- Email: [email protected]
Increase in hand hygiene compliance after regular intervention by dedicated infection control nurses
110
journal of patient safety & infection control 3 ( 2 0 1 5 ) 70–117
had significant relationship with number of perioperative antibiotics given (p = 0.004), presence of pulmonary catheter (p = 0.045), duration of right pleural drain (p = 0.01), presence of left pleural drain (p = 0.037), presence of peripheral venous catheter (p = 0.013). BSI and VAP both were significantly related to ICU stay, placement and duration of urinary catheter, duration of mechanical ventilation, duration of CVC, and death. Conclusions: Nearly one-third of the patients developed HAI, with VAP and BSI associated with the poorest outcomes. Therefore, stringent infection control policies and practices, specifically related to antibiotic prophylaxis and indwelling devices, need to be implemented in our patients for cardiac surgeries. Conflicts of interest: The present study was funded from institutional research funds of the authors. No pharmaceutical grants were used for this study. http://dx.doi.org/10.1016/j.jpsic.2015.10.181
P105 Increase in hand hygiene compliance after regular intervention by dedicated infection control nurses S. Rajpoot 1 , M. Biswal 1 , R. Mani 1 , K. Kaur 1 , L. Yadanapuddi 2 , A. Gupta 2 1
Medical Microbiology Department, PGIMER, Chandigarh, India 2 PGIMER, Chandigarh, India Introduction: Objective: To improve the hand hygiene (HH) compliance of healthcare workers of PGIMER, Chandigarh, three dedicated infection control nurses (ICNs) were regularly posted in the ICUs. They gave continuous feedback about HH compliance to the staff posted in the ICUs, held monthly meetings with the concerned Head of departments and liaised with the administration and hospital store to make soap and alcohol hand rubs available round the clock to HCWs. Extensive education and hands-on-training was organized by the ICNs during a 9month period. The aim of the present study was to assess the impact of these interventions on the HH compliance of our HCWs from March 2014 to Nov 2014. Method: The HH compliance of HCWs from different areas of PGIMER was monitored by direct observation using WHO HH observation performa. Result: A total 4763 opportunities were observed. The overall compliance increased from 32.75% to 47.59%. Conclusions: The regular feedback and intervention of our ICNs resulted in significant improvement in the HH practices in our HCWs. However, more efforts are needed to increase compliance at all WHO moments for HH. Conflicts of interest: The authors have none to declare. http://dx.doi.org/10.1016/j.jpsic.2015.10.182
P106 A prospective study of association of extended-spectrum antibiotic use with faecal colonization of multidrug resistant Acinetobacter baumannii (MDR AB) in ICU patients S. Rajpoot 1 , M. Biswal 1 , N. Taneja 1 , L. Yaddanapudi 2 , S. Podder 2 1
Medical Microbiology Department, PGIMER, Chandigarh, India 2 PGIMER, Chandigarh, India Introduction: Previous antimicrobial use is a strong risk factor favouring colonization by MDR AB in patients. This prospective study was planned in a cohort of patients admitted to an adult ICU to study the association of commonly used broad spectrum antimicrobial antibiotics in the development of GI colonization by MDR AB. Method: All patients fitting into inclusion criteria were included in the study. The detailed antibiotic intake of all patients was recorded. Oropharyngeal, axillary and rectal swabs were collected from all included patients at admission into the ICU, at 48 h of their ICU stay, and every week on predefined days until patient discharge or death. Result: One hundred and eighty-two patients were prospectively screened after admission into ICU. Fourteen (8%), 28 (15%), 16 (9%), 10 (2%) patients had received one, two, three and four antibiotics respectively. In the ICU, 10.9%, 21.7%, 20.7%, 15.2%, 12%, 6.5%, 6.5%, 2.2%, and 1.1% patients received zero, one, two, three, four, five, six, seven, eight and nine antibiotics, respectively. One hundred and four (57.3%) patients were found to develop colonization with MDR AB. The risk ratio for colonization with antibiotic therapy was 4.286 (95% CI 0.428–42.92, p = 0.309). The odds for death for colonized vs noncolonized patients was 1.69 (95% CI 0.66–4.29, p = 0.342). Fifty five (30%) patients developed at least one HCAI (0.3 ± 0.46/100 patients). The association between colonization and development of nosocomial infection was significant (RR 2.387 95% CI 1.057–7.723, p = 0.039). Conclusions: Although association between extendedspectrum antibiotic use with faecal colonization of MDR AB found to be week, there is a strong association between colonization and development of nosocomial infection. Conflicts of interest: The authors have none to declare. http://dx.doi.org/10.1016/j.jpsic.2015.10.183
P107 Prevention of surgical site infections – A journey of challenges and achievements over 3 years R. Sukanya Fortis Hospitals, B.G Road, Bangalore, India Introduction: Surgical site infections (SSIs) account for 15% of all nosocomial infections and lead to extended postoperative stay, escalated expenses, higher rates of readmission, and jeopardized outcomes. A project for reduction in SSIs was
