scholarly journals Intranasal Antiseptic and Universal Antiseptic Baths Are Effective in Reducing MRSA Acquisition in Extended-Care Facilities

2020 ◽  
Vol 41 (S1) ◽  
pp. s304-s305
Author(s):  
Angela Chow ◽  
Wei Zhang ◽  
Joshua Wong ◽  
Brenda Ang
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Compliance Rate ◽  
Care Facility ◽  
Clinical Problem ◽  
Clinical Samples ◽  
Extended Care ◽  
Care Facilities ◽  
The Mean ◽  
Hygiene Compliance

Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a growing clinical problem in rehabilitation hospitals, where patients stay for extended periods for intensive rehabilitation therapy. In addition to cutaneous sites, the nares could be a source for nosocomial MRSA transmission. Decolonization of nasal and cutaneous reservoirs could reduce MRSA acquisition. We evaluated the effectiveness of topical intranasal octenidine gel, coupled with universal chlorhexidine baths, in reducing MRSA acquisition in an extended-care facility. Methods: We conducted a quasi-experimental before-and-after study from January 2013 to June 2019. All patients admitted to a 100-bed rehabilitation hospital specialized in stroke and trauma care in Singapore were screened for MRSA colonization on admission. Patients screened negative for MRSA were subsequently screened at discharge for MRSA acquisition. Screening swabs were obtained from the nares, axillae, and groin and were cultured on selective chromogenic agar. Patients who tested positive for MRSA from clinical samples collected >3 days after admission were also considered to have hospital-acquired MRSA. Universal chlorhexidine baths were implemented throughout the study period. Intranasal application of octenidine gel for MRSA colonizers for use for 5 days from admission was added to the hospital’s protocol beginning in September 2017. An interrupted time series with segmented regression analysis was performed to evaluate the trends in MRSA acquisition before the intervention (January 2013–July 2017) and after the intervention (September 2017–June 2019) with intranasal octenidine. August 2017 was excluded from the analysis because the intervention commenced midmonth. Results: In total, 77 observational months (55 before the intervention and 22 after the intervention) were included. The mean monthly MRSA acquisition rates were 7.0 per 1,000 patient days before the intervention and 4.4 per 1,000 patient days after the intervention (P < .001), with a mean number of patient days of 2,516.3 per month before the intervention and 2,427.2 per month after the intervention (P = .0172). The mean monthly number of MRSA-colonized patients on admission to the hospital decreased from 24.8 before the intervention to 18.7 after the intervention (P < .001). Mean monthly hand hygiene compliance rate increased significantly from 65.7% before the intervention to 87.4% after the intervention (P < .001). After adjusting for the number of MRSA-colonized patients on admission and hand hygiene compliance rates, a constant trend was observed from January 2013 to July 2017 (adjusted mean coefficient, 0.012; 95% CI, −0.037 to 0.06), with an immediate drop in September 2017 (adjusted mean coefficient, −2.145; 95% CI, −0.248 to −0.002; P = .033), followed by a significant reduction in MRSA acquisition after the intervention from September 2017 through June 2019 (adjusted mean coefficient, −0.125; 95% CI, -4.109 to -0.181; P = .047). Conclusions: Topical intranasal octenidine, coupled with universal chlorhexidine baths, can reduce MRSA acquisition in extended-care facilities. Further studies should be conducted to validate the findings in other healthcare settings.Funding: NoneDisclosures: None

scholarly journals Hubungan Ketersediaan Sumber Daya, Kepemimpinan, Lama Kerja, dan Persepsi dengan Kepatuhan Mencuci Tangan Lima Momen di Rumah Sakit Islam Surabaya

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Fahrun Nisa Arsabani ◽  
Nevita Putri Nur Hadianti
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Compliance Rate ◽  
Care Facility ◽  
Health Care Facility ◽  
Cross Sectional ◽  
Hospital Employees ◽  
Hygiene Behavior ◽  
Hygiene Compliance ◽  
The Relationship

