- Email: [email protected]
Are Adults in Hong Kong Using Face Mask Correctly?
S36
Poster Abstracts / American Journal of Infection Control 45 (2017) S16-S93
CONCLUSIONS: Validation of NHSN LabID events has informed SHD of significant errors in reporting arising from the use of CDSS. The use of CDSS is best supplemented with monthly verification of results using a laboratory line list until the accuracy of CDSS can be improved. In addition, validation has provided SHD with valuable information about data quality as well as common misconceptions that can be addressed through education and training. Data validation also strengthened SHD’s relationships with infection preventionists, improving communication between SHD and the acute care hospital community.
Session DSV-056 12:30-1:30 p.m. Will Audit and Feedback Drive Compliance with UV Robot Disinfection? Michele Fleming, MSN, RN, CIC, Infection Preventionist, Virginia Commonwealth University Health System; Yvette Major, MBA, MT (ASCP), Molecular Microbiology and Epidemiology Laboratory Specialist, Virginia Commonwealth University Health System; Mark Gryskevicz, Director Environmental Services, Virginia Commonwealth University Health System, Aramark; Jerry Fife, MEd, Safety and Traning Manager for Environmental Services, Virginia Commonwealth University Health System, Aramark; Lisa Hassmer, MBA, Executive Assisstand, Virginia Commonwealth University Health System; Nadia Masroor, BS, Project Coordinator, Virginia Commonweatlh University Health System; Kaila Cooper, MSN, RN, CIC, Director Hospital Infection Prevention Program, Virginia Commonwealth University Health System; Michelle Doll, MD, MPH, Associate Professor of Internal Medicine, Associate Hospital Epidemiologist, Virginia Commonwealth University Health System; Michael Stevens, MD, MPH, FACP, FIDSA, Assistant Professor of Internal Medicine, Associate Hospital Epidemiologist, Director of Antimicrobial Stewardship Program, Associate Program Director for Internal Medicine Residency Program, Global Health & Health Disparities Pathway Director, Virginia Commonwealth University Health System; Gonzalo Bearman, MD, MPH, FACP, FSHEA, FIDSA, Hospital Epidemiologist, Associate Professor of Internal Medicine, Virginia Commonwealth University Health System BACKGROUND: Increasingly literature illustrates the importance of environmental cleaning, especially in rooms that house Clostridium difficile positive patients (CDPP). Ultra Violet Robots (UVR) are capable of inactivating microorganisms and have a positive impact on Clostridium difficile rates. Evidence of conformity with established protocols for UVR disinfection in rooms that house CDPP does not exist without retrospective review. This study assesses the impact of ongoing audit and feedback to end users to improve compliance with UVR deployment. METHODS: Protocols were established to ensure proper cleaning of patient rooms in an urban, tertiary, 865 bed academic medical center. Enhanced cleaning of rooms that housed patients diagnosed with Clostridium difficile included UVR deployment for room disinfection. On weekdays, environmental services (EVS) was provided a list of all rooms with a CDPP for enhanced room cleaning. A retrospective, manual review of CDPP room assignments was compared to an automated report of UVR deployment. Rooms were identified as compliant if the UVR ran at terminal clean; the compliance goal was 90%. Capture rate was generated by dividing the number of rooms that received UVR disinfection by the number of opportunities for UVR disinfection. EVS leadership was notified
of all non-compliant rooms and the monthly capture rate. Capture rate was also reported at monthly Infection Control Committee meetings and to key stakeholders. RESULTS: Data was analyzed and rate of compliance calculated during a 25 month period, (February 2015 through February 2017), 1,562 opportunities existed for UVR deployment. UVR compliance increased from 20% to 100% during this time period. Capture remained above 80% consecutively for 19 of the 25 months, and above 90% consecutively for the last 5 months. Tracking of daily UVR utilization indicated that as compliance increased, the number of days UVR was not used decreased. CONCLUSIONS: Auditing compliance and providing ongoing feedback of performance can improve compliance with established protocols for the deployment of a UVR for Clostridium difficile room disinfection.
