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P7.08 The Effectiveness of Education by ICT (Infection Control Team)
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Abstracts, 6th Int. Conf. of the Hospital Infection Society, 15–18 October 2006, Amsterdam, The Netherlands
Methods: Over a 5 year period all reported needlestick injuries (150/year) were analyzed: triage, time delays between accident and point of (in)action, the experience factor, the logistics of testing the source, the follow-up. A real time blinded test was done with a fake HIV positive source and a fake severe injury in order to test the availability on time of PEP. Results: The triage of NSI’s showed a learning curve. Time delays proved to be much longer than anticipated, handling of NSI’s improved significantly after analysis. The real time blinded PEP availability test revealed weaknesses in the logistics and produced points for improvement. PEP needed to be given only rarely in 5 years time. Discussion: The learning curve in the triage of NSI’s indicated that triage and handling of NSI’s should be done by a regular and experienced team. Analysis of the logistics indicated too that the direction of post exposition care should be in one hand. Our sense of good performance was affected after the analysis of time delays, but got restored after implementing points of improvement. The real time blinded PEP availability test worked out well, but was an eye-opener for weak points in the chain. Conclusion: Post-needlestick-injury care can work within the proper time limits, but only if the NSI prevention team is able to analyze its own performance and learn from its failings. P7.08 The Effectiveness of Education by ICT (Infection Control Team) H. Kunishima1 *, K. Kanemitsu1 , K. Mitsutake1 , K. Kaku1 , Y. Honda2 , M. Kaku1 . 1 Tohoku University Graduate School of Medicine, Japan, 2 Sendai Kousei hospital, Japan Background: The education for the healthcare worker is the most important for the infection control. The ICT (Infection Control Team) is expected to implement infection control measures against specific problems utilizing their expertise. The most important measure in infection control for all healthcare workers is their compliance with the standard precautions. Contamination in drug solution could cause serious infection diseases such as sepsis, so aseptic technique should be implemented for the preparation of drug solution. Also, sometimes specimens obtained are not of good quality which is essential for proper use of antibiotics and may make accurate dosage of antibiotics difficult. Objective: We examined the effectiveness of education by ICT organized by the doctor, pharmacist, nurse and microbiologist. The nurse of ICT educated the compliance of hand hygiene with MRSA active surveillance. The pharmacist of ICT educated clean prescription for nurse. The microbiologist of ICT educated specimen quality for health care workers. Study Design: Nonrandomized pre–post observational trial. Setting: A general hospital with 383 beds with one intensive care unit at Sendai, Japan. Results: The compliance of hand hygiene was 47.9% in the before the course and 55.7% after the course (P < 0.05). The clean prescription (hand hygiene at prescription) was 26% in the before the course and 78% after the course (P < 0.05). The wrong quality sputum (Miller-Jones classification M1 and 2) was 23% in the before the course and 9% after the course (P < 0.05). Conclusions: The education with ICT suggests that effective for compliance of infection control practices. The goal of ICT is to grasp the status of compliance with the standard preventive measures which is the foundation of infection control and to implement education and awareness programs for all healthcare workers.
