1
|
Humphreys H, Bak A, Ridgway E, Wilson APR, Vos MC, Woodhead K, Haill C, Xuereb D, Walker JM, Bostock J, Marsden GL, Pinkney T, Kumar R, Hoffman PN. Rituals and behaviours in the operating theatre - joint guidelines of the Healthcare Infection Society and the European Society of Clinical Microbiology and Infectious Diseases. J Hosp Infect 2023; 140:165.e1-165.e28. [PMID: 37454912 DOI: 10.1016/j.jhin.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 06/05/2023] [Accepted: 06/11/2023] [Indexed: 07/18/2023]
Affiliation(s)
- H Humphreys
- Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland; Healthcare Infection Society, London, UK; ESCMID Study Group for Nosocomial Infection, Basel, Switzerland.
| | - A Bak
- Healthcare Infection Society, London, UK
| | - E Ridgway
- Healthcare Infection Society, London, UK
| | - A P R Wilson
- Healthcare Infection Society, London, UK; University College London Hospitals, London, UK
| | - M C Vos
- ESCMID Study Group for Nosocomial Infection, Basel, Switzerland; Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Centre, Rotterdam, The Netherlands
| | - K Woodhead
- Association for Perioperative Practice, Harrogate, UK; Royal College of Nursing, London, UK
| | - C Haill
- Healthcare Infection Society, London, UK
| | - D Xuereb
- Infection Prevention Society, Seafield, UK
| | - J M Walker
- Healthcare Infection Society, London, UK; NHS Grampian, Greater Aberdeen, UK
| | - J Bostock
- Lay Member for Healthcare Infection Society, London, UK
| | - G L Marsden
- Healthcare Infection Society, London, UK; Royal College of General Practitioners, London, UK
| | - T Pinkney
- University of Birmingham, Birmingham, UK
| | - R Kumar
- Lay Member for Healthcare Infection Society, London, UK
| | | |
Collapse
|
2
|
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: 0.5] [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.
Collapse
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
| |
Collapse
|
3
|
AL-Essa NA, AlMutairi MA. To what extent do dental students comply with infection control practices? ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.sjdr.2016.10.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
4
|
Affiliation(s)
- ET Curran
- Infection Control Nurse, North Glasgow Hospitals University NHS Trust & Greater Glasgow Health Board
| |
Collapse
|
5
|
Francis RH, Mudery JA, Tran P, Howe C, Jacob A. The Case for Using Evidence-Based Guidelines in Setting Hospital and Public Health Policy. Front Surg 2016; 3:20. [PMID: 27066489 PMCID: PMC4810072 DOI: 10.3389/fsurg.2016.00020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 03/16/2016] [Indexed: 11/16/2022] Open
Abstract
Objective Hospital systems and regulating agencies enforce strict guidelines barring personal items from entering the operating room (OR) – touting surgical site infections (SSIs) and patient safety as the rationale. We sought to determine whether or not evidence supporting this recommendation exists by reviewing available literature. Background data Rules and guidelines that are not evidence based may lead to increased hospital expenses and limitations on healthcare provider autonomy. Methods PubMed, Embase, Scopus, Cochrane Library, Web of Science, and CINAHL were searched in order to find articles that correlated personal items in the OR to documented SSIs. Articles that satisfied the following criteria were included: (1) studies looking at personal items in the OR, such as handbags, purses, badges, pagers, backpacks, jewelry phones, and eyeglasses, but not just OR equipment; and (2) the primary outcome measure was infection at the surgical site. Results Seventeen articles met inclusion criteria and were evaluated. Of the 17, the majority did not determine if personal items increased risk for SSIs. Only one article examined the correlation between a personal item near the operative site and SSI, concluding that wedding rings worn in the OR had no impact on SSIs. Most studies examined colonization rates on personal items as potential infection risk; however, no personal items were causally linked to SSI in any of these studies. Conclusion There is no objective evidence to suggest that personal items in the OR increase risk for SSIs.