journal of patient safety & infection control 3 ( 2 0 1 5 ) 70–117
had significant relationship with number of perioperative antibiotics given (p = 0.004), presence of pulmonary catheter (p = 0.045), duration of right pleural drain (p = 0.01), presence of left pleural drain (p = 0.037), presence of peripheral venous catheter (p = 0.013). BSI and VAP both were significantly related to ICU stay, placement and duration of urinary catheter, duration of mechanical ventilation, duration of CVC, and death. Conclusions: Nearly one-third of the patients developed HAI, with VAP and BSI associated with the poorest outcomes. Therefore, stringent infection control policies and practices, specifically related to antibiotic prophylaxis and indwelling devices, need to be implemented in our patients for cardiac surgeries. Conflicts of interest: The present study was funded from institutional research funds of the authors. No pharmaceutical grants were used for this study. http://dx.doi.org/10.1016/j.jpsic.2015.10.181
P105 Increase in hand hygiene compliance after regular intervention by dedicated infection control nurses S. Rajpoot 1 , M. Biswal 1 , R. Mani 1 , K. Kaur 1 , L. Yadanapuddi 2 , A. Gupta 2 1
Medical Microbiology Department, PGIMER, Chandigarh, India 2 PGIMER, Chandigarh, India Introduction: Objective: To improve the hand hygiene (HH) compliance of healthcare workers of PGIMER, Chandigarh, three dedicated infection control nurses (ICNs) were regularly posted in the ICUs. They gave continuous feedback about HH compliance to the staff posted in the ICUs, held monthly meetings with the concerned Head of departments and liaised with the administration and hospital store to make soap and alcohol hand rubs available round the clock to HCWs. Extensive education and hands-on-training was organized by the ICNs during a 9month period. The aim of the present study was to assess the impact of these interventions on the HH compliance of our HCWs from March 2014 to Nov 2014. Method: The HH compliance of HCWs from different areas of PGIMER was monitored by direct observation using WHO HH observation performa. Result: A total 4763 opportunities were observed. The overall compliance increased from 32.75% to 47.59%. Conclusions: The regular feedback and intervention of our ICNs resulted in significant improvement in the HH practices in our HCWs. However, more efforts are needed to increase compliance at all WHO moments for HH. Conflicts of interest: The authors have none to declare. http://dx.doi.org/10.1016/j.jpsic.2015.10.182
P106 A prospective study of association of extended-spectrum antibiotic use with faecal colonization of multidrug resistant Acinetobacter baumannii (MDR AB) in ICU patients S. Rajpoot 1 , M. Biswal 1 , N. Taneja 1 , L. Yaddanapudi 2 , S. Podder 2 1
Medical Microbiology Department, PGIMER, Chandigarh, India 2 PGIMER, Chandigarh, India Introduction: Previous antimicrobial use is a strong risk factor favouring colonization by MDR AB in patients. This prospective study was planned in a cohort of patients admitted to an adult ICU to study the association of commonly used broad spectrum antimicrobial antibiotics in the development of GI colonization by MDR AB. Method: All patients fitting into inclusion criteria were included in the study. The detailed antibiotic intake of all patients was recorded. Oropharyngeal, axillary and rectal swabs were collected from all included patients at admission into the ICU, at 48 h of their ICU stay, and every week on predefined days until patient discharge or death. Result: One hundred and eighty-two patients were prospectively screened after admission into ICU. Fourteen (8%), 28 (15%), 16 (9%), 10 (2%) patients had received one, two, three and four antibiotics respectively. In the ICU, 10.9%, 21.7%, 20.7%, 15.2%, 12%, 6.5%, 6.5%, 2.2%, and 1.1% patients received zero, one, two, three, four, five, six, seven, eight and nine antibiotics, respectively. One hundred and four (57.3%) patients were found to develop colonization with MDR AB. The risk ratio for colonization with antibiotic therapy was 4.286 (95% CI 0.428–42.92, p = 0.309). The odds for death for colonized vs noncolonized patients was 1.69 (95% CI 0.66–4.29, p = 0.342). Fifty five (30%) patients developed at least one HCAI (0.3 ± 0.46/100 patients). The association between colonization and development of nosocomial infection was significant (RR 2.387 95% CI 1.057–7.723, p = 0.039). Conclusions: Although association between extendedspectrum antibiotic use with faecal colonization of MDR AB found to be week, there is a strong association between colonization and development of nosocomial infection. Conflicts of interest: The authors have none to declare. http://dx.doi.org/10.1016/j.jpsic.2015.10.183
P107 Prevention of surgical site infections – A journey of challenges and achievements over 3 years R. Sukanya Fortis Hospitals, B.G Road, Bangalore, India Introduction: Surgical site infections (SSIs) account for 15% of all nosocomial infections and lead to extended postoperative stay, escalated expenses, higher rates of readmission, and jeopardized outcomes. A project for reduction in SSIs was