Effect on the reduction of bacterial load after surgical hand antisepsis with triclosan 0.5% compared to triclosan 0.5% followed by 70% alcoholic solution

Triclosan 0.5% by scrubbing does not meet the UNE-EN12791 criteria to be used in the surgical hand preparation (SHP). Triclosan 0.5% by scrubbing followed by ethanol 70% hand rubbing is suitable without the additional characteristic of sustained effect. This limited effectiveness implies that triclosan should be avoided in SHP given the restrictions on its use in consumer antiseptic products. The trial was registered at ClinicalTrials.gov (ID: NCT04538365).

The practice of hand hygiene in the maternities of the public hospitals of Lubumbashi

Introduction: The objective of this study was to evaluate the practice of hand hygiene in the maternities of the public hospitals of Lubumbashi. Method and techniques: We carried out a cross-sectional descriptive study in which the population consisted on the one hand of the technical rooms of the maternity hospitals and the operating rooms for cesarean sections and on the other hand the nurses responsible for these maternities. The observation technique using an observation guide of the WHO model allowed us to collect the data. Results: Hand hygiene was not properly carried out in the maternity wards of Lubumbashi's public hospitals. Most of the prerequisites before hand washing and hydro-alcoholic hand rubbing were not respected, the prerequisites for surgical hand washing were observed only at 21.4%:e wearing of short-sleeved clothing (43.0%),absence of jewelry (78.6%), short nails without varnish and false nails (50.0%). In the absence of hydroalcoholic solution (SHA) (71.4%) for the friction, they used denatured alcohol (28.6%). The duration of soaping and friction was in an interval between 11 to 20 seconds or 42.9% and that of hygienic hand washing was observed at 28.6%. The duration of surgical and antiseptic hand washing was 21 to 40 seconds to 35.7%. Only 21.4% of the departments surveyed had used the broad-spectrum antiseptic foaming solution, no structure had a sterile disposable brush for hygienic and surgical hand washing, 2/14 departments surveyed had sterile disposable towels, the water used had not undergone bacteriological control and only one service, ie 7.1%, which had non-manually operated bins. Conclusion: Hand hygiene is not properly carried out in maternity hospitals in Lubumbashi's public hospitals, due to a lack of equipment and knowledge on this practice, equipment must be provided and staff trained in hand hygiene.

Hand Areas Which Are Commonly Missed during Hand Disinfection by Nursing Students Who Completed a Basic Educational Course in Hand Hygiene

Background: Teaching nursing students how to correctly perform hand hygiene procedures may guarantee a reduction in transmitting pathogens through direct contact and, thus, it may lead to a decrease in the number of hospital infections. The aim of the study, which was conducted in low fidelity simulation conditions, was to assess the performance and the efficiency of a hand-rubbing disinfection technique among nursing students on the last day of their course. Materials and methods: The study was conducted in a group of 190 nursing students studying at the Jagiellonian University and it focused on the performed hand-rubbing disinfection procedure. The accuracy of the task performance was assessed by measuring the percentage of the amount of Fluo-Rub (B. Braun) fluorescent alcohol-based gel remaining on students’ hands after disinfection. The gel was rubbed into particular hand parts including four surfaces (left palm, right palm, left back and right back) divided into thirteen areas (I–XIII) and each surface was examined separately. The results were then dichotomized based on the cut-off point of 10% and two categories: “clean” and “dirty” were established. Additionally, the range of negligence in the disinfection procedure was assessed by counting the total number of the areas classified as “dirty”. The comparison of continuous and categorical variables was conducted by means of Friedman’s and Cochrane’s tests, respectively. Results: It was found out that the palm surfaces that were commonly missed during hand disinfection included the whole thumb (I and VI), the fingertip of the little finger (V) and the midpalm (XIII), whereas in the case of back surfaces (on both right and left hand) the most commonly missed areas were the fingertips and the whole thumb I–VI. Only 30 students (13%) had all 52 areas of both hands completely clean, whereas more than one third—66 students (33%)—failed to disinfect properly more than 10 areas out of all assessed ones on the surfaces of both hands. Conclusions: In the examined group of nursing students, a significant lack of compliance with hand disinfection procedures was observed and it was related mainly to thumbs and back parts of both hands. Therefore, it is essential to conduct systematic training sessions and assessment of hand hygiene procedures for nursing students at the end of every educational stage as it can lead to their developing these skills properly.