Collapse
Affiliation(s)
- Ross H Francis
- Department of Otolaryngology - Head and Neck Surgery, The University of Arizona College of Medicine , Tucson, AZ , USA
| | - Jordan A Mudery
- Department of Otolaryngology - Head and Neck Surgery, The University of Arizona College of Medicine , Tucson, AZ , USA
| | - Phi Tran
- Department of Otolaryngology - Head and Neck Surgery, The University of Arizona College of Medicine , Tucson, AZ , USA
| | - Carol Howe
- Arizona Health Sciences Library, The University of Arizona College of Medicine , Tucson, AZ , USA
| | - Abraham Jacob
- Department of Otolaryngology - Head and Neck Surgery, The University of Arizona Ear Institute, The University of Arizona College of Medicine, Tucson, AZ, USA; The University of Arizona Cancer Center, The University of Arizona Bio5 Institute, Tucson, AZ, USA
| |
Collapse
|
6
|
Spierings EJW, Spierings PTJ, Nabuurs-Franssen M, Hopman J, Perencevich E, Voss A. A cross-sectional observational study about media and infection control practices: are photographic portrayals of healthcare workers setting a bad example? Antimicrob Resist Infect Control 2015; 4:53. [PMID: 26613018 PMCID: PMC4660788 DOI: 10.1186/s13756-015-0094-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 11/16/2015] [Indexed: 11/10/2022] Open
Abstract
Background Attempts to increase compliance with infection control practices are complex and are - in part - based on attempts to change behaviour. In particular, the behaviour of significant peers (role models) has been shown to be a strong motivator. While role models within the working environment are obviously the most important, some experts suggest that media and public display cannot be ignored. The aim of this present study was to examine the display of technique recommended by current infection control guidelines including the “bare below the elbow” principle, which is considered a basic requirement for good infection control in many countries, in sets of professional stock photos. Findings From 20 random photo-stock websites we selected pictures with search terms “doctor and patient” and “nurse and patient”. In all selected photos a doctor or nurse and a patient were presented, healthcare workers (HCWs) were wearing white coats or uniforms, and their arms were visible. Each photo was evaluated with regard to: closure of white coat, sleeve length, personal clothing covered, hairstyle and presence of a wristwatch, bracelet and/or ring. Overall, 1600 photos were evaluated. The most common mistakes were with regard to HCWs’ white coats/uniforms. Eighty-nine percent of the photos containing doctor’s images were considered incorrect while 28 % of nurse-containing photos were incorrect. Conclusions The results seem to reflect the real world with only 40 % displaying correct behaviour with doctors being worse than nurses. It seems that the stereotypical image of a doctor does not agree with the current infection control guidelines. If we aim for higher compliance rates of HCWs, we need to change the social image of doctors and improve production, selection and display of stock photo images.
Collapse
Affiliation(s)
- E J W Spierings
- Radboud University of Nijmegen, Medical School, Platolaan 340, 6525 KD Nijmegen, The Netherlands
| | | | - M Nabuurs-Franssen
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands
| | - J Hopman
- Department of Medical Microbiology, Radboud University of Nijmegen, Nijmegen, The Netherlands
| | - E Perencevich
- Division of Infectious Diseases and Epidemiology, University of Iowa Hospital and Clinics, Iowa City, IA USA
| | - A Voss
- Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands ; Department of Medical Microbiology, Radboud University of Nijmegen, Nijmegen, The Netherlands
| |
Collapse
|
7
|
Cowperthwaite L, Holm RL. Guideline Implementation: Surgical Attire. AORN J 2015; 101:188-94; quiz 195-7. [DOI: 10.1016/j.aorn.2014.12.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 12/04/2014] [Accepted: 12/06/2014] [Indexed: 12/01/2022]
|
8
|
