ABSTRACT
Background: Peripheral intravenous catheters (PIVCs) are the most commonly used invasive medical device in health care with an overall failure rate of 35-50%. Most complications are non-infectious, but local site and bloodstream infections can also occur. Even if PIVC-related infections are rare, the total number of affected patients and the preponderance of Staphylococcus aureus as related pathogen due to the frequent use of these devices are relevant arguments to implement preventive strategies. The aim of this document is to raise awareness that infections caused by PIVCs are a relevant problem that can be reduced by practice change. Methods: A panel of experts discussed this topic based on evidence and proposed practice points by consensus. Discussion: Despite published evidence-based guidelines, current practice concerning aseptic techniques during insertion and care of PIVCs often are substandard. These devices have become commonplace and tend to be perceived as safe. An overall lack of awareness about the true risks associated with the use of PIVCs results in limited surveillance and prevention efforts. Conclusion: Successful insertion and maintenance bundles in central venous lines are a blueprint to the implementation of adapted bundle strategies in the prevention of PIVC-associated infections. There is a need for studies to specifically investigate infection prevention in PIVCs and to agree on effective and implementable bundles.
ABSTRACT
The processes of anaesthesia during operations enable surgical disciplines to perform a wide range of procedures. However, anaesthesia procedure may also represent a potential risk of infection for the surgical patient. Important hygiene measures concern the following topics: hand hygiene, surface disinfection, administration of parenteral drugs, dealing with catheters, intubation, perioperative antibiotic prophylaxis, temperature management, change intervals, OR workflow organization. The selection of hygiene measures for anaesthesia staff in the operating theatre listed in this article is presented in the sequence of the work flow, whereby certain topics such as hand hygiene naturally play an important role in all work phases.
Subject(s)
Anesthesia , Cross Infection , Hand Hygiene , Surgical Wound Infection , Anesthesia/adverse effects , Cross Infection/etiology , Cross Infection/prevention & control , Disinfection , Humans , HygieneABSTRACT
BACKGROUND: Monitoring healthcare workers' (HCWs) hand hygiene (HH) performance is recommended for improving compliance. Observer biases challenge data validity, thus supplemental approaches such as video observation are needed to complement monitoring. METHODS: We investigate first-person view (FPV) video observation during simulated standardized patient care handling a catheter in a study with 71 HCWs. HH performance was evaluated for (1) all HH opportunities and (2) a subset of opportunities required in an ideal work sequence, hereafter core opportunities. HCWs' acceptance of FPV video observation and usability judgments were assessed. RESULTS: Compliance level for core HH opportunities (Mâ¯=â¯43.5%) was significantly higher than compliance considering all opportunities (Mâ¯=â¯30.4%, t(70)â¯=â¯8.493, P < .001). Reducing HH opportunities to core opportunities would significantly increase compliance levels from the observed average of 30.4% to 44.9% (t(70)â¯=â¯12.822, P < .001). Overall, both usability ratings and acceptance of the body camera were promising. DISCUSSION: FPV video observation in simulated standardized patient care provides new instruments to evaluate HH performance beyond mere compliance rates. Our results emphasize the role of optimizing workflow in order to improve HCW's HH compliance. CONCLUSIONS: FPV video observation in a standardized patient care simulation is feasible and offers information for HH interventions that target actual deficiencies.
