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Sasaoka K, Sato T, Morishita K, Hosoya K, Yokoyama N, Sato T, Horiuchi M, Takiguchi M. Antimicrobial resistance and self-reported hand hygiene awareness before and after an infection prevention and control programme: A 7-year analysis in a small animal veterinary teaching hospital. Vet J 2024; 306:106154. [PMID: 38823573 DOI: 10.1016/j.tvjl.2024.106154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 05/27/2024] [Accepted: 05/29/2024] [Indexed: 06/03/2024]
Abstract
Infection prevention and control (IPC) in veterinary medicine is crucial to protect patients, owners, staff, and the public. An IPC programme is recommended for every animal hospital. The objective of this retrospective longitudinal study was to describe the changes in bacterial and multidrug-resistant (MDR) bacterial isolates and self-reported hand hygiene awareness and practices after an IPC programme to assess the long-term effect of this programme in small animal veterinary medicine. The IPC programme was implemented at our veterinary teaching hospital in April 2018, which included the establishment of an infection control task force, regular IPC lectures and poster campaigns, infrastructure improvement, and manual refinement. Laboratory-based surveillance was retrospectively conducted before and after the programme (January 2016-December 2022). Level and slope changes in bacterial isolates were evaluated using interrupted time-series analysis. Self-reported hand hygiene awareness and practices were assessed using an annual questionnaire. Additionally, hygiene product purchases during the study period were investigated. The monthly number of total and MDR bacterial isolates decreased significantly after the programme (MDR level change: -0.426; 95% confidence interval: -0.744, -0.109; P = 0.009; and MDR slope change: -0.035; 95% confidence interval: -0.058, -0.011; P = 0.003). Additionally, awareness of hand hygiene before touching animals improved after the programme. Overall self-reported hand hygiene practices improved, and hygiene product purchases significantly increased. These results suggested that the IPC programme may have long-term effects regarding reducing total and MDR bacterial isolates and improving hand hygiene awareness in veterinary medicine.
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Affiliation(s)
- Kazuyoshi Sasaoka
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan; One Health Research Center, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Toyotaka Sato
- One Health Research Center, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan; Laboratory of Veterinary Hygiene, Graduate School of Infectious Diseases, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Keitaro Morishita
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Kenji Hosoya
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Nozomu Yokoyama
- Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Takachika Sato
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Motohiro Horiuchi
- One Health Research Center, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan; Laboratory of Veterinary Hygiene, Graduate School of Infectious Diseases, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan
| | - Mitsuyoshi Takiguchi
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan; One Health Research Center, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan; Laboratory of Veterinary Internal Medicine, Department of Veterinary Clinical Sciences, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0818, Japan.
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Boyce JM, Pittet D. Rinse, gel, and foam - is there any evidence for a difference in their effectiveness in preventing infections? Antimicrob Resist Infect Control 2024; 13:49. [PMID: 38730473 PMCID: PMC11084031 DOI: 10.1186/s13756-024-01405-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/01/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Following publication of the 2009 World Health Organizations Guidelines for Hand Hygiene in Health Care, a debate has emerged regarding the relative antimicrobial efficacy of the different formats (rinse, gel, foam) of ABHRs and their ability to contribute to reduction of healthcare-associated infections (HAIs). METHODS Data regarding the in-vivo antimicrobial efficacy of ABHRs and other factors that likely affect their effectiveness in reducing HAIs were reviewed, and a comprehensive review of studies that reported the effectiveness of each of the three ABHR formats to improve hand hygiene compliance and reduce HAIs was conducted. RESULTS The amount of rubbing time it takes for hands to feel dry (dry time) is the major driver of ABHR antimicrobial efficacy. ABHR format is not a major factor, and several studies found that rinse, gel, and foam ABHRs have comparable in-vivo antimicrobial efficacy. Other factors that likely impact the ability of ABHRs to reduce transmission of healthcare-associated pathogens and HAIs include ABHR formulation, the volume applied to hands, aesthetic characteristics, skin tolerance, acceptance by healthcare personnel, and hand hygiene compliance rates. When accompanied by complementary strategies, promoting the use of each of the three ABHR formats has been associated with improvements in hand hygiene compliance rates. A review of 67 studies failed to identify an ABHR format that was significantly more effective in yielding statistically significant reductions in transmission of healthcare-associated pathogens or HAIs. CONCLUSIONS Current evidence is insufficient to definitively determine if one ABHR format is more effective in reducing transmission of healthcare-associated pathogens and HAIs. More rigorous studies such as multicenter randomized controlled trials comparing the different formats are needed to establish if one format is significantly more effective in reducing HAIs.
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Affiliation(s)
| | - Didier Pittet
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Sopena N, Isernia V, Casas I, Díez B, Guasch I, Sabrià M, Pedro-Botet ML. Intervention to reduce the incidence of non-ventilator-associated hospital-acquired pneumonia: A pilot study. Am J Infect Control 2023; 51:1324-1328. [PMID: 37295678 DOI: 10.1016/j.ajic.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/31/2023] [Accepted: 06/03/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Our aim was to evaluate the effectiveness of an intervention to reduce the incidence of non-ventilator-associated hospital-acquired pneumonia (NV-HAP) and determine compliance with preventive measures. METHODS This was a quasi-experimental before-after study involving patients in the 53-bed Internal Medicine ward in a university hospital in Spain. The preventive measures included hand hygiene, dysphagia detection, head-of-bed elevation, withdrawal of sedatives in the event of confusion, oral care, and sterile or bottled water use. A prospective post-intervention study of the incidence of NV-HAP was carried out from February 2017 to January 2018 and compared with baseline incidence (May 2014 to April 2015). Compliance with preventive measures was analyzed with 3-point-prevalence studies (December 2015, October 2016, and June 2017). RESULTS The rate of NV-HAP decreased from 0.45 cases (95% confidence interval 0.24-0.77) in the pre-intervention period to 0.18 cases per 1,000 patient-days (95% confidence interval 0.07-0.39) in the post-intervention period (P = .07). Compliance with most preventive measures improved after intervention and remained stable over time. CONCLUSIONS The strategy improved the adherence to most of the preventive measures, with a decrease in the incidence of NV-HAP. Efforts to enhance adherence to such fundamental preventive measures are critical to lowering the incidence of NV-HAP.
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Affiliation(s)
- Nieves Sopena
- Department of Infectious Diseases, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain; Autonomous University of Barcelona, Bellaterra, Barcelona, Spain.
| | - Valentina Isernia
- Department of Infectious Diseases, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain
| | - Irma Casas
- Autonomous University of Barcelona, Bellaterra, Barcelona, Spain; Department of Preventive Medicine, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain
| | - Beatriz Díez
- Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain
| | - Ignasi Guasch
- Autonomous University of Barcelona, Bellaterra, Barcelona, Spain; Radiology Department, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain
| | - Miquel Sabrià
- Department of Infectious Diseases, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain; Autonomous University of Barcelona, Bellaterra, Barcelona, Spain
| | - María Luisa Pedro-Botet
- Department of Infectious Diseases, Germans Trias i Pujol Hospital, Badalona, Barcelona, Spain; Autonomous University of Barcelona, Bellaterra, Barcelona, Spain
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SafeHANDS: A Multimodal Hand Hygiene Intervention in a Resource-Limited Neonatal Unit. Trop Med Infect Dis 2022; 8:tropicalmed8010027. [PMID: 36668933 PMCID: PMC9867086 DOI: 10.3390/tropicalmed8010027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/28/2022] [Accepted: 12/25/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Hand hygiene (HH) is a cornerstone of programmes to prevent healthcare associated infections (HAI) globally, but HH interventions are seldom reported from African neonatal units. METHODS We conducted a quasi-experimental study evaluating the impact of a multi-modal intervention (SafeHANDS) on HH compliance rates, alcohol-based handrub (ABHR) usage, the Hand Hygiene Self-Assessment Framework (HHSAF) score, and healthcare-associated bloodstream infection (HA-BSI) rates at a 132-bed South African neonatal unit (4 wards and 1 neonatal intensive care unit [NICU]). The intervention included a campaign logo, HH training, maternal education leaflets, ABHR bottles for staff, and the setting of HH performance targets with feedback. Three 5-month study phases were completed in July 2020 (baseline), December 2020 (early) and May 2021 (intensive). RESULTS A total of 2430 HH opportunities were observed: 1002 (41.3%) at baseline, 630 (25.9%) at early and 798 (32.8%) at intensive study phases. At baseline, the overall neonatal unit HH compliance rate was 61.6%, ABHR use was 70 mL/patient day, and the baseline HHSAF score was 'basic' (165). The overall neonatal unit HH compliance rate was unchanged from baseline to intensive phases (617/1002 [61.6%] vs. 497/798 [62.3%]; p = 0.797). The ABHR use remained similar between phases (70 versus 73 mL/patient day). The HHSAF score improved to 'intermediate' level (262). There was no change in the neonatal unit HA-BSI rate. CONCLUSION Despite improvement in the HHSAF score, no improvement in overall HH compliance rates, ABHR usage, or HA-BSI rates was observed. Future HH interventions in resource-limited neonatal units should incorporate implementation science and behaviour modification strategies to better understand the barriers and facilitators of HH best practice.