Fagernes M, Lingaas E. Impact of Finger Rings on Transmission of Bacteria During Hand Contact. Infect Control Hosp Epidemiol 2015; 30:427-32. [DOI: 10.1086/596771] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Objective.To investigate the impact of finger rings on the transmission of bacteria from the hands of healthcare workers and the impact on the microflora on the hands of healthcare workers in clinical practice.Design.Our study had a nonequivalent control group posttest-only design (pre-experimental). Healthcare workers who wore finger ring(s) on 1 hand and no ring on the other hand (n = 100) and a control group of healthcare workers who did not wear any rings (n = 100) exchanged standardized hand shakes with an investigator wearing sterile gloves. Samples from the gloved hands of the investigators and the bare hands of the healthcare workers were thereafter obtained by the glove juice technique.Setting.Two Norwegian acute care hospitals.Participants.Healthcare workers (n = 200) during ordinary clinical work.Results.A significantly higher bacterial load (odds ratio, 2.63 [95% confidence interval, 1.28-5.43]; P = .009) and a significantly higher number of bacteria transmitted (odds ratio, 2.43 [95% confidence interval, 1.44-4.13]; P = .001) were associated with ringed hands, compared with control hands. However, a multiple analysis of covariance revealed no statistically significant effect of rings alone. The prevalence of nonfermentative gram-negative bacteria (42% vs 26%) and Enterobacteriaceae (26% vs 13%) was also significantly higher among persons who wore rings than among persons who did not wear rings. However, no statistically significant differences in the incidence of transmission of these pathogens were detected after hand contact. The prevalence of Staphylococcus aureus and incidence of transmission of S. aureus were the same in both groups.Conclusions.Wearing finger rings increases the carriage rate of nonfermentative gram-negative bacteria and Enterobacteriaceae on the hands of healthcare workers. However, no statistically significant differences in the incidence of transmission of nonfermentative gram-negative bacteria or Enterobacteriaceae were detected between the healthcare workers who wore rings and those who did not.
Collapse
|
9
|
Fagernes M, Lingaas E, Bjark P. Impact of a Single Plain Finger Ring on the Bacterial Load on the Hands of Healthcare Workers. Infect Control Hosp Epidemiol 2015; 28:1191-5. [PMID: 17828698 DOI: 10.1086/520739] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2007] [Accepted: 05/18/2007] [Indexed: 11/03/2022]
Abstract
Objective.To investigate the impact of a single plain finger ring on the number and types of bacteria on the hands of healthcare workers (HCWs).Design.Nonequivalent control groups, posttest only (preexperimental).Methods.A total of 121 HCWs wearing 1 plain ring and 113 HCWs wearing no rings had both hands sampled by the “glove juice” technique. Quantitative culture of the samples was performed and microorganisms were identified.Setting.Two Norwegian acute care hospitals.Participants.A total of 234 HCWs who had physical contact with patients.Results.Total bacterial counts did not differ when hands with rings and hands without rings were compared, both according to nonpaired analysis (which compared the ring-bearing hands of ring-wearing HCWs to the hands of HCWs who did not wear rings [P= .661]) and according to paired analysis (which compared the ring-bearing and ring-free hands of ring-wearing HCWs [P= .071]).Staphylococcus aureuswas recovered from 18.6% of the hands sampled, belonging to 26.9% of the HCWs, but neither paired nor nonpaired analysis showed any association with ring wearing. Gram-negative bacteria were recovered from 20.3% of the hands sampled, belonging to 28.6% of the HCWs. Ring-wearing HCWs were significantly more likely to be carriers of Enterobacteriaceae (P= .006), but paired comparison of the ring-bearing and ring-free hands of these HCWs did not show significant differences (P= .180). Carriage of nonfermentative gram-negative rods did not differ between the 2 groups, by either paired or nonpaired analysis.Conclusions.Wearing a single plain finger ring did not increase the total bacterial load on the hands, nor was it associated with an increased rate of carriage ofS. aureusor nonfermentative gram-negative rods. However, plain rings were associated with an increased rate of Enterobacteriaceae carriage.