Education and Competencies Session EC-057 12:30-1:30 p.m. Are Adults in Hong Kong Using Face Mask Correctly? Linda Yin King Lee, PhD, RN, RM, Professor, The Open University of Hong Kong; Evangeline Pui Wah Lam, MPH, BScN(Hons), RN, RM, IBCLC, Lecturer, The Open University of Hong Kong; Chin Kiu Chan, Student, The Open University of Hong Kong; Sum Yi Chan, Student, The Open University of Hong Kong; Man Ki Chiu, Student, The Open University of Hong Kong; Wing Hei Chong, Student, The Open University of Hong Kong; Kin Wai Chu, Student, The Open University of Hong Kong; Man Sze Hon, Student, The Open University of Hong Kong; Lok Ki Kwan, Student, The Open University of Hong Kong; Kit Lam Tsang, Student, The Open University of Hong Kong; Siu Lai Tsoi, Student, The Open University of Hong Kong; Chung Wai Wu, Student, The Open University of Hong Kong BACKGROUND: Correct use of face mask is important in decreasing the spread of respiratory infection. Although correct use of face mask implies adopting right practice and performing proper technique, previous evaluations on use of face mask in general population mainly focus on the practice aspect. Existing evidence is unlikely to provide comprehensive reference for promotion of public health. The objective of this study was to assess the practice and technique for using face mask among adults in Hong Kong. METHODS: This descriptive study was conducted in 2016. It recruited a convenient sample of six hundred adults in the public area in Hong Kong. With reference to established guidelines, a questionnaire and an observation checklist were developed to assess subjects’ practice and technique for using face mask respectively. The psychometric properties of these two instruments, including content validity, test-retest reliability and inter-rater reliability, were tested and established. Descriptive statistics, including frequency and percentage, were used to describe subjects’ performance. RESULTS: Subjects’ overall performance was unsatisfactory. Regarding their practice, only 21% of the subjects reported that they always wear face mask when caring for sick people with fever or respiratory infection. Regarding their technique, more than 95% of the subjects did not perform hand hygiene before putting on or taking off the face mask, or after disposing the face mask. On average,
APIC 44th Annual Educational Conference & International Meeting | Portland, OR | June 14-16, 2017
Poster Abstracts / American Journal of Infection Control 45 (2017) S16-S93
they correctly performed 6 out of 12 required steps. No subject was able to perform all the steps correctly. CONCLUSIONS: Despite of continuous territory-wide and worldwide effort devoted in promoting respiratory hygiene, adults in Hong Kong are not using face mask correctly. This study draws important implications to local and international healthcare practitioners. Effort is indicated to review the current health promotion strategies and develop initiatives to improve the practice and technique for using face mask among adults in Hong Kong.
Session EC-058 12:30-1:30 p.m. Biofilm—The Real Challenge for Infection Prevention Michael Gately, MBA, CMIP, CHEST, B Soc Sci, Managing Director, APIC, AHE; Mark Hodgson, MPH, CMIP, Senior Vice President, Medentech; Sarah Finn, PhD, R&D Scientist, Medentch BACKGROUND: Biofilms are prevalent in the healthcare environment. However, the risk in terms of infection transmission by biofilms within the environment may be under appreciated. Additionally, due to their complex nature, a standard testing method for demonstrating disinfectant efficacy on biofilms in a healthcare setting is not yet available for all regulatory bodies, which raises issues for biofilm control. However, the EPA have recently released a proposed method for examination of efficacy of disinfectants against biofilms of Staphylococcus aureus and Pseudomonas aeruginosa. The purpose of the study was to examine the effect of a chlorine based disinfectant containing surfactants against biofilms of Staphylococcus aureus and Psuedomonas aeruginosa according to modified. ASTM E2871. METHODS: Biofilms were cultivated in two phases, batch and continuous, using a CDC bioreactor. Disk carriers were suspended in a dilute broth and seeded with either S. aureus or P. aeruginosa. This was then incubated to allow growth on the disk carriers. The carriers were transferred to continuous flow where fresh dilute broth is pumped into the reactor under continuous stirring. Carriers are then removed and placed into a sterile tube to which the 4 ml of the disinfectant was added for a 4 min contact time. The disinfectant solution was neutralised using 36 ml of DE broth and surviving bacteria on carriers were enumerated. Three replicates were carried out. RESULTS: Upon the 4 min exposure to the disinfectant a >7.7 Log10 reduction in S. aureus biofilms and >6.87 Log10 reduction in P. aeruginosa biofilms was achieved compared to time zero. CONCLUSIONS: Testing efficacy of healthcare disinfectants against biofilm forming bacteria will be an important step in ensuring these products are adequately the issue of environmental pathogens. The data presented here are a first step towards this goal and indicate that the disinfectant chosen is sufficiently effective against biofilm forming bacteria.
