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Pedersen L, Elgin K, Peace B, Masroor N, Doll M, Sanogo K, Zuelzer W, Peterson G, Stevens MP, Bearman G. Barriers, perceptions, and adherence: Hand hygiene in the operating room and endoscopy suite. Am J Infect Control 2017; 45:695-697. [PMID: 28189412 DOI: 10.1016/j.ajic.2017.01.003] [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: 11/22/2016] [Revised: 01/03/2017] [Accepted: 01/03/2017] [Indexed: 10/20/2022]
Abstract
We examined the perceptions and barriers to nonsurgical scrubbed hand hygiene in the operating room and endoscopy procedure room using 2 anonymous Likert-scale surveys. Results indicated poor role modeling, inconvenience, and the need to monitor hand hygiene and feedback data to providers because of poor self-awareness of hand hygiene practices.
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Abstract
BACKGROUND Since the late 1970s there have been sporadic reports of nosocomial infections linked to endoscopic procedures. Infections by multidrug-resistant organisms (MDRO) have an increasing impact on healthcare systems worldwide. Since 2010 outbreaks involving MDRO have been reported as a result of endoscopic retrograde cholangiopancreatography (ERCP) from the USA, France, Germany and the Netherlands. METHODS This article evaluates the recent outbreaks and developments and demonstrates a structural approach to how to prevent future infections. Current national and international guidelines were used as a basis for discussions. RESULTS In some cases insufficient cleaning or drying supported the outbreak. In the majority of cases, outbreaks occurred despite the apparently appropriate reprocessing protocols being in use. Microlesions were identified on a number of endoscopes, which supported the growth of bacteria and represented a vehicle for the transmission of infectious material. National official bodies responded with warnings. Manufacturers informed their customers accordingly. Separate, purpose-designed reprocessing rooms and a sufficient number of competent staff provide the structural quality for a safe reprocessing. The process quality includes a thorough cleaning of all endoscope channels and crucial instrument components, followed by an automated and validated reprocessing procedure. Strict adherence to manufacturers' recommendations is essential. The outcome quality should be evaluated by regular audits, validation of reprocessing procedures and microbiological surveillance. If outbreaks occur, a close co-operation with official bodies and manufacturers is essential. CONCLUSION Health care professionals and manufacturers should be aware of their responsibility to ensure patient safety. A structural approach is key in prevention of endoscopy-associated infections.
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Affiliation(s)
- Michael Jung
- Klinik für Innere Medizin 2 (Gastroenterologie, Diabetologie, Onkologie), Katholisches Klinikum Mainz, Mainz, Germany
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Infektionsschutz und spezielle Hygienemaßnahmen in klinischen Disziplinen. KRANKENHAUS- UND PRAXISHYGIENE 2016. [PMCID: PMC7152143 DOI: 10.1016/b978-3-437-22312-9.00005-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Moura ML, Fenley JC, Baraldi MM, Boszczowski Í. Translational Research in Hand Hygiene Compliance. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2015. [DOI: 10.1007/s40506-015-0041-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Choi ES, Choi JH, Lee JM, Lee SM, Lee YJ, Kang YJ, Kim ES, Cho KB, Park KS, Jang BK, Hwang JS, Chung WJ, Ryoo NH, Jeon SW, Jung MK. Is the environment of the endoscopy unit a reservoir of pathogens? Intest Res 2014; 12:306-12. [PMID: 25374497 PMCID: PMC4214958 DOI: 10.5217/ir.2014.12.4.306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Revised: 04/11/2014] [Accepted: 04/14/2014] [Indexed: 12/03/2022] Open
Abstract
Background/Aims Given the characteristic procedures involved in the endoscopy unit, the spread of pathogens is much more frequent in this unit than in other environments. However, there is a lack of data elucidating the existence of pathogens in the endoscopy unit. The aim of this study was to detect the presence of possible pathogens in the endoscopy unit. Methods We performed environmental culture using samples from the endoscopy rooms of 2 tertiary hospitals. We used sterile cotton-tipped swabs moistened with sterile saline to swab the surfaces of 197 samples. Then, we cultured the swab in blood agar plate. Samples from the colonoscopy room were placed in thioglycollate broth to detect the presence of anaerobes. After 2 weeks of culture period, we counted the colony numbers. Results The most commonly contaminated spots were the doctor's keyboard, nurse's cart, and nurse's mouse. The common organisms found were non-pathogenic bacterial microorganisms Staphylococcus, Micrococcus, and Streptococcus spp.. No definite anaerobe organism was detected in the colonoscopy room. Conclusions Although the organisms detected in the endoscopy unit were mainly non-pathogenic organisms, they might cause opportunistic infections in immunocompromised patients. Therefore, the environment of the endoscopy room should be managed appropriately; moreover, individual hand hygiene is important for preventing possible hospital-acquired infections.
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Affiliation(s)
- Eun Sung Choi
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Jae Hyuk Choi
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Jung Min Lee
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Sang Min Lee
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Yoo Jin Lee
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Yu Jin Kang
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Eun Soo Kim
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Kwang Bum Cho
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Kyung Sik Park
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Byoung Kuk Jang
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Jae Seok Hwang
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Woo Jin Chung
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Nam Hee Ryoo
- Department of Laboratory Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Seong Woo Jeon
- Department of Internal Medicine, Kyungpook University School of Medicine, Daegu, Korea
| | - Min Kyu Jung
- Department of Internal Medicine, Kyungpook University School of Medicine, Daegu, Korea
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