Collapse
Affiliation(s)
- Mette Fagernes
- Department of Internal Medicine, Vestfold Hospital, Tonsberg, Norway.
| | | | | |
Collapse
|
10
|
Fagernes M, Lingaas E. Factors interfering with the microflora on hands: a regression analysis of samples from 465 healthcare workers. J Adv Nurs 2010; 67:297-307. [DOI: 10.1111/j.1365-2648.2010.05462.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
11
|
Todd ECD, Michaels BS, Greig JD, Smith D, Bartleson CA. Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 8. Gloves as barriers to prevent contamination of food by workers. J Food Prot 2010; 73:1762-73. [PMID: 20828485 DOI: 10.4315/0362-028x-73.9.1762] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The role played by food workers and other individuals in the contamination of food has been identified as an important contributing factor leading to foodborne outbreaks. To prevent direct bare hand contact with food and food surfaces, many jurisdictions have made glove use compulsory for food production and preparation. When properly used, gloves can substantially reduce opportunities for food contamination. However, gloves have limitations and may become a source of contamination if they are punctured or improperly used. Experiments conducted in clinical and dental settings have revealed pinhole leaks in gloves. Although such loss of glove integrity can lead to contamination of foods and surfaces, in the food industry improper use of gloves is more likely than leakage to lead to food contamination and outbreaks. Wearing jewelry (e.g., rings) and artificial nails is discouraged because these items can puncture gloves and allow accumulation of microbial populations under them. Occlusion of the skin during long-term glove use in food operations creates the warm, moist conditions necessary for microbial proliferation and can increase pathogen transfer onto foods through leaks or exposed skin or during glove removal. The most important issue is that glove use can create a false sense of security, resulting in more high-risk behaviors that can lead to cross-contamination when employees are not adequately trained.
Collapse
Affiliation(s)
- Ewen C D Todd
- Department of Advertising Public Relations and Retailing, Michigan State University, East Lansing, Michigan 48824, USA.
| | | | | | | | | |
Collapse
|
12
|
Jeans A, Moore J, Nicol C, Bates C, Read R. Wristwatch use and hospital-acquired infection. J Hosp Infect 2010; 74:16-21. [DOI: 10.1016/j.jhin.2009.06.032] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2009] [Accepted: 06/28/2009] [Indexed: 10/20/2022]
|
13
|
Pittet D, Allegranzi B, Boyce J. The World Health Organization Guidelines on Hand Hygiene in Health Care and their consensus recommendations. Infect Control Hosp Epidemiol 2009; 30:611-22. [PMID: 19508124 DOI: 10.1086/600379] [Citation(s) in RCA: 434] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The World Health Organization's Guidelines on Hand Hygiene in Health Care have been issued by WHO Patient Safety on 5 May 2009 on the occasion of the launch of the Save Lives: Clean Your Hands initiative. The Guidelines represent the contribution of more than 100 international experts and provide a comprehensive overview of essential aspects of hand hygiene in health care, evidence- and consensus-based recommendations, and lessons learned from testing their Advanced Draft and related implementation tools.
Collapse
Affiliation(s)
- Didier Pittet
- Infection Control Program, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland.
| | | | | | | |
Collapse
|
14
|
Bacterial colonization of wristwatches worn by health care personnel. Am J Infect Control 2009; 37:476-7. [PMID: 19243858 DOI: 10.1016/j.ajic.2008.11.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2008] [Revised: 11/03/2008] [Accepted: 11/05/2008] [Indexed: 11/20/2022]
Abstract
We examined bacterial colonization of wristwatches worn by 100 health care personnel in a community-teaching hospital. Seventy-eight percent of the wristwatches were colonized with bacterial skin flora, with only 1 of the 100 watches growing a potential pathogen, Staphylococcus aureus. Watches are unlikely to be sources of health-care associated pathogens.