P7.09 Changing Infection Control in the Course of 10 Years in Japan H. Yamanoue1 *, N. Fujita2 , S. Shiiki3 , T. Shimizu4 , M. Kanazawa5 , S. Tatsukuchi6 , S. Ikeda7 , R. Yoshizato8 , H. Kuroda1 , Y. Shigeno9 , S. Hatae10 . 1 Shizuoka Tokusyukai Hospital, Japan, 2 Kyoto Prefectural University of Medicine, Japan, 3 AIDS Medical Center, Osaka National Hospital, National Hospital Organization, Japan, 4 Kyoto City Hospital, Japan, 5 The Red Cross Society Nagasaki Atomic bomb Hospital, Japan, 6 Kanazawa University Hospital, Japan, 7 Nagano Prefectural Welfare Federation of Agricultural Cooperatives Hokushin General Hospital, Japan, 8 Okinawa Prefectural Nanbu Medical Center & Children’s Medical Center, Japan, 9 Jobisha Co., Ltd., Japan, 10 Japan Infection Control Hospital Group, Representative, Japan Background: J-ICHG (Japan Infection Control Hospital Group) is the group of HCWs, which consists of various specialists. Members of J-ICHG have repeatedly visited overseas hospitals to learn infection control. J-ICHG has been engaged in enlightenment activities on infection control in Japan through presentation at academic conference, lecture presentation and publication. Methods: Operation of Source Isolation Rooms In the USA, acute stage hospital’s beds normally provide each patient with an individual room. Because of no risk of cross infection, few people attach importance on the labeling of the isolation area, complete control of close of doors, etc. The same type hospitals in Canada, England, Netherlands and Sweden, a room with plural beds is the basis of a patient room and one nurse usually cares more than one patient. Then, it’s commonly practiced that isolation rooms are closed with door and signboards indicating required infection control are posted. Results: of J-ICHG activity J-ICHG has proposed measures based on those of European countries since Japanese medical system is similar to European countries. Formerly, we changed shoes and slipped into the cloth gown when entering a source isolation room in Japan, but for the past 10 years, it has become very common to wear the plastic apron. It’s become not uncommon to see that protective articles such as plastic aprons and gloves are wall-hung in front of patient rooms, and signboards indicating infection control are posted in patient rooms. It shows that infection control proposed by J-ICHG have been gradually accepted in Japan. Conclusion: The foreign guideline doesn’t necessarily fit to the Japanese situation. J-ICHG has examined infection control in abroad from various points of view, and advocated infection control suitable for Japan. We will continue sending information we obtain to those concerned all over Japan, and propose infection control more suitable for Japanese situation. P7.10 An Assessment of Contamination Risks and Use of Personal Protective Equipments in Medical Procedures such as Nasopharyngeal Aspiration M. Ip1 *, D. Hui1 , A. Wong1 , M. Chan2 , G. Joynt2 , A. So3 , J. Sung1 . 1 Centre of Emerging Infectious Diseases, School of Public Health, Chinese University of Hong Kong, Hong Kong, China, 2 Dept of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Hong Kong, China, 3 Dept of Building & Construction, City University of Hong Kong, Hong Kong, China Background: Personal protective equipments (PPEs) have been recommended for use in guidelines for standard and transmission-based precautions. Factors associated with risks for contamination for a specific ward procedure are often not well studied. Aims: A ‘patient simulator’ model, contaminated with fluorescent secretions, was used to assess the risks on contamination
Abstracts, 6th Int. Conf. of the Hospital Infection Society, 15–18 October 2006, Amsterdam, The Netherlands
Methods: Over a 5 year period all reported needlestick injuries (150/year) were analyzed: triage, time delays between accident and point of (in)action, the experience factor, the logistics of testing the source, the follow-up. A real time blinded test was done with a fake HIV positive source and a fake severe injury in order to test the availability on time of PEP. Results: The triage of NSI’s showed a learning curve. Time delays proved to be much longer than anticipated, handling of NSI’s improved significantly after analysis. The real time blinded PEP availability test revealed weaknesses in the logistics and produced points for improvement. PEP needed to be given only rarely in 5 years time. Discussion: The learning curve in the triage of NSI’s indicated that triage and handling of NSI’s should be done by a regular and experienced team. Analysis of the logistics indicated too that the direction of post exposition care should be in one hand. Our sense of good performance was affected after the analysis of time delays, but got restored after implementing points of improvement. The real time blinded PEP availability test worked out well, but was an eye-opener for weak points in the chain. Conclusion: Post-needlestick-injury care can work within the proper time limits, but only if the NSI prevention team is able to analyze its own performance and learn from its failings. P7.08 The Effectiveness of Education by ICT (Infection Control Team) H. Kunishima1 *, K. Kanemitsu1 , K. Mitsutake1 , K. Kaku1 , Y. Honda2 , M. Kaku1 . 1 Tohoku University Graduate School of Medicine, Japan, 2 Sendai Kousei hospital, Japan Background: The education for the healthcare worker is the most important for the infection control. The ICT (Infection Control Team) is expected to implement infection control measures against specific problems utilizing their expertise. The most important measure in infection control for all healthcare workers is their compliance with the standard precautions. Contamination in drug solution could cause serious infection diseases such as sepsis, so aseptic technique should be implemented for the preparation of drug solution. Also, sometimes specimens obtained are not of good quality which is essential for proper use of antibiotics and may make accurate dosage of antibiotics difficult. Objective: We examined the effectiveness of education by ICT organized by the doctor, pharmacist, nurse and microbiologist. The nurse of ICT educated the compliance of hand hygiene with MRSA active surveillance. The pharmacist of ICT educated clean prescription for nurse. The microbiologist of ICT educated specimen quality for health care workers. Study Design: Nonrandomized pre–post observational trial. Setting: A general hospital with 383 beds with one intensive care unit at Sendai, Japan. Results: The compliance of hand hygiene was 47.9% in the before the course and 55.7% after the course (P < 0.05). The clean prescription (hand hygiene at prescription) was 26% in the before the course and 78% after the course (P < 0.05). The wrong quality sputum (Miller-Jones classification M1 and 2) was 23% in the before the course and 9% after the course (P < 0.05). Conclusions: The education with ICT suggests that effective for compliance of infection control practices. The goal of ICT is to grasp the status of compliance with the standard preventive measures which is the foundation of infection control and to implement education and awareness programs for all healthcare workers.
