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Cai H, Garcia A, Polivka B, Spreckelmeyer K, Yang FM. Visibility and Accessibility of Hand Hygiene Stations and Fatigue Among Nurses Working in Long-Term Care (LTC) During the COVID-19 Pandemic. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:24-37. [PMID: 36691318 DOI: 10.1177/19375867221149126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Evaluate the relationship between nurses' perception of the long-term care (LTC) environment, specifically having visible and accessible hand hygiene stations (HHS), and nurses' fatigue during the COVID-19 pandemic. BACKGROUND LTC nurses experience not only heavy workloads and fatigue but also a high risk of infection during the COVID-19 pandemic. Few studies have evaluated the relationship between safety measures such as having visible and accessible HHS and nurses' fatigue. METHODS The cross-sectional COVID-19 Impact on Nurses Study (COINS) was an online survey distributed to members of the American Association of Post-Acute Care Nursing through the REDCap survey platform, between June 1, 2020, and January 31, 2021. Logistic regression modeling was conducted to identify the relationship between nurses' perception of having visible and accessible HHS and fatigue among LTC nurses. RESULTS The majority of LTC nurse respondents (78.35%) reported having moderate to very severe fatigue. Nurses who reported not having enough visible and accessible HHS in their work environment have statistically significantly higher odds (odds ratio [OR] = 0.37, 95% confidence interval [CI] [0.20, 0.70], p = .002) of reporting experiencing moderate to very severe fatigue compared to nurses who perceived there was adequate HHS. The logistic regression is significant while controlling for sociodemographic differences, guilt for family and patients, support from work, and confidence in the future of LTC. CONCLUSIONS This study reveals the LTC environment that incorporates better considerations of more visible and accessible HHS might mitigate nurses' fatigue during the pandemic. A conceptual framework has been proposed for future studies.
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Affiliation(s)
- Hui Cai
- Department of Architecture, University of Kansas, Lawrence, KS, USA
| | - Amy Garcia
- University of Kansas School of Nursing, Kansas City, KS, USA
| | - Barbara Polivka
- University of Kansas School of Nursing, Kansas City, KS, USA
| | | | - Frances M Yang
- University of Kansas School of Nursing, Kansas City, KS, USA
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Zhang N, Li Y, Huang H. Surface touch and its network growth in a graduate student office. INDOOR AIR 2018; 28:963-972. [PMID: 30178613 DOI: 10.1111/ina.12505] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 08/16/2018] [Accepted: 08/28/2018] [Indexed: 06/08/2023]
Abstract
Fomites transmit infection. A key question is how surface contamination in a building is spread by human touch. Using video cameras, we collected more than 120 000 touch actions from 60 hours of high-resolution data on surface touch across five typical weekdays in a graduate student office. The students touched surfaces with one or both hands during 94.6% of the observed period. On average, each student made five touches per minute, with an average duration of 22 seconds per touch. High-touch and high-risk surfaces and people were identified. 98.8% of the surfaces touched, such as mobile phones and human faces, were private, but public surfaces, such as a water dispenser button, were touched by 68% of the students in the office on average. Compared with females, males spent 3% more time touching surfaces. Right hands always had higher touch frequency than left hands. The surface network in the office was scale-free, whereas the hand network was small-world. The results revealed power law and logistic growth in the number of contaminated surfaces which suggests that fomite transmission can be extremely effective. The time taken for most surfaces to be contaminated after one surface became contaminated was much shorter for public than for private surfaces.
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Affiliation(s)
- Nan Zhang
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong, Hong Kong, China
| | - Hong Huang
- Institute of Public Safety Research, Department of Engineering Physics, Tsinghua University, Beijing, China
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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. Infect Control Hosp Epidemiol 2017; 38:1430-1434. [PMID: 29081301 DOI: 10.1017/ice.2017.217] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND For 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. METHODS We 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. RESULTS All 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). CONCLUSION Time 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.
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Hand Hygiene Adherence Among Health Care Workers at Japanese Hospitals: A Multicenter Observational Study in Japan. J Patient Saf 2016; 12:11-7. [PMID: 24717527 DOI: 10.1097/pts.0000000000000108] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Although proper hand hygiene among health care workers is an important component of efforts to prevent health care-associated infection, there are few data available on adherence to hand hygiene practices in Japan. OBJECTIVES The aim of this study was to examine hand hygiene adherence at teaching hospitals in Japan. METHODS An observational study was conducted from July to November 2011 in 4 units (internal medicine, surgery, intensive care, and/or emergency department) in 4 geographically diverse hospitals (1 university hospital and 3 community teaching hospitals) in Japan. Hand hygiene practice before patient contact was assessed by an external observer. RESULTS In a total of 3545 health care worker-patient observations, appropriate hand hygiene practice was performed in 677 (overall adherence, 19%; 95% confidence interval, 18%-20%). Subgroup rates of hand hygiene adherence were 15% among physicians and 23% among nurses. The ranges of adherence were 11% to 25% between hospitals and 11% to 31% between units. Adherence of the nurses and the physicians to hand hygiene was correlated within each hospital. There was a trend toward higher hand hygiene adherence in hospitals with infection control nurses, compared with hospitals without them (29% versus 16%). CONCLUSIONS The hand hygiene adherence in Japanese teaching hospitals in our sample was low, even lower than reported mean values from other international studies. Greater adherence to hand hygiene should be encouraged in Japan.
