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1.
Am J Infect Control ; 48(5): 503-506, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31924389

RESUMO

BACKGROUND: Alcohol based hand rubs (ABHR) are extremely effective at reducing microbial contamination and have an essential role in best practice hand hygiene described by the World Health Organization. METHODS: We determined ABHR drying time when performing hand hygiene in a laboratory setting. Which was followed by identifying the amount of ABHR needed for complete hand coverage. When the aforementioned was analyzed real-time data were gathered to examine the amount used for hand hygiene in a hospital setting. In parallel hands of healthcare workers (HCWs) were monitored for drying time and perception on ABHR use. RESULTS: In 86% (24,446,397/28,280,383) of the events a single dose of ABHR was used on clinical wards. Twenty-four HCWs expected hand hygiene to take 7.5 seconds (median; range 3-30 seconds). Forty-three HCWs show that 1.5 mL ABHR dose achieves the desired drying time according to World Health Organization guidelines (av. median 26 seconds), but is consistently perceived to have a longer drying time than expected (av. median 18 seconds). In-vivo results (n = 10) indicate that 2.25 mL ABHR is required for adequate coverage (82%-90%) of both sides of the hand. CONCLUSIONS: Results indicate that set standards for the use of ABHR do not match "in-vivo" behaviour of HCWs. Perceived drying times are shorter than actual drying time. The needed drying time to reach acceptable antimicrobial efficacy of ABHRs should be revisited.


Assuntos
Desinfecção das Mãos/métodos , Higienizadores de Mão/administração & dosagem , Fatores de Tempo , Infecção Hospitalar/prevenção & controle , Relação Dose-Resposta a Droga , Etanol/administração & dosagem , Fidelidade a Diretrizes , Mãos/microbiologia , Desinfecção das Mãos/normas , Higienizadores de Mão/química , Humanos , Resultado do Tratamento
2.
J Hosp Infect ; 101(1): 49-52, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30149087

RESUMO

Following the first point-prevalence study in Dutch nursing homes conducted each November from 2007 to 2009, we conducted a follow-up point-prevalence study of healthcare-associated infections (HCAIs) each November from 2010 to 2017. Similar methods and criteria were used. Resident characteristics were recorded, data collection was performed by the attending elderly care physicians via an online survey, as well as via a specifically designed App from 2012. As of the same year, information on incontinence was added. Between 2010 until 2017 on average 1786 residents per year were included, ranging from 1571 to 2185. HCAI prevalence with respect to age (mean: 83 years) and sex (31% men and 69% women) were similar over all the years. The overall mean prevalence rate in the first four years was 6.7% versus 2.2% in the last six years. Urinary tract infection was the most prevalent HCAI (1.5%). Most HCAIs occurred among residents of rehabilitation units. The prevalence of HCAI varied by nursing home (0.0-37.0%). The average use of antibiotics was stable over the years (6.0%) irrespective of HCAI rate. Use of incontinence materials was on average 73.5% with 64.3% of residents being reported as incontinent. Those implementing improvement of infection control and surveillance within a new setting do need to continue for multiple years before seeing the success of their endeavour.


Assuntos
Infecção Hospitalar/epidemiologia , Casas de Saúde , Fatores Etários , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Estudos Transversais , Uso de Medicamentos , Feminino , Seguimentos , Humanos , Masculino , Países Baixos/epidemiologia , Fatores Sexuais
3.
J Hosp Infect ; 78(1): 59-62, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21435737

RESUMO

From November 2007 for a period of three years (2007-2009), we conducted an annual one-day prevalence study of healthcare-associated infections (HAIs) among nursing home residents in the Nijmegen region of The Netherlands. In the absence of national HAI definitions applicable to the nursing home setting, we used modified definitions based on US Centers for Disease Control and Prevention criteria for bloodstream infection, lower respiratory tract infection, bacterial conjunctivitis, and gastroenteritis. For the surveillance of urinary tract infection (UTI), criteria established by the Dutch Association of Elderly Care Physicians were used. Resident characteristics were recorded and data collection was performed by the attending elderly care physicians. For the three-year period, 1275, 1323, and 1772 nursing home residents were included, resulting in a prevalence of HAIs of 6.7%, 7.6% and 7.6%, in 2007, 2008 and 2009, respectively. The demographics with respect to age (mean 81 years) and sex (31% men, 69% women) were almost identical in all three years. UTI was the most prevalent HAI with 3.5%, 4.2%, and 4.1% respectively. Most HAIs occurred among residents of rehabilitation units. The prevalence of HAIs varied by nursing home (range: 0.0-32.4%). We present the results of the first prevalence study of HAIs in Dutch nursing homes. Point prevalence studies of HAIs, as part of a quality improvement cycle, are an important cornerstone of infection control programmes in nursing homes, allowing us to further increase patient safety efforts in this setting.


Assuntos
Infecção Hospitalar/epidemiologia , Casas de Saúde , Idoso de 80 Anos ou mais , Bacteriemia/epidemiologia , Infecções Bacterianas/epidemiologia , Broncopneumonia/epidemiologia , Conjuntivite/epidemiologia , Feminino , Gastroenterite/epidemiologia , Humanos , Masculino , Países Baixos , Prevalência
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