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

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.

scholarly journals P123 The effect of having volunteers and face masks present at hospital entrances on the wearing of face masks and hand washing

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Paul B Stanier ◽  
Savneet K Lochab ◽  
John E Grice ◽  
Paul B Stanier ◽  
Savneet K Lochab
Keyword(s):  
Hand Hygiene ◽  
General Hospital ◽  
Infection Prevention ◽  
Cost Effective ◽  
District General Hospital ◽  
Hand Washing ◽  
Prevention Measures ◽  
Hygiene Measures ◽  
Improve Compliance ◽  
Hospital Transmission

Abstract Background The spread of COVID-19 has put inpatients lives at risk and increased stress on hospital. Simple, cost effective measures such as mask wearing and hand hygiene have been shown to reduce the spread of droplet borne viruses. Compliance with these measures is variable and when performed improperly, reduce efficacy. Objective In this paper we aim to determine whether the provision of masks at hospital entrances and the use of volunteers to ensure correct mask wearing and hand hygiene can improve compliance with infection prevention measures for COVID-19. Method Visitor and staff compliance with mask wearing and hand hygiene measures were observed with and without the presence of masks and volunteers at hospital entrances at a District General Hospital. Results A total of 519 people were observed entering the hospital. Mask wearing went from 71% to 99% (P = &lt;0.001) with the addition of volunteers. Provision of masks increased mask wearing from 56% to 97% (P = &lt;0.001). Hand hygiene was improved from 9% to 84% (P = &lt;0.001) with the presence of volunteers. Discussion A statistically significant improvement in hand hygiene and correct mask wearing was seen with both the presence of volunteers at hospital entrances and with the provision of masks. This is a relatively small study with heterogenous cohorts of staff and visitors. However, these results appear to indicate that use of volunteers and provision of masks at entrances may improve the compliance with the measures that been shown to reduce the in-hospital transmission of COVID-19.

scholarly journals Understanding Infection Prevention Behaviour in Maternity Wards: A Mixed-Methods Analysis of Hand Hygiene in Zanzibar

2020 ◽  
pp. 113543
Author(s):  
Mícheál de Barra ◽  
Giorgia Gon ◽  
Susannah Woodd ◽  
Wendy J. Graham ◽  
Marijn de Bruin ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Hand Hygiene ◽  
Infection Prevention

scholarly journals Effect of Removing Contact Precautions for Multidrug-Resistant Organisms on Hospital Infections in a Pediatric Health System

2020 ◽  
Vol 41 (S1) ◽  
pp. s199-s200
Author(s):  
Matthew Linam ◽  
Dorian Hoskins ◽  
Preeti Jaggi ◽  
Mark Gonzalez ◽  
Renee Watson ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Antibiotic Stewardship ◽  
Infection Prevention ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
Contact Precautions ◽  
Stewardship Program ◽  
Tract Infections ◽  
The Impact

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

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

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.

Knowledge and Practice of Health-care Workers regarding Hand Hygiene during Third Wave of COVID-19

2021 ◽  
Vol 15 (6) ◽  
pp. 1198-1202
Author(s):  
M.l Fatima ◽  
M. Waqar ◽  
H. Qamar ◽  
M. Akram ◽  
F. Zia ◽  
...  
Keyword(s):  
Health Care ◽  
Hand Hygiene ◽  
Health Care Workers ◽  
Current Knowledge ◽  
Preventive Measure ◽  
Hospital Environment ◽  
Third Wave ◽  
Cross Sectional ◽  
Care Workers ◽  
Hygiene Measures

Background: Iatrogenic and nosocomial infections are a serious threat to a healthcare setting especially during a pandemic. Hand hygiene among the health-care workers stands out to be a pivotal preventive measure. Practical application of hand hygiene measures during third wave of COVID-19 pandemic primarily depend upon the current knowledge among the health care workers. Methods: A cross-sectional study design based on validated WHO questionnaire for hand hygiene among the health care workers was conducted during March till May2021 in the settings of Shalamar and Central Park hospital and medical colleges. Results: The sample consisted of 271 participants with 110 males and 161 females, with the mean age of 24.72+ 4.174 years. The sample consisted of 36.2% of medical students, 49.1% of doctors and 14.8% of paramedical staff. Nearly 50.6% of the individuals claim to receive formal training. 47.6% believe that “Health-care workers’ hands when not clean” are the main route of cross-transmission. Nearly 57.2% believed that the hospital environment (surfaces)the most frequent source of germs. Comparison of hand-rubbing and washing revealed that major percentage believe hand rub to be rapid however less effective causing dryness. A majority believe that hand hygiene before touching the patient, immediately after exposure to body fluids or immediate surroundings of patients prevents transmission of germs to the patient and vice versa afterwards prevents transmission to HCW. Conclusion: A large proportion of the sample has considerable knowledge regarding essential hand hygiene in a health care setting. However more frequent training sessions should be conducted to improve it further. Key words: Hand hygiene, Health-care workers, Knowledge

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

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.

“Sharing the Love” - Facilitating the implementation of a hospital wide hand hygiene auditing program from an infection prevention and control led model

2018 ◽  
Vol 23 ◽  
pp. S7
Author(s):  
Kylie Fomiatti ◽  
Tara McRaith ◽  
Sharon Kenny ◽  
Alison Wainwright ◽  
Heather Ilton ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
And Control
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