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Chew A, Tan SY, Chandran R, Tang MM, Poulose V, Punithavathi A, Ang WB, Tee A. Spreading of hand hygiene change package across an acute hospital. BMJ Open Qual 2025; 14:e003220. [PMID: 40187747 PMCID: PMC11973750 DOI: 10.1136/bmjoq-2024-003220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2024] [Accepted: 03/16/2025] [Indexed: 04/07/2025] Open
Abstract
BACKGROUND A set of interventions in a hand hygiene change package was developed in a pilot ward by the end of 2017. In 2018, Changi General Hospital embarked on scaling up the change package to other wards with the intention to eventually spread the hand hygiene change package hospital-wide. METHODS Changi General Hospital conducted a quality improvement project on hand hygiene with the intention to effect organisation-wide improvement in hand hygiene. Spread methodologies such as the Institute for Healthcare Improvement's framework for Spread and various complementary spread concepts such as having an organisational strategy, which plans for spread as early as possible, and addressing social aspects of change were applied in order to scale up and spread a change package. SETTING A general tertiary care hospital in Singapore. RESULTS Overall hospital-wide hand hygiene compliance improved from a median of 66% during the pilot phase to 73% in the scale-up phase (p<0.05) to 82% during the spread phase (p<0.05). CONCLUSIONS A systematic approach to hand hygiene improvement based on spread literature successfully improved and sustained hospital-wide hand hygiene compliance. Success factors included the development of a change package that had clear guiding principles, with the intent to create proactive learning cycles within units which could be adapted to work in various contexts.
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Affiliation(s)
- Alvin Chew
- Office of Improvement Science, Changi General Hospital, Singapore
| | - Seow Yen Tan
- Infectious Diseases, Changi General Hospital, Singapore
| | - Rajkumar Chandran
- Anaesthesia & Surgical Intensive Care, Changi General Hospital, Singapore
| | - Mui Mui Tang
- Radiology Clinic, Changi General Hospital, Singapore
| | - Vijo Poulose
- Respiratory & Critical Care Medicine, Changi General Hospital, Singapore
| | - A Punithavathi
- Nursing Administration, Changi General Hospital, Singapore
| | - Woo Boon Ang
- Office of Improvement Science, Changi General Hospital, Singapore
| | - Augustine Tee
- Division of Medicine, Changi General Hospital, Singapore
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Provenzano DA, Hanes M, Hunt C, Benzon HT, Grider JS, Cawcutt K, Doshi TL, Hayek S, Hoelzer B, Johnson RL, Kalagara H, Kopp S, Loftus RW, Macfarlane AJR, Nagpal AS, Neuman SA, Pawa A, Pearson ACS, Pilitsis J, Sivanesan E, Sondekoppam RV, Van Zundert J, Narouze S. ASRA Pain Medicine consensus practice infection control guidelines for regional anesthesia and pain medicine. Reg Anesth Pain Med 2025:rapm-2024-105651. [PMID: 39837579 DOI: 10.1136/rapm-2024-105651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/27/2024] [Indexed: 01/23/2025]
Abstract
BACKGROUND To provide recommendations on risk mitigation, diagnosis and treatment of infectious complications associated with the practice of regional anesthesia, acute and chronic pain management. METHODS Following board approval, in 2020 the American Society of Regional Anesthesia and Pain Medicine (ASRA Pain Medicine) commissioned evidence-based guidelines for best practices for infection control. More than 80 research questions were developed and literature searches undertaken by assigned working groups comprising four to five members. Modified US Preventive Services Task Force criteria were used to determine levels of evidence and certainty. Using a modified Delphi method, >50% agreement was needed to accept a recommendation for author review, and >75% agreement for a recommendation to be accepted. The ASRA Pain Medicine Board of Directors reviewed and approved the final guidelines. RESULTS After documenting the incidence and infectious complications associated with regional anesthesia and interventional pain procedures including implanted devices, we made recommendations regarding the role of the anesthesiologist and pain physician in infection control, preoperative patient risk factors and management, sterile technique, equipment use and maintenance, healthcare setting (office, hospital, operating room), surgical technique, postoperative risk reduction, and infection symptoms, diagnosis, and treatment. Consensus recommendations were based on risks associated with different settings and procedures, and keeping in mind each patient's unique characteristics. CONCLUSIONS The recommendations are intended to be multidisciplinary guidelines for clinical care and clinical decision-making in the regional anesthesia and chronic interventional pain practice. The issues addressed are constantly evolving, therefore, consistent updating will be required.
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Affiliation(s)
| | - Michael Hanes
- Jax Spine and Pain Centers, Jacksonville, Florida, USA
| | - Christine Hunt
- Anesthesiology-Pain Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Honorio T Benzon
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Division of Pain Medicine, Northwestern Memorial Hospital, Chicago, Illinois, USA
| | - Jay S Grider
- Department of Anesthesiology, University of Kentucky, Lexington, Kentucky, USA
| | - Kelly Cawcutt
- Division of Infectious Diseases and Pulmonary & Critical Care Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Tina L Doshi
- Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Division of Pain Medicine, John Hopkins University, Baltimore, Maryland, USA
- Department of Neurosurgery, John Hopkins University, Baltimore, Maryland, USA
| | - Salim Hayek
- Anesthesiology, Case Western Reserve University, Cleveland, Ohio, USA
- University Hospitals of Cleveland, Cleveland, Ohio, USA
| | | | - Rebecca L Johnson
- Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Hari Kalagara
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic in Florida, Jacksonville, Florida, USA
| | - Sandra Kopp
- Anesthesiology, Mayo Clinic Graduate School for Biomedical Sciences, Rochester, Minnesota, USA
| | - Randy W Loftus
- Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Ameet S Nagpal
- Department of Orthopaedics and Physical Medicine & Rehabilitation, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Stephanie A Neuman
- Department of Pain Medicine, Gundersen Health System, La Crosse, Wisconsin, USA
| | - Amit Pawa
- Department of Theatres, Anaesthesia and Perioperative Medicine, Guy's and St Thomas' Hospitals NHS Trust, London, UK
- King's College London, London, UK
| | - Amy C S Pearson
- Anesthesia, Advocate Aurora Health Inc, Milwaukee, Wisconsin, USA
| | | | - Eellan Sivanesan
- Neuromodulation, Division of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rakesh V Sondekoppam
- Department of Anesthesia, Pain, and Perioperative Medicine, Stanford University, Palo Alto, California, USA
| | - Jan Van Zundert
- Anesthesiology and Pain Medicine, Maastricht University Medical Centre+, Maastricht, Limburg, The Netherlands
- Anesthesiology, Critical Care and Multidisciplinary Pain Center, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Samer Narouze
- Division of Pain Management, University Hospitals, Cleveland, Ohio, USA
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Allegranzi B, Tartari E, Kilpatrick C, Storr J, Bellare N, Bana J, Flávia Santos A, Charnaud S, Ross AL, Schwaber MJ, Pittet D. WHO global research agenda for hand hygiene improvement in health care: a Delphi consensus study. Infect Control Hosp Epidemiol 2025; 46:1-16. [PMID: 40109269 PMCID: PMC7617569 DOI: 10.1017/ice.2025.32] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2025]
Abstract
OBJECTIVE To identify global research priorities for improving hand hygiene in healthcare settings and develop a 2023-2030 research agenda to guide funding, coordinate research, promote investment, and inform policy for enhanced healthcare quality and safety. DESIGN Expert consensus study using a modified Delphi process. PARTICIPANTS A 105-member panel of international hand hygiene experts including the World Health Organization (WHO) Technical Advisory Group of Experts on Hand Hygiene in Healthcare representing all WHO regions and World Bank income levels. METHODS The research priorities were identified through a multiphase approach including a meta-review to establish knowledge gaps and inform initial priorities, followed by expert consultations using a modified Delphi process. 192 preliminary priorities were included in a two-round Delphi survey. Experts rated each priority in the first round, and then reviewed and adjusted responses based on the panel's aggregated, anonymous responses in the second round. Ratings were collected on a five-point Likert scale. Consensus was defined as a combined "strongly agree" and "agree" frequency of at least 70%. RESULTS Consensus was achieved for 178 of 192 priorities (92.7%), categorized into six domains: system change; training and education; evaluation and feedback; reminders and communications; institutional safety climate; and hand hygiene improvement impact on healthcare-associated infections and antimicrobial resistance. Of these, 121 priorities reached >80% consensus. The Delphi process, maintained a 92% response rate over two rounds. CONCLUSIONS A structured consensus process yielded a research agenda to address gaps in hand hygiene improvement, supporting enhanced healthcare quality and safety globally.
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Affiliation(s)
- Benedetta Allegranzi
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Ermira Tartari
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
- Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Claire Kilpatrick
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Julie Storr
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Nita Bellare
- Infection Prevention and Control Unit and Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
| | | | - Ana Flávia Santos
- CEGIST, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal
| | - Sarah Charnaud
- Research for Health department, World Health Organization, Geneva, Switzerland
| | - Anna Laura Ross
- Research for Health department, World Health Organization, Geneva, Switzerland
| | - Mitchell J. Schwaber
- National Center for Infection Control, Israel Ministry of Health, Jerusalem, Israel
| | - Didier Pittet
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Brandão SMG, Urasaki MBM, Yamada BFA, Lemos DM, Matos LN, Costa MTF, Nogueira PC, Santos VLCDG. Infection epidemiology, preventive measures and principles of best practices involving the skin and dressing of patients with a ventricular assist device: A scoping review. Intensive Crit Care Nurs 2025; 86:103840. [PMID: 39306939 DOI: 10.1016/j.iccn.2024.103840] [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: 08/12/2024] [Revised: 09/05/2024] [Accepted: 09/10/2024] [Indexed: 12/06/2024]
Abstract
BACKGROUND Specific knowledge of several domains for managing care in the driveline externalization area may be necessary for the broader application of left ventricular assist devices. OBJECTIVES This study aimed to map the recommendations for adult patients undergoing left ventricular assist device implantation. DESIGN This scoping review, is being registered in the Open Science Framework under DOI https://doi.org/10.17605/OSF.IO/Q76B3 (https://osf.io/q76b3/). METHOD Left ventricular assist device coordinators and nurse specialists in dermatology and stomatherapy conducted a scoping review limited to the period between 2015 and 2022. The results of this scoping review will be discussed and presented separately in 3 articles. This third article synthesizes research evidence on the epidemiology of device infections, infection preventive measures, local skin care and dressings in adult patients with left ventricular assist devices. RESULTS The initial search resulted in 771 studies. Sixty nine met the eligibility criteria and were included in the scoping review. Eighteen articles addressing the epidemiology of device infections, infection preventive measures, and local skin and dressing care that answered the question of this article were included. The most common bacterial pathogens reported have been Gram-positive bacteria, typically Staphylococcus species. With respect to infection preventive measures, there are evidence gaps in local skin care and transmission system dressings. CONCLUSION The driveline still remains the most common type of device infection. There exists imperfect knowledge on the standardization of care with the dressing and the area of skin for left ventricular assist device patients. Furthermore, there is a methodological fragility of the studies. These elements imply an opportunity for future research on these subjects. IMPLICATIONS FOR CLINICAL PRACTICE This review provides an overview of the principles of best practices involving the skin and dressing of patients with a ventricular assist device without local dermatological diseases or infectious diseases. The central figure of an experienced professional can make a difference.
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Affiliation(s)
- Sara Michelly Gonçalves Brandão
- Instituto do Coracao (InCor) do Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, SP - BR, Brazil.
| | | | | | - Dayanna Machado Lemos
- Nursing School of Universidade Federal do Rio Grande so Sul, Porto Alegre, SP - BR, Brazil
| | | | | | - Paula Cristina Nogueira
- Department of Medical-Surgical Nursing of Nursing School of Universidade de Sao Paulo, Sao Paulo, SP - BR, Brazil
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Iorizzo M, Pasch MC. Bacterial and viral infections of the nail unit: Tips for diagnosis and management. HAND SURGERY & REHABILITATION 2024; 43S:101502. [PMID: 36427761 DOI: 10.1016/j.hansur.2022.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/25/2022] [Accepted: 11/10/2022] [Indexed: 11/26/2022]
Abstract
The nail unit is the most commonly affected area in hand infections, which can be primary infection or superinfection complicating other nail or skin disorders. Trauma, mechanical or chemical, is usually the trigger enabling infiltration of infectious organisms. Artificial nails and nail polish are also a possible cause of bacterial infection, harboring microorganisms. In severe acute bacterial infection, surgical intervention is often needed to prevent morbidity and disability. Abscess should always be drained, but viral infection such as herpetic whitlow, may mimic an abscess and, in contrast, requires non-operative treatment; to prevent sequelae. A more conservative approach is also generally advisable in less severe bacterial infection, other viral infections and in subacute or chronic nail infection. The present review deals with acute, subacute and chronic bacterial and viral infections of the nail unit, with a focus on diagnostic and treatment options. LEVEL OF EVIDENCE: III, systematic review of level III studies.