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Bredin D, O'Doherty D, Hannigan A, Kingston L. Hand hygiene compliance by direct observation in physicians and nurses: a systematic review and meta-analysis. J Hosp Infect 2022; 130:20-33. [PMID: 36089071 DOI: 10.1016/j.jhin.2022.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/05/2022] [Accepted: 08/29/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Direct observation of hand hygiene compliance is the "gold standard" despite limitations and potential for bias. Previous literature highlights poorer hand hygiene compliance amongst physicians than nurses and suggests that covert monitoring may give better compliance estimates than overt monitoring. AIM This review aimed to explore differences in compliance between physicians and nurses further, and to analyse if compliance estimates differed when observations were covert rather than overt. METHODS A systematic search of databases PubMed, EMBASE, CENTRAL and CINAHL was performed. Experimental or observational studies in hospital settings in high-income countries published in English from 2010 onwards were included if estimates for both physicians and nurses using direct observation were reported. The search yielded 4814 studies, of which 105 were included. FINDINGS The weighted pooled compliance rate for nurses was 52% (95% CI 47% to 57%) and for doctors was 45% (95% CI 40% to 49%). Heterogeneity was considerable (I2=99%). The majority of studies were at moderate or high risk of bias. Random-effects meta-analysis of low risk of bias studies suggests higher compliance for nurses than physicians for both overt (difference of 7%, 95% CI for the difference 0.8% to 13.5%, p=0.027) and covert (difference of 7%, 95% CI 3% to 11%, p=0.0002) observation. Considerable heterogeneity was found in all analyses. CONCLUSION Wide variability in compliance estimates and differences in the methodological quality of hand hygiene studies were identified. Further research with meta-regression should explore sources of heterogeneity and improve the conduct and reporting of hand hygiene studies.
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Affiliation(s)
- D Bredin
- School of Medicine, University of Limerick, Ireland
| | - D O'Doherty
- School of Medicine, University of Limerick, Ireland
| | - A Hannigan
- School of Medicine, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland
| | - L Kingston
- Department of Nursing and Midwifery, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland.
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Mouajou V, Adams K, DeLisle G, Quach C. HAND HYGIENE COMPLIANCE IN THE PREVENTION OF HOSPITAL ACQUIRED INFECTIONS: A SYSTEMATIC REVIEW. J Hosp Infect 2021; 119:33-48. [PMID: 34582962 DOI: 10.1016/j.jhin.2021.09.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Healthcare worker's (HCW) hands are known to be a primary source of transmission of hospital-acquired infections (HAIs). Thus, practicing hand hygiene (HH) and adhering to HH guidelines are both expected to decrease the risk of transmission but there is no consensus on the optimal hand hygiene compliance (HHC) rate that HCWs should aim for. AIM The objective of this study was to systematically review the published literature to determine an optimal threshold of HCW HHC rate associated with the lowest incidence rate of HAIs. METHODS This systematic review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. We searched online databases using a comprehensive search criterion for randomized controlled trials and non-randomized controlled studies, investigating the impact of HCW's HHC rate on HAI rates in patients of all ages, within healthcare facilities in high income countries. FINDINGS Of the 8,093 articles citations and abstracts screened, 35 articles were included in the review. Most studies reported overall HAIs per 1000 patient-days and device-associated HAIs per 1000 device-days. Most studies reported HHC rates between 60%-70%. Lower incidence HAI rates seemed to be achieved with HHC rates of approximately 60%. Studies included were not originally designed to assess the impact of HHC on HAI rates but risk of bias was assessed as per our predetermined exposure and outcome criterion. 11 (31%) of studies were deemed at low risk of bias. CONCLUSIONS Although HHC is part of HCW's code of conduct, very high HHC rates were difficult to reach. In observational studies, HHC and HAI followed a negative relationship up to about 60%. Due to flaws in study design, causality could not be inferred; only general trends could be discussed. Given the limitations, there is a need for high-quality evidence to support the implementation of specified targets of HHC rates.
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Affiliation(s)
- V Mouajou
- Department of Microbiology, Infectious Disease and Immunology, University of Montreal, Montreal, QC, Canada
| | - K Adams
- Department of Epidemiology and Biostatistics, McGill University, Montreal, QC, Canada; Research Centre, CHU Sainte-Justine, Montreal, QC, Canada
| | - G DeLisle
- Research Centre, CHU Sainte-Justine, Montreal, QC, Canada
| | - C Quach
- Department of Microbiology, Infectious Disease and Immunology, University of Montreal, Montreal, QC, Canada; Research Centre, CHU Sainte-Justine, Montreal, QC, Canada; Infection Prevention and Control, CHU Sainte-Justine, Montreal, QC, Canada.
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High colonization by Candida parapsilosis sensu stricto on hands and surfaces in an adult intensive care unit. J Mycol Med 2021; 31:101110. [PMID: 33450538 DOI: 10.1016/j.mycmed.2020.101110] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 12/19/2020] [Accepted: 12/29/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Yeasts of the Candida parapsilosis complex have frequently been reported as agents of fungal infection in Brazil and worldwide, most of the cases are related to hospital-acquired infection. C. parapsilosis is the third most common cause of candidemia, and the hands of hospital workers as well as hospital surfaces have been suggested as possible sources. OBJECTIVES In this study we verified the frequency of C. parapsilosis on the hands of workers and on surfaces in the adult intensive care unit (AICU) of a tertiary hospital in Paraná-Brazil. METHODS Surface samples were collected with swabs moistened with saline, and a plastic bag with distilled water was used to collect samples from hands. The yeasts were identified by morphology, MALDI-TOF mass spectrometry and PCR-RFLP of the secondary alcohol dehydrogenase-encoding gene (SADH) after digestion with the restriction enzyme BanI. RESULTS AND CONCLUSIONS A total of 223 yeast were found, of which 101 (45.29%) were identified as C. parapsilosis sensu stricto. Of these, 46.66% (n=35) were found on surfaces and 44.59% (n=66) on the hands of the employees. The analysis of C. parapsilosis strains by microsatellite loci (CP1, CP4, CP6 and B5) showed 80 different genotypes. Their antifungal susceptibility profile, evaluated by the microdilution broth method, revealed that C. parapsilosis was sensitive to amphotericin B, fluconazole and voriconazole, but not to micafungin. The results revealed the heterogeneity of the yeast population, suggesting that there is no common source of contamination in the AICU of this hospital.
