THE IMPACT OF HAND HYGIENE OF HEALTHCARE PROFESSIONALS ON THE TRANSMISSION OF ETIOLOGICAL AGENTS OF HEALTHCARE ASSOCIATED INFECTIONS – HAI

Background: Though high hand hygiene (HH) levels significantly reduce the risk of healthcare-associated infections (HCAIs), the current cost of HCAIs and the impact of optimal HH practices on HCAIs are poorly defined. The last NHS England financial assessment was in 2009. Methods: The number of HCAIs per bed per year for NHS England were calculated and average costs were attributed using data from three sources; National Audit Office report, a commercially available calculator, and a financial analysis by a specialist paediatric hospital in England. Improved HH compliance for NHS England was based on a sustained rise in compliance rates from 50 to 80% combined with an HCAI reduction of at least 20%. The cost savings based on such improvements were then calculated. Results: In 2020, it is estimated that the number of HCAIs per bed per year ranges from 3.0 to 9.3, with a midpoint of 5.1. The direct costs of HCAI to NHS England were found to lie between £1.6 and £5 billion. Based on a 20% reduction in HCAI rates, this could lead to cost savings of between £322 million and £1 billion per year. Conclusion: Current direct costs of HCAIs consume approximately 1.3% to 4.1% of NHS England’s annual budget. Improving HH compliance among healthcare workers can lead to significant cost savings. There appears to be a strong financial argument for investment into innovative HH compliance technologies that have been historically perceived as too expensive.

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Investigating the use of an electronic hand hygiene monitoring and prompt device: influence and acceptability

Journal of Infection Prevention ◽

10.1177/1757177417714045 ◽

2017 ◽

Vol 18 (6) ◽

pp. 278-287 ◽

Cited By ~ 6

Author(s):

Judith Dyson ◽

Maurice Madeo

Keyword(s):

Hand Hygiene ◽

Monitoring Systems ◽

Healthcare Associated Infections ◽

Healthcare Practitioner ◽

Entry And Exit ◽

Improve Compliance ◽

Healthcare Associated ◽

The Impact

Introduction: Hand hygiene (HH) prevents the transmission of healthcare-associated infections. Electronic HH monitoring and prompt devices have been developed to overcome problems with monitoring HH and to improve compliance. Devices monitor room entry and exit and soap use through communication between ceiling sensors and badges worn by practitioners and the badges sense alcohol rub. Objectives: To investigate (1) the impact of devices on HH compliance, (2) how devices influence behaviour and (3) the experience and opinions of practitioners on the use devices. Methods: HH compliance was monitored (before, during and after system installation) by observations and alcohol rub usage. Compliance during installation was also monitored by the device. Healthcare practitioner interviews (n = 12) explored how the device influenced behaviour and experiences and opinions of wearing the device. Results: HH compliance improved during the period the device was installed. Practitioners reported the device increased their awareness, enhancing their empathy for patients and encouraged patients and colleagues to prompt when HH was needed. Practitioners’ reported better HH, gaming the system and feelings of irritation. Conclusion: HH prompt and monitoring systems seem to improve compliance but improvements may be undermined by practitioner irritation and system gaming.

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Positive deviance in infection prevention and control: A systematic literature review

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1256 ◽

2020 ◽

pp. 1-8

Author(s):

Mohammed A. Alzunitan ◽

Michael B. Edmond ◽

Mohammed A. Alsuhaibani ◽

Riley J. Samuelson ◽

Marin L. Schweizer ◽

...

Keyword(s):