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Affiliation(s)
- M Iorizzo
- Private Dermatology Practice, Viale Stazione 16, 6500 Bellinzona, Switzerland.
| | - M C Pasch
- Department of Dermatology, Radboud University Medical Center, Rene Descartesdreef 1, 6500 Nijmegen, The Netherlands
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Bodoga A, Nistorac A, Dragomir A, Ailenei EC, Seul A, Diaconu M, Balan CD, Loghin MC. Ozone–Vacuum-Based Decontamination: Balancing Environmental Responsibility and Textile Waste. SUSTAINABILITY 2023; 15:16068. [DOI: 10.3390/su152216068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
Abstract
This study explores the use of ozone decontamination as a sustainable approach for eradicating pathogens from various environments. Ozone, a highly reactive gas, demonstrates remarkable efficacy in eliminating bacteria, viruses, and fungi. Decontamination of textile materials using an innovative ozone treatment method conducted under vacuum conditions has been investigated. A hybrid apparatus comprising a vacuum and an ozone generator was employed for the decontamination process. Ozone decontamination offers environmental benefits by avoiding harmful by-products and minimising long-term environmental exposure. However, challenges include the need for proper equipment and training to ensure safety and effectiveness. This research underscores the promise of ozone decontamination as a powerful and eco-friendly method for pathogen eradication in textile materials with future developments in diverse settings.
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Affiliation(s)
- Alexandra Bodoga
- Faculty of Industrial Design and Business Management, “Gheorghe Asachi” Technical University of Iasi, 29 Prof. Dimitrie Mangeron Blvd., 700050 Iasi, Romania
| | - Andreea Nistorac
- Faculty of Industrial Design and Business Management, “Gheorghe Asachi” Technical University of Iasi, 29 Prof. Dimitrie Mangeron Blvd., 700050 Iasi, Romania
| | - Alin Dragomir
- Faculty of Electronics, Telecommunications and Information Technology, “Gheorghe Asachi” Technical University of Iasi, 73 Prof. Dimitrie Mangeron Blvd., 700050 Iasi, Romania
| | - Eugen Constantin Ailenei
- Faculty of Industrial Design and Business Management, “Gheorghe Asachi” Technical University of Iasi, 29 Prof. Dimitrie Mangeron Blvd., 700050 Iasi, Romania
| | - Arina Seul
- Faculty of Industrial Design and Business Management, “Gheorghe Asachi” Technical University of Iasi, 29 Prof. Dimitrie Mangeron Blvd., 700050 Iasi, Romania
| | - Mariana Diaconu
- Cristofor Simionescu Faculty of Chemical Engineering and Environmental Protection, “Gheorghe Asachi” Technical University of Iasi, 73 Prof. Dimitrie Mangeron Blvd., 700050 Iasi, Romania
| | - Catalin Dumitrel Balan
- Cristofor Simionescu Faculty of Chemical Engineering and Environmental Protection, “Gheorghe Asachi” Technical University of Iasi, 73 Prof. Dimitrie Mangeron Blvd., 700050 Iasi, Romania
| | - Maria Carmen Loghin
- Faculty of Industrial Design and Business Management, “Gheorghe Asachi” Technical University of Iasi, 29 Prof. Dimitrie Mangeron Blvd., 700050 Iasi, Romania
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Dick A, Sterr CM, Dapper L, Nonnenmacher-Winter C, Günther F. Tailored positioning and number of hand rub dispensers: the fundamentals for optimized hand hygiene compliance. J Hosp Infect 2023; 141:71-79. [PMID: 37660889 DOI: 10.1016/j.jhin.2023.08.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/03/2023] [Accepted: 08/13/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Availability of alcohol-based hand rub (ABHR) dispensers at positions adapted to the work flow of healthcare workers (HCWs) is decisive in order to carry out indication-based hand rubbing. Although requirements and guidelines regarding the positioning of ABHR dispensers are in place, scientific evidence is often lacking. METHODS In order to analyse the impact of the location and number of ABHR dispensers on hand hygiene performance, additional dispensers were systematically placed in patient rooms in a surgical 38-bed ward at Marburg University Hospital, Germany to complement the existing dispenser locations. ABHR use was monitored continuously before and after complementation using the NosoEx hand hygiene monitoring system. The ward had 53 dispensers before the intervention and 82 dispensers after the intervention. RESULTS The addition of dispensers increased ABHR consumption across the entire ward. Before the intervention, mean consumption was 20.6 mL/patient-day, whereas mean consumption after the intervention was 25.3 mL/patient-day. Depending on the combination of dispenser locations, consumption increased through targeted supplementation in patient rooms. The presence of two or three dispensers per patient room resulted in significantly greater ABHR consumption compared with one dispenser per patient room. The preferred location combinations were entrance-front bed-back bed and entrance-foot end. CONCLUSION ABHR consumption can be increased significantly by optimizing the position and number of dispensers. The outstanding factors are visibility and integrability of dispenser use into the work flow; in particular, a dispenser should be positioned in the entrance area. Recommendations should be optimized with regard to the required number and location of dispensers in patient rooms.
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Affiliation(s)
- A Dick
- Division of Infection Control and Hospital Epidemiology, Marburg University Hospital, Marburg, Germany
| | - C M Sterr
- Division of Infection Control and Hospital Epidemiology, Marburg University Hospital, Marburg, Germany
| | - L Dapper
- Division of Infection Control and Hospital Epidemiology, Marburg University Hospital, Marburg, Germany
| | - C Nonnenmacher-Winter
- Division of Infection Control and Hospital Epidemiology, Marburg University Hospital, Marburg, Germany
| | - F Günther
- Division of Infection Control and Hospital Epidemiology, Marburg University Hospital, Marburg, Germany.
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Kirchner M, Goulter RM, Bernstein C, Lavallee A, Schaffner D, Chapman B, Jaykus LA. The role of hands in cross-contamination of kitchen surfaces during meal preparation. Am J Infect Control 2023; 51:A44-A57. [PMID: 37890953 DOI: 10.1016/j.ajic.2023.04.162] [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: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Foodborne pathogen transmission during food preparation is a common occurrence, and cross-contamination can be a contributing factor. Behaviors that lead to cross-contamination during meal preparation have not been well characterized. The study objective was to determine how hands and food handling behaviors (with a focus on handwashing and touch-based events) affect the risk of cross-contamination of kitchen surfaces and foods during meal preparation. METHODS Data from a prior study in which participants were observed preparing turkey burgers inoculated with bacteriophage MS2 and a salad provided the data for analysis. Cross-contamination was assessed using environmental sampling data. Behavioral coding was performed for handwashing and touch-based behaviors. Cross-contamination risk was defined as the likelihood (number of contaminated surfaces) and degree (contaminant concentration) of MS2 on surfaces. Statistical analyses were performed in R, SPSS, and SigmaPlot. RESULTS The significantly reduced risk of cross-contamination (P.ß<.ß.0001) was observed for participants who attempted handwashing or completed more handwashing steps. Scrubbing hands for 5.ßseconds, on average, reduced the risk of cross-contamination (P.ß<.ß.05). Cross-contamination regression models created using the most significant predictor variables showed that increased handwashing attempts, completion of more handwashing steps, and average scrub times>5.ßseconds all decreased the risk of cross-contamination (P.ß<.ß.05). CONCLUSIONS This analysis can be used in future risk assessment modeling and for informing education and outreach to reduce pathogen transmission during food preparation.
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Affiliation(s)
- Margaret Kirchner
- North Carolina State University, Department of Food, Bioprocessing and Nutrition Sciences, Raleigh, NC
| | - Rebecca M Goulter
- North Carolina State University, Department of Food, Bioprocessing and Nutrition Sciences, Raleigh, NC.
| | | | - Aaron Lavallee
- US Department of Agriculture, Food Safety and Inspection Service, Office of Public Affairs and Consumer Education, Washington, DC
| | - Don Schaffner
- Rutgers ... The State University of New Jersey, Department of Food Science, School of Environmental and Biological Sciences, Brunswick, NJ
| | - Benjamin Chapman
- North Carolina State University, Department of Agricultural and Human Sciences, Raleigh, NC
| | - Lee-Ann Jaykus
- North Carolina State University, Department of Food, Bioprocessing and Nutrition Sciences, Raleigh, NC
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Hamilton DK. Challenges to Long-Accepted Beliefs Encourage Us to Think in New Ways. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:11-14. [PMID: 37563969 DOI: 10.1177/19375867231193750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Affiliation(s)
- D Kirk Hamilton
- School of Architecture, Texas A&M University, College Station, TX, USA
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10
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AIUM Official Statement: Guidelines for Cleaning and Preparing External- and Internal-Use Ultrasound Transducers and Equipment Between Patients as Well as Safe Handling and Use of Ultrasound Coupling Gel. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2023; 42:E13-E22. [PMID: 36655607 DOI: 10.1002/jum.16167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
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Ghorbanmovahhed S, Shahbazi S, Gilani N, Ostadi A, Shabanloei R, Gholizadeh L. Effectiveness of implementing of an infection control link nurse program to improve compliance with standard precautions and hand hygiene among nurses: a quasi-experimental study. BMC MEDICAL EDUCATION 2023; 23:265. [PMID: 37076871 PMCID: PMC10116755 DOI: 10.1186/s12909-023-04208-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/29/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Standard precautions (SPs) including hand hygiene are considered fundamental protective measures to manage health care-associated infections (HCAIs) and to reduce occupational health hazards. The purpose of this research was to examine the effectiveness of an infection control link nurse (ICLN) program on compliance with SPs and hand hygiene among nurses. METHODS A quasi-experimental study with a pretest-post-test design was conducted with participating of 154 clinical nurses who worked in different wards of a tertiary referral teaching hospital in Iran. The intervention group (n = 77) had 16 infection control link nurses nominated. The control group (n = 77) received only the standard multimodal approach used in the hospital. Pre- and post-test assessment of compliance with standard precautions and hand hygiene compliance was performed via the Compliance with Standard Precautions Scale (CSPS) and the World Health Organization observational hand hygiene form. Two independent sample t-tests were used to examine differences between Compliance with Standard Precautions and hand hygiene Compliance among nurses in intervention and control group. Multiple linear regression analysis was used to assess the effect size. RESULTS After developing and implementing the infection control link nurse program, no statistically significant improvement was found in the Compliance with Standard Precautions (β = 5.18; 95% CI= -0.3-10.65, p = 0.064). An improvement in hand hygiene compliance was observed among nurses in the intervention group that improved statistically significant from 18.80% before the program to 37.32% 6 months after the program (β = 20.82; 95% CI 16.40-25.25, p < 0.001). CONCLUSIONS Given the continuing level of interest that exists in improving health care workers' hand hygiene practices, the findings of this study provide significant practical implications for hospitals seeking to improve compliance with hand hygiene among nurses, showing the effectiveness of using infection control link nurse program. Further research is needed to assess effectiveness of using infection control link nurse program to improve compliance with standard precautions.
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Affiliation(s)
- Shamsi Ghorbanmovahhed
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahla Shahbazi
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, PO Box 5138947-977, Tabriz, Iran
- Clinical Research Development Unit, Sina Educational, Research and Treatment Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Gilani
- Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Ostadi
- Department of Internal Medicine, Sina Educational, Research and Treatment Center, faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Shabanloei
- Department of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Gholizadeh
- Faculty of Health, University of Technology Sydney, Sydney, Australia
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Ye YJ, Lou JJ, Zhang YN, Lou XY, Chen Q. Is simply washing hands before dialysis procedures sufficient for reducing peritoneal dialysis peritonitis?-A single center study from 2015 to 2020 in Yiwu, China. Ther Apher Dial 2023; 27:335-342. [PMID: 36039759 DOI: 10.1111/1744-9987.13924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 08/23/2022] [Accepted: 08/27/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The study aimed to improve the qualified rate of hand hygiene and reduce the incidence of peritonitis in peritoneal dialysis (PD) patients. METHODS A hand hygiene questionnaire was distributed to patients during home visits and outpatient visits in 2015 and 2020. Hand-washing practices were evaluated by collecting cultures from the hands of patients after hand washing, evaluating their household environment, and recording the antimicrobial resistance of pathogenic bacteria. RESULTS Compared to patients in 2015, patients in 2020 had fewer errors in hand washing (p < 0.05), but the rate of qualification after hand washing was lower (p < 0.01). Furthermore, patients who used hand disinfectants after washing had a higher qualified rate. Coagulase-negative staphylococcus (CNS) was the most common isolated bacteria. From 2015 to 2020, the annual incidence of CNS PD peritonitis did not decrease, while the proportion of methicillin-resistant CNS decreased. CONCLUSION The use of hand disinfectants after standard hand washing may help reduce the incidence of peritonitis in PD patients.