Collapse
|
15
|
A prospective comparative study of the relationship between different types of ring and microbial hand colonization among pediatric intensive care unit nurses. Int J Nurs Stud 2008; 45:1572-6. [DOI: 10.1016/j.ijnurstu.2008.02.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2007] [Revised: 12/22/2007] [Accepted: 02/22/2008] [Indexed: 11/19/2022]
|
16
|
Al-Allak A, Sarasin S, Key S, Morris-Stiff G. Wedding rings are not a significant source of bacterial contamination following surgical scrubbing. Ann R Coll Surg Engl 2008; 90:133-5. [PMID: 18325213 DOI: 10.1308/003588408x242051] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Despite some evidence that the wearing of rings may increase the microbial load, there is currently nothing to suggest that viable bacteria remain following a standard surgical scrub. The aim of the study was to examine the distribution and type of microbial flora seen on the hands of doctors following a standard surgical scrub. MATERIALS AND METHODS Ten surgeons and 10 anaesthetists, all of whom wore wedding rings on the fourth finger of their left hand, participated in the study. Each individual was asked to 'scrub-up' as for their normal first scrub of the day. Following completion of washing, the wedding ring was removed, its internal circumference swabbed and the swab placed in a culture medium. Volunteers placed each hand palm-down on separate agar plates. The plates were incubated and the number of colonies counted and classified. RESULTS The culture plates of one of the anaesthetists were damaged in transit leaving a total of 19 subjects for analysis. In all the palm imprint plates, coagulase-negative staphylococci were grown. One surgeon grew coagulase-negative staphylococci from the ring swab. A Candida spp. from the right hand of one surgeon was grown. There was no statistically significant difference between the number of colony-forming units (CFUs) cultured from the right and left (ring-wearing) hands of the surgeons (P = 0.260) and anaesthetists ( P = 0.345). There was no statistical difference in CFUs when surgeons were compared with anaesthetists (P = 0.383 for right hand and P = 0.234 for left). CONCLUSIONS This preliminary study would suggest that a traditional band wedding ring is not a source of a bacterial load following a standard surgical scrub procedure and, as such, there is no requirement for their removal pre-operatively.
Collapse
Affiliation(s)
- A Al-Allak
- Department of Surgery, Princess of Wales Hospital, Bridgend, UK.
| | | | | | | |
Collapse
|
17
|
Abstract
Studies have shown that despite infection control guidelines recommending that false fingernails, nail varnish, stoned rings and wrist watches not be worn by clinical staff, a large proportion of them continue to do so. The recently updated epic guidelines (Pratt et al, 2007) state that hand jewellery and false finger nails should be kept short, clean and free from nail polish. This article discusses the bacterial carriage, contributions to outbreaks of infection and interference with proper hand hygiene practices, thereby explaining why these recommendations are made in infection control policies and guidelines.
Collapse
|
18
|
Waterman TR, Smeak DD, Kowalski J, Hade EM. Comparison of bacterial counts in glove juice of surgeons wearing smooth band rings versus those without rings. Am J Infect Control 2006; 34:421-5. [PMID: 16945687 DOI: 10.1016/j.ajic.2005.11.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2005] [Revised: 11/22/2005] [Accepted: 11/22/2005] [Indexed: 10/24/2022]
Abstract
BACKGROUND Removal of rings is recommended before surgeons aseptically prepare for surgical procedures. OBJECTIVES This study was undertaken to determine whether there is a difference between bacterial counts under surgical gloves of ring wearers compared with nonring wearers after proper aseptic hand preparation and 3 hours of wear. METHODS Twenty volunteer veterinary medical students were divided into 2 groups: One group wore a smooth ring band (without projections or mounted stones) on their ring finger, and the other group did not wear a ring. A modified glove juice method was used to obtain bacterial counts (colony-forming units/mL) inside surgically gloved hands prior to a proper aseptic hand preparation and 3 hours after hand preparation and wear. Each of the pre- and postsurgical glove juice samples were inoculated onto Letheen agar plates, which were incubated aerobically under atmospheric conditions for 48 hours at 35 degrees C. Gloves were tested for perforations using a water pressure test. RESULTS No differences, or significant change, in bacterial counts were found before or after surgery between all ring hands and nonring hands or between ring and nonring hands for ringed participants. No differences in bacterial counts were found within perforated versus nonperforated gloves. CONCLUSION There is no compelling evidence to suggest that surgeons wearing rings possess higher bacterial counts under their gloves during surgery.