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Ge XY, Pu Y, Liao CH, Huang WF, Zeng Q, Zhou H, Yi B, Wang AM, Dou QY, Zhou PC, Chen HL, Liu HX, Xu DM, Chen X, Huang X. Evaluation of the exposure risk of SARS-CoV-2 in different hospital environment. SUSTAINABLE CITIES AND SOCIETY 2020; 61:102413. [PMID: 32834932 PMCID: PMC7375302 DOI: 10.1016/j.scs.2020.102413] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/16/2020] [Accepted: 07/18/2020] [Indexed: 05/03/2023]
Abstract
The ongoing coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has imposed a significant impact on social and economic activities. As a high infectious pathogen, the existence of SARS-CoV-2 in public space is very important for its transmission. During the COVID-19 pandemic, hospitals are the main places to deal with the diseases. In this work, we evaluated the exposure risk of SARS-CoV-2 in hospital environment in order to protect healthcare workers (HCWs). Briefly, air and surface samples from 6 different sites of 3 hospitals with different protection levels were collected and tested for the SARS-CoV-2 nucleic acid by reverse transcription real-time fluorescence PCR method during the COVID-19 epidemic. We found that the positive rate of SARS-CoV-2 nucleic acid was 7.7 % in a COVID-19 respiratory investigation wards and 82.6 % in a ICUs with confirmed COVID-19 patients. These results indicated that in some wards of the hospital, such as ICUs occupied by COVID-19 patients, the nucleic acid of SARS-CoV-2 existed in the air and surface, which indicates the potential occupational exposure risk of HCWs. This study has clarified retention of SARS-CoV-2 in different sites of hospital, suggesting that it is necessary to monitor and disinfect the SARS-CoV-2 in hospital environment during COVID-19 pandemic, and will help to prevent the iatrogenic infection and nosocomial transmission of SARS-CoV-2 and to better protect the HCWs.
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Affiliation(s)
- Xing-Yi Ge
- Institute of Pathogen Biology and Immunology, College of Biology, Hunan Provincial Key Laboratory of Medical Virology, Hunan University, Changsha, China
| | - Ying Pu
- Department of Hospital Infection Control Center, Xiangya Hospital of Central South University, Changsha, China
- Department of Endocrine Subspecialty of Gerontology, Xiangya Hospital of Central South University, Changsha, China
| | - Ce-Heng Liao
- Institute of Pathogen Biology and Immunology, College of Biology, Hunan Provincial Key Laboratory of Medical Virology, Hunan University, Changsha, China
| | - Wen-Fen Huang
- Department of Infectious Diseases, Chenzhou Second People's Hospital, Chenzhou, China
| | - Qi Zeng
- Department of Infectious Diseases, Shaoyang Central Hospital, Shaoyang, China
| | - Hui Zhou
- Clinical Laboratory, Xiangya Hospital of Central South University, Changsha, China
| | - Bin Yi
- Clinical Laboratory, Xiangya Hospital of Central South University, Changsha, China
| | - Ai-Min Wang
- Department of Emergency Medicine, Xiangya Hospital of Central South University, Changsha, China
| | - Qing-Ya Dou
- Department of Hospital Infection Control Center, Xiangya Hospital of Central South University, Changsha, China
| | - Peng-Cheng Zhou
- Department of Hospital Infection Control Center, Xiangya Hospital of Central South University, Changsha, China
| | - Hui-Ling Chen
- Department of Endocrine Subspecialty of Gerontology, Xiangya Hospital of Central South University, Changsha, China
| | - Hui-Xia Liu
- Department of Endocrine Subspecialty of Gerontology, Xiangya Hospital of Central South University, Changsha, China
| | - Dao-Miao Xu
- Department of Critical Care Medicine, Xiangya Hospital of Central South University, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital of Central South University, Changsha, China
| | - Xun Huang
- Department of Hospital Infection Control Center, Xiangya Hospital of Central South University, Changsha, China
- National Center for Clinical Medicine of Geriatric Diseases, Changsha, China
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Lauterbach SE, Nelson SW, Martin AM, Spurck MM, Mathys DA, Mollenkopf DF, Nolting JM, Wittum TE, Bowman AS. Adoption of recommended hand hygiene practices to limit zoonotic disease transmission at agricultural fairs. Prev Vet Med 2020; 182:105116. [PMID: 32768662 PMCID: PMC7494593 DOI: 10.1016/j.prevetmed.2020.105116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/30/2020] [Accepted: 07/30/2020] [Indexed: 11/23/2022]
Abstract
Rapid transmission and spread of infectious pathogens are enhanced by the agricultural fair environment, where large numbers of livestock and people from numerous backgrounds congregate for several days. The transmission of influenza A virus and zoonotic enteric pathogens to fairgoers is a considerable risk and has occurred several times over the past decade. In an effort to mitigate zoonotic disease transmission in these settings, public health guidelines and recommendations including hand sanitation stations have been implemented. While hand hygiene recommendations to prevent the spread of zoonotic disease are well communicated, it is hypothesized that the adoption of these recommendations by agricultural fairs and fairgoers is low. To test this hypothesis, hand hygiene data collected from 658 agricultural fairs between 2012 and 2019 was analyzed to determine frequency and function of hand sanitation stations at the fairs, as well as utilization of educational signage. In addition, an observational study was performed to calculate the proportion of fairgoers who use hand sanitation stations at the fair. Lastly, samples were taken from working hand sanitation stations present at the exits of livestock barns and tested for the presence of influenza A virus and antimicrobial resistant coliform bacteria. Hand sanitation stations were present at most fairs (77.4 %) as recommended, but only 142 out of 2021 (7.0 %) visitors were observed using the stations. Health risk signage was displayed at more than half of fairs while the proper wash procedure was displayed at less than half. No influenza A virus was detected on any of the hand sanitation stations, however antimicrobial resistant coliform bacteria were recovered from 75.5 % of the sampled hand sanitation stations. Fairs should employ educational material along with functional hand sanitation stations in order to promote hand hygiene at fairs. Stations should be maintained and cleaned often to ensure effectiveness, as hand hygiene continues to be recommended to fairgoers when exiting animal barns to reduce zoonotic disease transmission.
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Affiliation(s)
- Sarah E Lauterbach
- The Ohio State University, Department of Veterinary Preventive Medicine, 1920 Coffey Road, Columbus, OH, 43210, USA.
| | - Sarah W Nelson
- The Ohio State University, Department of Veterinary Preventive Medicine, 1920 Coffey Road, Columbus, OH, 43210, USA.
| | - Alison M Martin
- The Ohio State University, Department of Veterinary Preventive Medicine, 1920 Coffey Road, Columbus, OH, 43210, USA.
| | - Michele M Spurck
- The Ohio State University, Department of Veterinary Preventive Medicine, 1920 Coffey Road, Columbus, OH, 43210, USA.
| | - Dimitria A Mathys
- The Ohio State University, Department of Veterinary Preventive Medicine, 1920 Coffey Road, Columbus, OH, 43210, USA.
| | - Dixie F Mollenkopf
- The Ohio State University, Department of Veterinary Preventive Medicine, 1920 Coffey Road, Columbus, OH, 43210, USA.
| | - Jacqueline M Nolting
- The Ohio State University, Department of Veterinary Preventive Medicine, 1920 Coffey Road, Columbus, OH, 43210, USA.
| | - Thomas E Wittum
- The Ohio State University, Department of Veterinary Preventive Medicine, 1920 Coffey Road, Columbus, OH, 43210, USA.
| | - Andrew S Bowman
- The Ohio State University, Department of Veterinary Preventive Medicine, 1920 Coffey Road, Columbus, OH, 43210, USA.
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Barker AK, Scaria E, Safdar N, Alagoz O. Evaluation of the Cost-effectiveness of Infection Control Strategies to Reduce Hospital-Onset Clostridioides difficile Infection. JAMA Netw Open 2020; 3:e2012522. [PMID: 32789514 PMCID: PMC7426752 DOI: 10.1001/jamanetworkopen.2020.12522] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 05/25/2020] [Indexed: 12/14/2022] Open
Abstract
Importance Clostridioides difficile infection is the most common hospital-acquired infection in the United States, yet few studies have evaluated the cost-effectiveness of infection control initiatives targeting C difficile. Objective To compare the cost-effectiveness of 9 C difficile single intervention strategies and 8 multi-intervention bundles. Design, Setting, and Participants This economic evaluation was conducted in a simulated 200-bed tertiary, acute care, adult hospital. The study relied on clinical outcomes from a published agent-based simulation model of C difficile transmission. The model included 4 agent types (ie, patients, nurses, physicians, and visitors). Cost and utility estimates were derived from the literature. Interventions Daily sporicidal cleaning, terminal sporicidal cleaning, health care worker hand hygiene, patient hand hygiene, visitor hand hygiene, health care worker contact precautions, visitor contact precautions, C difficile screening at admission, and reduced intrahospital patient transfers. Main Outcomes and Measures Cost-effectiveness was evaluated from the hospital perspective and defined by 2 measures: cost per hospital-onset C difficile infection averted and cost per quality-adjusted life-year (QALY). Results In this agent-based model of a simulated 200-bed tertiary, acute care, adult hospital, 5 of 9 single intervention strategies were dominant, reducing cost, increasing QALYs, and averting hospital-onset C difficile infection compared with baseline standard hospital practices. They were daily cleaning (most cost-effective, saving $358 268 and 36.8 QALYs annually), health care worker hand hygiene, patient hand hygiene, terminal cleaning, and reducing intrahospital patient transfers. Screening at admission cost $1283/QALY, while health care worker contact precautions and visitor hand hygiene interventions cost $123 264/QALY and $5 730 987/QALY, respectively. Visitor contact precautions was dominated, with increased cost and decreased QALYs. Adding screening, health care worker hand hygiene, and patient hand hygiene sequentially to the daily cleaning intervention formed 2-pronged, 3-pronged, and 4-pronged multi-intervention bundles that cost an additional $29 616/QALY, $50 196/QALY, and $146 792/QALY, respectively. Conclusions and Relevance The findings of this study suggest that institutions should seek to streamline their infection control initiatives and prioritize a smaller number of highly cost-effective interventions. Daily sporicidal cleaning was among several cost-saving strategies that could be prioritized over minimally effective, costly strategies, such as visitor contact precautions.
