Beyond hand hygiene: preventing cross-contamination on hospital wards

Hospital-acquired infections are the most common adverse event for inpatients worldwide | BMJ Quality & Safety

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Background: Efforts to prevent microbial cross-contamination currently focus on hand hygiene and use of personal protective equipment (PPE), with variable success. Better understanding is needed of infection prevention and control (IPC) in routine clinical practice.

Results: We found that healthcare workers’ routine IPC work goes beyond hand hygiene and PPE. It also involves, for instance, the distribution of team members during rounds, the choreography of performing aseptic procedures and moving ‘from clean to dirty’ when examining patients. We account for these practices as the logistical work of moving bodies and objects across boundaries, especially from contaminated to clean/vulnerable spaces, while restricting the movement of micro-organisms through cleaning, applying barriers and buffers, and trajectory planning.

Conclusions: Attention to the logistics of moving people and objects around healthcare spaces, especially into vulnerable areas, allows for a more comprehensive approach to IPC through better contextualisation of hand hygiene and PPE protocols, better identification of transmission risks, and the design and promotion of a wider range of preventive strategies and solutions.

Full reference: Hor, S. et al. (2017) Beyond hand hygiene: a qualitative study of the everyday work of preventing cross-contamination on hospital wards. BMJ Quality & Safety. 26:552-558.

 

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