Session EC-059 12:30-1:30 p.m. Bridging the Gap: Impacting Foley Catheter Insertions Through Collaboration and Communication between Emergency Department and an Orthopedic Progressive Care Unit Juliana Green, BSN, RN, Infection Preventionist, FL Hospital; Lisa Glass, BSN, RN, PCCN, RN Educator, FL Hospital;
S37
Clarissa Welbaum, MSN, RN, CCNS, CCTN, Clinical Nurse Specialist, FL Hospital; Kimberley Kerns, MSN, RN, Infection Preventionist, FL Hospital BACKGROUND: Although indwelling urinary catheters (IUC’s) can provide comfort to the orthopedic trauma patient, the risk for negative outcomes, such as urethral trauma, infection, and decreased mobility still prevail. A clear argument surrounding IUC necessity for the orthopedic trauma patient has not been well established and paucity of data exists regarding the severity of the trauma that drives IUC insertion. The primary objective of this study was to explore the compliance of IUC insertion with proper pericare prior to insertion and to verify that devices were inserted only after receiving appropriate physician orders for orthopedic patients being admitted. METHODS: A performance improvement study was conducted related to orthopedic trauma patients that were admitted to the 40 bed level II trauma unit from our Emergency Departments (ED). Data collected from November 2015-November 2016 included ED location, order verification including indication, pericare prior to insertion, and documented clinical necessity. All identified catheter insertions were reviewed in real time with frontline staff, leaders and physician partners. Data related to insertions were provided to ED Leadership and Orthopedic Staff via email to establish awareness. RESULTS: Daily review of catheter insertions began in November 2015 to November 2016. At this time email and feedback related to interventions were also initiated. We looked at a comparison of the first six months of data collection versus the last six months. We saw an average of a 75% increase in pericare performed prior to IUC insertion in the ED and an 8% increase in IUC insertion with a provider order. CONCLUSIONS: Using a focused approach for communication to our ED partners regarding pericare prior to IUC insertion and provider ordering of IUC with appropriate indication has led to improvement in compliance with our strategies and has become a standard of care in our system ED locations.
Session EC-060 12:30-1:30 p.m. Comparative Analysis of Four Major Hospital Cleaning Validation Methods William Rutala, BS, MS, MPH, PhD, Director, Hospital Epidemiology, UNC Hospitals; Hajime Kanamori, MD, PhD, MPH, Postdoctoral Fellow, Hospital Epidemiology, UNC Health Care; Maria Gergen, MT (ASCP), Microbiological Specialist, Hospital Epidemiology, University of North Carolina Health Care; Emily Sickbert-Bennett, PhD, MS, CIC, Associate Director, Hospital Epidemiology, UNC Healthcare; Kirk Huslage, MSPH, BSN, RN, CIC, FAPIC, Director of Infection Control, Duke University Hospitals; David Weber, MD, MPH, Medical director, Hospital Epidemiology, UNC Hospitals BACKGROUND: Cleaning and disinfection have been shown to significantly decrease environmental contamination of healthcareassociated pathogens. The aim of this study was to examine four validation methods for assessing the thoroughness of hospital cleaning practice, including visual inspection, fluorescent dye markers, adenosine triphosphate (ATP)-based system, and standard aerobic cultures. METHODS: During a 3-month period, we conducted a prospective study in 10 ICU and 14 non-ICU patient rooms at an academic
APIC 44th Annual Educational Conference & International Meeting | Portland, OR | June 14-16, 2017
Poster Abstracts / American Journal of Infection Control 45 (2017) S16-S93
CONCLUSIONS: Validation of NHSN LabID events has informed SHD of significant errors in reporting arising from the use of CDSS. The use of CDSS is best supplemented with monthly verification of results using a laboratory line list until the accuracy of CDSS can be improved. In addition, validation has provided SHD with valuable information about data quality as well as common misconceptions that can be addressed through education and training. Data validation also strengthened SHD’s relationships with infection preventionists, improving communication between SHD and the acute care hospital community.