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Affiliation(s)
- Anna K. Barker
- Department of Internal Medicine, University of Michigan, Ann Arbor
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin–Madison
| | - Elizabeth Scaria
- Department of Industrial and Systems Engineering, College of Engineering, University of Wisconsin–Madison
| | - Nasia Safdar
- Division of Infectious Diseases, Department of Medicine, School of Medicine and Public Health, University of Wisconsin–Madison
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
| | - Oguzhan Alagoz
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin–Madison
- Department of Industrial and Systems Engineering, College of Engineering, University of Wisconsin–Madison
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Ben Fredj S, Ben Cheikh A, Bhiri S, Ghali H, Khefacha S, Dhidah L, Merzougui L, Ben Rejeb M, Said Latiri H. Multimodal intervention program to improve hand hygiene compliance: effectiveness and challenges. J Egypt Public Health Assoc 2020; 95:11. [PMID: 32813132 PMCID: PMC7364722 DOI: 10.1186/s42506-020-00039-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 02/25/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Hand hygiene (HH) is considered the most important measure to tackle the transmission of healthcare-associated pathogens. However, compliance with recommendations is usually low and effective improvement strategies are needed. We aimed to assess the effectiveness of an intervention targeting hand hygiene promotion among healthcare workers (HCWs). METHODS We conducted a pre-post interventional study design in the university hospital Sahloul, Sousse, Tunisia, from January 2015 to December 2016. The intervention program consisted of training sessions and distribution of posters of hand hygiene guidelines. To assess the evolution of HH observance at pre- and post-intervention, the same observation form was distributed and collected at healthcare workers' workplace. RESULTS Of the 1201 and 1057 opportunities for hand hygiene observed among all categories of HCWs, overall compliance enhanced significantly from 32.1 to 39.4% (p < 0.001) respectively at pre- and post-intervention. Nurses were the most compliant with a significant improvement from 34.1 to 45.7% (p < 0.001) respectively at pre- and post-intervention. Furthermore, analysis by department showed significant improvement of compliance in orthopedic department (p < 0.001), maxillofacial-surgery department (p < 0.001), pediatrics department (p = 0.013), and emergencies (p = 0.038). CONCLUSION This study showed the feasibility and effectiveness of a health-setting-based intervention to enhance hand hygiene observance in the context of a developing country.
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Affiliation(s)
- Sihem Ben Fredj
- Department of Prevention and Care Safety, University Hospital Sahloul, 4011 Sousse, Tunisia
| | - Asma Ben Cheikh
- Department of Prevention and Care Safety, University Hospital Sahloul, 4011 Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
| | - Sana Bhiri
- Department of Prevention and Care Safety, University Hospital Sahloul, 4011 Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
| | - Hela Ghali
- Department of Prevention and Care Safety, University Hospital Sahloul, 4011 Sousse, Tunisia
| | - Salwa Khefacha
- Department of Prevention and Care Safety, University Hospital Sahloul, 4011 Sousse, Tunisia
| | - Lamine Dhidah
- Department of Prevention and Care Safety, University Hospital Sahloul, 4011 Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
| | - Latifa Merzougui
- Department of Epidemiology, University Hospital Ibn El Jazzar, 3100 Kairouan, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
| | - Mohamed Ben Rejeb
- Department of Prevention and Care Safety, University Hospital Sahloul, 4011 Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
| | - Houyem Said Latiri
- Department of Prevention and Care Safety, University Hospital Sahloul, 4011 Sousse, Tunisia
- Faculty of Medicine of Sousse, University of Sousse, 4000 Sousse, Tunisia
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Sakihama T, Kayauchi N, Kamiya T, Saint S, Fowler KE, Ratz D, Sato Y, Iuchi R, Honda H, Tokuda Y. Assessing sustainability of hand hygiene adherence 5 years after a contest-based intervention in 3 Japanese hospitals. Am J Infect Control 2020; 48:77-81. [PMID: 31345615 DOI: 10.1016/j.ajic.2019.06.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/13/2019] [Accepted: 06/14/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND Our goal was to evaluate the 5-year sustainability of a multimodal intervention that included a prize to the hospital with the highest overall hand hygiene adherence rates among health care workers. METHODS We conducted an observational study in 3 Japanese tertiary care hospitals using unobtrusive direct observation of physician and nurse hand hygiene adherence. Observations were performed by a trained observer on inpatient medical, surgical, intensive care, and emergency units. The primary outcome was hand hygiene adherence rates before patient contact. Secondary outcomes were health care worker survey responses to a World Health Organization (WHO) questionnaire on hand hygiene practices. RESULTS Hand hygiene adherence rates had improved significantly after the introduction of a multimodal intervention (based on principles recommend by the WHO) in 2012 and 2013 (from 18.0% pre-intervention to 32.7% 6 months post-intervention; P < .001). No significant changes were found in hand hygiene adherence in these hospitals 5 years after the original intervention (31.9% 5 years after intervention; P = .53); however, substantial variability in hand hygiene adherence by unit and health care worker type was noted. CONCLUSIONS A multimodal hand hygiene initiative achieved sustained improvement in hand hygiene adherence in 3 Japanese hospitals 5 years after the original intervention.
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Ackers L, Ackers-Johnson G, Welsh J, Kibombo D, Opio S. Infection Prevention Control (IPC) and Antimicrobial Resistance (AMR). ANTI-MICROBIAL RESISTANCE IN GLOBAL PERSPECTIVE 2020. [PMCID: PMC7682585 DOI: 10.1007/978-3-030-62662-4_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
This chapter outlines a key component of improved AMR; namely infection prevention control (IPC). It addresses some of the issues most commonly associated with IPC including hand hygiene, waste disposal and infrastructure. It then addresses wound management as an Infection Control issue. The emergence of wound management as a central focus in the Maternal Sepsis Intervention proved pivotal in shaping the pathway to antimicrobial stewardship.
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Pessin YJ, Matthews EP. Glow Powder: See the Germs? An Innovative Teaching Technique in a Student Sonography Laboratory. JOURNAL OF DIAGNOSTIC MEDICAL SONOGRAPHY 2019. [DOI: 10.1177/8756479319855006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this study was to compare the disinfection rate of a laboratory environment before and after glow powder exposure and training of sonography students (n = 23) and establish if glow powder was an effective teaching technique for infection protection and control (IPC). Fourteen locations at four scanning stations were contaminated with glow powder, visible under ultraviolet light. Students were shown contaminated areas and debriefed on the importance of disinfection. This activity was repeated to ascertain effectiveness of the training. In total, 204 areas were examined for contamination. Observation 1 revealed 21 locations (30.8%), and observation 2 detected glow powder on 12 locations (17.6%). Overall decrease in contamination rate was 13%. The gel bottle was the most frequently contaminated. The curved 3.5-MHz transducer was consistently cleaned. Disinfectant spray, time gain compensation, bed, stool, screen, and handles of the machine remained contaminated. Students’ IPC increased significantly after glow powder training, and secondary spread was reduced by 16%.