Hospital as health care facility has an obligation to make, implement and maintain quality standards for health services. Hospital infection are one of the main causes of death and increased morbidity in patients, which can occur due to non-hygiene behavior, which can be prevented by five moment hand hygiene. However, in Surabaya Islamic Hospital  has a low hand hygiene compliance rate of 81.87% with a target of 85% in the third quarter of 2017.The purpose of this study was to analyze the relationship between the availability of resources, leadership, length of work, and perception with five moment hand hygiene compliance at Surabaya Islamic Hospital. This research was an observational analytic study, by questionnaires and observation to 67 employees of Surabaya Islamic Hospital. The research design was cross sectional with statistical analysis, chi-square.The results showed 56.72% of respondents did not comply with hand hygiene. There were a relationship between the availability of resources (p = 0,032) and perception (p = 0,00) with five moment hand hygiene compliance, while leadership (p = 0,13) and length of work (p = 0,249) were not associated with five moment hand hygiene compliance in Surabaya Islamic Hospital. The conclusion of this study is the condition of five moment hand hygiene compliance in Surabaya Islamic Hospital employees is low with the relationship between the availability of resources and perception with five moment hand hygiene compliance.

scholarly journals A Decade in Trying to Increase Hand Hygiene—Finally Success

2020 ◽  
Vol 41 (S1) ◽  
pp. s93-s94
Author(s):  
Linda Huddleston ◽  
Sheila Bennett ◽  
Christopher Hermann
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Compliance Rate ◽  
Bloodstream Infections ◽  
Central Line ◽  
Second Phase ◽  
Two Phase ◽  
Hygiene Compliance ◽  
Tract Infections ◽  
The Voice

Background: Over the past 10 years, a rural health system has tried 10 different interventions to reduce hospital-associated infections (HAIs), and only 1 intervention has led to a reduction in HAIs. Reducing HAIs is a goal of nearly all hospitals, and improper hand hygiene is widely accepted as the main cause of HAIs. Even so, improving hand hygiene compliance is a challenge. Methods: Our facility implemented a two-phase longitudinal study to utilize an electronic hand hygiene reminder system to reduce HAIs. In the first phase, we implemented an intervention in 2 high-risk clinical units. The second phase of the study consisted of expanding the system to 3 additional clinical areas that had a lower incidence of HAIs. The hand hygiene baseline was established at 45% for these units prior to the voice reminder being turned on. Results: The system gathered baseline data prior to being turned on, and our average hand hygiene compliance rate was 49%. Once the voice reminder was turned on, hand hygiene improved nearly 35% within 6 months. During the first phase, there was a statistically significant 62% reduction in the average number of HAIs (catheter associated urinary tract infections (CAUTI), central-line–acquired bloodstream infections (CLABSIs), methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant organisms (MDROs), and Clostridiodes difficile experienced in the preliminary units, comparing 12 months prior to 12 months after turning on the voice reminder. In the second phase, hand hygiene compliance increased to >65% in the following 6 months. During the second phase, all HAIs fell by a statistically significant 60%. This was determined by comparing the HAI rates 6 months prior to the voice reminder being turned on to 6 months after the voice reminder was turned on. Conclusions: The HAI data from both phases were aggregated, and there was a statistically significant reduction in MDROs by 90%, CAUTIs by 60%, and C. difficile by 64%. This resulted in annual savings >$1 million in direct costs of nonreimbursed HAIs.Funding: NoneDisclosures: None

scholarly journals Hand hygiene compliance monitoring in anaesthetics: Feasibility and validity

2018 ◽  
Vol 19 (3) ◽  
pp. 116-122 ◽  
Author(s):  
A Jeanes ◽  
J Dick ◽  
P Coen ◽  
N Drey ◽  
DJ Gould
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Care Delivery ◽  
Compliance Rate ◽  
Significant Risk ◽  
World Health ◽  
Compliance Monitoring ◽  
Infection Control Practitioner ◽  
Hygiene Compliance ◽  
Health Organization