Session DSV-056 12:30-1:30 p.m. Will Audit and Feedback Drive Compliance with UV Robot Disinfection? Michele Fleming, MSN, RN, CIC, Infection Preventionist, Virginia Commonwealth University Health System; Yvette Major, MBA, MT (ASCP), Molecular Microbiology and Epidemiology Laboratory Specialist, Virginia Commonwealth University Health System; Mark Gryskevicz, Director Environmental Services, Virginia Commonwealth University Health System, Aramark; Jerry Fife, MEd, Safety and Traning Manager for Environmental Services, Virginia Commonwealth University Health System, Aramark; Lisa Hassmer, MBA, Executive Assisstand, Virginia Commonwealth University Health System; Nadia Masroor, BS, Project Coordinator, Virginia Commonweatlh University Health System; Kaila Cooper, MSN, RN, CIC, Director Hospital Infection Prevention Program, Virginia Commonwealth University Health System; Michelle Doll, MD, MPH, Associate Professor of Internal Medicine, Associate Hospital Epidemiologist, Virginia Commonwealth University Health System; Michael Stevens, MD, MPH, FACP, FIDSA, Assistant Professor of Internal Medicine, Associate Hospital Epidemiologist, Director of Antimicrobial Stewardship Program, Associate Program Director for Internal Medicine Residency Program, Global Health & Health Disparities Pathway Director, Virginia Commonwealth University Health System; Gonzalo Bearman, MD, MPH, FACP, FSHEA, FIDSA, Hospital Epidemiologist, Associate Professor of Internal Medicine, Virginia Commonwealth University Health System BACKGROUND: Increasingly literature illustrates the importance of environmental cleaning, especially in rooms that house Clostridium difficile positive patients (CDPP). Ultra Violet Robots (UVR) are capable of inactivating microorganisms and have a positive impact on Clostridium difficile rates. Evidence of conformity with established protocols for UVR disinfection in rooms that house CDPP does not exist without retrospective review. This study assesses the impact of ongoing audit and feedback to end users to improve compliance with UVR deployment. METHODS: Protocols were established to ensure proper cleaning of patient rooms in an urban, tertiary, 865 bed academic medical center. Enhanced cleaning of rooms that housed patients diagnosed with Clostridium difficile included UVR deployment for room disinfection. On weekdays, environmental services (EVS) was provided a list of all rooms with a CDPP for enhanced room cleaning. A retrospective, manual review of CDPP room assignments was compared to an automated report of UVR deployment. Rooms were identified as compliant if the UVR ran at terminal clean; the compliance goal was 90%. Capture rate was generated by dividing the number of rooms that received UVR disinfection by the number of opportunities for UVR disinfection. EVS leadership was notified
of all non-compliant rooms and the monthly capture rate. Capture rate was also reported at monthly Infection Control Committee meetings and to key stakeholders. RESULTS: Data was analyzed and rate of compliance calculated during a 25 month period, (February 2015 through February 2017), 1,562 opportunities existed for UVR deployment. UVR compliance increased from 20% to 100% during this time period. Capture remained above 80% consecutively for 19 of the 25 months, and above 90% consecutively for the last 5 months. Tracking of daily UVR utilization indicated that as compliance increased, the number of days UVR was not used decreased. CONCLUSIONS: Auditing compliance and providing ongoing feedback of performance can improve compliance with established protocols for the deployment of a UVR for Clostridium difficile room disinfection.