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Affiliation(s)
- Yosefa J. Pessin
- Department of Diagnostic Medical Imaging, College of Health Related Professions, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Eric P. Matthews
- A. T. Still University, School of Graduate Studies, Mesa, AZ, USA
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15
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Jeanes A, Coen PG, Gould DJ, Drey NS. Validity of hand hygiene compliance measurement by observation: A systematic review. Am J Infect Control 2019; 47:313-322. [PMID: 30322815 DOI: 10.1016/j.ajic.2018.08.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 08/02/2018] [Accepted: 08/02/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Hand hygiene is monitored by direct observation to improve practice, but this approach can potentially cause information, selection, and confounding bias, threatening the validity of findings. The aim of this study was to identify and describe the potential biases in hand hygiene compliance monitoring by direct observation; develop a typology of biases and propose improvements to reduce bias; and increase the validity of compliance measurements. METHODS This systematic review of hospital-based intervention studies used direct observation to monitor health care workers' hand hygiene compliance. RESULTS Seventy-one publications were eligible for review. None was free of bias. Selection bias was present in all studies through lack of data collection on the weekends (n = 61, 86%) and at night (n = 46, 65%) and observations undertaken in single-specialty settings (n = 35, 49%). We observed inconsistency of terminology, definitions of hand hygiene opportunity, criteria, tools, and descriptions of the data collection. Frequency of observation, duration, or both were not described or were unclear in 58 (82%) publications. Observers were trained in 56 (79%) studies. Inter-rater reliability was measured in 26 (37%) studies. CONCLUSIONS Published research of hand hygiene compliance measured by direct observation lacks validity. Hand hygiene should be measured using methods that produce a valid indication of performance and quality. Standardization of methodology would expedite comparison of hand hygiene compliance between clinical settings and organizations.
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Affiliation(s)
- Annette Jeanes
- Infection Control Department, University College London Hospitals, London, United Kingdom.
| | - Pietro G Coen
- Infection Division, University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | | | - Nicolas S Drey
- School of Health Sciences, Cardiff, University of London, London, United Kingdom
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Espadale E, Pinchbeck G, Williams NJ, Timofte D, McIntyre KM, Schmidt VM. Are the Hands of Veterinary Staff a Reservoir for Antimicrobial-Resistant Bacteria? A Randomized Study to Evaluate Two Hand Hygiene Rubs in a Veterinary Hospital. Microb Drug Resist 2018; 24:1607-1616. [PMID: 30332336 PMCID: PMC6306656 DOI: 10.1089/mdr.2018.0183] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Hand hygiene (HH) is the most successful intervention for hospital infection control. HH rubs with residual action are desired. This study aimed to compare the efficacy of alcohol (A-HH) and lactic acid (LA-HH) rubs, with the latter being marketed as having residual activity. We investigated reductions in bacterial colony-forming units (CFUs), prevalence of antimicrobial-resistant (AMR) organisms, and risk factors for increased counts on the hands of veterinary staff. A randomized, crossover study (53 individuals) was performed in a referral veterinary teaching hospital. Hand plates were taken before, immediately after, and 6 hours after HH. A blinded investigator counted CFUs per plate. Methicillin-resistant Staphylococcus aureus/pseudintermedius (MRSA/MRSP), Enterobacteriaceae, and Pseudomonas species (spp.) were characterized. Gender, profession, time point, and HH product were included as variables within multivariable analyses. A significant reduction in bacterial CFU was seen immediately after A-HH rub application (p < 0.001); however, neither product showed any significant residual action. Veterinarians had higher bacterial CFUs than nurses (p = 0.005); contact with patients, rather than the environment, was also associated with higher counts (p < 0.001). MRSA, MRSP, Enterobacteriaceae spp., and Pseudomonas spp. were detected on 7%, 2%, 14%, and 2% of study participant's hands (n = 208 samples), respectively. Frequent HH administration using an A-HH rub was effective at reducing bacterial CFU on hands in vivo in this veterinary hospital setting, but its use needs further encouragement in veterinary staff. The high prevalence of antimicrobial bacteria on hands is of concern; they might act as reservoirs for patients, the environment, and in-contact people.
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Affiliation(s)
- Eva Espadale
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, United Kingdom
- Address correspondence to: Eva Espadale DVM, Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Leahurst Campus, Chester High Road, Neston CH64 7TE, United Kingdom
| | - Gina Pinchbeck
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Neston, United Kingdom
| | - Nicola J. Williams
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Neston, United Kingdom
| | - Dorina Timofte
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, United Kingdom
- Department of Infection Biology, Institute of Infection and Global Health, University of Liverpool, Neston, United Kingdom
| | - K. Marie McIntyre
- Department of Epidemiology and Population Health, Institute of Infection and Global Health, University of Liverpool, Neston, United Kingdom
| | - Vanessa M. Schmidt
- Department of Small Animal Clinical Science, Institute of Veterinary Science, University of Liverpool, Neston, United Kingdom
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Barker AK, Alagoz O, Safdar N. Interventions to Reduce the Incidence of Hospital-Onset Clostridium difficile Infection: An Agent-Based Modeling Approach to Evaluate Clinical Effectiveness in Adult Acute Care Hospitals. Clin Infect Dis 2018; 66:1192-1203. [PMID: 29112710 PMCID: PMC5888988 DOI: 10.1093/cid/cix962] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 10/31/2017] [Indexed: 12/18/2022] Open
Abstract
Background Despite intensified efforts to reduce hospital-onset Clostridium difficile infection (HO-CDI), its clinical and economic impacts continue to worsen. Many institutions have adopted bundled interventions that vary considerably in composition, strength of evidence, and effectiveness. Considerable gaps remain in our knowledge of intervention effectiveness and disease transmission, which hinders HO-CDI prevention. Methods We developed an agent-based model of C. difficile transmission in a 200-bed adult hospital using studies from the literature, supplemented with primary data collection. The model includes an environmental component and 4 distinct agent types: patients, visitors, nurses, and physicians. We used the model to evaluate the comparative clinical effectiveness of 9 single interventions and 8 multiple-intervention bundles at reducing HO-CDI and asymptomatic C. difficile colonization. Results Daily cleaning with sporicidal disinfectant and C. difficile screening at admission were the most effective single-intervention strategies, reducing HO-CDI by 68.9% and 35.7%, respectively (both P < .001). Combining these interventions into a 2-intervention bundle reduced HO-CDI by 82.3% and asymptomatic hospital-onset colonization by 90.6% (both, P < .001). Adding patient hand hygiene to healthcare worker hand hygiene reduced HO-CDI rates an additional 7.9%. Visitor hand hygiene and contact precaution interventions did not reduce HO-CDI, compared with baseline. Excluding those strategies, healthcare worker contact precautions were the least effective intervention at reducing hospital-onset colonization and infection. Conclusions Identifying and managing the vast hospital reservoir of asymptomatic C. difficile by screening and daily cleaning with sporicidal disinfectant are high-yield strategies. These findings provide much-needed data regarding which interventions to prioritize for optimal C. difficile control.
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Affiliation(s)
- Anna K Barker
- Department of Population Health Sciences, School of Medicine and Public Health, Madison, Wisconsin
| | - Oguzhan Alagoz
- Department of Population Health Sciences, School of Medicine and Public Health, Madison, Wisconsin
- Department of Industrial and Systems Engineering, College of Engineering, Madison, Wisconsin
| | - Nasia Safdar
- Division of Infectious Diseases, Department of Medicine, School of Medicine and Public Health, University of Wisconsin–Madison, Madison, Wisconsin
- William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
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Ojo OO, Ojo O. Assessing students' knowledge of healthcare-associated infections: a global perspective. ACTA ACUST UNITED AC 2017; 26:1121-1126. [PMID: 29125365 DOI: 10.12968/bjon.2017.26.20.1121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of this review was to explore students' knowledge of healthcare-associated infections (HCAIs) from a global perspective. HCAIs may be the result of treatment in or contact with healthcare or social care settings and have been shown to cause an increase in morbidity, mortality and increased length of hospital stay. Student placements may involve interactions between university students, patients and/or health professionals and this may be a source of cross-contamination of the microbial agents that cause HCAIs. This situation may be exacerbated in some countries owing to variations in the levels of infrastructure development, knowledge, and economic status. A literature search was carried out, resulting in 12 studies selected for review. Findings were organised into two themes: nursing students' knowledge of HCAIs and students in other health-related subjects' knowledge of HCAIs. Nursing students' knowledge was adequate in some aspects of HCAIs, although poor in certain areas. Knowledge of HCAIs varied between students studying different health-related subjects. Curriculum differences between the student groups may account for this variation. A review of the curricula for healthcare students should ensure they include training and practical skills in the prevention of HCAIs, including modes of disease transmission, handwashing and disinfection techniques.
