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Compromised healthcare worker safety – Do we care?
j o u r n a l o f p a t i e n t s a f e t y & i n f e c t i o n c o n t r o l 2 ( 2 0 1 4 ) 7 e8
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.elsevier.com/locate/jpsic
Compromised healthcare worker safety e Do we care? It is expected that every healthcare worker (HCW) is entitled to the knowledge about blood and body fluid exposure, personal protective equipment (PPE), periodic immunization, safe equipment, reporting of exposure, post-exposure prophylaxis (PEP), isolation precautions for dangerous infections such as MRSA, miliary tuberculosis, swine flu and chicken pox. The main issues concerning the safety of the healthcare workers are sharp injuries, blood and body fluid exposure, deficiency in PEP, deficiency in PPE, care of HCWs dealing with patients under isolation, radiation safety and infrastructural safety. Globally HCW safety is a major growing problem. Developed countries such as USA and Germany have sharp injuries upwards of 600,000 annually. Hitherto any meaningful Indian data is lacking. It is estimated that there are about one HCW per 10,000 population, at that rate, one could expect around 3.5 million HCW's in India. A moderate estimate about HCW injury in India should be in the range of 100e115 lakh injuries. Everyone would agree this is a big sized problem. There is very little Indian data about the HCW injuries. We published prospective data from four Indian Hospitals, in 2010. The India data starkly differs from the western one; the incidence of injuries in housekeeping is unacceptably high.
The participating Hospitals met and decided on a few actionable points which appeared to have beneficial effect on HCW safety. This data is soon to be published. It is clear that HCW safety is in jeopardy. Institutions do not address the problem, the way one would expect them to do.
Conclusion Every healthcare worker should prioritize issues regarding safety. They should set targets and strive for safety of the working environment.
Murli Chakravarty Chief Consultant, Anesthesia, Care and Pain Relief, Fortis Hospitals, Bangalore, India http://dx.doi.org/10.1016/j.jpsic.2014.05.004 2214-207X/Copyright © 2014, Hospital Infection Society India. Published by Reed Elsevier India Pvt. Ltd. All rights reserved.
Antibiotic prophylaxis in surgery Aseptic technique can reduce but not eliminate bacterial contamination of the surgical wound. Hence there is a need for antibiotic prophylaxis.
1.
1.1.
Wound microenvironment
Theoretically even 1 microorganism introduced into the operating field can set up an infection. The period of highest risk is the close, not the beginning, of surgery. Wound hyperemia leads to hematogenous seeding, before the process of endothelialization which can give rise to hematogenous infection.
Questions for discussion
Which organisms are encountered? Which cases benefit? Which antibiotic should be used? When should it be started? How much should be given? How long should it be continued?
Grafts, prostheses, cardiac, neurosurgery Head, neck, breast Chest, orthopedic Abdominal Obstetrics e Gynecology Urological
S. aureus, coagulase negative staphylococci “þStreptococcus spp “þGram negative bacilli Gram negative bacilli þ anaerobes “þenterococci Gram negative bacilli
Available online at www.sciencedirect.com
ScienceDirect journal homepage: www.elsevier.com/locate/jpsic
Compromised healthcare worker safety e Do we care? It is expected that every healthcare worker (HCW) is entitled to the knowledge about blood and body fluid exposure, personal protective equipment (PPE), periodic immunization, safe equipment, reporting of exposure, post-exposure prophylaxis (PEP), isolation precautions for dangerous infections such as MRSA, miliary tuberculosis, swine flu and chicken pox. The main issues concerning the safety of the healthcare workers are sharp injuries, blood and body fluid exposure, deficiency in PEP, deficiency in PPE, care of HCWs dealing with patients under isolation, radiation safety and infrastructural safety. Globally HCW safety is a major growing problem. Developed countries such as USA and Germany have sharp injuries upwards of 600,000 annually. Hitherto any meaningful Indian data is lacking. It is estimated that there are about one HCW per 10,000 population, at that rate, one could expect around 3.5 million HCW's in India. A moderate estimate about HCW injury in India should be in the range of 100e115 lakh injuries. Everyone would agree this is a big sized problem. There is very little Indian data about the HCW injuries. We published prospective data from four Indian Hospitals, in 2010. The India data starkly differs from the western one; the incidence of injuries in housekeeping is unacceptably high.
The participating Hospitals met and decided on a few actionable points which appeared to have beneficial effect on HCW safety. This data is soon to be published. It is clear that HCW safety is in jeopardy. Institutions do not address the problem, the way one would expect them to do.
Conclusion Every healthcare worker should prioritize issues regarding safety. They should set targets and strive for safety of the working environment.
Murli Chakravarty Chief Consultant, Anesthesia, Care and Pain Relief, Fortis Hospitals, Bangalore, India http://dx.doi.org/10.1016/j.jpsic.2014.05.004 2214-207X/Copyright © 2014, Hospital Infection Society India. Published by Reed Elsevier India Pvt. Ltd. All rights reserved.
Antibiotic prophylaxis in surgery Aseptic technique can reduce but not eliminate bacterial contamination of the surgical wound. Hence there is a need for antibiotic prophylaxis.
1.
1.1.
Wound microenvironment
Theoretically even 1 microorganism introduced into the operating field can set up an infection. The period of highest risk is the close, not the beginning, of surgery. Wound hyperemia leads to hematogenous seeding, before the process of endothelialization which can give rise to hematogenous infection.
Questions for discussion
Which organisms are encountered? Which cases benefit? Which antibiotic should be used? When should it be started? How much should be given? How long should it be continued?
Grafts, prostheses, cardiac, neurosurgery Head, neck, breast Chest, orthopedic Abdominal Obstetrics e Gynecology Urological
S. aureus, coagulase negative staphylococci “þStreptococcus spp “þGram negative bacilli Gram negative bacilli þ anaerobes “þenterococci Gram negative bacilli