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Affiliation(s)
- Yuan-Jun Ye
- Department of Nephrology, Yiwu Central Hospital, Zhejiang, China
| | - Jia-Jia Lou
- Department of Nephrology, Yiwu Central Hospital, Zhejiang, China
| | - Ya-Nan Zhang
- Department of Clinical Laboratory, Yiwu Central Hospital, Zhejiang, China
| | - Xiao-Ying Lou
- Department of Nephrology, Yiwu Central Hospital, Zhejiang, China
| | - Qin Chen
- Department of Nephrology, Yiwu Central Hospital, Zhejiang, China
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13
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Denat Y, Kuzgun H. Effect of glove use on manual dexterity of nursing students. Niger J Clin Pract 2023; 26:491-496. [PMID: 37203115 DOI: 10.4103/njcp.njcp_601_22] [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: 05/20/2023]
Abstract
Background Manual dexterity is vital in nursing. Nurses need to carry out applications requiring manual dexterity in the quickest and most accurate way. However, gloves are also necessary during such applications as a precaution against infections. Therefore, manual dexterity and the effect of gloves on manual dexterity are essential subjects to be investigated in the nursing field. Aims This study aims to determine the effect of using gloves on the manual dexterity of nursing students. Materials and Method The sample of the semi-experimental study consisted of 80 nursing students. The data were collected using a questionnaire and Purdue Pegboard Test. Results The participants were 22.03 ± 1.35 years of age on average; 61.2% of them were 22 years of age or above, 50% were female, 50% were male, 50% were in the third grade, 50% were in the fourth, 80% were high school graduates, and 97.5% did not work in any job. As a result, 47.5% reported that gloves impacted their manual dexterity, 52.5% reported only a partial effect, 12.5% indicated that gloves increased their manual dexterity, 66.3% stated that it reduced their manual dexterity, and 21.2% reported no change. The right-hand and assembly scores were found to be significantly higher in the tests performed with bare hands than in the tests performed with gloves (P < 0.05). Conclusions Using latex gloves impacts the dominant-hand dexterity and assembly dexterity. Therefore, designing more ergonomic gloves, increasing nurses' habit of working with gloves already in school, and supporting the improvement of their manual dexterity with gloves are recommended.
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Affiliation(s)
- Y Denat
- Department of Nursing, Aydın Adnan Menderes University Faculty of Nursing, Aydin, Turkey
| | - H Kuzgun
- Department of Nursing, Sakarya University Institute of Health Sciences, Sakarya, Turkey
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Lopez-Gigosos RM, Mariscal-Lopez E, Gutierrez-Bedmar M, Mariscal A. Effect of Long-Term Use of Alcohol-Containing Handwashing Gels on the Biofilm-Forming Capacity of Staphylococcus epidermidis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5037. [PMID: 36981945 PMCID: PMC10049709 DOI: 10.3390/ijerph20065037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/09/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
The spread of coronavirus disease 2019 (COVID-19) has promoted the use of hand sanitizers among the general population as recommended by health authorities. Alcohols, which are used in many hand sanitizers, have been shown to promotes the formation of biofilms by certain bacteria and to increase bacterial resistance to disinfection. We investigated the effect of continued use of alcohol-based gel hand sanitizer on biofilm formation by the Staphylococcus epidermidis resident strain isolated from the hands of health science students. Hand microbes were counted before and after handwashing, and the ability to produce biofilms was investigated. We found that 179 (84.8%) strains of S. epidermidis isolated from hands had the ability to form biofilm (biofilm-positive strains) in an alcohol-free culture medium. Furthermore, the presence of alcohol in the culture medium induced biofilm formation in 13 (40.6%) of the biofilm-negative strains and increased biofilm production in 111 (76.6%) strains, which were classified as low-grade biofilm-producing. Based on our findings, there is no clear evidence that the continued use of alcohol-based gels results in the selection of strains with the capacity to form biofilms. However, other disinfectant formulations that are more commonly used in clinical settings, such as alcohol-based hand-rub solutions, should be tested for their long-term effects.
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Affiliation(s)
- Rosa M. Lopez-Gigosos
- Department of Preventive Medicine and Public Health, Malaga University, 29016 Málaga, Spain; (R.M.L.-G.); (M.G.-B.)
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29590 Málaga, Spain
| | - Eloisa Mariscal-Lopez
- Department of Preventive Medicine and Public Health, Malaga University, 29016 Málaga, Spain; (R.M.L.-G.); (M.G.-B.)
- Hospital Costa del Sol, 29603 Marbella, Spain
| | - Mario Gutierrez-Bedmar
- Department of Preventive Medicine and Public Health, Malaga University, 29016 Málaga, Spain; (R.M.L.-G.); (M.G.-B.)
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29590 Málaga, Spain
- CIBERCV Cardiovascular Diseases, Carlos III Health Institute, 28029 Madrid, Spain
| | - Alberto Mariscal
- Department of Preventive Medicine and Public Health, Malaga University, 29016 Málaga, Spain; (R.M.L.-G.); (M.G.-B.)
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29590 Málaga, Spain
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Szumska E, Czajkowski P, Zablocki M, Rozkiewicz D. A Multifaceted Approach to the "Bare below the Elbow" Concept and Hand Hygiene Compliance among Healthcare Professionals-Multicenter Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4435. [PMID: 36901445 PMCID: PMC10002297 DOI: 10.3390/ijerph20054435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Nosocomial infections remain an important issue for patient safety concerns. Since hospital infections are mainly connected with healthcare professionals' routines, an increase in hand hygiene effectiveness through compliance with the "bare below the elbow" (BBE) concept could reduce the number of nosocomial infections. Therefore, this study aims to evaluate hand hygiene and to investigate healthcare professionals' compliance with the BBE concept. We performed our study on a group of 7544 hospital professionals involved in patient care. During the national preventive action, questionnaires, demographic data, and hand hygiene preparations were recorded. Hand disinfection was verified by COUCOU BOX, containing a UV camera. We noted that 3932 (52.1%) persons complied with the BBE rules. Nurses and non-medical personnel were significantly more often classified as BBE rather than non-BBE (2025; 53.3% vs. 1776; 46.7%, respectively, p = 0.001 and 1220; 53.7% vs. 1057; 46.3%, p = 0.006). Different proportions were demonstrated for the groups of physicians-non-BBE (783; 53.3%) compared to BBE (687; 46.7%) (p = 0.041). Healthcare workers from the BBE group statistically more often disinfected their hands correctly (2875/3932; 73.1%) compared to the non-BBE group (2004/3612; 55.5%) (p < 0.0001). This study demonstrates the positive impact of compliance with the BBE concept on effective hand disinfection and patient safety. Therefore, education and infection-prevention actions should be popularized to improve the BBE policy's effectiveness as well.
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Affiliation(s)
- Emilia Szumska
- Medilab Sp. z o. o., Niedzwiedzia 60, 15-531 Bialystok, Poland
| | - Przemyslaw Czajkowski
- Clinical Research Centre, Medical University of Bialystok, Jana Kilinskiego 1, 15-089 Bialystok, Poland
| | - Michal Zablocki
- Medilab Sp. z o. o., Niedzwiedzia 60, 15-531 Bialystok, Poland
| | - Dorota Rozkiewicz
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, Waszyngtona 17, 15-274 Bialystok, Poland
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16
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Perkins AV, Sellon DC, Gay JM, Lofgren ET, Jones LP, Davis MA. Longitudinal observation of meticillin-resistant Staphylococcus pseudintermedius pulsotypes in six veterinary hospitals in the north-western United States. Vet Rec Open 2022; 9:e241. [PMID: 35928590 PMCID: PMC9344261 DOI: 10.1002/vro2.41] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/13/2022] [Accepted: 07/08/2022] [Indexed: 12/02/2022] Open
Abstract
Background Meticillin-resistant Staphylococcus pseudintermedius (MRSP) infections in companion animals are increasing and are difficult to treat. Environmental contamination with MRSP in small animal primary care hospitals may pose an exposure risk to animal patients. Methods This longitudinal study assessed the genotypic relationships of MRSP isolated from 39 environmental samples collected from six private small animal primary care hospitals, in the north-eastern United States, between August 2018 and April 2019. Results Of the 39 bacterial isolates, 18 unique pulsotypes were identified based on pulsed-field gel electrophoresis, including six clusters of two or more indistinguishable isolates. Single pulsotypes were frequently detected from multiple hand-contact and animal-contact surfaces within a hospital during a single sampling event, but detection of a single pulsotype within the same hospital on subsequent visits was infrequent. However, one pulsotype was recovered from three separate hospitals, which suggests that either MRSP transmission between hospitals may have occurred via people, animals, or fomites or that there was a dominant community strain. Conclusions Single strains of MRSP were isolated from various hand-contact and animal-contact surfaces within hospitals, indicating the important role of humans, animals and the environment in MRSP transmission. Additionally, the detection of a single strain between hospitals and over time suggests that either MRSP transmission between hospitals may have occurred via people, animals or fomites or that there was a dominant community strain.
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Affiliation(s)
- Andrea V. Perkins
- Auburn University College of Veterinary Medicine—Veterinary Clinical Sciences, Vaughan Large Animal Teaching HospitalAuburnAlabamaUSA
| | - Debra C. Sellon
- Washington State University College of Veterinary Medicine—Veterinary Clinical SciencesPullmanWashingtonUSA
| | - John M. Gay
- Washington State University College of Veterinary Medicine—Veterinary Clinical SciencesPullmanWashingtonUSA
| | - Eric T. Lofgren
- Washington State University College of Veterinary Medicine—Paul G. Allen School for Global HealthPullmanWashingtonUSA
| | - Lisa P. Jones
- Washington State University College of Veterinary Medicine—Paul G. Allen School for Global HealthPullmanWashingtonUSA
| | - Margaret A. Davis
- Washington State University College of Veterinary Medicine—Paul G. Allen School for Global HealthPullmanWashingtonUSA
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17
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Simmons CG, Hennigan AW, Loyd JM, Loftus RW, Sharma A. Patient Safety in Anesthesia: Hand Hygiene and Perioperative Infection Control. CURRENT ANESTHESIOLOGY REPORTS 2022; 12:493-500. [PMID: 36345323 PMCID: PMC9631600 DOI: 10.1007/s40140-022-00545-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2022] [Indexed: 11/06/2022]
Abstract
Purpose of Review This review highlights the importance of the anesthesia team in minimizing perioperative infection risks and prevention of surgical site infection. Due to the immense financial and patient care burden that results from perioperative infection, a foundational knowledge in preventive measures is essential. Recent Findings Perioperative infection control, the role of the anesthesia team in reducing infection risk, and more specifically the outsized importance of hand hygiene in this space have become increasingly apparent. Maintenance of workspace cleanliness along with hand hygiene forms the cornerstone of preventing microbial transmission. Unfortunately, improvements around perioperative infection control are lacking. Summary The importance of the anesthesia team in maintaining proper hand hygiene, a clean work environment, and appropriate patient conditions to minimize risk of perioperative infection cannot be overstated. Poor clinical outcomes, economic burden, and external pressure from payers highlight the need for anesthesia providers to have an up-to-date knowledge of best practices in this area. In this article, we will review the current recommendations for hand hygiene practices and perioperative infection prevention.
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Affiliation(s)
- Colby G. Simmons
- Department of Anesthesiology, University of Colorado– Anschutz Medical Campus, Mail Stop B113, Leprino Building, 12401 E 17th Ave. Leprino Bldg #734, Aurora, CO 80045 USA
| | - Andrew W. Hennigan
- Department of Anesthesiology, University of Colorado– Anschutz Medical Campus, Mail Stop B113, Leprino Building, 12401 E 17th Ave. Leprino Bldg #734, Aurora, CO 80045 USA
| | - Jacob M. Loyd
- Department of Anesthesiology, University of Colorado– Anschutz Medical Campus, Mail Stop B113, Leprino Building, 12401 E 17th Ave. Leprino Bldg #734, Aurora, CO 80045 USA
| | - Randy W. Loftus
- Department of Anesthesia, University of Iowa Roy J. and Lucille A. Carver College of Medicine, 200 Hawkins Drive, 6618 John Colloton Pavillion, Iowa City, IA 52242 USA
| | - Archit Sharma
- Department of Anesthesia, University of Iowa Roy J. and Lucille A. Carver College of Medicine, 200 Hawkins Drive, 6618 John Colloton Pavillion, Iowa City, IA 52242 USA
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Lv H, Liu J, Wang Y, Xia X, Li Y, Hou W, Li F, Guo L, Li X. Upconversion nanoparticles and its based photodynamic therapy for antibacterial applications: A state-of-the-art review. Front Chem 2022; 10:996264. [PMID: 36267658 PMCID: PMC9577018 DOI: 10.3389/fchem.2022.996264] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/12/2022] [Indexed: 11/30/2022] Open
Abstract
Major medical advances in antibiotics for infectious diseases have dramatically improved the quality of life and greatly increased life expectancy. Nevertheless, the widespread and inappropriate exploitation of antibacterial agents has resulted in the emergence of multi-drug-resistant bacteria (MDR). Consequently, the study of new drugs for the treatment of diseases associated with multi-drug-resistant bacteria and the development of new treatments are urgently needed. Inspiringly, due to the advantages of a wide antimicrobial spectrum, fast sterilization, low resistance, and little damage to host tissues and normal flora, antibacterial photodynamic therapy (APDT), which is based on the interaction between light and a nontoxic photosensitizer (PS) concentrated at the lesion site to generate reactive oxygen species (ROS), has become one of the most promising antibacterial strategies. Recently, a burgeoning APDT based on a variety of upconversion nanoparticles (UCNPs) such as PS and near-infrared (NIR) light has been fully integrated in antibacterial applications and achieved excellent performances. Meanwhile, conjugated nanoparticles have been frequently reported in UCNP design, including surface-modified PS conjugates, antibiotic-PS conjugates, and dual or multiple antibacterial modal PS conjugates. This article provides an overview of the state-of-the-art design and bactericidal effects of UCNPs and their based APDTs. The first part discusses the design and mechanisms for UCNPs currently implemented in biomedicine. The second part focuses on the applications and antimicrobial effects of diverse APDT based on UCNPs in antibacterial-related infectious diseases.