Literature Review ◽

Hand Hygiene ◽

Systematic Literature Review ◽

Positive Deviance ◽

Infection Prevention And Control ◽

Healthcare Associated Infections ◽

Single Intervention ◽

Healthcare Associated ◽

And Control ◽

The Impact

Abstract Background: Healthcare-associated infections (HAIs) remain a major challenge. Various strategies have been tried to prevent or control HAIs. Positive deviance, a strategy that has been used in the last decade, is based on the observation that a few at-risk individuals follow uncommon, useful practices and that, consequently, they experience better outcomes than their peers who share similar risks. We performed a systematic literature review to measure the impact of positive deviance in controlling HAIs. Methods: A systematic search strategy was used to search PubMed, CINAHL, Scopus, and Embase through May 2020 for studies evaluating positive deviance as a single intervention or as part of an initiative to prevent or control healthcare-associated infections. The risk of bias was evaluated using the Downs and Black score. Results: Of 542 articles potentially eligible for review, 14 articles were included for further analysis. All studies were observational, quasi-experimental (before-and-after intervention) studies. Hand hygiene was the outcome in 8 studies (57%), and an improvement was observed in association with implementation of positive deviance as a single intervention in all of them. Overall HAI rates were measured in 5 studies (36%), and positive deviance was associated with an observed reduction in 4 (80%) of them. Methicillin-resistant Staphylococcus aureus infections were evaluated in 5 studies (36%), and positive deviance containing bundles were successful in all of them. Conclusions: Positive deviance may be an effective strategy to improve hand hygiene and control HAIs. Further studies are needed to confirm this effect.

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Motivating healthcare professionals (nurses, nurse assistants, physicians) to integrate new practices for preventing healthcare-associated infections into the care continuum: turning Positive Deviance into positive norms

BMC Infectious Diseases ◽

10.1186/s12879-021-06215-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Anat Gesser-Edelsburg ◽

Ricky Cohen ◽

Adva Mir Halavi ◽

Mina Zemach

Keyword(s):

Infection Prevention ◽

Healthcare Professionals ◽

Infection Prevention And Control ◽

Healthcare Associated Infections ◽

Central Processing ◽

Dissemination Process ◽

Healthcare Associated ◽

And Control ◽

Action Dialogue ◽

The Impact

Abstract Background The literature examining healthcare-associated infections (HAI) points to two main problems in conforming to infection prevention and control (IPC) guidelines among healthcare professionals (HP). One is the discrepancy between HPs’ behavioral intentions and their implementation in practice. The other refers to how HPs maintain these practices after the intervention stage ends. The method proposed in this study seeks to address both these issues by using the Positive Peviance (PD) approach to focus on the dissemination stage of interventions. The study seeks to offer a method for disseminating 27 PD practices to 135 HPs, among them nurses, nurse assistants and physicians, so as to help them maintain IPC guidelines, offer feedback on the dissemination process and examine the impact of the dissemination stage on changes in their behavior. Methods The theoretical model underlying this qualitative research was the Recognition-Primed dDecision (RPD) model, which we implemented in the field of healthcare-associated infections (HAIs). Moreover, we used the Discovery & Action Dialogue (DAD) and Think Aloud (TA) techniques to describe the methodological development of simulations for HPs. Feedback from the HP demonstrators underwent content analysis, while descriptive statistics were used to characterize behavioral changes. Results HPs’ information processing regarding infection prevention shifts from peripheral/automatic processing to intuition and analytical/central processing, turning PD practices into positive norms. The HPs personally experienced finding a solution and made repeated corrections until they overcame the barriers. Most of the HPs (69.4%) reported that the practices were fully implemented, together with additional practices. Conclusions Implementation of the dissemination stage indicates that in order for HPs to integrate and assimilate practices that are not in the official guidelines, merely observing simulations is not sufficient. Rather, each staff member must personally carry out the procedures.

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Assessment of nurses’ knowledge of nosocomial infections transmitted through contact

Polish Journal of Public Health ◽

10.2478/pjph-2020-0007 ◽

2021 ◽

Vol 130 (1) ◽

pp. 26-29

Author(s):

Wiesława Janiszewska ◽

Stanisław Manulik ◽

Krzysztof Chmielowiec ◽

Jolanta Chmielowiec ◽

Agnieszka Boroń

Keyword(s):

