Shortening the Application Time of Alcohol-Based Hand Rubs to 15 Seconds May Improve the Frequency of Hand Antisepsis Actions in a Neonatal Intensive Care Unit

2017 ◽  
Vol 38 (12) ◽  
pp. 1430-1434 ◽  
Author(s):  
Axel Kramer ◽  
Didier Pittet ◽  
Romana Klasinc ◽  
Stefan Krebs ◽  
Torsten Koburger ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Practice ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Application Time ◽  
Improve Hand Hygiene ◽  
Independent Observer ◽  
Hand Antisepsis

BACKGROUNDFor alcohol-based hand rubs, the currently recommended application time of 30 seconds is longer than the actual time spent in clinical practice. We investigated whether a shorter application time of 15 seconds is microbiologically safe in neonatal intensive care and may positively influence compliance with the frequency of hand antisepsis actions.METHODSWe conducted in vitro experiments to determine the antimicrobial efficacy of hand rubs within 15 seconds, followed by clinical observations to assess the effect of a shortened hand antisepsis procedure under clinical conditions in a neonatal intensive care unit (NICU). An independent observer monitored the frequency of hand antisepsis actions during shifts.RESULTSAll tested hand rubs fulfilled the requirement of equal or even significantly higher efficacy within 15 seconds when compared to a reference alcohol propan-2-ol 60% (v/v) within 30 seconds. Microbiologically, reducing the application time to 15 seconds had a similar effect when compared to 30-second hand rubbing, but it resulted in significantly increased frequency of hand antisepsis actions (7.9±4.3 per hour vs 5.8±2.9 per hour; P=.05).CONCLUSIONTime pressure and workload are recognized barriers to compliance. Therefore, reducing the recommended time for hand antisepsis actions, using tested and well-evaluated hand rub formulations, may improve hand hygiene compliance in clinical practice.Infect Control Hosp Epidemiol 2017;38:1430–1434

The association between shift patterns and the quality of hand antisepsis in a neonatal intensive care unit: An observational study

2020 ◽  
Vol 112 ◽  
pp. 103686
Author(s):  
Judith Rittenschober-Böhm ◽  
Katharina Bibl ◽  
Michael Schneider ◽  
Romana Klasinc ◽  
Péter Szerémy ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Observational Study ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Hand Antisepsis

scholarly journals Time Series Analysis for Forecasting Hospital Census: Application to the Neonatal Intensive Care Unit

2016 ◽  
Vol 07 (02) ◽  
pp. 275-289 ◽  
Author(s):  
Stephen Hoover ◽  
Eric Jackson ◽  
David Paul ◽  
Robert Locke ◽  
Muge Capan
Keyword(s):  
Intensive Care Unit ◽  
Time Series ◽  
Intensive Care ◽  
Clinical Practice ◽  
Linear Regression ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Resource Planning ◽  
Forecasting Models ◽  
Best Fitting

SummaryAccurate prediction of future patient census in hospital units is essential for patient safety, health outcomes, and resource planning. Forecasting census in the Neonatal Intensive Care Unit (NICU) is particularly challenging due to limited ability to control the census and clinical trajectories. The fixed average census approach, using average census from previous year, is a forecasting alternative used in clinical practice, but has limitations due to census variations.Our objectives are to: (i) analyze the daily NICU census at a single health care facility and develop census forecasting models, (ii) explore models with and without patient data characteristics obtained at the time of admission, and (iii) evaluate accuracy of the models compared with the fixed average census approach.We used five years of retrospective daily NICU census data for model development (January 2008 - December 2012, N=1827 observations) and one year of data for validation (January - December 2013, N=365 observations). Best-fitting models of ARIMA and linear regression were applied to various 7-day prediction periods and compared using error statistics.The census showed a slightly increasing linear trend. Best fitting models included a nonseasonal model, ARIMA(1,0,0), seasonal ARIMA models, ARIMA(1,0,0)×(1,1,2)7 and ARIMA(2,1,4)×(1,1,2)14, as well as a seasonal linear regression model. Proposed forecasting models resulted on average in 36.49% improvement in forecasting accuracy compared with the fixed average census approach.Time series models provide higher prediction accuracy under different census conditions compared with the fixed average census approach. Presented methodology is easily applicable in clinical practice, can be generalized to other care settings, support shortand long-term census forecasting, and inform staff resource planning.

