We talk often about the 5 Moments for Hand Hygiene but frequently neglect the 5th moment (after contact with a patient’s environment). So much so, that you might even describe this as the “Cinderella moment for hand hygiene”! Could it be that the Cinderella moment is actually the most important in the transmission of pathogens that cause HCAI? Maybe sometimes. But that’s missing the point. If we don’t focus our attention on all moments for hand hygiene, we won’t be as effective as we could be in preventing cross-transmission.
Continue readinghand hygiene
COVID-19 & PPE / face coverings / masks / shields: personal safety depends on more than what you wear
There’s a huge amount of academic and pragmatic discussion and debate about the appropriate levels of PPE to wear in various healthcare settings to reduce the risk of spreading COVID-19 to yourself and others in healthcare settings. And more recently, when to wear face coverings / masks / shields in public areas of hospitals, on public transport, and in shops. However, there is much, much less discussion about the importance of careful doffing (removal) of PPE and face coverings etc in order to ensure the safe and effective use of PPE. This helpful Cochrane Review, updated for the COVID-19 era, covers a lot of ground and one key conclusion is that doffing is key: if it is done carefully, the risk of self-contamination is lower.
The most visited Reflections posts of 2019
As 2019 draws to a close, I thought it would be fun to share the most visited posts of 2019 on Reflections. And here they are:
| Blog post | % views of top 10 posts | Year published |
| Do you know your CRO from your CPO from your CRE from your CPE? | 11.4 | 2013 |
| Focusing on the role of nurses in environmental hygiene | 11.3 | 2018 |
| Hand hygiene and the courage to challenge: a personal reflection | 11.1 | 2019 |
| Bad things happen when you don’t do hand hygiene | 10.7 | 2019 |
| We need to win hearts and minds to improve hand hygiene practice | 10.7 | 2019 |
| Dispersal of CPE from contaminated sinks and drains: a refection from Infection Prevention 2019 | 9.6 | 2019 |
| CRE can survive on dry surfaces for longer than you may expect | 9.3 | 2014 |
| CPE infection prevention and control guidelines: an update | 8.8 | 2019 |
| An endless one-sided confidence in Pip-tazo? | 8.6 | 2018 |
| Studying bacteriophages: catch-22 | 8.5 | 2019 |
I mean cleaning…no, disinfection…no, both. (What you mean is ”environmental hygiene”!)
I’ve been struggling for years to find the best ‘catch-all’ term to describe hospital cleaning or disinfection or both. And, after much thought, I’ve settled on a proposal to share with you, dear reader: “environmental hygiene”.
WHO is setting your IPC agenda
The World Health Organisation has updated its 2009 Guidelines on Core Components of Infection Prevention and Control Programmes. The report highlights eight ‘core components’ for IPC:
Do single rooms reduce HCAI?
An interesting review article examines the relationship between three related variables: the proportion of single rooms, the size of the patient room and patient proximity, and the availability of antiseptic hand rub, with various HCAI indicators. The bottom line is that both a move towards a higher proportion of single rooms and larger patient rooms are associated with reduced HCAI, and making hand gels more available improves compliance with their use (unsurprisingly).
Hand hygiene in healthcare (or the lack of it)
I had posted about Sanjay Saint’s great TED talk. He now wrote an article for the general public – based on his talk: “Hand washing stops infections, so why do health care workers skip it?”
While I am a big fan of hand rubbing (we don’t have the time to hand wash) I still feature his picture he included in his article. Have fun reading his article:
https://theconversation.com/hand-washing-stops-infections-so-why-do-health-care-workers-skip-it-58763
Hand hygiene – social norms and compassion
I just saw Sanjay Saint’s TEDx UofM-talk and have to say that I was impressed. The message is clear, the characters portrayed recognizable, and the conclusion something we all have to agree with. I “love” his final thoughts (and if you watch the talk to the end you know why I used “love”) and I share his views on compassion. Intentionally we branded our campaign for better infection control as “iCare”.
Hope you enjoy Sanjay’s talk as much as I did: http://www.youtube.com/watch?v=U3MtvvNjUR4&sns=em
Adapt to adopt | Didier Pittet | TEDxPlaceDesNations
Just as another way of sharing here the link to Didier’s TEDx PlaceDesNations talk: http://tinyurl.com/AdaptToAdopt or click on the picture.
Reflections from Infection Prevention 2015 Part III: Thinking outside the box
For the third and final installment of my blog-report from Infection Prevention 2015, I thought I’d cover some of the more innovative approaches in and around the IPC sphere:
Part II: Improving the systems
Part III: Thinking outside the box
New technology to improve hand and environmental hygiene
I for one am pretty sick of seeing unrealistically high levels of hand hygiene compliance being reported from peer-to-peer manual auditing approaches. One way to get more realistic compliance data is through automated approaches to hand hygiene compliance, reviewed here by Drs Dawson (Warwick) and Mackrill (Imperial College London), who also presented their findings at the conference, and by another group here. Drs Dawson and Mackrill considered issues around product usage, self-reporting, direct observation, perceptions of technology (often viewed, unhelpfully, as a ‘silver bullet’), and staff perceptions of need and benefit. They divided the technology into those that monitored product usage, surveillance systems that monitored individual performance, and systems that monitored both product usage and individual performance. Although automated surveillance systems will always be imperfect and involve a degree of inference, would you rather monitor the 5 moments sporadically / badly or have robust measurements of a smaller number of moments? Automated surveillance methods will not replace manual audits – at least for now – but it’s time to take a long hard look at what is available.
Reflections on Infection Prevention and Control 