P7.09 Changing Infection Control in the Course of 10 Years in Japan H. Yamanoue1 *, N. Fujita2 , S. Shiiki3 , T. Shimizu4 , M. Kanazawa5 , S. Tatsukuchi6 , S. Ikeda7 , R. Yoshizato8 , H. Kuroda1 , Y. Shigeno9 , S. Hatae10 . 1 Shizuoka Tokusyukai Hospital, Japan, 2 Kyoto Prefectural University of Medicine, Japan, 3 AIDS Medical Center, Osaka National Hospital, National Hospital Organization, Japan, 4 Kyoto City Hospital, Japan, 5 The Red Cross Society Nagasaki Atomic bomb Hospital, Japan, 6 Kanazawa University Hospital, Japan, 7 Nagano Prefectural Welfare Federation of Agricultural Cooperatives Hokushin General Hospital, Japan, 8 Okinawa Prefectural Nanbu Medical Center & Children’s Medical Center, Japan, 9 Jobisha Co., Ltd., Japan, 10 Japan Infection Control Hospital Group, Representative, Japan Background: J-ICHG (Japan Infection Control Hospital Group) is the group of HCWs, which consists of various specialists. Members of J-ICHG have repeatedly visited overseas hospitals to learn infection control. J-ICHG has been engaged in enlightenment activities on infection control in Japan through presentation at academic conference, lecture presentation and publication. Methods: Operation of Source Isolation Rooms In the USA, acute stage hospital’s beds normally provide each patient with an individual room. Because of no risk of cross infection, few people attach importance on the labeling of the isolation area, complete control of close of doors, etc. The same type hospitals in Canada, England, Netherlands and Sweden, a room with plural beds is the basis of a patient room and one nurse usually cares more than one patient. Then, it’s commonly practiced that isolation rooms are closed with door and signboards indicating required infection control are posted. Results: of J-ICHG activity J-ICHG has proposed measures based on those of European countries since Japanese medical system is similar to European countries. Formerly, we changed shoes and slipped into the cloth gown when entering a source isolation room in Japan, but for the past 10 years, it has become very common to wear the plastic apron. It’s become not uncommon to see that protective articles such as plastic aprons and gloves are wall-hung in front of patient rooms, and signboards indicating infection control are posted in patient rooms. It shows that infection control proposed by J-ICHG have been gradually accepted in Japan. Conclusion: The foreign guideline doesn’t necessarily fit to the Japanese situation. J-ICHG has examined infection control in abroad from various points of view, and advocated infection control suitable for Japan. We will continue sending information we obtain to those concerned all over Japan, and propose infection control more suitable for Japanese situation. P7.10 An Assessment of Contamination Risks and Use of Personal Protective Equipments in Medical Procedures such as Nasopharyngeal Aspiration M. Ip1 *, D. Hui1 , A. Wong1 , M. Chan2 , G. Joynt2 , A. So3 , J. Sung1 . 1 Centre of Emerging Infectious Diseases, School of Public Health, Chinese University of Hong Kong, Hong Kong, China, 2 Dept of Anaesthesia and Intensive Care, Chinese University of Hong Kong, Hong Kong, China, 3 Dept of Building & Construction, City University of Hong Kong, Hong Kong, China Background: Personal protective equipments (PPEs) have been recommended for use in guidelines for standard and transmission-based precautions. Factors associated with risks for contamination for a specific ward procedure are often not well studied. Aims: A ‘patient simulator’ model, contaminated with fluorescent secretions, was used to assess the risks on contamination