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Affiliation(s)
| | - Omorogieva Ojo
- Senior Lecturer in Primary Care, Faculty of Education and Health, University of Greenwich, London
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19
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Al Kuwaiti A. Impact of a multicomponent hand hygiene intervention strategy in reducing infection rates at a university hospital in Saudi Arabia. Interv Med Appl Sci 2017; 9:137-143. [PMID: 29201437 PMCID: PMC5700699 DOI: 10.1556/1646.9.2017.24] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 06/08/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS Few studies have reported the correlation between hand hygiene (HH) practices and infection rates in Saudi Arabia. This work was aimed to study the effect of a multicomponent HH intervention strategy in improving HH compliance and reducing infection rates at King Fahd Hospital of the University, Al-Khobar, Saudi Arabia between January 2014 and December 2016. METHODS A yearlong multicomponent HH intervention, which included various strategies recommended by the World Health Organization, was introduced. HH compliance among staff and infection rates observed in the inpatient wards were assessed and compared at pre- and post-interventional phases. RESULTS There was a significant increase in mean HH compliance from 50.17% to 71.75% after the intervention (P < 0.05). Hospital-acquired infection (HAI) and catheter-associated urinary tract infection (CAUTI) rates decreased from 3.37 to 2.59 and from 3.73 to 1.75, respectively (P < 0.05). HH compliance was found to be negatively correlated with HAI (r = -0.278) and CAUTI (r = -0.523) rates. CONCLUSIONS Results show that multicomponent intervention is effective in improving HH compliance, and that an increase in HH compliance among hospital staff decreases infection rates. Further studies on cost-effectiveness of such a model could augment to these findings.
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Affiliation(s)
- Ahmed Al Kuwaiti
- Deanship of Quality and Academic Accreditation, Imam Abdulrahman Bin Faisal University (Formerly University of Dammam), Al-Khobar, Kingdom of Saudi Arabia
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20
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Yallew WW, Kumie A, Yehuala FM. Risk factors for hospital-acquired infections in teaching hospitals of Amhara regional state, Ethiopia: A matched-case control study. PLoS One 2017; 12:e0181145. [PMID: 28719665 PMCID: PMC5515417 DOI: 10.1371/journal.pone.0181145] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 06/26/2017] [Indexed: 12/29/2022] Open
Abstract
Background Hospital-acquired infection affects hundreds of millions of people worldwide. It is a major global issue for patient safety. Understanding the potential risk factors is important to appreciate the local context. A matched case control study design, which is the first of its kind in the study region, was undertaken to identify risk factors in teaching hospitals of Amhara regional state, Ethiopia. Method A matched case control study design matched with age and hospital type was used. The study was conducted in University of Gondar and Felege-Hiwot medical teaching hospital. Cases were patients who fulfilled the criteria based on CDC definition of hospital-acquired infection and controls were patients admitted to the hospital that stayed for more than 48 hours in the ward in the study period, but who did not develop infection. For one case, four controls were selected. Of 545 patients, 109 were cases and 436 were controls. Conditional logistic regression using STATA 13 was used for data analysis. Result The median length of stay for cases and controls was 7 and 8 days, respectively. Patients admitted in wards with the presence of medical waste container in the room had 82% less chance of developing hospital-acquired infection (AOR 0.18; 95% CI, 0.03–0.98). The odds of developing hospital-acquired infection among immune deficient patients were 2.34 times higher than their counterparts (95% CI; 1.17–4.69). Patients received antimicrobials, central vascular catheter and surgery since admission had 8.63, 6.91 and 2.35 higher odds of developing hospital-acquired infection, respectively. Conclusion Health providers and mangers should consider the provision and availability of healthcare materials and facilities in all of the ward rooms, follow appropriate safe medical procedures for use of external devices on patients, and give attention to the immunocompromised patients for the prevention and control of hospital-acquired infections.
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Affiliation(s)
- Walelegn Worku Yallew
- Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Abera Kumie
- School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Feleke Moges Yehuala
- Department of Medical Microbiology, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Shek K, Patidar R, Kohja Z, Liu S, Gawaziuk JP, Gawthrop M, Kumar A, Logsetty S. Rate of contamination of hospital privacy curtains on a burns and plastic surgery ward: a cross-sectional study. J Hosp Infect 2017; 96:54-58. [PMID: 28413115 DOI: 10.1016/j.jhin.2017.03.012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 03/09/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Surfaces in the patient environment may play a role in microbial transmission if they become colonized by bacteria. Patient privacy curtains are one such surface that may pose a high risk for transmission because they are high-contact surfaces, are infrequently cleaned, and healthcare workers are less likely to wash their hands after contacting inanimate objects such as curtains. AIM To determine the amount and type of bacterial colonization of patient privacy curtains at a regional burns/plastic surgery unit. METHODS Privacy curtain contamination on the burns/plastic surgery ward was determined for two separate occasions six months apart: 23 curtains on August 2015 and 26 curtains on January 2016. Dey-Engley neutralizing agar (DENA) replicate organism detection and counting (RODAC) contact plates were used daily to sample curtains near the edge hem where they are most frequently touched. Microbial contamination was reported as cfu/cm2 and the presence of meticillin-resistant Staphylococcus aureus (MRSA) was determined. Swabs were also taken of any open wounds and from tracheostomy sites on the ward. FINDINGS Curtain contamination in August 2015 was 0.7-4.7 cfu/cm2 with 22% testing positive for MRSA, whereas contamination on January 2016 was 0.6-13.3 cfu/cm2 with 31% of curtains testing positive for MRSA. CONCLUSION Curtains on the burns/plastic surgery ward become colonized with significant quantities of bacteria. Future studies will need to address the rate of colonization and the clinical impact of this colonization to better inform cleaning protocols.
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Affiliation(s)
- K Shek
- College of Medicine, BSc Med Research Program, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - R Patidar
- Department of Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Z Kohja
- College of Medicine, BSc Med Research Program, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - S Liu
- Department of Biosystems Engineering, Faculty of Agricultural and Food Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - J P Gawaziuk
- Manitoba Firefighter's Burn Unit, Health Sciences Centre, Winnipeg, Manitoba, Canada
| | - M Gawthrop
- Manitoba Firefighter's Burn Unit, Health Sciences Centre, Winnipeg, Manitoba, Canada
| | - A Kumar
- Department of Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - S Logsetty
- Manitoba Firefighter's Burn Unit, Health Sciences Centre, Winnipeg, Manitoba, Canada; Department of Surgery and Children's Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
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Sopjani I, Jahn P, Behrens J. Training as an Effective Tool to Increase the Knowledge About Hand Hygiene Actions. An Evaluation Study of Training Effectiveness in Kosovo. Med Arch 2017; 71:16-19. [PMID: 28428667 PMCID: PMC5364797 DOI: 10.5455/medarh.2017.71.16-19] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: Hand hygiene (HH) compliance with World Health Organization (WHO) guidelines is essential to prevent bacterial transmission and infections acquired from hospital settings. Aim: The aim of this study was to evaluate the impact of training tool of World Health Organization’s (WHOs) Hand Hygiene multi modal campaign at all public hospitals and at the University Clinical Center in Kosovo (UCCK). Method: During February 2016, 691 questionnaires were distributed to health care workers. The data collection was conducted through a questionnaire distributed before and after training. Measurement of questions was realized through a 5 point Likert scale. Results: The gender structure of participants turned out to be greater for women (n=571, 85%). The knowledge of health care workers differed significantly before and after the training (p<0.001), emphasizing that the impact of the training was important to improve the knowledge of participants. Thus, the average value of improvement of HCW’ knowledge was about 41.66 %. Conclusion: The findings emphasized the role of the training to improve the knowledge of participants about hand hygiene as well as prevention from infection.