Education and Competencies Session EC-057 12:30-1:30 p.m. Are Adults in Hong Kong Using Face Mask Correctly? Linda Yin King Lee, PhD, RN, RM, Professor, The Open University of Hong Kong; Evangeline Pui Wah Lam, MPH, BScN(Hons), RN, RM, IBCLC, Lecturer, The Open University of Hong Kong; Chin Kiu Chan, Student, The Open University of Hong Kong; Sum Yi Chan, Student, The Open University of Hong Kong; Man Ki Chiu, Student, The Open University of Hong Kong; Wing Hei Chong, Student, The Open University of Hong Kong; Kin Wai Chu, Student, The Open University of Hong Kong; Man Sze Hon, Student, The Open University of Hong Kong; Lok Ki Kwan, Student, The Open University of Hong Kong; Kit Lam Tsang, Student, The Open University of Hong Kong; Siu Lai Tsoi, Student, The Open University of Hong Kong; Chung Wai Wu, Student, The Open University of Hong Kong BACKGROUND: Correct use of face mask is important in decreasing the spread of respiratory infection. Although correct use of face mask implies adopting right practice and performing proper technique, previous evaluations on use of face mask in general population mainly focus on the practice aspect. Existing evidence is unlikely to provide comprehensive reference for promotion of public health. The objective of this study was to assess the practice and technique for using face mask among adults in Hong Kong. METHODS: This descriptive study was conducted in 2016. It recruited a convenient sample of six hundred adults in the public area in Hong Kong. With reference to established guidelines, a questionnaire and an observation checklist were developed to assess subjects’ practice and technique for using face mask respectively. The psychometric properties of these two instruments, including content validity, test-retest reliability and inter-rater reliability, were tested and established. Descriptive statistics, including frequency and percentage, were used to describe subjects’ performance. RESULTS: Subjects’ overall performance was unsatisfactory. Regarding their practice, only 21% of the subjects reported that they always wear face mask when caring for sick people with fever or respiratory infection. Regarding their technique, more than 95% of the subjects did not perform hand hygiene before putting on or taking off the face mask, or after disposing the face mask. On average,
APIC 44th Annual Educational Conference & International Meeting | Portland, OR | June 14-16, 2017
Poster Abstracts / American Journal of Infection Control 45 (2017) S16-S93
they correctly performed 6 out of 12 required steps. No subject was able to perform all the steps correctly. CONCLUSIONS: Despite of continuous territory-wide and worldwide effort devoted in promoting respiratory hygiene, adults in Hong Kong are not using face mask correctly. This study draws important implications to local and international healthcare practitioners. Effort is indicated to review the current health promotion strategies and develop initiatives to improve the practice and technique for using face mask among adults in Hong Kong.
Session EC-058 12:30-1:30 p.m. Biofilm—The Real Challenge for Infection Prevention Michael Gately, MBA, CMIP, CHEST, B Soc Sci, Managing Director, APIC, AHE; Mark Hodgson, MPH, CMIP, Senior Vice President, Medentech; Sarah Finn, PhD, R&D Scientist, Medentch BACKGROUND: Biofilms are prevalent in the healthcare environment. However, the risk in terms of infection transmission by biofilms within the environment may be under appreciated. Additionally, due to their complex nature, a standard testing method for demonstrating disinfectant efficacy on biofilms in a healthcare setting is not yet available for all regulatory bodies, which raises issues for biofilm control. However, the EPA have recently released a proposed method for examination of efficacy of disinfectants against biofilms of Staphylococcus aureus and Pseudomonas aeruginosa. The purpose of the study was to examine the effect of a chlorine based disinfectant containing surfactants against biofilms of Staphylococcus aureus and Psuedomonas aeruginosa according to modified. ASTM E2871. METHODS: Biofilms were cultivated in two phases, batch and continuous, using a CDC bioreactor. Disk carriers were suspended in a dilute broth and seeded with either S. aureus or P. aeruginosa. This was then incubated to allow growth on the disk carriers. The carriers were transferred to continuous flow where fresh dilute broth is pumped into the reactor under continuous stirring. Carriers are then removed and placed into a sterile tube to which the 4 ml of the disinfectant was added for a 4 min contact time. The disinfectant solution was neutralised using 36 ml of DE broth and surviving bacteria on carriers were enumerated. Three replicates were carried out. RESULTS: Upon the 4 min exposure to the disinfectant a >7.7 Log10 reduction in S. aureus biofilms and >6.87 Log10 reduction in P. aeruginosa biofilms was achieved compared to time zero. CONCLUSIONS: Testing efficacy of healthcare disinfectants against biofilm forming bacteria will be an important step in ensuring these products are adequately the issue of environmental pathogens. The data presented here are a first step towards this goal and indicate that the disinfectant chosen is sufficiently effective against biofilm forming bacteria.
