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.

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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

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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”.

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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).

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Hand hygiene in healthcare (or the lack of it)

Schermafbeelding 2016-05-19 om 12.01.35I 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

Schermafbeelding 2016-04-26 om 21.00.15

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”.Schermafbeelding 2016-04-26 om 21.02.03

Hope you enjoy Sanjay’s talk as much as I did: http://www.youtube.com/watch?v=U3MtvvNjUR4&sns=em

Reflections from Infection Prevention 2015 Part III: Thinking outside the box

think 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 I: Beating the bugs

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.

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5th May Hand Hygiene Day

safehandsDear friends and colleagues, The Hand Hygiene day on the 5th of May is approaching. However, this year is different. 2015 is the 10th anniversary of the WHO Clean Care is Safe Care program and we would like you to help us commemorate this day. We are simply asking you to participate to the #safeHANDS campaign by taking your photo using WHO #safeHANDS board and posting it on the website (see below) or on the social media Twitter or Instagram to remind the world that hand hygiene saves lives. It is as simple as that. You can also organize a Hand Sanitizing Relay and even beat a GUINNESS WORLD RECORD. Here are links providing you all information: 1) WHO campaign webpage:  http://www.who.int/gpsc/5may/EN_PSP_GPSC1_5May_2015/en/ 2) Where to post your pictures: http://www.CleanHandsSaveLives.org/safehands/ 3) The safeHANDS campaign promotion clip: http://tinyurl.com/safeHANDSclip 4) The Hand Sanitizing Relay – possible Guinness World Record explanatory clip:  http://tinyurl.com/HHRelay