Assessment of trained hand hygiene observers using parallel observations

Objectives: To validate hand hygiene [HH] observers following training and determine the concordance between the observers and the Kappa index

Methods: This study was conducted during June 2017. HH observers from 15 hospital units received eight-hours training including a two-hour workshop conducted by the infection control practitioner and hospital epidemiologist. After its completion, parallel observations were conducted by trained nurses from each respective unit for a maximum of 20 minutes per session at any time or day

Results: A total of 789 parallel observations were performed. In observed HH actions, the percentage of agreement between trained and experienced observers was 75.4%, with a Kappa index of agreement of 0.61 [95% confidence interval [CI]: 0.57-0.66]. For the observed HH moments, the agreement among observers was 83.8% with a Kappa index of 0.71 [95% CI: 0.66-0.75]

Conclusions: HH observers were validated after a dedicated training in correspondence with the recommendation to improve HH monitoring. Additional studies should focus on evaluating the sustainability of the agreement, the requirement of retraining, and other alternatives for observers' validation

Incidence and etiology of surgical site infections in appendectomies: a 3-year prospective study

Objectives: Surgical site infections [SSIs] constitute a threat, especially in complicated appendicitis, and are commonly due to gram-negative organisms. We sought to describe the incidence of SSIs in appendectomies performed during a three-year period [January 2013 to December 2015] in a community hospital in Qatar, and compare this with external benchmarks

Methods: We conducted a longitudinal study at The Cuban Hospital, Qatar. We used the standardized surveillance criteria to define SSI developed by the Centers for Disease Control. Information about age, sex, smoking habits, diabetes mellitus status, body mass index, and the result of bacteriologic studies were collected

Results: Of a total 603 patients, 22 [3.6%] cases of SSI were reported, with an infection rate of 13.6%, 4.5%, and 1.0% in 2013, 2014, and 2015, respectively. SSIs were observed more frequently in patients with contaminated/dirty wounds [6.6%]. About 65% of isolates from the surgical site were multidrug-resistant organisms [Escherichia coli and Klebsiella spp.]

Conclusions: This study describes the incidence of SSI in appendectomy, which could be used as a benchmark for the facility improvement program. The high frequency of multidrug-resistant organisms in SSIs requires additional studies focused on evaluating the effectiveness of the current preventive practices with a particular reference to antimicrobial prophylaxis