Session EC-059 12:30-1:30 p.m. Bridging the Gap: Impacting Foley Catheter Insertions Through Collaboration and Communication between Emergency Department and an Orthopedic Progressive Care Unit Juliana Green, BSN, RN, Infection Preventionist, FL Hospital; Lisa Glass, BSN, RN, PCCN, RN Educator, FL Hospital;
S37
Clarissa Welbaum, MSN, RN, CCNS, CCTN, Clinical Nurse Specialist, FL Hospital; Kimberley Kerns, MSN, RN, Infection Preventionist, FL Hospital BACKGROUND: Although indwelling urinary catheters (IUC’s) can provide comfort to the orthopedic trauma patient, the risk for negative outcomes, such as urethral trauma, infection, and decreased mobility still prevail. A clear argument surrounding IUC necessity for the orthopedic trauma patient has not been well established and paucity of data exists regarding the severity of the trauma that drives IUC insertion. The primary objective of this study was to explore the compliance of IUC insertion with proper pericare prior to insertion and to verify that devices were inserted only after receiving appropriate physician orders for orthopedic patients being admitted. METHODS: A performance improvement study was conducted related to orthopedic trauma patients that were admitted to the 40 bed level II trauma unit from our Emergency Departments (ED). Data collected from November 2015-November 2016 included ED location, order verification including indication, pericare prior to insertion, and documented clinical necessity. All identified catheter insertions were reviewed in real time with frontline staff, leaders and physician partners. Data related to insertions were provided to ED Leadership and Orthopedic Staff via email to establish awareness. RESULTS: Daily review of catheter insertions began in November 2015 to November 2016. At this time email and feedback related to interventions were also initiated. We looked at a comparison of the first six months of data collection versus the last six months. We saw an average of a 75% increase in pericare performed prior to IUC insertion in the ED and an 8% increase in IUC insertion with a provider order. CONCLUSIONS: Using a focused approach for communication to our ED partners regarding pericare prior to IUC insertion and provider ordering of IUC with appropriate indication has led to improvement in compliance with our strategies and has become a standard of care in our system ED locations.
Session EC-060 12:30-1:30 p.m. Comparative Analysis of Four Major Hospital Cleaning Validation Methods William Rutala, BS, MS, MPH, PhD, Director, Hospital Epidemiology, UNC Hospitals; Hajime Kanamori, MD, PhD, MPH, Postdoctoral Fellow, Hospital Epidemiology, UNC Health Care; Maria Gergen, MT (ASCP), Microbiological Specialist, Hospital Epidemiology, University of North Carolina Health Care; Emily Sickbert-Bennett, PhD, MS, CIC, Associate Director, Hospital Epidemiology, UNC Healthcare; Kirk Huslage, MSPH, BSN, RN, CIC, FAPIC, Director of Infection Control, Duke University Hospitals; David Weber, MD, MPH, Medical director, Hospital Epidemiology, UNC Hospitals BACKGROUND: Cleaning and disinfection have been shown to significantly decrease environmental contamination of healthcareassociated pathogens. The aim of this study was to examine four validation methods for assessing the thoroughness of hospital cleaning practice, including visual inspection, fluorescent dye markers, adenosine triphosphate (ATP)-based system, and standard aerobic cultures. METHODS: During a 3-month period, we conducted a prospective study in 10 ICU and 14 non-ICU patient rooms at an academic
APIC 44th Annual Educational Conference & International Meeting | Portland, OR | June 14-16, 2017