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Affiliation(s)
- Hanlin Lv
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
| | - Jie Liu
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
| | - Ying Wang
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
| | - Xiaomin Xia
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
| | - Ying Li
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
| | - Wenxue Hou
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
| | - Feng Li
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
| | - Lantian Guo
- College of Automation and Electronic Engineering, Qingdao University of Science and Technology, Qingdao, China
| | - Xue Li
- Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao, China
- School of Stomatology, Qingdao University, Qingdao, China
- *Correspondence: Xue Li,
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Maria A, Sooden A, Wadhwa R, Kaur R, Gaur I, Lhamo K, Nagaratna V. Improving handwashing among parent-attendants visiting a newborn unit practising family participatory care. BMJ Open Qual 2022; 11:e001811. [PMID: 36270651 PMCID: PMC9594575 DOI: 10.1136/bmjoq-2022-001811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 10/12/2022] [Indexed: 11/21/2022] Open
Abstract
In our newborn intensive care unit (NICU), we practise family participatory care, where the unit staff encourage parents and attendants of sick newborns to partner with them and be involved in care for their babies. There remains a concern that this practice may increase the risk of nosocomial infections being carried into the unit by parent-attendants. Staff observed that handwashing behaviours were suboptimal and inconsistent among parent-attendants. With facilitation from an improvement coach, we formed a quality improvement team of NICU staff to improve hand hygiene practices among attendants. From a baseline estimate of around 20% of attendants adhering to hand hygiene standards, the team planned to reach a target of 80% over 8 weeks by introducing a series of changes. At the end of 9 weeks, 80% of attendants were following standard hand hygiene practices.
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Affiliation(s)
- Arti Maria
- Neonatology, Dr Ram Manohar Lohia Hospital PGIMER, New Delhi, Delhi, India
| | - Ankur Sooden
- USAID ASSIST Project, University Research Co, Bethesda, Maryland, USA
- SAMVEG project, John Snow India Pvt. Ltd, New Delhi, Delhi, India
| | - Rashmi Wadhwa
- Neonatology, Dr Ram Manohar Lohia Hospital PGIMER, New Delhi, Delhi, India
| | - Ravleen Kaur
- Neonatology, Dr Ram Manohar Lohia Hospital PGIMER, New Delhi, Delhi, India
| | - Indu Gaur
- Neonatology, Dr Ram Manohar Lohia Hospital PGIMER, New Delhi, Delhi, India
| | - Kalsang Lhamo
- Neonatology, Dr Ram Manohar Lohia Hospital PGIMER, New Delhi, Delhi, India
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Price L, Gozdzielewska L, Matuluko A, Pittet D, Allegranzi B, Reilly J. Comparing the effectiveness of hand hygiene techniques in reducing the microbial load and covering hand surfaces in healthcare workers: Updated systematic review. Am J Infect Control 2022; 50:1079-1090. [PMID: 35167898 DOI: 10.1016/j.ajic.2022.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND This review, commissioned by the World Health Organization (WHO), examined the effectiveness of the WHO 6-step hand hygiene (HH) technique in reducing microbial load on hands and covering hand surfaces, and compared its effectiveness to other techniques. METHODS Medline, CINAHL, ProQuest, Web of Science, Mednar, and Google Scholar were searched for primary studies, published in English (1978-February 2021), evaluating the microbiological effectiveness or hand surface coverage of HH techniques in healthcare workers. Reviewers independently performed quality assessment using Cochrane tools. The protocol for the narrative review was registered (PROSPERO 2021: CRD42021236138). RESULTS Nine studies were included. Evidence demonstrated that the WHO technique reduced microbial load on hands. One study found the WHO technique more effective than the 3-step technique (P = .02), while another found no difference between these 2 techniques (P = .08). An adapted 3-step technique was more effective than the WHO technique in laboratory settings (P = .021), but not in clinical practice (P = .629). One study demonstrated that an adapted 6-step technique was more effective than the WHO technique (P = .001). Evidence was heterogeneous in application time, product, and volume. All studies were high risk of bias. CONCLUSIONS Eight studies found that the WHO 6-step technique reduced microbial load on healthcare workers' hands; but the studies were heterogeneous and further research is required to identify the most effective, yet feasible technique.
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Affiliation(s)
- Lesley Price
- SHIP Research Group, Research Centre for Health, Glasgow Caledonian University, Glasgow, UK
| | - Lucyna Gozdzielewska
- SHIP Research Group, Research Centre for Health, Glasgow Caledonian University, Glasgow, UK.
| | - Ayodeji Matuluko
- SHIP Research Group, Research Centre for Health, Glasgow Caledonian University, Glasgow, UK
| | - Didier Pittet
- Infection Control Programme and WHO Collaborating Center on Patient Safety, The University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Benedetta Allegranzi
- Infection Prevention and Control Technical and Clinical Hub, Department of Integrated Health Services, World Health Organization, Geneva, Switzerland
| | - Jacqui Reilly
- SHIP Research Group, Research Centre for Health, Glasgow Caledonian University, Glasgow, UK
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21
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Szumska E, Czajkowski P, Zablocki M, Rozkiewicz D. The Association between Hand Disinfection Techniques and Their Barriers, as Well as the "Bare below the Elbows" Concept, among Healthcare Professionals-A Study Based on a Polish Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811781. [PMID: 36142054 PMCID: PMC9517209 DOI: 10.3390/ijerph191811781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/05/2022] [Accepted: 09/15/2022] [Indexed: 06/01/2023]
Abstract
Hand hygiene is the most effective way to prevent nosocomial infections. Nevertheless, the hands of healthcare professionals are still the primary route of transmission of pathogens responsible for such infections. The aim of this study was to evaluate hand disinfection techniques and investigate the risk factors that may explain the improper hand disinfection techniques among healthcare workers. We selected 7544 hospital workers directly involved in patient care. We recorded data based on the questionnaires, demographic data, and the preparation of hands for disinfection, including risk factors. Correct hand disinfection was verified by COUCOU BOX, with a UV camera. Proper hand disinfection was demonstrated among 4879 (64.7%) subjects, while 2665 (35.3%) subjects disinfected their hands incorrectly. In most places of work, nurses properly disinfected their hands more often than the physicians, particularly in general departments (62.1% vs. 69.2%; p = 0.0019). We observed that long nails and artificial/polished nails were more often observed in the group of nurses than in the group of physicians (7.3% vs. 4.7%, respectively; p = 0.0006 and 19.3% vs. 10.1%; p = 0.0000), while an inverse relationship was found in relation to watches (24.0% vs. 12.0%; p = 0.0000) and long sleeves (24.4% vs. 8.1%; p = 0.0000). Incorrect and less effective hand hygiene among some groups of hospital workers is still present. Therefore, the continuation of education actions concerned with hand hygiene among healthcare workers is needed.
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Affiliation(s)
- Emilia Szumska
- Medilab Sp. z o. o., Niedzwiedzia 60, 15-531 Bialystok, Poland
| | - Przemyslaw Czajkowski
- Clinical Research Centre, Medical University of Bialystok, Jana Kilinskiego 1, 15-089 Bialystok, Poland
| | - Michal Zablocki
- Medilab Sp. z o. o., Niedzwiedzia 60, 15-531 Bialystok, Poland
| | - Dorota Rozkiewicz
- Department of Pediatric Infectious Diseases, Medical University of Bialystok, Waszyngtona 17, 15-274 Bialystok, Poland
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22
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Yu Y, Zhao Y, He Y, Pang J, Yang Z, Zheng M, Yin R. Inhibition of efflux pump encoding genes and biofilm formation by sub-lethal photodynamic therapy in methicillin susceptible and resistant Staphylococcus aureus. Photodiagnosis Photodyn Ther 2022; 39:102900. [PMID: 35525433 DOI: 10.1016/j.pdpdt.2022.102900] [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: 01/20/2022] [Revised: 04/28/2022] [Accepted: 05/03/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) is an effective method to inactivate microorganisms which is based on reactive oxygen species (ROS) generated by photosensitizer and light at certain wavelength. Exposure to sub-lethal dose of PDT (sPDT) could activate the regulatory systems in the surviving bacteria in response to oxidative stress. This study aimed to evaluate the effect of sPDT on efflux pump and biofilm formation in Staphylococcus aureus (S. aureus), which are two important virulence related factors. METHODS Different light irradiation time and toluidine blue O (TBO) concentrations were tested to select a sPDT in methicillin-susceptible and methicillin-resistant S. aureus (MSSA and MRSA). Efflux function was evaluated with EtBr efflux experiment. Biofilm formation was evaluated by crystal violet staining. Gene expressions of norA, norB, sepA, mepA and mdeA following sPDT were analyzed with real-time PCR. RESULTS Sub-lethal PDT was set at 40 J/cm2 associated with 0.5 μM TBO. Efflux function was significantly inhibited in both strains. The average expression levels of mdeA and mepA in MSSA and MRSA were increased by (3.09, 1.77, 1.57) and (3,44, 1.59, 6.29) fold change respectively, norB and sepA were decreased by (3.77, 6.14) and (3.02, 3.47) fold change respectively. Expression level of norA was decreased by 5.44-fold change in MSSA but increased by 2.80-fold change in MRSA. Biofilm formation in both strains was impeded. CONCLUSIONS TBO-mediated sPDT could inhibit efflux pump function, alter efflux pump encoding gene expression levels and retard biofilm formation in MSSA and MRSA. Therefore, sPDT is proposed as a potential adjuvant therapy for infections.
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Affiliation(s)
- Yanlan Yu
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400030, China.
| | - Yan Zhao
- Department of Microbiology,Third Military Medical University (Army Medical University), Chongqing, 400030, China.
| | - Yaxiong He
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400030, China.
| | - Jiayin Pang
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400030, China.
| | - Zengjun Yang
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400030, China.
| | - Mengxue Zheng
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400030, China.
| | - Rui Yin
- Department of Dermatology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, 400030, China.
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Owings A, Christion L, Gilliam C, Glover B, Bhatia S, Tang L, Hakim H. Improving visitors' hand hygiene compliance in a pediatric oncology unit. Am J Infect Control 2022; 50:724-728. [PMID: 34848293 DOI: 10.1016/j.ajic.2021.11.018] [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: 09/01/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hand hygiene (HH) is the single most important method to prevent infections. We aim at improving HH compliance by visitors to a pediatric oncology unit. METHODS A performance improvement project implemented several Plan-Do-Study-Act cycles in July-November 2018. At baseline, a wall-mounted alcohol-based hand sanitizer dispenser was available at the unit entrance. Cycle 1 (visual cue), cycle 2 (visual cue plus verbal symptom screen), and cycle 3 (visual cue, symptom screen, plus HH verbal instructions) were tested. Patient care associates (PCA) positioned at the entrance implemented the cycles and recorded data about visitor's estimated age, day and time of observations, and covert HH compliance monitoring. Participating PCAs were surveyed regarding process feasibility. RESULTS Of 1230 (97%) analyzed observations; 204 (17%) were baseline, 293 (24%) in cycle 1, 374 (30%) in cycle 2, and 359 (29%) in cycle 3. The visitors' HH compliance significantly increased to 16.0%, 22.5%, and 48.5% in cycles 1, 2, and 3, respectively, from a baseline of 4.9% (P < .001). Visitors were more likely to perform HH when directly instructed (cycle 3) compared to baseline (adjusted OR = 19.77, 95% CI, 10.30-42.09, P < .001). Although the surveyed PCAs agreed the process is easy and fast, they reported few barriers. CONCLUSIONS Direct verbal instructions for HH were the most effective in improving visitors' HH compliance.
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Affiliation(s)
- Angie Owings
- Department of Infection Prevention and Control, St. Jude Children's Research Hospital, Memphis, TN
| | - Lori Christion
- Department of Nursing, St. Jude Children's Research Hospital, Memphis, TN
| | - Craig Gilliam
- Department of Infection Prevention and Control, St. Jude Children's Research Hospital, Memphis, TN
| | - Bethany Glover
- Department of Infection Prevention and Control, St. Jude Children's Research Hospital, Memphis, TN
| | - Shalini Bhatia
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN
| | - Li Tang
- Department of Infection Prevention and Control, St. Jude Children's Research Hospital, Memphis, TN
| | - Hana Hakim
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN.
