Antibacterial effects on dry-fast and traditional water-based surgical scrubbing methods: a two-time points experimental study.

This study determined the in-use effects of dry-fast and traditional hand-washing surgical scrubs among operating room staff members. This is a static group comparison study with purposive sampling. A total of 156 staff members were recruited in an operating room in a medical center located in southern Taiwan. The participants were divided into traditional and dry-fast hand-washing groups. Microbial counts were measured right after the two groups finished surgical scrubbing and at the completion of surgery. The results showed that the use of dry-fast antisepsis has a better persistent effect (P = 0.001), more nurses chose dry-fast antisepsis than surgeons (P = 0.012), and the post-operation number of colonies for nurses was significantly higher than that for surgeons (P = 0.003). Operating room nurses are long-term and frequent users of antibacterial agents, and their requirement of skin protection is higher. The dry-fast technique has the advantage of being less irritating to the skin and less time consuming; therefore, brush-free and dry-fast antisepsis is recommended.

[A refinement of the supply system to reduce instrument packaging re-sterilization rates].

BACKGROUND: Sterilized instrument packages facilitate instrument availability in surgery. However, repeated sterilizations after expiration of disinfection validity results in additional costs. Last year, an average of 2,505 instrument packages were re-sterilized each month due to expiration. Reducing the re-sterilization rate is an issue in terms of cost reduction. OBJECTS: In this study, we tried to decrease the instrument package re-sterilization rate by refining the hospital instrument supply system. The result reduced costs and enhanced patient safety. RESOLUTION: Refinement procedures included staff re-education, changing sterilization and packing methods to extend the validity period, establishing a warning system, periodic examination of demand, and establishing an auditing system. Average numbers of expired packages and sterilization costs were compared pre- and post-study period. RESULTS: The average amount of expired packages fell from 2505/month to 592/month. The expiration rate decreased from 25.7 % to 5.9 %. Costs of re-sterilization decreased from 82,665 NTD per month to 19,536 NTD per month (i.e., a decrease of 63,129 NTD in costs per month). CONCLUSION: Refining the supply system can reduce expiration and re-sterilization rates for instrument packaging, achieving lower costs without sacrificing quality.

[A project to improve the validity rate for nursing staff operating single door autoclave sterilizers].

This project was designed to improve the low validity rate for nurses responsible to operate single door autoclave sterilizers in the operating room. By investigating the current status, we found that the nursing staff validity rate of cognition on the autoclave sterilizer was 85%, and the practice operating check validity rate was only 80%. Such was due to a lack of in-service education. Problems with operation included: 1. Unsafe behaviors - not following standard procedure, lacking relevant operating knowledge and absence of a check form; 2. Unsafe environment - the conveying steam piping was typically not covered and lacked operation marks. Recommended improvement measures included: 1. holding in-service education; 2. generating an operation procedure flow chart; 3. implementing obstacle eliminating procedures; 4. covering piping to prevent fire and burns; 5. performing regular checks to ensure all procedures are followed. Following intervention, nursing staff cognition rose from 85% to 100%, while the operation validity rate rose from 80% to 100%. These changes ensure a safer operating room environment, and helps facilities move toward a zero accident rate in the healthcare environment.