Hand Hygiene ◽

Nosocomial Infections ◽

Work Experience ◽

Healthcare Professionals ◽

Medical Personnel ◽

General Level ◽

Healthcare Associated Infections ◽

Sick People ◽

Level Of Knowledge ◽

Healthcare Associated

AbstractIntroduction. Due to frequent contact with sick people, the hands of healthcare professionals are the most popular way of transmitting pathogens from patient to patient and from hospital to patient. Hand hygiene is crucial when it comes to reducing HCAI (healthcare-associated infections).Aim. The aim is to analyze the professional knowledge of nurses about nosocomial infections transmitted through contact. Its main assumption is the evaluation of this knowledge in the context of preventing the spread of nosocomial infections.Material and method. A proprietary questionnaire consisting of questions was used to assess the knowledge of medical personnel. The survey contains 25 questions based on the principle of “true/false”. The reliability of the scale was measured and assessed with the Cronbach’s alpha test at the level of 68.4%.Results. Factors adversely affecting the general level of knowledge in the field of hand hygiene turned out to be older age (p=0.012), longer work experience (p=0.023) and the lack of higher education (p=0.048).

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Impact of an automated hand hygiene monitoring system and additional promotional activities on hand hygiene performance rates and healthcare-associated infections

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2019.77 ◽

2019 ◽

Vol 40 (7) ◽

pp. 741-747 ◽

Cited By ~ 6

Author(s):

John M. Boyce ◽

Jennifer A. Laughman ◽

Michael H. Ader ◽

Pamela T. Wagner ◽

Albert E. Parker ◽

...

Keyword(s):

Hand Hygiene ◽

Monitoring System ◽

Hand Hygiene Compliance ◽

Healthcare Personnel ◽

Incidence Density ◽

Healthcare Associated Infections ◽

Improve Hand Hygiene ◽

Hygiene Compliance ◽

Healthcare Associated ◽

The Impact

AbstractObjective:Determine the impact of an automated hand hygiene monitoring system (AHHMS) plus complementary strategies on hand hygiene performance rates and healthcare-associated infections (HAIs).Design:Retrospective, nonrandomized, observational, quasi-experimental study.Setting:Single, 93-bed nonprofit hospital.Methods:Hand hygiene compliance rates were estimated using direct observations. An AHHMS, installed on 4 nursing units in a sequential manner, determined hand hygiene performance rates, expressed as the number of hand hygiene events performed upon entering and exiting patient rooms divided by the number of room entries and exits. Additional strategies implemented to improve hand hygiene included goal setting, hospital leadership support, feeding AHHMS data back to healthcare personnel, and use of Toyota Kata performance improvement methods. HAIs were defined using National Healthcare Safety Network criteria.Results:Hand hygiene compliance rates generated by direct observation were substantially higher than performance rates generated by the AHHMS. Installation of the AHHMS without supplementary activities did not yield sustained improvement in hand hygiene performance rates. Implementing several supplementary strategies resulted in a statistically significant 85% increase in hand hygiene performance rates (P < .0001). The incidence density of non–Clostridioies difficile HAIs decreased by 56% (P = .0841), while C. difficile infections increased by 60% (P = .0533) driven by 2 of the 4 study units.Conclusion:Implementation of an AHHMS, when combined with several supplementary strategies as part of a multimodal program, resulted in significantly improved hand hygiene performance rates. Reductions in non–C. difficile HAIs occurred but were not statistically significant.

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Effects of a 4-year intervention on hand hygiene compliance and incidence of healthcare associated infections: a longitudinal study

Infection ◽

10.1007/s15010-021-01626-5 ◽

2021 ◽

Author(s):

Chengyi Han ◽

Qing Song ◽

Xin Meng ◽

Ying Lv ◽

Dongsheng Hu ◽

...

Keyword(s):

Longitudinal Study ◽

Hand Hygiene ◽

Hand Hygiene Compliance ◽

Healthcare Associated Infections ◽

Hygiene Compliance ◽

Healthcare Associated

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Group Electronic Monitoring of Hand Hygiene on Inpatient Units: A Multicenter Cluster Randomized Quality Improvement Study

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.518 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s38-s39

Author(s):

Jerome Leis ◽

Jeff Powis ◽

Allison McGeer ◽

Daniel Ricciuto ◽

Tanya Agnihotri ◽

...