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Use of ventilator utilization ratio for stratifying alcohol-based hand-rub consumption data to improve surveillance on intensive care units. J Hosp Infect 2016; 95:185-188. [PMID: 27887755 DOI: 10.1016/j.jhin.2016.10.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 10/26/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Germany has established a nationwide surveillance system of alcohol-based hand-rub consumption (AHC) per patient-day in hospital settings as a surrogate parameter for hand hygiene (HH) compliance. Analysis of AHC data in intensive care units (ICUs) shows not only a wide range of consumption between units of different specialties, but also within units of one specialty. This seems to reflect variation in the number of HH opportunities per patient-day between ICUs due to variation in complexity of care. AIM To investigate whether ventilator utilization ratio (VUR) might be a good surrogate for describing complexity and intensity of care on ICUs and whether stratification by VUR works as a new method of setting benchmarks for AHC data. METHODS Data from 365 ICUs participating in the German national nosocomial infection surveillance system (KISS) were used. VUR was calculated by dividing the number of ventilator-days per unit by the number of patient-days per unit. AHC was stratified according to VUR in quartiles. FINDINGS The median AHC was 107mL/patient-day [interquartile range (IQR): 86-134] and the median VUR was 33% (IQR: 22-45%). The Spearman rank correlation coefficient was 0.28 (P<0.0001). After stratifying AHC according to VUR, the AHC in quartile I was significantly lower compared to quartile IV. There was also significant difference between quartile I and quartiles II and III. CONCLUSION Stratification of AHC data according to VUR is suggested to improve the quality of benchmark parameters based on AHC data as surrogate parameter for HH compliance in ICUs.
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Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene. Infect Control Hosp Epidemiol 2016; 35 Suppl 2:S155-78. [DOI: 10.1017/s0899823x00193900] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Previously published guidelines provide comprehensive recommendations for hand hygiene in healthcare facilities. The intent of this document is to highlight practical recommendations in a concise format, update recommendations with the most current scientific evidence, and elucidate topics that warrant clarification or more robust research. Additionally, this document is designed to assist healthcare facilities in implementing hand hygiene adherence improvement programs, including efforts to optimize hand hygiene product use, monitor and report back hand hygiene adherence data, and promote behavior change. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.
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Assessment of Fidelity in Interventions to Improve Hand Hygiene of Healthcare Workers: A Systematic Review. Infect Control Hosp Epidemiol 2016; 37:567-75. [PMID: 26861117 DOI: 10.1017/ice.2015.341] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Compliance with hand hygiene in healthcare workers is fundamental to infection prevention yet remains a challenge to sustain. We examined fidelity reporting in interventions to improve hand hygiene compliance, and we assessed 5 measures of intervention fidelity: (1) adherence, (2) exposure or dose, (3) quality of intervention delivery, (4) participant responsiveness, and (5) program differentiation. DESIGN Systematic review METHODS A librarian performed searches of the literature in PubMed, Cumulative Index to Nursing and Allied Health (CINAHL), Cochrane Library, and Web of Science of material published prior to June 19, 2015. The review protocol was registered in PROSPERO International Prospective Register of Systematic Reviews, and assessment of study quality was conducted for each study reviewed. RESULTS A total of 100 studies met the inclusion criteria. Only 8 of these 100 studies reported all 5 measures of intervention fidelity. In addition, 39 of 100 (39%) failed to include at least 3 fidelity measures; 20 of 100 (20%) failed to include 4 measures; 17 of 100 (17%) failed to include 2 measures, while 16 of 100 (16%) of the studies failed to include at least 1 measure of fidelity. Participant responsiveness and adherence to the intervention were the most frequently unreported fidelity measures, while quality of the delivery was the most frequently reported measure. CONCLUSIONS Almost all hand hygiene intervention studies failed to report at least 1 fidelity measurement. To facilitate replication and effective implementation, reporting fidelity should be standard practice when describing results of complex behavioral interventions such as hand hygiene.
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Sopena-Galindo N, Hornero-Lopez A, Freixas-Sala N, Bella-Cueto F, Pérez-Jové J, Limon-Cáceres E, Gudiol-Munté F. [Survey of methicillin-resistant Staphylococcus aureus control measures in hospitals participating in the VINCat program]. Enferm Infecc Microbiol Clin 2015; 34:409-14. [PMID: 26589755 DOI: 10.1016/j.eimc.2015.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 09/24/2015] [Accepted: 09/28/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION VINCat is a nosocomial infection surveillance program in hospitals in Catalonia. The aim of the study was to determine the surveillance and control measures of methicillin-resistant Staphylococcus aureus (MRSA) in these centres. METHODS An e-mail survey was carried out from January to March 2013 with questions related to the characteristics of the hospitals and their control measures for MRSA. RESULTS A response was received from 53 hospitals (>500 beds: 7; 200-500 beds: 14;<200 beds: 32; had ICU: 29). Computer alert of readmissions was available in 63%. There was active surveillance of patients admitted from another hospital (46.2%) or a long-term-care centre (55.8%), both being significantly more common measures in hospitals with a rate of MRSA≤22% (global median). Compliance with hand hygiene was observed in 77.4% of the centres, and was greater than 50% in 69.7% of them. All hospitals had contact precautions, although 62.3% did not have exclusive frequently used clinical material in bedrooms. The room cleaning was performed more frequently in 54.7% of hospitals, and 67.9% of them had programs for the appropriate use of antibiotics. CONCLUSIONS This study provides information on the implementation of measures to prevent MRSA in hospitals participating in the VINCat program. Most of the centres have an MRSA protocol, however compliance with it should be improved, especially in areas such as active detection on admission in patients at risk, hand hygiene adherence, cleaning frequency and optimising the use of antibiotics.
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Affiliation(s)
- Nieves Sopena-Galindo
- Control de Infección Nosocomial, Hospital Germans Trias i Pujol, Badalona, Barcelona, España.
| | - Anna Hornero-Lopez
- Control de Infección Nosocomial, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - Núria Freixas-Sala
- Control de Infección, Hospital Universitari Mútua Terrassa, Terrassa, Barcelona, España
| | - Feliu Bella-Cueto
- Servicio de Medicina Interna, Consorci Sanitari de Terrassa, Terrassa, Barcelona, España
| | - Josefa Pérez-Jové
- Microbiología, CatLab, Parc Logístic de Salut, Viladecavalls, Barcelona, España
| | - Enric Limon-Cáceres
- Centro Coordinador Programa VINCat, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
| | - Francesc Gudiol-Munté
- Servicio de Enfermedades Infecciosas, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España
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Increase in hospital purchase of hand hygiene products: The importance of focusing on the right product. Am J Infect Control 2015; 43:765-6. [PMID: 25920704 DOI: 10.1016/j.ajic.2015.02.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 02/25/2015] [Accepted: 02/26/2015] [Indexed: 11/23/2022]
Abstract
Alcohol-based handrub (AHR) consumption is positively correlated with increases in hand hygiene (HH) compliance. In our 2,000-bed hospital in India, multiple awareness drives have been conducted to promote HH. This study aimed to determine the quantitative effect of these campaigns on use of HH products (soap and AHR) in the hospital. Over the last 6 years, bar soap consumption has increased by 389.15%, whereas that of AHR increased by 146.7%. We also evaluated microbial contamination of 99 bar soap and 60 liquid soap samples in our hospital for a year. Of the samples, 61 (61.6%) of the bar soaps and 2 (3.3%) of the liquid soaps were found to be contaminated with various organisms (P < .0002). To conclude, the focus should be to increase the right kind of HH product so that hospitals in developing countries procure liquid soaps instead of bar soaps for handwashing purposes.
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Ellingson K, Haas JP, Aiello AE, Kusek L, Maragakis LL, Olmsted RN, Perencevich E, Polgreen PM, Schweizer ML, Trexler P, VanAmringe M, Yokoe DS. Strategies to prevent healthcare-associated infections through hand hygiene. Infect Control Hosp Epidemiol 2015; 35:937-60. [PMID: 25026608 DOI: 10.1086/677145] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Previously published guidelines provide comprehensive recommendations for hand hygiene in healthcare facilities. The intent of this document is to highlight practical recommendations in a concise format, update recommendations with the most current scientific evidence, and elucidate topics that warrant clarification or more robust research. Additionally, this document is designed to assist healthcare facilities in implementing hand hygiene adherence improvement programs, including efforts to optimize hand hygiene product use, monitor and report back hand hygiene adherence data, and promote behavior change. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.