Collapse
Affiliation(s)
- Tami R Waterman
- College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.
| | | | | | | |
Collapse
|
19
|
|
20
|
Qudeimat MA, Farrah RY, Owais AI. Infection control knowledge and practices among dentists and dental nurses at a Jordanian University Teaching Center. Am J Infect Control 2006; 34:218-22. [PMID: 16679180 DOI: 10.1016/j.ajic.2005.06.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2005] [Revised: 06/21/2005] [Accepted: 06/28/2005] [Indexed: 11/21/2022]
Abstract
BACKGROUND Information regarding compliance with infection control precautions in the dental settings in the Middle East is scant. OBJECTIVE To examine the knowledge and practices in infection control among dental staff and dental nurses at a university teaching dental center. METHODS A self-administered, confidential questionnaire concerning various aspects of infection control knowledge and practices was distributed to 48 dental staff and 28 dental nurses working at the Jordan University of Science and Technology Dental Teaching Center. RESULTS Responses came from 37 (77%) dental teaching staff members and 23 (82%) dental nurses. Of the dental staff participants, 95% received hepatitis B immunization in comparison with 87% of the dental nurses. Dental nurses were more prone to percutaneous dental injuries (P < .05). In both groups, 100% reported routine wearing of gloves. Although the dental staff reported a statistically higher frequency of washing hands before gloving (46%), dental nurses reported a higher frequency of washing hands after removing the gloves (100%). Dental staff reported statistically higher frequency of routine mask use (43%) than dental nurses (30%). CONCLUSION Compliance with recommended guidelines for control of cross infection varied among the 2 tested groups. A need exists for proper practice of infection control by both dental staff and dental nurses.
Collapse
|
21
|
Jumaa PA. Hand hygiene: simple and complex. Int J Infect Dis 2005; 9:3-14. [PMID: 15603990 DOI: 10.1016/j.ijid.2004.05.005] [Citation(s) in RCA: 126] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2004] [Revised: 05/22/2004] [Accepted: 05/24/2004] [Indexed: 11/26/2022] Open
Abstract
This review gives an overview of hand hygiene in healthcare and in the community, including some aspects which have attracted little attention, such as hand drying and cultural issues determining hand hygiene behaviour. Hand hygiene is the most effective measure for interrupting the transmission of microorganisms which cause infection both in the community and in the healthcare setting. Using hand hygiene as a sole measure to reduce infection is unlikely to be successful when other factors in infection control, such as environmental hygiene, crowding, staffing levels and education are inadequate. Hand hygiene must be part of an integrated approach to infection control. Compliance with hand hygiene recommendations is poor worldwide. While the techniques involved in hand hygiene are simple, the complex interdependence of factors which determine hand hygiene behaviour makes the study of hand hygiene complex. It is now recognised that improving compliance with hand hygiene recommendations depends on altering human behaviour. Input from behavioural and social sciences is essential when designing studies to investigate compliance. Interventions to increase compliance with hand hygiene practices must be appropriate for different cultural and social needs. New strategies to promote hand hygiene worldwide include the formation of public-private partnerships.
Collapse
Affiliation(s)
- P A Jumaa
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates.
