Hand Hygiene in Intensive Care Units: A Matter of Time?

Stahmeyer, J.T. The Journal of Hospital Infection. Published online: January 28, 2017

clock-650753_960_720

Background: Healthcare-associated infections are a frequent threat to patient safety and cause significant disease burden. The most important single preventive measure is hand hygiene (HH). Barriers to adherence with HH recommendations include structural aspects, knowledge gaps, and organizational issues, especially a lack of time in daily routine.

Conclusion: Complying with guidelines is time consuming. Sufficient time for HH should be considered in staff planning.

Read the full abstract here

Advertisements

Effects of control interventions on Clostridium difficile infection in England

Dingle, K.E. et al. The Lancet Infectious Diseases. Published online: 24 January 2017

A colour-enhanced scanning electron micrograph image showing a cluster of Clostridium difficile on a surface.

Image source: Annie Cavanagh – Wellcome Images // CC BY-NC-ND 4.0

A colour-enhanced scanning electron micrograph image showing a cluster of Clostridium difficile on a surface.

Background: The control of Clostridium difficile infections is an international clinical challenge. The incidence of C difficile in England declined by roughly 80% after 2006, following the implementation of national control policies; we tested two hypotheses to investigate their role in this decline. First, if C difficile infection declines in England were driven by reductions in use of particular antibiotics, then incidence of C difficile infections caused by resistant isolates should decline faster than that caused by susceptible isolates across multiple genotypes. Second, if C difficile infection declines were driven by improvements in hospital infection control, then transmitted (secondary) cases should decline regardless of susceptibility.

Interpretation: Restricting fluoroquinolone prescribing appears to explain the decline in incidence of C difficile infections, above other measures, in Oxfordshire and Leeds, England. Antimicrobial stewardship should be a central component of C difficile infection control programmes.

Read the full article here

Capacity of English NHS hospitals to monitor quality in infection prevention and control using a new European framework

Iwami M. et al. (2017) BMJ Open. 7:e012520

NHS Framework Documant 2008

Objective: (1) To assess the extent to which current English national regulations/policies/guidelines and local hospital practices align with indicators suggested by a European review of effective strategies for infection prevention and control (IPC); (2) to examine the capacity of local hospitals to report on the indicators and current use of data to inform IPC management and practice.

Results: National regulations/policies/guidelines largely cover the suggested European indicators. The ability of individual hospitals to report some of the indicators at ward level varies across staff groups, which may mask required improvements. A reactive use of staffing-related indicators was observed rather than the suggested prospective strategic approach for IPC management.

Conclusions: For effective patient safety and infection prevention in English hospitals, routine and proactive approaches need to be developed. Our approach to evaluation can be extended to other country settings.

Read the full article here

Screening test recommendations for methicillin-resistant Staphylococcus aureus surveillance practices

Whittington, M.D. et al. American Journal of Infection Control. Published online: 23 January 2017

Highlights: 

  • Rapid screening tests reduce unnecessary surveillance costs.
  • Using polymerase chain reaction with universal preemptive isolation minimizes total costs.
  • Using chromogenic agar 24-hour with targeted isolation minimizes total costs.
  • Although polymerase chain reaction minimized inappropriate costs, the added cost per test was only offset with universal preemptive isolation.

Read the full abstract here

Oral care in ventilated intensive care unit patients

Diaz, T.L. et al. American Journal of Infection Control. Published online: 23 January 2017

teeth-1670434_960_720-1

Highlights:

  • A quality improvement project was developed to evaluate the pre/post effects of standardized placement and supply of oral care equipment in patient rooms.
  • Daily audits were performed to assess nursing behavior related to the performance of oral care on intubated patients with components from a 24 hour kit.
  • Increasing supply and creating uniform placement of oral care tools in patient rooms contributes to increased performance of oral hygiene interventions by nurses.

Read the full abstract here

Record numbers of NHS frontline staff have had flu jab this winter

Record numbers of NHS staff have had their flu jab this winter, official figures from Public Health England (PHE) show | OnMedica

syringe-1696020_960_720.png

Some 594,700 (61.8%) frontline NHS staff across England were vaccinated against flu between 1 September and 31 December last year. That figure is expected to increase in January and February.

The highest level achieved by the end of February in previous winters was 541,757 (just under 55%) in 2014-15.

PHE does not have recorded numbers of deaths from flu. But it is estimated that, in 2015-16, there were about 2,300 excess deaths over the winter linked to the time of year. Flu and extreme cold weather are the two most likely causes.

Read the news story here

Identification badge lanyards as infection control risk

Murphy, C.M. et al. Journal of Hospital Infection. Published online: 20 January 2017

name-1714231_960_720.png

Staphylococcus aureus cultures from name badge lanyards were phenotypically and genotypically indistinguishable from the wearer’s nasal carrier strains by pulsed field gel electrophoresis and antibiogram. Lanyards had a mean age of 22 months and hygiene was poor with only 9 % ever having been laundered. Molecular analysis showed that 26% of S. aureus nasal carriers shared an indistinguishable strain on their lanyard. Lanyards should not be recommended for staff in frontline clinical care.

Read the abstract here