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Fukui S, Morikawa T, Hirahara M, Terada Y, Shimizu M, Takeuchi K, Takagi Y. A mild hand cleanser, alkyl ether sulphate supplemented with alkyl ether carboxylic acid and alkyl glucoside, improves eczema on the hand and prevents the growth ofStaphylococcus aureuson the skin surface. Int J Cosmet Sci 2016; 38:599-606. [DOI: 10.1111/ics.12325] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 03/23/2016] [Indexed: 11/30/2022]
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Piai-Morais TH, Fortaleza CMCB, Figueiredo RMD. Good Practices For Infection Prevention and Control at a Psychiatric Hospital in Brazil. Issues Ment Health Nurs 2015; 36:513-7. [PMID: 26309170 DOI: 10.3109/01612840.2015.1007539] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This exploratory cross-sectional study aims to investigate good practice for preventing and controlling infections in a psychiatric hospital and for limiting potential exposure to biohazards for nursing professionals at this hospital located in the State of São Paulo, Brazil. The researchers directly and systematically observed 830 nursing procedures, 40.6% of which presented a moderate to high risk of biohazard exposure. Results indicate very low adherence to hand hygiene (1.2% before procedures, 2.9% after procedures), inappropriate use of gloves, and other instances of noncompliance to the standards of good practice for preventing and controlling infection, such as a lack of concurrent/terminal cleaning of dirty beds (132 instances) and careless manipulation of sharp devices (34 instances).
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Affiliation(s)
- Thaís Helena Piai-Morais
- a Federal University of São Carlos, Nursing Graduate Program , Rodovia Washington Luís, São Carlos , São Paulo State, Brazil
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Piai-Morais TH, Orlandi FDS, Figueiredo RMD. [Factors influencing adherence to standard precautions among nursing professionals in psychiatric hospitals]. Rev Esc Enferm USP 2015; 49:478-85. [PMID: 26107709 DOI: 10.1590/s0080-623420150000300016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 02/20/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Evaluate and correlate individual, work-related and organizational factors that influence adherence to standard precautions among nursing professionals of psychiatric hospitals in São Paulo. METHOD An exploratory cross-sectional study conducted with 35 nursing professionals, using the assessment tool for adherence to standard precautions through the Likert scale, ranging from 1 to 5. RESULTS Knowledge of the precautions received a high score (4.69); adherence received (3.86) and obstacles (3.78), while intermediaries and the scales of organizational factors received low scores (2.61). There was a strong correlation between the magnitude adherence scale and the personal protective equipment availability (r = 0.643; p = 0.000). The training scale for prevention of HIV exposure (p = 0.007) was statistically different between the nurses and nursing assistants. CONCLUSION The organizational factors negatively contributed to adherence to standard precautions, indicating that psychiatric institutions lack safe working conditions, ongoing training and management actions to control infections.
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Fujita R, Iimuro S, Shinozaki T, Sakamaki K, Uemura Y, Takeuchi A, Matsuyama Y, Ohashi Y. Decreased duration of acute upper respiratory tract infections with daily intake of fermented milk: a multicenter, double-blinded, randomized comparative study in users of day care facilities for the elderly population. Am J Infect Control 2013; 41:1231-5. [PMID: 23890374 DOI: 10.1016/j.ajic.2013.04.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Revised: 04/08/2013] [Accepted: 04/10/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is insufficient evidence of preventive effect of probiotics on upper respiratory tract infections (URTIs) in an elderly population. METHODS We conducted a multicenter, double-blinded, randomized, placebo-controlled parallel group study. Elderly persons had participated who used day care at 4 facilities in Tokyo. We used fermented milks containing Lactobacillus casei strain Shirota (LcS) and placebo drinks as test drinks. RESULTS A total of 154 subjects was analyzed. The number of persons diagnosed with an acute URTIs was almost identical in both groups (LcS: 31, placebo: 32), whereas the number of acute URTIs events (LcS: 68, placebo: 51) and the symptom score (LcS: 425, placebo: 396) were both higher in the LcS group. Permutation tests performed using the total number of acute URTIs infection events/total days of observation and the total symptom score/total days of observation found no statistically significant difference respectively (P values of .89 and .64, respectively). Comparing the mean duration of infection per infection event found a shorter mean duration in the LcS group (LcS: 3.71 days, placebo: 5.40 days), and the difference was statistically significant. CONCLUSION The results suggest that fermented milk containing LcS probably reduces the duration of acute URTIs.