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Cohen R, Gesser-Edelsburg A, Singhal A, Benenson S, Moses AE. Translating a theory-based positive deviance approach into an applied tool: Mitigating barriers among health professionals (HPs) regarding infection prevention and control (IPC) guidelines. PLoS One 2022; 17:e0269124. [PMID: 35657940 PMCID: PMC9165831 DOI: 10.1371/journal.pone.0269124] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 05/13/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Although a wide range of intervention programs and methods have been implemented to increase health professionals’ (HPs) adherence with infection prevention and control (IPC) guidelines and decrease the incidence of healthcare associated infections (HAIs), a significant discrepancy remains between the guidelines and their implementation in practice.
Objectives
This study proposes an applied tool based on the integrated theoretical framework of the positive deviance (PD) approach for developing more effective interventions to mitigate this discrepancy.
Methods
A qualitative study guided by the PD approach based on data from two sources: (1) in-depth archival analysis of systematic review articles, and (2) integration and synthesis of findings based on an extensive empirical study we conducted, involving 250 HPs (nurses, physicians, support staff and cleaning staff) from three governmental hospitals in Israel, over 35 months (January 2017 to November 2020).
Results
The barriers faced by HPs were classified into four main categories: (1) individual-motivational, (2) social-cultural, (3) organizational, and (4) work environment and resource-centered. For each barrier, we constructed a set of questions based on the PD approach. For each question, we adapted and applied methodological tools (e.g., in-depth interviews, focus groups, social network maps, video clips and simulations) to help solve the problem.
Conclusion
Translating a theory-based approach into an applied tool that offers step-by-step actions can help researchers and practitioners adopt and implement the approach within intervention programs to mitigate barriers.
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Affiliation(s)
- Ricky Cohen
- School of Public Health, University of Haifa, Haifa, Israel
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel
- * E-mail:
| | - Anat Gesser-Edelsburg
- School of Public Health, University of Haifa, Haifa, Israel
- The Health and Risk Communication Research Center, University of Haifa, Haifa, Israel
| | - Arvind Singhal
- Department of Communication, The University of Texas at El Paso, El Paso, Texas, United States of America
- School of Business and Social Sciences, Inland University of Applied Sciences, Hamar, Norway
| | - Shmuel Benenson
- Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel
| | - Allon E. Moses
- Department of Clinical Microbiology and Infectious Diseases, Hadassah-Hebrew University Medical Center, Ein-Kerem, Jerusalem, Israel
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Casaroto E, Generoso JR, Tofaneto BM, Bariani LM, Auler MDA, Xavier N, Prado M, Victor EDS, Kobayashi T, Edmond MB, de Menezes FG, Marra AR. Hand hygiene performance in an intensive care unit before and during the COVID-19 pandemic. Am J Infect Control 2022; 50:585-587. [PMID: 35114323 PMCID: PMC8801589 DOI: 10.1016/j.ajic.2022.01.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 01/24/2022] [Accepted: 01/25/2022] [Indexed: 12/28/2022]
Abstract
The current COVID-19 pandemic has heightened the focus on infection prevention in hospitals. We evaluated hand hygiene compliance with alcohol-based hand rub via electronic observation among healthcare workers in an intensive care unit from 2017 to 2020. The COVID-19 pandemic was not associated with an increase in hand hygiene compliance.
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Poulose V, Punithavathi A, Ali M, Mohamad Assalam F, Phyo KK, Soh A, Tan SH, Li J, Ang WB, Chew A. Improving hand hygiene in a medical ward: a multifaceted approach. BMJ Open Qual 2022; 11:bmjoq-2021-001659. [PMID: 35393292 PMCID: PMC8991053 DOI: 10.1136/bmjoq-2021-001659] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 03/27/2022] [Indexed: 11/18/2022] Open
Abstract
Background Hand hygiene is a fundamental action which is simple, inexpensive and an effective tool in reducing hospital-acquired infections, yet compliance remains low in healthcare settings. In 2014, Changi General Hospital embarked on a pilot project to improve hand hygiene compliance in a pilot ward with the intention to eventually spread a multifaceted set of interventions hospital wide. Methods A before and after interventional study of a pilot project. Hand hygiene data collection was through direct observations by auditors using WHO monitoring standards and techniques based on the five-moment model. Setting A medical ward in an acute hospital in Singapore. Results Overall hand hygiene compliance improved from a median of 53% in 2015 to 80% by end of 2017. Hand hygiene compliance of doctors increased from 43% to 60% (p=0.00), nurses from 62% to 89% (p=0.014) and allied health staff from 67% to 83% (p=0.002). Conclusions A multifaceted set of interventions developed by the project team was effective in improving hand hygiene compliance of doctors, nurses and allied health staff.
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Affiliation(s)
- Vijo Poulose
- Respiratory and Critical Care Medicine, Changi General Hospital, Singapore
| | | | | | | | | | - Amanda Soh
- Rehabilitative Services, Changi General Hospital, Singapore
| | - Shi Hua Tan
- Rehabilitative Services, Changi General Hospital, Singapore
| | - Jie Li
- Infection Prevention and Control, Changi General Hospital, Singapore
| | - Woo Boon Ang
- Office of Improvement Science, Changi General Hospital, Singapore
| | - Alvin Chew
- Office of Improvement Science, Changi General Hospital, Singapore
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Price L, Gozdzielewska L, Alejandre JC, Jorgenson A, Stewart E, Pittet D, Reilly J. Systematic review on factors influencing the effectiveness of alcohol-based hand rubbing in healthcare. Antimicrob Resist Infect Control 2022; 11:16. [PMID: 35073993 PMCID: PMC8785453 DOI: 10.1186/s13756-021-01049-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/29/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The effectiveness of hand rubbing with alcohol-based handrub (ABHR) is impacted by several factors. To investigate these, World Health Organization (WHO) commissioned a systematic review. AIM To evaluate the impact of ABHR volume, application time, rubbing friction and hand size on microbiological load reduction, hand surface coverage or drying time. METHODS Medline, CINAHL, Web of Science and ScienceDirect databases were searched for healthcare or laboratory-based primary studies, published in English, (1980- February 2021), investigating the impact of ABHR volume, application time, rubbing friction or hand size on bacterial load reduction, hand coverage or drying time. Two reviewers independently performed data extraction and quality assessment. The results are presented narratively. FINDINGS Twenty studies were included in the review. Categories included: ABHR volume, application time and rubbing friction. Sub-categories: bacterial load reduction, hand size, drying time or hand surface coverage. All used experimental or quasi-experimental designs. Findings showed as ABHR volume increased, bacterial load reduced, and drying times increased. Furthermore, one study showed that the application of sprayed ABHR without hand rubbing resulted in significantly lower bacterial load reduction than poured or sprayed ABHR with hand rubbing (- 0.70; 95%CI: - 1.13 to - 0.28). Evidence was heterogeneous in application time, volume, technique, and product. All studies were assessed as high risk of bias. CONCLUSIONS There is insufficient evidence to change WHO recommendation of a palmful of ABHR in a cupped hand applied for 20-30 s or manufacturer-recommended volume applied for about 20 s (Centers for Disease Control and Prevention). Future hand hygiene research should standardise volume, application time, and consider hand size.
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Affiliation(s)
- Lesley Price
- SHIP Research Group, Research Centre for Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - Lucyna Gozdzielewska
- SHIP Research Group, Research Centre for Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK.
| | - Julius Cesar Alejandre
- SHIP Research Group, Research Centre for Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
- School of Computing, Engineering, and Built Environment, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - Annelysse Jorgenson
- SHIP Research Group, Research Centre for Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
| | - Emma Stewart
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Berkeley Square, 99 Berkeley Street, Glasgow, G3 7HR, UK
| | - Didier Pittet
- Infection Control Programme and WHO Collaborating Center on Patient Safety, The University of Geneva Hospitals and Faculty of Medicine, Geneva, Rue Gabrielle Perret-Gentil, 1211, Geneva 4, Switzerland
| | - Jacqui Reilly
- SHIP Research Group, Research Centre for Health, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland, UK
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Indirect effects of Covid-19 on water quality. WATER-ENERGY NEXUS 2022; 5:29-38. [PMCID: PMC9635952 DOI: 10.1016/j.wen.2022.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 10/17/2022] [Accepted: 10/31/2022] [Indexed: 06/17/2023]
Abstract
The provision of safe water and functioning waste management play key roles in preventing and combatting disease outbreaks such as the Covid-19 pandemic. Good water quality is needed for effective hygiene measures like washing hands as well as for lowering pathogen transmission. Almost all over the world, especially in developing countries, water is vulnerable and at high risk and surging insecurity with time. Effective water management, sanitation, and hygiene help to protect lives during the global COVID-19 pandemic. While sanitation and hygiene also disturb the quality and increase water consumption per capita to 40% comparatively and wastewater production in many developing countries. This rapid increase in water consumption puts direct pressure on water reservoirs and inadequate management of wastewater is also a serious threat to waterways, nowadays. Similarly, the quality of water bodies is significantly affected by the COVID-19 pandemic, but the risk of transmission of COVID-19 through sewerage systems is recorded as low. Hence, the current review paper aims to highlight the main concerns directly linked with the frequent usage of detergents/soaps and alcohol-based hand sanitizers on water quality and the post-pandemic handwashing habits to overcome the COVID-19 spread also threatening the water reserve reservoirs via water high consumption along with more wastewater production with less water reuse efficiency and collectively the pressure on drinking water facilities. This review also focuses on the indirect influence of COVID-19 on water quality through technical interventions among COVID-19, water pollution; soaps/detergents, and hand sanitizer and the complete water management plan for water security and safety from policymakers to end users after the viral revolution briefly.
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Singh M, Agrawal A, Sisodia D, Kasar PK, Kaur A, Datta V, Savanna RS, Singh M, Livesley N. Supplementing hand washing with proper use of alcoholic hand rub in a special neonatal care unit in a large academic public health institute at Jabalpur, Madhya Pradesh, India. BMJ Open Qual 2021; 10:bmjoq-2020-001131. [PMID: 34759034 PMCID: PMC8587682 DOI: 10.1136/bmjoq-2020-001131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 10/25/2021] [Indexed: 11/29/2022] Open
Abstract
Objective The purpose was to increase use of alcoholic hand rub (AHR) in specialised newborn care unit (SNCU) to improve hand hygiene in order to reduce neonatal sepsis and mortality at Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur. Design A prospective interventional and observational study. Methodology We formed a quality improvement (QI) team in our SNCU consisting of doctors, nurses, auxiliary staff and parents (a floating member) to improve proper use of AHR. To identify the barriers to the problem, we used fishbone analysis tool. The barriers which were not allowing the health providers to use AHR properly identified were amount of AHR in millilitres to be used per day per baby, how much and when the amount of AHR to be indented from the main store and what is the proper site to place the bottle. We used plan–do–study–act cycles to test and adapt solutions to these problems. Within 5–6 weeks of starting our project, AHR use increased from 44 mL to 92 mL per baby per day and this is sustained around 100 mL per baby per day for over 2 years now. Results Significant decrease in neonatal mortality was observed (reduced from median of 41.0 between August 2016 and April 2018 to 24.0 between May 2018 and December 2019). The neonates discharged alive improved from 41.2 to 52.3 as a median percentage value. The percentage of babies who were referred out and went Left Against Medical Advice (LAMA) deceased too. Conclusion Multiple factors can lead to neonatal deaths, but the important factors are always contextual to facilities. QI methodology provides health workers with the skills to identify the major factors contributing to mortality and develop strategies to deal with them. Improving processes of care can lead to improved hand hygiene and saves lives.
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Affiliation(s)
- Mahtab Singh
- Department of Quality Improvement, Nationwide Quality of Care Network, New Delhi, Delhi, India
| | - Avyact Agrawal
- Department of Pediatrics, Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur, India
| | - Deepti Sisodia
- Department of Pediatrics, Netaji Subhash Chandra Bose Medical College and Hospital, Jabalpur, India
| | | | - Arvinder Kaur
- Nationwide Quality of Care Network, New Delhi, Delhi, India
| | - Vikram Datta
- Department of Neonatology, Kalawati Saran Children's Hospital, New Delhi, Delhi, India.,Department of Neonatology, Lady Hardinge Medical College, New Delhi, Delhi, India
| | - Ravi Shankar Savanna
- Faculty of Medicine, University of Kuala Lumpur Royal College of Medicine Perak, Ipoh, Malaysia
| | - Manish Singh
- National Health Mission, Government of Madhya Pradesh, Bhopal, India
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Preventing Central Line Blood Stream Infections in Critical Care Patients. Crit Care Nurs Clin North Am 2021; 33:419-429. [PMID: 34742498 DOI: 10.1016/j.cnc.2021.08.001] [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: 11/20/2022]
Abstract
Currently, the Centers for Disease Control reports close to 40,000 central line-associated bloodstream infections (CLABSI) occur in acute care facilities in the United States each year. Most are considered preventable. Evidence-based practices such as the CLABSI bundle and central line maintenance bundles have demonstrated their effectiveness in reducing CLABSI. This article reviews these best practices and provides a framework for consistent implementation.
