3) before the clean phase, and (4) after the ADC. A process analysis of the preintervention phase (331 ADCs) was used to develop a standardized ADCC. The ADCC was introduced and iteratively adopted during the intervention phase. The effect was evaluated during the postintervention phase (374 ADCs). Results: Hand hygiene adherence was significantly increased by the introduction of the ADCC for all indications: (1) before the preparation of the ADC equipment (from 34% before to 85% after, P <.001), (2) immediately before an ADC (from 32% before to 85% after; P < .001), (3) before the clean phase (from 42% before to 96% after; P < .001), and (4) after an ADC (from 74% before to 99% after; P < .001). Overall hand hygiene adherence was analyzed before the indications for an ADC (from 9.6% before to 74% after; P < .001). The same strategy was applied to the following process parameters: use of a clean work surface, clean withdrawal of equipment from the dressing trolley, and appropriate waste disposal. Conclusions: A PLP sufficiently implemented a standardized concept for aseptic dressing change during an iterative improvement process, which resulted in a significant improvement in hand hygiene and adherence to other specific ADCC process steps.

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The Effect of Infection Prevention and Control Link Nurse Supervision and Resource Availability on Paramedic Hand Hygiene at Hanau Hospital, Seruyan District, Central Kalimantan

10.26911/the7thicph-fp.01.03 ◽

2020 ◽

Author(s):

Jhonferi Sidabalok ◽

◽

Pujiyanto Pujiyanto ◽

Keyword(s):

Hand Hygiene ◽

Resource Availability ◽

Prevention And Control ◽

Infection Prevention ◽

Infection Prevention And Control ◽

Central Kalimantan ◽

And Control

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A study assessing knowledge of hand hygiene in nosocomial infection prevention at a tertiary health care hospital

Journal of Patient Safety & Infection Control ◽

10.1016/j.jpsic.2015.10.117 ◽

2015 ◽

Vol 3 (2) ◽

pp. 84-85

Author(s):

R. Benson ◽

V. Narinder ◽

D. Deodhar ◽

R. Jairus ◽

A. Panu

Keyword(s):

Health Care ◽

Hand Hygiene ◽

Nosocomial Infection ◽

Infection Prevention ◽

Care Hospital

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Identification of factors associated with hand hygiene adherence as a support for creating curriculum for nurses training – a multivariate analysis

Journal of Medical Science ◽

10.20883/medical.e444 ◽

2020 ◽

Vol 89 (3) ◽

pp. e444

Author(s):

Anna Garus-Pakowska

Keyword(s):

Multivariate Analysis ◽

Hand Hygiene ◽

Infection Prevention ◽

Participant Observation ◽

Univariate Analysis ◽

World Health Organisation ◽

World Health ◽

Important Conclusion ◽

Average Value ◽

Educational Programmes

Aim. Handwashing is the easiest way to prevent infection but is often neglected. The purpose of the study was to identify the barriers limiting the respect for hygiene procedures by nurses. Material and Methods. The study involved direct quasi-participant observation and a questionnaire of 11 nurses in six wards of three hospitals in Poland. Results. In total,1,195 observations were conducted in which 3,355 activities requiring hygiene procedures were observed over 8 months. The nurses’ knowledge of proper hand hygiene and infection prevention principles were unsatisfactory, with an average value of correct answers in the knowledge test of 8.7 (Max = 15). The univariate analysis indicated the following barriers in hand hygiene: emergencies, allergies, or too few dispensers. In multivariate analysis, the application of hygiene procedures depended on the level of education (higher education – worse compliance with the rules) and subjective conviction that handwashing/glove use was important. Conclusion. Educational programmes on hand hygiene should focus on the World Health Organisation indications that glove use is not a substitute for handwashing.

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New N-(oxazolylmethyl)-thiazolidinedione Active against Candida albicans Biofilm: Potential Als Proteins Inhibitors

Molecules ◽

10.3390/molecules23102522 ◽

2018 ◽

Vol 23 (10) ◽

pp. 2522 ◽

Cited By ~ 9

Author(s):

Gabriel Marc ◽

Cătălin Araniciu ◽

Smaranda Oniga ◽

Laurian Vlase ◽

Adrian Pîrnău ◽

...

Keyword(s):

Biofilm Formation ◽

Infection Prevention ◽

Public Health Problem ◽

Opportunistic Pathogen ◽

Surface Proteins ◽

Form Complex ◽

New Approach ◽

New Class ◽

New Compounds

C. albicans is the most frequently occurring fungal pathogen, and is becoming an increasing public health problem, especially in the context of increased microbial resistance. This opportunistic pathogen is characterized by a versatility explained mainly by its ability to form complex biofilm structures that lead to enhanced virulence and antibiotic resistance. In this context, a review of the known C. albicans biofilm formation inhibitors were performed and a new N-(oxazolylmethyl)-thiazolidinedione scaffold was constructed. 16 new compounds were synthesized and characterized in order to confirm their proposed structures. A general antimicrobial screening against Gram-positive and Gram-negative bacteria, as well as fungi, was performed and revealed that the compounds do not have direct antimicrobial activity. The anti-biofilm activity evaluation confirmed the compounds act as selective inhibitors of C. albicans biofilm formation. In an effort to substantiate this biologic profile, we used in silico investigations which suggest that the compounds could act by binding, and thus obstructing the functions of, the C. albicans Als surface proteins, especially Als1, Als3, Als5 and Als6. Considering the well documented role of Als1 and Als3 in biofilm formation, our new class of compounds that target these proteins could represent a new approach in C. albicans infection prevention and management.

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