Use of an Alcohol-Based Hand Rub and Quality Improvement Interventions to Improve Hand Hygiene in a Russian Neonatal Intensive Care Unit

2003 ◽  
Vol 24 (3) ◽  
pp. 172-179 ◽  
Author(s):  
Samuel M. Brown ◽  
Anna V. Lubimova ◽  
Natalya M. Khrustalyeva ◽  
Svetlana V. Shulaeva ◽  
Iya Tekhova ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Hand Hygiene ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Quality Improvement Intervention ◽  
Antibiotic Administration ◽  
Improve Hand Hygiene ◽  
Device Use

AbstractBackground:Hand hygiene (HH) is critical to infection control, but compliance is low. Alcohol-based antiseptics may improve HH. HH practices in Russia are not well described, and facilities are often inadequate.Setting:Four 6-bed units in a neonatal intensive care unit in St. Petersburg, Russia.Methods:Prospective surveillance of HH compliance, nosocomial colonization, and antibiotic administration was performed from January until June 2000. In February 2000, alcohol-based hand rub was provided for routine HH use. Eight weeks later, a quality improvement intervention was implemented, consisting of review of interim data, identification of opinion leaders, posting of colonization incidence rates, and regular feedback. Means of compliance, colonization, and antibiotic use were compared for periods before and after each intervention.Results:A total of 1,027 events requiring HH were observed. Compliance was 44.2% before the first intervention, 42.3% between interventions, and 48% after the second intervention. Use of alcohol rose from 15.2% of HH indications to 25.2% between interventions and 41.5% after the second intervention. The incidence of nosocomial colonization (per 1,000 patient-days) with Klebsiella pneumoniae was initially 21.5, decreased to 4.7, and then was 3.2 in the final period. Rates of antibiotic and device use also decreased.Conclusions:HH may have increased slightly, but the largest effect was a switch from soap and water to alcohol, which may have been associated with decreased cross-transmission of Klebsiella, although this may have been confounded by lower device use. Alcohol-based antiseptic may be an improvement over current practices, but further research is required.

scholarly journals South Korean nursing students' experiences of clinical practice in the newborn nursery and neonatal intensive care unit: A phenomenological study

2021 ◽  
Vol 27 (1) ◽  
pp. 3-12
Author(s):  
In Ok Sim ◽  
Ok Yeon Bae ◽  
Tae Hoon Kim
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nursing Education ◽  
Clinical Practice ◽  
Nursing Students ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Basic Data ◽  
Undergraduate Nursing ◽  
Study Results

Purpose: While clinical practice is crucial for nursing students to acquire the skills needed to provide professional, high-quality nursing care, further studies on improving undergraduate nursing programs are needed to provide a supportive clinical learning environment for student nurses. This study aimed to understand nursing students' clinical experiences in newborn nurseries and neonatal intensive care units and to provide basic data for the establishment of strategies to promote effective clinical education.Methods: Interviews were held with 15 nursing students at J University who had clinical practice experience in the newborn nursery and neonatal intensive care unit. The collected data were analyzed using the phenomenological analysis method developed by Colaizzi (1978).Results: The nursing students' experiences were grouped into four categories: “expectations for and anxiety about clinical practice", "acquisition of a wide range of knowledge regarding neonatal nursing", "challenges faced in clinical practice", and "experiencing interpersonal changes".Conclusion: The current neonatal practice nursing education system provides students with positive learning experiences. However, the lack of practice opportunities, insufficient instruction, and the theory-practice gap were identified as major issues hindering students' learning needs. These study results are expected to provide basic data for curriculum development to improve undergraduate nursing education.

Sign in / Sign up

Export Citation Format

Share Document