Microbiological Assessment of the Different Hand Drying Methods and Washroom Environment Cross-Contamination

Proper hand drying is a fundamental part of the hand hygiene process looking at optimizing the elimination of potentially pathogenic microbes. This research compared the effectiveness of three different hand drying methods—paper towels, the use of warm air dryers in stationary hands position, and the use of air drying while hand rubbing—and their potential for cross-contamination of other users and the surrounding environment. One hundred sixty samples were collected from finger pads and palms, before and after drying. The outlet of the air dryers, air current emitted from the air dryers, and washroom environment air were also tested. The study reported that paper towels were more successful in eliminating bacteria and lead to less contamination to the washroom environment compared to the air dryers. The average number of bacteria obtained from volunteers using hand air dryer while hand rubbing was significantly higher than drying with air dryer while holding hands stationary. Plates exposed to the turned-off dryer for 5 minutes gave an average of only 25 colonies/plate, while plates exposed to the air outlet of the turned-on warm air dryers provided 292 colonies/plate. Placing Petri dishes at least one meter away from the dryer in the washroom for 30 minutes gave 72.5 colonies/plate. The current research also documented frequent contamination of public washroom environments and showed dissemination of potential pathogens, including Escherichia coli (E. coli), Klebsiella species, Bacillus cereus (B. cereus), Staphylococcus aureus (S. aureus), and coagulase-negative Staphylococci. Over 70.0% of Staphylococci were resistant to at least three antibiotics and 50.0% revealed coresistance to at least four antibiotics including penicillin, erythromycin, clindamycin, and co-trimoxazole. The method of hand drying may serve as a risk factor of cross-contamination from users to the environment and subsequent users and as reservoirs of drug-resistant bacteria in public washrooms.

Rancang Bangun Mesin Pengupas Kulit Lada Menggunakan Cutter Rubber Pad

Surian Subdistrict, especially in Mekarsari village, has the largest potential of pepper production in Sumedang Regency. The full potential has not been achieved due to lack of mechanization in the pepper production. Currently, the peeling process of peppercorns uses manual hand rubbing, which is inefficient and causing tiredness and skin irritation. The purpose of this research is to design and build a peppercorn peeling machine to increase productivity. The design process used Autodesk Inventor 2015 CAD software. The machine-building process comprised of design actualization, Work Preparation planning, tools and materials preparation, machining and fabrication process and test run. The result of the design is a peeling machine having dimensions (l x w x h) of 993 x 590 x 670 mm. The machine is equipped with a 5.5 HP and 3600 rpm motor drive which yields in 28 kg/hour pepper production capacity. The working principle of this machine is to grind the peppercorns in the filter and then the cutter cuts and separates the pepper seeds from its shell.Kecamatan Surian memiliki potensi penghasil lada terbesar di Kabupaten Sumedang, khususnya di Desa Mekarsari (Yosini, 2018: 105-115). Permasalahan petani lada adalah masih secara manual dalam pengupasan kulit lada. Proses yang dilakukan hanya menggunakan kedua telapak tangan dalam menggosok buah lada sehingga memerlukan waktu yang lama dan menyebabkan kelelahan dan iritasi pada kulit telapak tangan. Tujuan penelitian ini adalah merancang dan membuat mesin pengupas kulit lada agar dapat membantu petani lada dalam meningkatkan produktivitasnya. Teknik perancangan menggunakan software Autodesk Inventor 2015. Proses manufaktur dilakukan melalui tahapan pembacaan desain, pembuatan work preparation, persiapan alat dan bahan, proses manufaktur hingga uji kinerja. Hasil penelitian yaitu dihasilkan mesin pengupas kulit lada dengan dimensi panjang 993 mm, lebar 590 mm dan tinggi 670 mm dengan motor 5,5 HP dan putaran 3.600 rpm dan kapasitas 28 kg/jam. Prinsip kerja mesin ini yaitu menggiling lada yang terdapat pada filter kemudian cutter bertabrakan dengan lada sampai terpisah dengan kulitnya.

Behavioural Determinants of Hand Washing and Glove Recontamination before Aseptic Procedures at Birth: A Time-and-Motion Study and Survey in Zanzibar Labour Wards

Recent research calls for distinguishing whether the failure to comply with World Health Organisation hand hygiene guidelines is driven by omitting to rub/wash hands, or subsequently recontamination of clean hands or gloves prior to a procedure. This study examined the determinants of these two behaviours. Across the 10 highest-volume labour wards in Zanzibar, we observed 103 birth attendants across 779 hand hygiene opportunities before aseptic procedures (time-and-motion methods). They were then interviewed using a structured cross-sectional survey. We used mixed-effect multivariable logistic regressions to investigate the independent association of candidate determinants with hand rubbing/washing and avoiding glove recontamination. After controlling for confounders, we found that availability of single-use material to dry hands (OR:2.9; CI:1.58–5.14), a higher workload (OR:29.4; CI:12.9–67.0), more knowledge about hand hygiene (OR:1.89; CI:1.02–3.49), and an environment with more reminders from colleagues (OR:1.20; CI:0.98–1.46) were associated with more hand rubbing/washing. Only the length of time elapsed since donning gloves (OR:4.5; CI:2.5–8.0) was associated with avoiding glove recontamination. We identified multiple determinants of hand washing/rubbing. Only time elapsed since washing/rubbing was reliably associated with avoiding glove recontamination. In this setting, these two behaviours require different interventions. Future studies should measure them separately.