Background: Hand hygiene compliance scores in the anaesthetic department of an acute NHS hospital were persistently low. Aims: To determine the feasibility and validity of regular accurate measurement of HHC in anaesthetics and understand the context of care delivery, barriers and opportunities to improve compliance. Methods: The hand hygiene compliance of one anaesthetist was observed and noted by a senior infection control practitioner (ICP). This was compared to the World Health Organization five moments of hand hygiene and the organisation hand hygiene tool. Findings: In one sequence of 55 min, there were approximately 58 hand hygiene opportunities. The hand hygiene compliance rate was 16%. The frequency and speed of actions in certain periods of care delivery made compliance measurement difficult and potentially unreliable. During several activities, taking time to apply alcohol gel or wash hands would have put the patients at significant risk. Discussion: We concluded that hand hygiene compliance monitoring by direct observation was invalid and unreliable in this specialty. It is important that hand hygiene compliance is optimal in anaesthetics particularly before patient contact. Interventions which reduce environmental and patient contamination, such as cleaning the patient and environment, could ensure anaesthetists encounter fewer micro-organisms in this specialty.

scholarly journals Hand hygiene compliance among healthcare workers in Ghana’s health care institutions: An observational study

2020 ◽  
Vol 25 (5) ◽  
pp. 177-186
Author(s):  
Aaron Asibi Abuosi ◽  
Samuel Kaba Akoriyea ◽  
Gloria Ntow-Kummi ◽  
Joseph Akanuwe ◽  
Patience Aseweh Abor ◽  
...  
Keyword(s):  
Health Care ◽  
Observational Study ◽  
Hand Hygiene ◽  
Outcome Measures ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Hand Washing ◽  
Job Aids ◽  
The Mean ◽  
Hygiene Compliance

Objective To assess hand hygiene compliance in selected primary hospitals in Ghana. Design A cross-sectional health facility-based observational study was conducted in primary health care facilities in five regions in Ghana. A total of 546 healthcare workers including doctors, nurses, midwives and laboratory personnel from 106 health facilities participated in the study. Main outcome measures The main outcome measures included availability of hand hygiene materials and alcohol job aids; compliance with moments of hand hygiene; and compliance with steps in hygienic hand washing. These were assessed using descriptive statistics. Results The mean availability of hand hygiene material and alcohol job aids was 75% and 71% respectively. This was described as moderately high, but less desirable. The mean hand hygiene compliance with moments of hand hygiene was 51%, which was also described asmoderately high, but less desirable. It was observed that, generally, hand hygiene was performed after procedures than before. However, the mean compliance with steps in hygienic hand washing was 86%, which was described as high and desirable. Conclusion Healthcare workers are generally competent in performance of hygienic hand washing. However, this does not seem to influence compliance with moments of hand hygiene. Efforts must therefore be made to translate the competence of healthcare workers in hygienic hand washing into willingness to comply with moments of hand hygiene, especially contact with patients.

Improvement of hand hygiene compliance among health professional staff of Neonatology Department in Nyamata Hospital

2016 ◽  
Vol 24 (4) ◽  
pp. 349-356 ◽  
Author(s):  
Solange Umulisa ◽  
Angele Musabyimana ◽  
Rex Wong ◽  
Eva Adomako ◽  
April Budd ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Compliance Rate ◽  
Professional Staff ◽  
Routine Practice ◽  
Improve Hand Hygiene ◽  
Improvement Project ◽  
Content Type ◽  
Hygiene Compliance

Purpose The purpose of this study is to improve the hand hygiene compliance in a hospital in Rwanda. Hand hygiene is a fundamental routine practice that can greatly reduce risk of hospital-acquired infections; however, hand hygiene compliance in the hospital was low. Design/methodology/approach A multiple-strategy intervention was implemented with a focus on ensuring stable water supply was available through installing mobile hand hygiene facilities. Findings The intervention significantly increased the overall hand hygiene compliance rate by 35 per cent. The compliance for all of the five hand hygiene moments and all professions also significantly increased. Practical implications By implementing an intervention that involved multiple strategies to address the root causes of the problem, this quality improvement project successfully created an enabling environment to increase hand hygiene compliance. The hospital should encourage using the strategic problem-solving method to conduct more quality improvement projects in other departments. Originality/value Findings from this study may be useful for hospitals in similar settings seeking to improve hand hygiene compliance.