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Puhto T, Syrjälä H. Incidence of healthcare-associated infections in a tertiary care hospital: results from a three-year period of electronic surveillance. J Hosp Infect 2015; 90:46-51. [DOI: 10.1016/j.jhin.2014.12.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Accepted: 12/30/2014] [Indexed: 02/06/2023]
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Lambertini E, Buchanan RL, Narrod C, Pradhan AK. Transmission of Bacterial Zoonotic Pathogens between Pets and Humans: The Role of Pet Food. Crit Rev Food Sci Nutr 2015; 56:364-418. [DOI: 10.1080/10408398.2014.902356] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Ye D, Shan J, Huang Y, Li J, Li C, Liu X, He W, Li Y, Mao P. A gloves-associated outbreak of imipenem-resistant Acinetobacter baumannii in an intensive care unit in Guangdong, China. BMC Infect Dis 2015; 15:179. [PMID: 25886493 PMCID: PMC4415246 DOI: 10.1186/s12879-015-0917-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 03/31/2015] [Indexed: 11/17/2022] Open
Abstract
Background Imipenem-resistant Acinetobacter baumannii (IRAB) is an important cause of hospital-acquired infection. We aimed to describe an outbreak of IRAB infection and to investigate its possible source in an intensive care unit. Methods An environmental investigation was undertaken. Antimicrobial susceptibility testing was performed by microdilution. These isolates were genotyped by use of repetitive extragenic palindromic polymerase chain reaction (rep-PCR; DiversiLab). The study included 11 patients infected with IRAB and 14 control patients free of IRAB. Case and control patients were compared for possible predisposing factors. A multifaceted intervention was implemented to control the outbreak. Results Thirty-nine IRABs were isolated from patients and the environmental surveillance culture in August, November, and December 2011. All isolates were resistant to imipenem. The IRAB strains belonged to seven clones (A–G) by the use of rep-PCR. There were four epidemic clones (D–G) in the outbreak, and Clone D was predominant. For the case–control study, patients with chronic obstructive pulmonary disease were susceptible to infection with IRAB. The hospital mortality of the case group was significantly higher than that of the control group. Conclusions The outbreak strains were transmitted among infected patients and equipment by inappropriate use of gloves. A combination of aggressive infection control measures is essential for preventing recurrent nosocomial outbreaks of IRAB.
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Affiliation(s)
- Dan Ye
- Department of Infection Control, The First Affiliated Hospital of Guangzhou medical university, Guangzhou, Guangdong, 510120, China.
| | - Jinglan Shan
- Department of Infection Control, The First Affiliated Hospital of Guangzhou medical university, Guangzhou, Guangdong, 510120, China.
| | - Yongbo Huang
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou medical university, Guangzhou, Guangdong, 510120, China. .,Intensive Care Unit, The First Affiliated Hospital of Guangzhou medical university, Guangzhou, Guangdong, 510120, China.
| | - Jianchun Li
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou medical university, Guangzhou, Guangdong, 510120, China. .,Intensive Care Unit, The First Affiliated Hospital of Guangzhou medical university, Guangzhou, Guangdong, 510120, China.
| | - Changan Li
- Department of Infection Control, The First Affiliated Hospital of Guangzhou medical university, Guangzhou, Guangdong, 510120, China.
| | - Xiaoqing Liu
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou medical university, Guangzhou, Guangdong, 510120, China. .,Intensive Care Unit, The First Affiliated Hospital of Guangzhou medical university, Guangzhou, Guangdong, 510120, China.
| | - Weiqun He
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou medical university, Guangzhou, Guangdong, 510120, China. .,Intensive Care Unit, The First Affiliated Hospital of Guangzhou medical university, Guangzhou, Guangdong, 510120, China.
| | - Yimin Li
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou medical university, Guangzhou, Guangdong, 510120, China. .,Intensive Care Unit, The First Affiliated Hospital of Guangzhou medical university, Guangzhou, Guangdong, 510120, China.
| | - Pu Mao
- State Key Laboratory of Respiratory Disease, The First Affiliated Hospital of Guangzhou medical university, Guangzhou, Guangdong, 510120, China.
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Moura ML, Fenley JC, Baraldi MM, Boszczowski Í. Translational Research in Hand Hygiene Compliance. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2015. [DOI: 10.1007/s40506-015-0041-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Ellingson K, Haas JP, Aiello AE, Kusek L, Maragakis LL, Olmsted RN, Perencevich E, Polgreen PM, Schweizer ML, Trexler P, VanAmringe M, Yokoe DS. Strategies to Prevent Healthcare-Associated Infections through Hand Hygiene. Infect Control Hosp Epidemiol 2015. [DOI: 10.1086/651677] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Previously published guidelines provide comprehensive recommendations for hand hygiene in healthcare facilities. The intent of this document is to highlight practical recommendations in a concise format, update recommendations with the most current scientific evidence, and elucidate topics that warrant clarification or more robust research. Additionally, this document is designed to assist healthcare facilities in implementing hand hygiene adherence improvement programs, including efforts to optimize hand hygiene product use, monitor and report back hand hygiene adherence data, and promote behavior change. This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA) and is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the American Hospital Association (AHA), the Association for Professionals in Infection Control and Epidemiology (APIC), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise. The list of endorsing and supporting organizations is presented in the introduction to the 2014 updates.
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Schweizer ML, Reisinger HS, Ohl M, Formanek MB, Blevins A, Ward MA, Perencevich EN. Searching for an Optimal Hand Hygiene Bundle: A Meta-analysis. Clin Infect Dis 2013; 58:248-59. [DOI: 10.1093/cid/cit670] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Monistrol O, López ML, Riera M, Font R, Nicolás C, Escobar MA, Freixas N, Garau J, Calbo E. Hand contamination during routine care in medical wards: the role of hand hygiene compliance. J Med Microbiol 2013; 62:623-629. [DOI: 10.1099/jmm.0.050328-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- Olga Monistrol
- Nosocomial Infection Control and Service of Internal Medicine, Hospital Universitari MútuaTerrassa, Plaça Dr Robert 08221 Terrassa, Barcelona, Spain
| | - M. Liboria López
- Catlab, Parc Logístic de Salut, Vial de Sant Jordi s/n Viladecavalls, Barcelona, Spain
| | - Montserrat Riera
- Nosocomial Infection Control and Service of Internal Medicine, Hospital Universitari MútuaTerrassa, Plaça Dr Robert 08221 Terrassa, Barcelona, Spain
| | - Roser Font
- Nosocomial Infection Control and Service of Internal Medicine, Hospital Universitari MútuaTerrassa, Plaça Dr Robert 08221 Terrassa, Barcelona, Spain
| | - Carme Nicolás
- Nosocomial Infection Control and Service of Internal Medicine, Hospital Universitari MútuaTerrassa, Plaça Dr Robert 08221 Terrassa, Barcelona, Spain
| | - Miguel Angel Escobar
- Nursing Faculty, Campus de Ciències de la Salut, University of Lleida, Avinguda de l’Alcalde Rovira Roure, 44, E-25198 Lleida, Spain
| | - Núria Freixas
- Nosocomial Infection Control and Service of Internal Medicine, Hospital Universitari MútuaTerrassa, Plaça Dr Robert 08221 Terrassa, Barcelona, Spain
| | - Javier Garau
- Nosocomial Infection Control and Service of Internal Medicine, Hospital Universitari MútuaTerrassa, Plaça Dr Robert 08221 Terrassa, Barcelona, Spain
| | - Esther Calbo
- Campus Sant Cugat, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
- Nosocomial Infection Control and Service of Internal Medicine, Hospital Universitari MútuaTerrassa, Plaça Dr Robert 08221 Terrassa, Barcelona, Spain
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Hand hygiene and healthcare system change within multi-modal promotion: a narrative review. J Hosp Infect 2013; 83 Suppl 1:S3-10. [DOI: 10.1016/s0195-6701(13)60003-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Sopena Galindo N. [Hand hygiene for a safer care]. Med Clin (Barc) 2012; 138:663-5. [PMID: 22459576 DOI: 10.1016/j.medcli.2012.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 02/02/2012] [Indexed: 10/28/2022]
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