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Affiliation(s)
- Retsu Fujita
- Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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Ford EW, Boyer BT, Menachemi N, Huerta TR. Increasing hand washing compliance with a simple visual cue. Am J Public Health 2013; 104:1851-6. [PMID: 24228670 DOI: 10.2105/ajph.2013.301477] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We tested the efficacy of a simple, visual cue to increase hand washing with soap and water. Automated towel dispensers in 8 public bathrooms were set to present a towel either with or without activation by users. We set the 2 modes to operate alternately for 10 weeks. Wireless sensors were used to record entry into bathrooms. Towel and soap consumption rates were checked weekly. There were 97,351 hand-washing opportunities across all restrooms. Towel use was 22.6% higher (P=.05) and soap use was 13.3% higher (P=.003) when the dispenser presented the towel without user activation than when activation was required. Results showed that a visual cue can increase hand-washing compliance in public facilities.
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Affiliation(s)
- Eric W Ford
- At the time of the study, Eric W. Ford was with the Bryan School of Business and Economics, University of North Carolina at Greensboro (UNCG). Brian T. Boyer is with the Bryan School of Business and Economics, UNCG. Nir Menachemi is with the School of Public Health, University of Alabama, Birmingham. Timothy R. Huerta is with the College of Medicine, Ohio State University, Columbus
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Darawad MW, Al-Hussami M, Almhairat II, Al-Sutari M. Investigating Jordanian nurses' handwashing beliefs, attitudes, and compliance. Am J Infect Control 2012; 40:643-7. [PMID: 22245246 DOI: 10.1016/j.ajic.2011.08.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2011] [Revised: 08/29/2011] [Accepted: 08/29/2011] [Indexed: 11/27/2022]
Abstract
BACKGROUND Low rates of handwashing compliance among nurses are still reported in literature. Handwashing beliefs and attitudes were found to correlate and predict handwashing practices. However, such an important field is not fully explored in Jordan. OBJECTIVES This study aims at exploring Jordanian nurses' handwashing beliefs, attitudes, and compliance and examining the predictors of their handwashing compliance. METHODS A cross-sectional multicenter survey design was used to collect data from registered nurses and nursing assistants (N = 198) who were providing care to patients in governmental hospitals in Jordan. Data collection took place over 3 months during the period of February 2011 to April 2011 using the Handwashing Assessment Inventory. RESULTS Participants' mean score of handwashing compliance was 74.29%. They showed positive attitudes but seemed to lack knowledge concerning handwashing. Analysis revealed a 5-predictor model, which accounted for 37.5% of the variance in nurses' handwashing compliance. Nurses' beliefs relatively had the highest prediction effects (β = .309, P < .01), followed by skin assessment (β = .290, P < .01). CONCLUSION Jordanian nurses reported moderate handwashing compliance and were found to lack knowledge concerning handwashing protocols, for which education programs are recommended. This study raised the awareness regarding the importance of complying with handwashing protocols.
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Erkan T, Findik UY, Tokuc B. Hand-washing behaviour and nurses' knowledge after a training programme. Int J Nurs Pract 2011; 17:464-9. [PMID: 21939477 DOI: 10.1111/j.1440-172x.2011.01957.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this study was to evaluate the nurses' hand-washing behaviour and knowledge before and after a training programme. This prospective study involved 200 nurses who participated in hand-washing training at a university hospital in Turkey. The data were collected using a personal information form and pre- and post-test surveys that had been developed by the researchers. During the study, the nurses received 40 min of training on hand washing and a handbook prepared by the researchers. The hand-washing behaviour and knowledge of the nurses were assessed before training and 1 month after the training. To analyse the data, descriptive statistics, a t-test and a Mc Nemar chi-squared test were used. Following the training, there was a significant increase in the frequency of hand washing by the nurses (t = -2.202, P = 0.029), together with an increase in the time allowed for hand washing (P = 0.024, P < 0.05), knowledge of hand-washing practices (t = -16.081, P < 0.05) and quality (t = -10.874, P < 0.05). Planned training programmes for hand washing should be implemented to improve the behaviour and knowledge of nurses.
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Affiliation(s)
- Tulay Erkan
- Trakya University Training and Research Hospital, Edirne, Turkey
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