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Nudging hand hygiene compliance: a large-scale field experiment on hospital visitors. J Hosp Infect 2021; 118:63-69. [PMID: 34560166 DOI: 10.1016/j.jhin.2021.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/03/2021] [Accepted: 09/15/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Hospital-care-associated infections (HCAIs) represent the most frequent adverse event during care delivery, affecting hundreds of millions of patients around the world. Implementing and ensuring conformity to standard precautions, particularly best hand hygiene practices, is regarded as one of the most important and cheapest strategies for preventing HCAIs. However, despite consistent efforts at increasing conformity to standard hand hygiene practices at hospitals, research has repeatedly documented low conformity levels amongst staff, patients and visitors alike. AIM The behavioural sciences have documented the potential of adjusting seemingly irrelevant contextual features in order to 'nudge' people to conform to desirable behaviours such as hand hygiene compliance (HHC). In this field experiment we investigate the effect on HHC amongst visitors upon entry of a hospital by varying such features. METHODS Over 50 days, we observed the HHC of a total of 46,435 hospital visitors upon their entry to the hospital in a field experimental design covering eight variations over the salience, placement and assertion of the hand sanitizer in the foyer, including the presence of the yearly national HHC campaign and a follow up during the COVID-19 pandemic. FINDINGS Our experiment found that varying seemingly irrelevant features increased HHC from a baseline of 0.4%-19.7% (47.6% during COVID-19). The experiment also found that the national HHC-campaign had no direct statistically significant effect on HHC. CONCLUSION Varying seemingly irrelevant contextual features provides an effective, generic, cheap and easy to scale approach to increasing HHC relative to sanitizing one's hands at hospitals.
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Suciu M, Porav S, Radu T, Rosu MC, Lazar MD, Macavei S, Socaci C. Photodynamic effect of light emitting diodes on E. coli and human skin cells induced by a graphene-based ternary composite. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2021; 223:112298. [PMID: 34474299 DOI: 10.1016/j.jphotobiol.2021.112298] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 01/10/2023]
Abstract
In this paper, the photodynamic effect of a ternary nanocomposite (TiO2-Ag/graphene) on Escherichia coli bacteria and two human cell lines: A375 (melanoma) and HaCaT (keratinocyte) after exposure to different wavelength domains (blue, green or red-Light Emitting Diode, LED) was analyzed. The results obtained through bioassays were correlated with the morphological, structural and spectral data obtained through FT-IR, XPS and UV-Vis spectroscopy, powder X-Ray diffractometry (XRD) and STEM/EDX techniques, leading to conclusions that showed different photodynamic activation mechanisms and effects on bacteria and human cells, depending on the wavelength. The nanocomposite proved a therapeutic potential for blue light-activated antibacterial treatment and revealed a keratinocyte cytotoxic effect under blue and green LEDs. The red light-nanocomposite duo gave a metabolic boost to normal keratinocytes and induced stasis to melanoma cells. The light and nanocomposite combination could be a potential therapy for bacterial keratosis or for skin tumors.
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Affiliation(s)
- Maria Suciu
- National Institute for Research and Development of Isotopic and Molecular Technologies, Donat 67-103 Str., RO-400293 Cluj-Napoca, Romania; Biology and Geology Faculty, Babes-Bolyai University, 5-7 Clinicilor Str, Cluj-Napoca, Romania
| | - Sebastian Porav
- National Institute for Research and Development of Isotopic and Molecular Technologies, Donat 67-103 Str., RO-400293 Cluj-Napoca, Romania
| | - Teodora Radu
- National Institute for Research and Development of Isotopic and Molecular Technologies, Donat 67-103 Str., RO-400293 Cluj-Napoca, Romania
| | - Marcela C Rosu
- National Institute for Research and Development of Isotopic and Molecular Technologies, Donat 67-103 Str., RO-400293 Cluj-Napoca, Romania
| | - Mihaela D Lazar
- National Institute for Research and Development of Isotopic and Molecular Technologies, Donat 67-103 Str., RO-400293 Cluj-Napoca, Romania
| | - Sergiu Macavei
- National Institute for Research and Development of Isotopic and Molecular Technologies, Donat 67-103 Str., RO-400293 Cluj-Napoca, Romania
| | - Crina Socaci
- National Institute for Research and Development of Isotopic and Molecular Technologies, Donat 67-103 Str., RO-400293 Cluj-Napoca, Romania.
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Laher AE, Van Rooyen LR, Jawa A, Enyuma COA, Swartzberg KM. Compliance with hygiene practices among healthcare workers at an academic hospital emergency department. Afr J Emerg Med 2021; 11:352-355. [PMID: 34367895 PMCID: PMC8327483 DOI: 10.1016/j.afjem.2021.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 04/25/2021] [Accepted: 05/09/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Healthcare-associated infections (HCAIs) are an important contributor to patient morbidity and mortality. Healthcare workers (HCWs) hands are the chief mode of transmission of HCAIs. The emergency centre (EC) is frequently the first point of contact for patients within the health care system. The aim of this study is to determine compliance with hygiene practices among healthcare workers at a tertiary hospital EC. Methods Hygiene practices of staff were observed over a six-week period. Data pertaining to compliance rates with hand cleansing and other hygiene practices was collected. Consent was obtained retrospectively to avoid influencing participant behaviour. Results From a total of 477 potential hygiene opportunities, compliance with hand hygiene was only 34.4% (n = 164). Hand cleansing with an alcohol-based hand rub was observed in 87 (26.7%) of the 326 (68.3%) opportunities where it was indicated, while handwashing with soap and water was observed in 35 (23.2%) of the 151 opportunities where this was indicated. Compliance to each of the six steps of handwashing ranged between 62.2% and 83.5%, with there being a gradual deterioration in compliance from step one through to step six. Compliance with ‘bare below the elbows’ was observed in 242 (50.7%) opportunities while disposable surgical gloves were worn on 85 (44.7%) of the 190 opportunities where this was indicated. Conclusion Compliance with hygiene practices among EC HCWs is suboptimal. Various strategies including ongoing systematic training and regular audits may improve overall hygiene practices among EC staff.
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Affiliation(s)
- Abdullah E. Laher
- Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Corresponding author at: Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, 5 Jubilee Road, Parktown, Johannesburg 2193, South Africa.
| | - Ljuba-Ruth Van Rooyen
- Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ali Jawa
- Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Callistus OA Enyuma
- Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Paediatrics, Faculty of Medicine, University of Calabar, Nigeria
| | - Kylen M. Swartzberg
- Department of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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DeVries M, Sarbenoff J, Scott N, Wickert M, Hayes LM. Improving Vascular Access Dressing Integrity in the Acute Care Setting: A Quality Improvement Project. J Wound Ostomy Continence Nurs 2021; 48:383-388. [PMID: 34198309 PMCID: PMC8415728 DOI: 10.1097/won.0000000000000787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this quality improvement project was to evaluate transparent vascular access dressings and the use of a liquid gum mastic adhesive on improving dressing integrity over peripheral intravenous (PIV) insertion sites without increasing medical adhesive-related skin injuries (MARSIs) such as tears. PARTICIPANTS AND SETTING A multidisciplinary team consisting of specialists in infection prevention, vascular access, nursing professional development, materials management, and WOC nurses met to review current audit data and available products to trial on 2 intermediate care units in our 2 hospitals in Indiana with a combined average daily unit census of 35 patients. APPROACH Four dressing protocols-including our existing dressing with education, and an updated dressing with education, and the updated and new dressing, both with education and the addition of a gum mastic adhesive agent-were sequentially implemented by nurses on the units, each over a 2-week period. The goal was for 80% of the dressings to remain with all 4 corners fully intact without reinforcement at day 7, or sooner if PIV was discontinued before day 7. Data were reported as frequencies for intact dressings and skin complications. OUTCOMES Education combined with the original dressing and the updated dressing did not achieve the goal of 80% fully intact dressings in the samples evaluated. The addition of the adhesive agent to the updated and new dressings with education exceeded the 80% goal. In addition, there were zero exposed PIV insertion sites and no documented MARSI in any of the 4 protocols. IMPLICATIONS FOR PRACTICE We continued to collect postproject data of 30,049 vascular access sites including central line catheters and observed the same effectiveness of incorporating a gum mastic adhesive on dressing integrity. This practice change has now become standard of care in our institution.
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Affiliation(s)
- Michelle DeVries
- Correspondence: Michelle DeVries, MPH, CIC, VA-BC, Infection Control, Methodist Hospitals, Gary, IN 46402 ()
| | - Jill Sarbenoff
- Michelle DeVries, MPH, CIC, VA-BC, Methodist Hospitals, Gary, Indiana, and AVATAR Group, Menzies Health Institute, Griffith University, Queensland, Australia
- Jill Sarbenoff, MSN, RN, CCRN, Methodist Hospitals, Gary, Indiana
- Nancy Scott, DNP, APN, ACNS-BC, CIC, VA-BC, PCCN, CNRN, Methodist Hospitals, Gary, Indiana
- Margaret Wickert, RN, MSN, CNS, Methodist Hospitals, Gary, Indiana
- Lisa Marie Hayes, RN, BSN, CWOCN, CFCN, Methodist Hospitals, Gary, Indiana
| | - Nancy Scott
- Michelle DeVries, MPH, CIC, VA-BC, Methodist Hospitals, Gary, Indiana, and AVATAR Group, Menzies Health Institute, Griffith University, Queensland, Australia
- Jill Sarbenoff, MSN, RN, CCRN, Methodist Hospitals, Gary, Indiana
- Nancy Scott, DNP, APN, ACNS-BC, CIC, VA-BC, PCCN, CNRN, Methodist Hospitals, Gary, Indiana
- Margaret Wickert, RN, MSN, CNS, Methodist Hospitals, Gary, Indiana
- Lisa Marie Hayes, RN, BSN, CWOCN, CFCN, Methodist Hospitals, Gary, Indiana
| | - Margaret Wickert
- Michelle DeVries, MPH, CIC, VA-BC, Methodist Hospitals, Gary, Indiana, and AVATAR Group, Menzies Health Institute, Griffith University, Queensland, Australia
- Jill Sarbenoff, MSN, RN, CCRN, Methodist Hospitals, Gary, Indiana
- Nancy Scott, DNP, APN, ACNS-BC, CIC, VA-BC, PCCN, CNRN, Methodist Hospitals, Gary, Indiana
- Margaret Wickert, RN, MSN, CNS, Methodist Hospitals, Gary, Indiana
- Lisa Marie Hayes, RN, BSN, CWOCN, CFCN, Methodist Hospitals, Gary, Indiana
| | - Lisa Marie Hayes
- Michelle DeVries, MPH, CIC, VA-BC, Methodist Hospitals, Gary, Indiana, and AVATAR Group, Menzies Health Institute, Griffith University, Queensland, Australia
- Jill Sarbenoff, MSN, RN, CCRN, Methodist Hospitals, Gary, Indiana
- Nancy Scott, DNP, APN, ACNS-BC, CIC, VA-BC, PCCN, CNRN, Methodist Hospitals, Gary, Indiana
- Margaret Wickert, RN, MSN, CNS, Methodist Hospitals, Gary, Indiana
- Lisa Marie Hayes, RN, BSN, CWOCN, CFCN, Methodist Hospitals, Gary, Indiana
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Shenoy ES, Weber DJ. Occupational Health Update: Approach to Evaluation of Health Care Personnel and Preexposure Prophylaxis. Infect Dis Clin North Am 2021; 35:717-734. [PMID: 34362540 PMCID: PMC8331250 DOI: 10.1016/j.idc.2021.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Erica S Shenoy
- Infection Control Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 334, Boston, MA 02114, USA; Division of Infectious Diseases, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 334, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - David J Weber
- Division of Infectious Disease, School of Medicine, University of North Carolina at Chapel Hill, Bioinformatics Building, Suite 2163, Campus Box 7030, 130 Mason Farm Road, Chapel Hill, NC 27599-7030, USA; Department of Hospital Epidemiology, UNC Medical Center, Chapel Hill, NC, USA
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Opportunities for Nanomedicine in Clostridioides difficile Infection. Antibiotics (Basel) 2021; 10:antibiotics10080948. [PMID: 34438998 PMCID: PMC8388953 DOI: 10.3390/antibiotics10080948] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/30/2021] [Accepted: 08/03/2021] [Indexed: 12/19/2022] Open
Abstract
Clostridioides difficile, a spore-forming bacterium, is a nosocomial infectious pathogen which can be found in animals as well. Although various antibiotics and disinfectants were developed, C. difficile infection (CDI) remains a serious health problem. C. difficile spores have complex structures and dormant characteristics that contribute to their resistance to harsh environments, successful transmission and recurrence. C. difficile spores can germinate quickly after being exposed to bile acid and co-germinant in a suitable environment. The vegetative cells produce endospores, and the mature spores are released from the hosts for dissemination of the pathogen. Therefore, concurrent elimination of C. difficile vegetative cells and inhibition of spore germination is essential for effective control of CDI. This review focused on the molecular pathogenesis of CDI and new trends in targeting both spores and vegetative cells of this pathogen, as well as the potential contribution of nanotechnologies for the effective management of CDI.