Keyword(s):

Quality Improvement ◽

Hand Hygiene ◽

Electronic Monitoring ◽

Current Approach ◽

Antibiotic Resistant ◽

Guide Unit ◽

Cluster Randomized ◽

Healthcare Associated ◽

The Impact ◽

Inpatient Units

Background: The current approach to measuring hand hygiene (HH) relies on human auditors who capture <1% of HH opportunities and rapidly become recognized by staff, resulting in inflation in performance. Our goal was to assess the impact of group electronic monitoring coupled with unit-led quality improvement on HH performance and prevention of healthcare-associated transmission and infection. Methods: A stepped-wedge cluster randomized quality improvement study was undertaken across 5 acute-care hospitals in Ontario, Canada. Overall, 746 inpatient beds were electronically monitored across 26 inpatient medical and surgical units. Daily HH performance as measured by group electronic monitoring was reported to inpatient units who discussed results to guide unit-led improvement strategies. The primary outcome was monthly HH adherence (%) between baseline and intervention. Secondary outcomes included transmission of antibiotic resistant organisms such as methicillin resistant Staphylococcus aureus (MRSA) and other healthcare-associated infections. Results: After adjusting for the correlation within inpatient units, there was a significant overall improvement in HH adherence associated with the intervention (IRR, 1.73; 95% CI, 1.47–1.99; P < .0001). Monthly HH adherence relative to the intervention increased from 29% (1,395,450 of 4,544,144) to 37% (598,035 of 1,536,643) within 1 month, followed by consecutive incremental increases up to 53% (804,108 of 1,515,537) by 10 months (P < .0001). We identified a trend toward reduced healthcare-associated transmission of MRSA (0.74; 95% CI, 0.53–1.04; P = .08). Conclusions: The introduction of a system for group electronic monitoring led to rapid, significant, and sustained improvements in HH performance within a 2-year period.Funding: NoneDisclosures: None

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Should We Routinely Use Mupirocin to Prevent Staphylococcal Infections?

Infection Control and Hospital Epidemiology ◽

10.1086/501720 ◽

2000 ◽

Vol 21 (11) ◽

pp. 745-749 ◽

Cited By ~ 2

Author(s):

Virginia R. Roth ◽

Cathryn Murphy ◽

Trish M. Perl ◽

Alfred DeMaria ◽

Annette H. Sohn ◽

...

Keyword(s):

Healthcare Professionals ◽

Healthcare Associated Infections ◽

International Conference ◽

Attitudes And Practices ◽

Staphylococcal Infections ◽

Healthcare Associated

AbstractRoutine use of mupirocin to prevent staphylococcal infections is controversial. We assessed attitudes and practices of healthcare professionals attending the Fourth Decennial International Conference on Nosocomial and Healthcare-Associated Infections regarding mupirocin prophylaxis. Eighty percent of participants did not use mupirocin routinely. At the end of the session, 58% indicated they would consider increased use of mupirocin.

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Impact of Healthcare-Associated Infections Connected to Medical Devices—An Update

Microorganisms ◽

10.3390/microorganisms9112332 ◽

2021 ◽

Vol 9 (11) ◽

pp. 2332

Author(s):

Nitin Chandra Teja Dadi ◽

Barbora Radochová ◽

Jarmila Vargová ◽

Helena Bujdáková

Keyword(s):

Medical Devices ◽

Surgical Site Infections ◽

Central Line ◽

Ventilator Associated Pneumonia ◽

Healthcare Associated Infections ◽

Care Bundles ◽

Planktonic Form ◽

Novel Approaches ◽

Healthcare Associated ◽

The Impact

Healthcare-associated infections (HAIs) are caused by nosocomial pathogens. HAIs have an immense impact not only on developing countries but also on highly developed parts of world. They are predominantly device-associated infections that are caused by the planktonic form of microorganisms as well as those organized in biofilms. This review elucidates the impact of HAIs, focusing on device-associated infections such as central line-associated bloodstream infection including catheter infection, catheter-associated urinary tract infection, ventilator-associated pneumonia, and surgical site infections. The most relevant microorganisms are mentioned in terms of their frequency of infection on medical devices. Standard care bundles, conventional therapy, and novel approaches against device-associated infections are briefly mentioned as well. This review concisely summarizes relevant and up-to-date information on HAIs and HAI-associated microorganisms and also provides a description of several useful approaches for tackling HAIs.

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