| |
Collapse
|
22
|
Trick WE, Vernon MO, Hayes RA, Nathan C, Rice TW, Peterson BJ, Segreti J, Welbel SF, Solomon SL, Weinstein RA. Impact of ring wearing on hand contamination and comparison of hand hygiene agents in a hospital. Clin Infect Dis 2003; 36:1383-90. [PMID: 12766832 DOI: 10.1086/374852] [Citation(s) in RCA: 120] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2002] [Accepted: 01/30/2003] [Indexed: 01/26/2023] Open
Abstract
We determined risk factors for hand contamination and compared the efficacy of 3 randomly allocated hand hygiene agents in a group of surgical intensive care unit nurses. We cultured samples of one of the subjects' hands before and samples of the other hand after hand hygiene was performed. Ring wearing was associated with 10-fold higher median skin organism counts; contamination with Staphylococcus aureus, gram-negative bacilli, or Candida species; and a stepwise increased risk of contamination with any transient organism as the number of rings worn increased (odds ratio [OR] for 1 ring worn, 2.6; OR for >1 ring worn, 4.6). Compared with use of plain soap and water, hand contamination with any transient organism was significantly less likely after use of an alcohol-based hand rub (OR, 0.3; 95% confidence interval [CI], 0.1-0.8) but not after use of a medicated hand wipe (OR, 0.9; 95% CI, 0.5-1.6). Ring wearing increased the frequency of hand contamination with potential nosocomial pathogens. Use of an alcohol-based hand rub resulted in significantly less frequent hand contamination.
Collapse
Affiliation(s)
- William E Trick
- Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Boyce JM, Pittet D. Guideline for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HIPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Am J Infect Control 2002; 30:S1-46. [PMID: 12461507 DOI: 10.1067/mic.2002.130391] [Citation(s) in RCA: 453] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The Guideline for Hand Hygiene in Health-Care Settings provides health-care workers (HCWs) with a review of data regarding handwashing and hand antisepsis in health-care settings. In addition, it provides specific recommendations to promote improved hand-hygiene practices and reduce transmission of pathogenic microorganisms to patients and personnel in health-care settings. This report reviews studies published since the 1985 CDC guideline (Garner JS, Favero MS. CDC guideline for handwashing and hospital environmental control, 1985. Infect Control 1986;7:231-43) and the 1995 APIC guideline (Larson EL, APIC Guidelines Committee. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251-69) were issued and provides an in-depth review of hand-hygiene practices of HCWs, levels of adherence of personnel to recommended handwashing practices, and factors adversely affecting adherence. New studies of the in vivo efficacy of alcohol-based hand rubs and the low incidence of dermatitis associated with their use are reviewed. Recent studies demonstrating the value of multidisciplinary hand-hygiene promotion programs and the potential role of alcohol-based hand rubs in improving hand-hygiene practices are summarized. Recommendations concerning related issues (e.g., the use of surgical hand antiseptics, hand lotions or creams, and wearing of artificial fingernails) are also included.
Collapse
|
24
|
Boyce JM, Pittet D. Guideline for Hand Hygiene in Health-Care Settings: recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infect Control Hosp Epidemiol 2002; 23:S3-40. [PMID: 12515399 DOI: 10.1086/503164] [Citation(s) in RCA: 628] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The Guideline for Hand Hygiene in Health-Care Settings provides health-care workers (HCWs) with a review of data regarding handwashing and hand antisepsis in health-care settings. In addition, it provides specific recommendations to promote improved hand-hygiene practices and reduce transmission of pathogenic microorganisms to patients and personnel in health-care settings. This report reviews studies published since the 1985 CDC guideline (Garner JS, Favero MS. CDC guideline for handwashing and hospital environmental control, 1985. Infect Control 1986;7:231-43) and the 1995 APIC guideline (Larson EL, APIC Guidelines Committee. APIC guideline for handwashing and hand antisepsis in health care settings. Am J Infect Control 1995;23:251-69) were issued and provides an in-depth review of hand-hygiene practices of HCWs, levels of adherence of personnel to recommended handwashing practices, and factors adversely affecting adherence. New studies of the in vivo efficacy of alcohol-based hand rubs and the low incidence of dermatitis associated with their use are reviewed. Recent studies demonstrating the value of multidisciplinary hand-hygiene promotion programs and the potential role of alcohol-based hand rubs in improving hand-hygiene practices are summarized. Recommendations concerning related issues (e.g., the use of surgical hand antiseptics, hand lotions or creams, and wearing of artificial fingernails) are also included.
Collapse
Affiliation(s)
- John M Boyce
- Hospital of Saint Raphael, New Haven, Connecticut, USA
| | | |
Collapse
|