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Hawk C, Amorin-Woods L, Evans MW, Whedon JM, Daniels CJ, Williams RD, Parkin-Smith G, Taylor DN, Anderson D, Farabaugh R, Walters SA, Schielke A, Minkalis AL, Crivelli LS, Alpers C, Hinkeldey N, Hoang J, Caraway D, Whalen W, Cook J, Redwood D. The Role of Chiropractic Care in Providing Health Promotion and Clinical Preventive Services for Adult Patients with Musculoskeletal Pain: A Clinical Practice Guideline. J Altern Complement Med 2021; 27:850-867. [PMID: 34314609 DOI: 10.1089/acm.2021.0184] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective: To develop evidence-based recommendations on best practices for delivery of clinical preventive services by chiropractors and to offer practical resources to empower provider applications in practice. Design: Clinical practice guideline based on evidence-based recommendations of a panel of practitioners and experts on clinical preventive services. Methods: Synthesizing the results of a literature search for relevant clinical practice guidelines and systematic reviews, a multidisciplinary steering committee with training and experience in health promotion, clinical prevention, and/or evidence-based chiropractic practice drafted a set of recommendations. A Delphi panel of experienced practitioners and faculty, primarily but not exclusively chiropractors, rated the recommendations by using the formal consensus methodology established by the RAND Corporation/University of California. Results: The Delphi consensus process was conducted during January-February 2021. The 65-member Delphi panel reached a high level of consensus on appropriate application of clinical preventive services for screening and health promotion counseling within the chiropractic scope of practice. Interprofessional collaboration for the successful delivery of clinical preventive services was emphasized. Recommendations were made on primary, secondary, tertiary, and quaternary prevention of musculoskeletal pain. Conclusions: Application of this guideline in chiropractic practice may facilitate consistent and appropriate use of screening and preventive services and foster interprofessional collaboration to promote clinical preventive services and contribute to improved public health.
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Affiliation(s)
- Cheryl Hawk
- Texas Chiropractic College, Pasadena, Texas, USA
| | | | - Marion W Evans
- University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - James M Whedon
- Southern California University of Health Sciences, Whittier, California, USA
| | | | | | | | | | - Derek Anderson
- VA Puget Sound Health Care System American Lake Division, Tacoma, Washington, USA
| | | | | | | | | | | | | | | | | | | | | | - Jason Cook
- VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA
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Nawa M, Nkhoma P, Samutela MT, Simulundu E, Munsaka S, Kwenda G, Kalonda A. Bacteriological profile and antimicrobial efficacy of alcohol-based hand rubs among health care workers and family caregivers at the children's university teaching hospital in Lusaka, Zambia. SCIENTIFIC AFRICAN 2021. [DOI: 10.1016/j.sciaf.2021.e00775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Kuster S, Roth JA, Frei R, Meier CA, Dangel M, Widmer AF. Handrub dispensers per acute care hospital bed: a study to develop a new minimum standard. Antimicrob Resist Infect Control 2021; 10:93. [PMID: 34134772 PMCID: PMC8206889 DOI: 10.1186/s13756-021-00949-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/12/2021] [Indexed: 11/16/2022] Open
Abstract
Background Accessibility to alcohol-based handrub (ABHR) dispenser is crucial to improve compliance to hand hygiene (HH), being offered as wall-mounted dispensers (ABHR-Ds), and/or pocket bottles. Nevertheless, information on the distribution and density of ABHR-Ds and their impact on HH have hardly been studied. Institutions such as the World Health Organisation or the Centers for Disease Control and Prevention do not provide guidance. The Robert-Koch-Institute (RKI) from Germany recommends an overall density of > 0.5 dispensers per patient bed. We aimed to investigate current conditions in hospitals to develop a standard on the minimal number of ABHR-D. Methods Between 07 and 09/2019, we applied a questionnaire to 178 hospitals participating in the Swissnoso National Surveillance Network to evaluate number and location of ABHR-Ds per bed in acute care hospitals, and compared the data with consumption and compliance with HH. Results 110 of the 178 (62%) hospitals provided data representing approximately 20,000 hospital beds. 83% hospitals provided information on both the total number of ABHR-Ds and patient beds, with a mean of 2.4 ABHR-Ds per bed (range, 0.4–22.1). While most hospitals (84%) had dispensers located at the room entrance, 47% reported also locations near or at the bed. Additionally, pocket-sized dispensers (100 mL) are available in 97% of hospitals. Conclusions Swiss hospitals provide 2.4 dispensers per bed, much more than governmental recommendation. The first study on the number of ABHR-Ds in hospitals may help to define a minimal standard for national and international recommendations Supplementary Information The online version contains supplementary material available at 10.1186/s13756-021-00949-0.
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Affiliation(s)
- Sabine Kuster
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Jan A Roth
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Reno Frei
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Christoph A Meier
- Medical Director, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland.,Department of Internal Medicine, Clinic and Amublance of Internal Medicine, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Marc Dangel
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Andreas F Widmer
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Petersgraben 4, 4031, Basel, Switzerland. .,Swissnoso, Swiss National Center for Infenction Prevention, Sulgenecstrasse 35, 3007, Bern, Switzerland.
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Oh HS, Ryu M, Yang Y. Characteristics of hand-to-environment contact during indoor activities in daily life among Korean adults using a video-based observation method. Osong Public Health Res Perspect 2021; 12:187-195. [PMID: 34102046 PMCID: PMC8256303 DOI: 10.24171/j.phrp.2021.0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 05/13/2021] [Indexed: 11/05/2022] Open
Abstract
Objectives The aim of this study was to describe the characteristics of hand-to-environmental contact (HEC) and to identify the factors influencing HEC behavior in Korean adults’ indoor daily life. Methods Thirty participants were enrolled from January 14 to February 12, 2018 after providing informed consent for being videotaped. Data were collected by recording their indoor daily lives for 2 hours, resulting in 4,732 HEC cases. To ensure the accuracy and reliability of the HEC readings, 3 training sessions were conducted for the videotape readers. Rereading and verifying randomly selected data ensured the validity of intra- and inter-reader readings. Results The most frequent contact items were phones, papers, computer accessories, and furniture surfaces. The contact density (frequency-duration/min) was highest for category II (items occasionally shared by others, 56.8), followed in descending order by category I (items for individual use, 35.9), and category III (public use items, 3.4). Significant differences in contact density were found according to participants’ demographic characteristics. Conclusion As mobile phones were the most frequent contact item, regular and strict mobile phone cleansing or disinfection strategies are needed, in addition to preventative measures taken for category II and III items. Avoiding sharing personal items with others, refraining from unnecessary HEC, and maintaining strict hand hygiene are recommended.
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Affiliation(s)
- Hyang Soon Oh
- Department of Nursing, College of Life Science and Natural Resources, Sunchon National University, Suncheon, Korea
| | - Mikyung Ryu
- Department of Nursing, College of Nursing and Public Health, Daegu University, Daegu, Korea
| | - Youngran Yang
- College of Nursing, Research Institute of Nursing Science, Jeonbuk National University, Jeonju, Korea
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Gesser-Edelsburg A, Cohen R, Halavi AM, Zemach M. Motivating healthcare professionals (nurses, nurse assistants, physicians) to integrate new practices for preventing healthcare-associated infections into the care continuum: turning Positive Deviance into positive norms. BMC Infect Dis 2021; 21:495. [PMID: 34049512 PMCID: PMC8161960 DOI: 10.1186/s12879-021-06215-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 05/20/2021] [Indexed: 11/18/2022] Open
Abstract
Background The literature examining healthcare-associated infections (HAI) points to two main problems in conforming to infection prevention and control (IPC) guidelines among healthcare professionals (HP). One is the discrepancy between HPs’ behavioral intentions and their implementation in practice. The other refers to how HPs maintain these practices after the intervention stage ends. The method proposed in this study seeks to address both these issues by using the Positive Peviance (PD) approach to focus on the dissemination stage of interventions. The study seeks to offer a method for disseminating 27 PD practices to 135 HPs, among them nurses, nurse assistants and physicians, so as to help them maintain IPC guidelines, offer feedback on the dissemination process and examine the impact of the dissemination stage on changes in their behavior. Methods The theoretical model underlying this qualitative research was the Recognition-Primed dDecision (RPD) model, which we implemented in the field of healthcare-associated infections (HAIs). Moreover, we used the Discovery & Action Dialogue (DAD) and Think Aloud (TA) techniques to describe the methodological development of simulations for HPs. Feedback from the HP demonstrators underwent content analysis, while descriptive statistics were used to characterize behavioral changes. Results HPs’ information processing regarding infection prevention shifts from peripheral/automatic processing to intuition and analytical/central processing, turning PD practices into positive norms. The HPs personally experienced finding a solution and made repeated corrections until they overcame the barriers. Most of the HPs (69.4%) reported that the practices were fully implemented, together with additional practices. Conclusions Implementation of the dissemination stage indicates that in order for HPs to integrate and assimilate practices that are not in the official guidelines, merely observing simulations is not sufficient. Rather, each staff member must personally carry out the procedures.
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Affiliation(s)
- Anat Gesser-Edelsburg
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, 3498838, Haifa, Israel. .,The Health and Risk Communication Research Center, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, 3498838, Haifa, Israel.
| | - Ricky Cohen
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, 3498838, Haifa, Israel.,The Health and Risk Communication Research Center, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, 3498838, Haifa, Israel
| | - Adva Mir Halavi
- School of Public Health, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, 3498838, Haifa, Israel.,The Health and Risk Communication Research Center, University of Haifa, 199 Aba Khoushy Ave., Mount Carmel, 3498838, Haifa, Israel
| | - Mina Zemach
- Midgam Consulting & Research Ltd. Derech Ben Gurion 13, 68181, Bnei Brak, Israel
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Disinfection of Ultrasound Transducers Used for Percutaneous Procedures: Intersocietal Position Statement. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:895-897. [PMID: 33590915 DOI: 10.1002/jum.15653] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 06/12/2023]
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Oh HS, Ryu M, Yang Y. Hand-to-face contact behaviors during indoor activities in daily life among Korean adults: an observational pilot study using videotaping. Epidemiol Health 2021; 43:e2021030. [PMID: 33887819 PMCID: PMC8189842 DOI: 10.4178/epih.e2021030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 04/22/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Hand-to-face contact (HFC) is the major route for the self-inoculation of pathogens. This study aimed to describe the characteristics of HFC behaviors among Korean adults during indoor activities. METHODS Thirty participants were enrolled in the study, and 2 hours of videotaped data were collected from each participant. Contact data were recorded by examining the frequency and duration of HFC on the videos. Three training sessions were conducted for 2 readers to ensure the accuracy and reliability of videotape reading. Re-reading and verification of selected video data were performed to confirm intrapersonal and interpersonal validity. Contact exposure (CE) was determined by multiplying the contact frequency (CF) by the contact duration (CD) to quantify the intensity of contact during the observation time (2 hours). RESULTS A total of 3,007 HFCs (1,305 mucous membrane contacts and 1,702 non-mucous membrane contacts) were observed for 60 person-hours. The median CF (person/2 hr) of the mucous membranes (eye; 4.0, nose; 15.5, mouth; 16.5) was 39.5/person and the median total CD was 177.0 sec/person. The median CE (frequency-duration/sec/person) was 5,795.0 (mouth: 1,356.0, nose: 600.0, eye: 57.5). CONCLUSIONS This study showed that the mouth and nose were the most frequent exposure sites for HFC. Avoiding habitual HFC, awareness of self-inoculation by HFC, and vigorous hand hygiene should be strengthened to prevent the spread of infections.
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Affiliation(s)
- Hyang Soon Oh
- Department of Nursing, College of Life Science and Natural Resources, Sunchon National University, Suncheon, Korea
| | - Mikyung Ryu
- Department of Nursing, College of Nursing and Public Health, Daegu University, Daegu, Korea
| | - Youngran Yang
- Research Institute of Nursing Science, Jeonbuk National University College of Nursing, Jeonju, Korea
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Anderson DM, Cronk R, Pak E, Malima P, Fuente D, Tracy JW, Mofolo I, Kafanikhale H, Hoffman I, Bartram J. Development and application of tools to cost the delivery of environmental health services in healthcare facilities: a financial analysis in urban Malawi. BMC Health Serv Res 2021; 21:329. [PMID: 33849531 PMCID: PMC8042714 DOI: 10.1186/s12913-021-06325-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 03/28/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Environmental health services (EHS) in healthcare facilities (HCFs) are critical for providing a safe, functional healthcare environment, but little is known about their costs. Poor understanding of costs impedes progress towards universal access of EHS in HCFs. We developed frameworks of essential expenses required to provide EHS and conducted an ex-post financial analysis of EHS in a network of medical research and training facilities in Lilongwe, Malawi, serving an estimated 42,000 patients annually through seven outpatient buildings. METHODS We estimated the cost of providing the following EHS: water, sanitation, hygiene, personal protective equipment use at the point of care, waste management, cleaning, laundry, and vector control. We developed frameworks of essential outputs and inputs for each EHS through review of international guidelines and standards, which we used to identify expenses required for EHS delivery and evaluate the completeness of costs data in our case study. For costing, we use a mixed-methods approach, applying qualitative interviews to understand facility context and review of electronic records to determine costs. We calculated initial costs to establish EHS and annual operations and maintenance. RESULTS Available records contained little information on the upfront, capital costs associated with establishing EHS. Annual operations and maintenance totaled USD 220,427 for all EHS across all facilities (USD 5.21 per patient encounter), although costs of many essential inputs were missing from records. Annual operations and maintenance costs were highest for cleaning (USD 69,372) and waste management (USD 46,752). DISCUSSION Missing expenses suggests that documented costs are substantial underestimates. Costs to establish services were missing predominantly because purchases pre-dated electronic records. Annual operations and maintenance costs were incomplete primarily because administrative records did not record sufficient detail to disaggregate and attribute expenses. CONCLUSIONS Electronic health information systems have potential to support efficient data collection. However, we found that existing records systems were decentralized and poorly suited to identify EHS costs. Our research suggests a need to better code and disaggregate EHS expenses to properly leverage records for costing. Frameworks developed in this study are a potential tool to develop more accurate estimates of the cost of providing EHS in HCFs.