scholarly journals Using targeted solution tools as an initiative to improve hand hygiene: challenges and lessons learned

2017 ◽  
Vol 146 (2) ◽  
pp. 276-282 ◽  
Author(s):  
J. A. AL-TAWFIQ ◽  
M. TREBLE ◽  
R. ABDRABALNABI ◽  
C. OKEAHIALAM ◽  
S. KHAZINDAR ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Hand Hygiene Compliance ◽  
Compliance Rate ◽  
Blood Stream ◽  
Lessons Learned ◽  
Healthcare Associated Infection ◽  
Contributing Factors ◽  
Improve Hand Hygiene ◽  
Hygiene Compliance ◽  
Tract Infections

SUMMARYThe Joint Commission Centre for Transforming Healthcare's Web-based Targeted Solutions Tool (TST) for improving hand hygiene was implemented to elucidate contributing factors to low compliance rates of hand hygiene. Monitoring of compliance was done by trained unknown and known observers and rates of hospital-acquired infections were tracked and correlated against the changes in hand hygiene compliance. In total, 5669 of hand hygiene observations were recorded by the secret observers. The compliance rate increased from 75·4% at baseline (May–August 2014) to 88·6% during the intervention (13 months) and the control periods (P < 0·0001). Reductions in healthcare-associated infection rates were recorded for Clostridium difficle infections from 7·95 (CI 0·8937–28·72) to 1·84 (CI 0·02411–10·26) infections per 10 000 patient-days (P = 0·23), central line-associated blood-stream infections from 5·9 (CI 1·194–17·36) to 2·9 (0·7856–7·475) per 1000 device days (P = 0·37) and catheter-associated urinary tract infections from 5·941 (CI 1·194–17·36) to 0 per 1000 device days (P = 0·42). The top contributing factors for non-compliance were: improper use of gloves, hands full of supplies or medications and frequent entry or exit in isolation areas. We conclude that the application of TST allows healthcare organisations to improve hand hygiene compliance and to identify the factors contributing to non-compliance.

scholarly journals The effect of education on improving hand hygiene compliance among healthcare workers

2019 ◽  
Vol 3 (2) ◽  
pp. 66-71
Author(s):  
Abigail Mitchell ◽  
Christian Schadt ◽  
Shamarra Johnson ◽  
Mary Thisbe Quilab
Keyword(s):  
Interventional Radiology ◽  
Hand Hygiene ◽  
Cardiac Catheterization ◽  
Healthcare Workers ◽  
Hand Hygiene Compliance ◽  
Statistical Significance ◽  
Compliance Rate ◽  
Observation Data ◽  
Cardiac Catheterization Laboratory ◽  
Hygiene Compliance

Background: Proper hand hygiene is the most effective way to reduce healthcare-associated infections (HAI). Hand hygiene compliance rates among healthcare workers remain unsatisfactory. This study investigated the effects of unit in-service education on hand hygiene compliance in an Interventional Radiology and Cardiac Catheterization Laboratory department in a tertiary hospital in Florida. Methods: An observational study was conducted for five weeks. A total of 120 participants, consisting of 40 physicians, 40 registered nurses, 40 technologists were observed by a secret shopper pre-education and post education. A pre-education baseline compliance rate was established for each group. Pre-education observation occurred for two weeks before the intervention, one week for the implementation of unit in-service education, another two weeks for post education observation. The hand hygiene audit tool was utilized to record the observation data. Data analysis: Quantitative data were analyzed using a one-tailed T-test to determine P values for each group. Results: Results showed a 20 % increase among physicians, 15% among nurses and 5% among technologists. There was a statistical significance for the physician and nurse groups. Conclusion: The study implies that education is an effective intervention in improving hand hygiene compliance rates among the staff in the interventional radiology and cardiac catheterization department.

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