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Affiliation(s)
- Darcy M Anderson
- The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
| | | | - Emily Pak
- The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | | | - David Fuente
- School of Earth, Ocean and the Environment, University of South Carolina, Columbia, SC, USA
| | | | - Innocent Mofolo
- UNC Project Malawi, Lilongwe, Malawi
- Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Irving Hoffman
- UNC Project Malawi, Lilongwe, Malawi
- Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jamie Bartram
- The Water Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- School of Civil Engineering, University of Leeds, Leeds, UK
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Hussain AS, Ahmed AM, Arbab S, Ariff S, Ali R, Demas S, Zeb J, Rizvi A, Saleem A, Farooqi J. CLABSI reduction using evidence based interventions and nurse empowerment: a quality improvement initiative from a tertiary care NICU in Pakistan. Arch Dis Child 2021; 106:394-400. [PMID: 32253277 DOI: 10.1136/archdischild-2019-318779] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 03/02/2020] [Accepted: 03/13/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Central line associated bloodstream infection (CLABSI) is an important cause of morbidity and mortality in the neonatal intensive care unit (NICU). We designed a CLABSI Prevention Package (CPP) to decrease NICU CLABSI rates, using evidence-proven interventions. DESIGN This was a quality improvement (QI) project. Data collection was divided into three phases (pre-implementation, implementation and post implementation). SQUIRE2.0 guidelines were used to design, implement and report this QI initiative. SETTING A tertiary care level 3 NICU at the Aga Khan University Hospital (AKUH), Karachi, Pakistan. PATIENTS All patients admitted to the AKUH NICU from 1 January 2016 to 31 March 2018 who had a central line in place during their NICU admission. INTERVENTIONS CPP used evidence-based interventions focusing on hand hygiene, aseptic central line insertion techniques and central line care, prevention of fungal infections and nurse empowerment. MAIN OUTCOME MEASURES CLABSI rates pre and post intervention were recorded. Secondary outcomes were risk factors for CLABSI, device (central line) utilisation ratio, CLABSI related mortality and micro-organism profile. RESULTS CLABSI rates decreased from 17.1/1000 device days to 5.0/1000 device days (relative risk (RR)=0.36, CI=0.17-0.74). Device (central line) utilisation ratio declined from 0.30 to 0.25. Out of 613 patients enrolled in our study, 139 (22.7%) died. Mortality was higher in CLABSI group (n=20, 44%) as compared with non CLABSI group (n=119, 21.1%) (p<0.001). Gestational age of <27 weeks was an independent risk factor for CLABSI (RR=4.45, CI=1.10-18.25, p=0.03). A total of 158 pathogens were isolated among which 68 were associated with CLABSI. Gram-negative bacteria 31 (47.7%) were the most common cause of CLABSI. Ninety-seven (61%) micro-organisms were multi-drug resistant. CONCLUSIONS CPP was effective in decreasing NICU CLABSI rates and can be used as a model to decrease NICU CLABSI rates in low or middle-income countries.
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Affiliation(s)
- Ali Shabbir Hussain
- Department of Pediatrics & Child Health, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Anjum Mohyuddin Ahmed
- Department of Pediatrics & Child Health, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Saba Arbab
- Department of Pediatrics & Child Health, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Shabina Ariff
- Department of Pediatrics & Child Health, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Rehan Ali
- Department of Pediatrics, The Indus Hospital, Karachi, Sindh, Pakistan
| | - Simon Demas
- Department of Pediatrics & Child Health, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Jehan Zeb
- Department of Pediatrics & Child Health, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Arjumand Rizvi
- Department of Pediatrics & Child Health, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Ali Saleem
- Department of Pediatrics & Child Health, The Aga Khan University, Karachi, Sindh, Pakistan
| | - Joveria Farooqi
- Department of Pediatrics & Child Health, The Aga Khan University, Karachi, Sindh, Pakistan
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Villa C, Russo E. Hydrogels in Hand Sanitizers. MATERIALS (BASEL, SWITZERLAND) 2021; 14:1577. [PMID: 33804917 PMCID: PMC8037907 DOI: 10.3390/ma14071577] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/12/2021] [Accepted: 03/20/2021] [Indexed: 11/21/2022]
Abstract
Hand hygiene can be considered a strategic key useful in the containment of infections such as COVID-19 both at home and in communities because it can dramatically reduce the widespread outbreak of infections. In case of the unavailability of soap and water, "instant" hand sanitizers are recommended because their application can be considered easy, versatile, quick and often less aggressive for the skin. For these reasons, alcoholic and alcohol-free hand rub gels can be considered the best performing formulations on the market. Together with disinfectants and antiseptic agents, hydrogels play a fundamental role in obtaining stable formulations and are easy to disperse, with a pleasant skin feel and an overall good performance. Several compounds commonly used in the pharmaceutical, cosmetic and food industry are available for this purpose, in particular, cellulose derivatives and synthetic polymers derivatives. Each of them is available in several grades, presenting different thickening behavior, rheological properties and compatibility with other ingredients, alcohols in particular. For all these reasons, it is important to explore hydrogel properties and behaviors in different contexts (i.e., hydroalcoholic and aqueous media) in order to develop new and performing hand rub gels, always taking into account the different international legal frameworks regarding disinfectant and sanitizing formulations.
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Affiliation(s)
- Carla Villa
- Section of Medicinal and Cosmetic Chemistry, Department of Pharmacy, University of Genova, Viale Benedetto XV, 3-16132 Genova, Italy
| | - Eleonora Russo
- Section of Medicinal and Cosmetic Chemistry, Department of Pharmacy, University of Genova, Viale Benedetto XV, 3-16132 Genova, Italy
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Xiao Q, Mai B, Nie Y, Yuan C, Xiang M, Shi Z, Wu J, Leung W, Xu C, Yao SQ, Wang P, Gao L. In Vitro and In Vivo Demonstration of Ultraefficient and Broad-Spectrum Antibacterial Agents for Photodynamic Antibacterial Chemotherapy. ACS APPLIED MATERIALS & INTERFACES 2021; 13:11588-11596. [PMID: 33656316 DOI: 10.1021/acsami.0c20837] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Increasing threats from both pathogenic infections and antibiotic resistance highlight the pressing demand for nonantibiotic agents and alternative therapies. Herein, we report several new phenothiazinium-based derivatives, which could be readily synthesized via fragment-based assembly, which exhibited remarkable bactericidal activities both in vitro and in vivo. Importantly, in contrast to numerous clinically and preclinically used antibacterial photosensitizers, these compounds were able to eliminate various types of microorganisms, including Gram-(+) Staphylococcus aureus (S. aureus), Gram-(-) Escherichia coli, multidrug-resistant S. aureus, and their associated biofilms, at low drug and light dosages (e.g., 0.21 ng/mL in vitro and 1.63 ng/cm2 in vivo to eradicate S. aureus at 30 J/cm2). This study thus unveils the potential of these novel phenothiaziniums as potent antimicrobial agents for highly efficient photodynamic antibacterial chemotherapy.
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Affiliation(s)
- Qicai Xiao
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-Sen University, Shenzhen 518107, P. R. China
- School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, China
- Department of Chemistry, National University of Singapore, 3 Science Drive 3, Singapore 117543, Singapore
| | - Bingjie Mai
- Key Laboratory of Medicinal Resources and Natural Pharmaceutical Chemistry, Ministry of Education, College of Life Sciences, Shaanxi Normal University, Xi'an 710119, P. R. China
| | - Yichu Nie
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-Sen University, Shenzhen 518107, P. R. China
| | - Chuang Yuan
- Department of Hematology, Xiangya Hospital, Central South University, Changsha 410000, P. R. China
- Department of Critical Care Medicine, The Second People's Hospital of Shenzhen & First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen 518035, P. R. China
| | - Menghua Xiang
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-Sen University, Shenzhen 518107, P. R. China
| | - Zihan Shi
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-Sen University, Shenzhen 518107, P. R. China
| | - Juan Wu
- School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Wingnang Leung
- School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Chuanshan Xu
- The Fifth Affiliated Hospital, Key Laboratory of Molecular Target & Clinical Pharmacology and the State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences, Guangzhou Medical University, Guangzhou 511436, P. R. China
- School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Shao Q Yao
- Department of Chemistry, National University of Singapore, 3 Science Drive 3, Singapore 117543, Singapore
| | - Pan Wang
- Key Laboratory of Medicinal Resources and Natural Pharmaceutical Chemistry, Ministry of Education, College of Life Sciences, Shaanxi Normal University, Xi'an 710119, P. R. China
| | - Liqian Gao
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-Sen University, Shenzhen 518107, P. R. China
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Manaye G, Muleta D, Henok A, Asres A, Mamo Y, Feyissa D, Ejeta F, Niguse W. Evaluation of the Efficacy of Alcohol-Based Hand Sanitizers Sold in Southwest Ethiopia. Infect Drug Resist 2021; 14:547-554. [PMID: 33613030 PMCID: PMC7887333 DOI: 10.2147/idr.s288852] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 01/28/2021] [Indexed: 11/23/2022] Open
Abstract
Background Regarding the protection of community and health professionals suffering from a COVID-19 outbreak, currently different alcohol-based hand sanitizers have been distributed. Even though for effective protection effective alcohol-based hand sanitizers are mandatory. Their efficacy was not evaluated. This is the reason why this research was designed to assess the antimicrobial efficacy of hand sanitizers that have been sold in southern parts of Ethiopia. Methods Six test organisms (Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Salmonella typhimurium and Shigella boydii) were selected from different clinical specimens. Then seven locally made products of alcohol-based hand sanitizers (MTU, Folium Fine, Epharm, Harego, Taflen and Sheba) were purchased and the disc diffusion, minimum inhibition concentration and minimum bactericidal concentration test were done against selected test organisms. Quality control measures throughout the whole process of the laboratory work were implemented and descriptive parameters were analyzed. Results The zones of inhibition of the hand sanitizers at their claim concentration were ranged from noninhibition zone (Folium) to 27mm (Sheba). The minimum inhibitory concentration against all selected test organisms was observed at 45%, 55%, 65% and Taflen on undiluted form. The growth of test organisms was decreased across increasing the concentration gradient of different hand sanitizers. MTU except against E. coli, Fine, Hargo, Ephra and Sheba hand sanitizers were showed growth below 60% concentrations for all test micro-organisms. But a Folium product against all selected test micro-organisms and MTU product against E. coli were not bactericidal. Conclusion Fine, Hargo, Ephra, Sheba and Taflen sanitizers were the products that were effective in inhibiting the growth of all the selected test organisms, and they were having effective bactericidal activity in vitro at their claim concentration. But MTU product against E. coli and Folium product against all test microorganisms were not having an effective bactericidal activity. So, regulatory authorities and manufacturers should implement strict quality control measures and regular observations throughout the production to ensure the efficacy of hand sanitizers.
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Affiliation(s)
- Gizachew Manaye
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Desalegn Muleta
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Andualem Henok
- Department of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Abyot Asres
- Department of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Yitagesu Mamo
- Department of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Desalegn Feyissa
- Department of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Fikadu Ejeta
- Department of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Wondwossen Niguse
- Department of Nursing, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
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50
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Abstract
Bacterial and viral infections of the nail unit are very common as primary infections, especially bacterial paronychia and warts, but they can also be superinfections complicating other nail disorders. In many nail unit infections, the clinical presentation is nonspecific: in these cases, diagnostic tests are mandatory before treatment, to avoid spread of the infection and drug resistance. The most common forms of bacterial and viral infections that may affect the nail unit are herein described in detail, with diagnostic and treatment options provided.
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Affiliation(s)
- Matilde Iorizzo
- Private Dermatology Practice, Viale Stazione 16, Bellinzona 6500, Switzerland.
| | - Marcel C Pasch
- Department of Dermatology, Radboud University Medical Center, Rene Descartesdreef 1, Nijmegen 6525GL, The Netherlands
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