scholarly journals Use of an Alcohol-Based Handrub and Quality Improvement Interventions to Improve Hand Hygiene in a Russian Neonatal Intensive Care Unit

2004 ◽  
Vol 25 (3) ◽  
pp. 191-191
Author(s):  
Samuel M. Brown ◽  
Anna V. Lubimova ◽  
lya Tekhova ◽  
Ludmila P. Zueva ◽  
Natalya M. Khrustalyeva ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Hand Hygiene ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Improve Hand Hygiene ◽  
Improvement Interventions ◽  
Quality Improvement Interventions

Use of an Alcohol-Based Hand Rub and Quality Improvement Interventions to Improve Hand Hygiene in a Russian Neonatal Intensive Care Unit

2003 ◽  
Vol 24 (3) ◽  
pp. 172-179 ◽  
Author(s):  
Samuel M. Brown ◽  
Anna V. Lubimova ◽  
Natalya M. Khrustalyeva ◽  
Svetlana V. Shulaeva ◽  
Iya Tekhova ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Hand Hygiene ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Quality Improvement Intervention ◽  
Antibiotic Administration ◽  
Improve Hand Hygiene ◽  
Device Use

AbstractBackground:Hand hygiene (HH) is critical to infection control, but compliance is low. Alcohol-based antiseptics may improve HH. HH practices in Russia are not well described, and facilities are often inadequate.Setting:Four 6-bed units in a neonatal intensive care unit in St. Petersburg, Russia.Methods:Prospective surveillance of HH compliance, nosocomial colonization, and antibiotic administration was performed from January until June 2000. In February 2000, alcohol-based hand rub was provided for routine HH use. Eight weeks later, a quality improvement intervention was implemented, consisting of review of interim data, identification of opinion leaders, posting of colonization incidence rates, and regular feedback. Means of compliance, colonization, and antibiotic use were compared for periods before and after each intervention.Results:A total of 1,027 events requiring HH were observed. Compliance was 44.2% before the first intervention, 42.3% between interventions, and 48% after the second intervention. Use of alcohol rose from 15.2% of HH indications to 25.2% between interventions and 41.5% after the second intervention. The incidence of nosocomial colonization (per 1,000 patient-days) with Klebsiella pneumoniae was initially 21.5, decreased to 4.7, and then was 3.2 in the final period. Rates of antibiotic and device use also decreased.Conclusions:HH may have increased slightly, but the largest effect was a switch from soap and water to alcohol, which may have been associated with decreased cross-transmission of Klebsiella, although this may have been confounded by lower device use. Alcohol-based antiseptic may be an improvement over current practices, but further research is required.

Shortening the Application Time of Alcohol-Based Hand Rubs to 15 Seconds May Improve the Frequency of Hand Antisepsis Actions in a Neonatal Intensive Care Unit

2017 ◽  
Vol 38 (12) ◽  
pp. 1430-1434 ◽  
Author(s):  
Axel Kramer ◽  
Didier Pittet ◽  
Romana Klasinc ◽  
Stefan Krebs ◽  
Torsten Koburger ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Practice ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Application Time ◽  
Improve Hand Hygiene ◽  
Independent Observer ◽  
Hand Antisepsis

BACKGROUNDFor alcohol-based hand rubs, the currently recommended application time of 30 seconds is longer than the actual time spent in clinical practice. We investigated whether a shorter application time of 15 seconds is microbiologically safe in neonatal intensive care and may positively influence compliance with the frequency of hand antisepsis actions.METHODSWe conducted in vitro experiments to determine the antimicrobial efficacy of hand rubs within 15 seconds, followed by clinical observations to assess the effect of a shortened hand antisepsis procedure under clinical conditions in a neonatal intensive care unit (NICU). An independent observer monitored the frequency of hand antisepsis actions during shifts.RESULTSAll tested hand rubs fulfilled the requirement of equal or even significantly higher efficacy within 15 seconds when compared to a reference alcohol propan-2-ol 60% (v/v) within 30 seconds. Microbiologically, reducing the application time to 15 seconds had a similar effect when compared to 30-second hand rubbing, but it resulted in significantly increased frequency of hand antisepsis actions (7.9±4.3 per hour vs 5.8±2.9 per hour; P=.05).CONCLUSIONTime pressure and workload are recognized barriers to compliance. Therefore, reducing the recommended time for hand antisepsis actions, using tested and well-evaluated hand rub formulations, may improve hand hygiene compliance in clinical practice.Infect Control Hosp Epidemiol 2017;38:1430–1434

Addressing Hand Hygiene Compliance in a Low-Resource Neonatal Intensive Care Unit: a Quality Improvement Project

2018 ◽  
Vol 8 (5) ◽  
pp. 408-413 ◽  
Author(s):  
Arunava Biswas ◽  
Sangeeta Das Bhattacharya ◽  
Arun Kumarendu Singh ◽  
Mallika Saha
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Neonatal Intensive Care Unit ◽  
Conceptual Framework ◽  
Neonatal Intensive Care ◽  
Hand Hygiene Compliance ◽  
Hand Washing ◽  
Root Cause ◽  
Hygiene Compliance

Abstract Objective Our goal for this study was to quantify healthcare provider compliance with hand hygiene protocols and develop a conceptual framework for increasing hand hygiene compliance in a low-resource neonatal intensive care unit. Materials and Methods We developed a 3-phase intervention that involved departmental discussion, audit, and follow-up action. A 4-month unobtrusive audit during night and day shifts was performed. The audit results were presented, and a conceptual framework of barriers to and solutions for increasing hand hygiene compliance was developed collectively. Results A total of 1308 hand hygiene opportunities were observed. Among 1227 planned patient contacts, hand-washing events (707 [58.6%]), hand rub events (442 [36%]), and missed hand hygiene (78 [6.4%]) events were observed. The missed hand hygiene rate was 20% during resuscitation. Missed hand hygiene opportunities occurred 3.2 times (95% confidence interval, 1.9–5.3 times) more often during resuscitation procedures than during planned contact and 6.14 times (95% confidence interval, 2.36–16.01 times) more often when providers moved between patients. Structural and process determinants of hand hygiene noncompliance were identified through a root-cause analysis in which all members of the neonatal intensive care unit team participated. The mean hand-washing duration was 40 seconds. In 83% of cases, drying hands after washing was neglected. Hand recontamination after hand-washing was seen in 77% of the cases. Washing up to elbow level was observed in 27% of hand-wash events. After departmental review of the study results, hand rubs were placed at each bassinet to address these missed opportunities. Conclusions Hand hygiene was suboptimal during resuscitation procedures and between patient contacts. We developed a conceptual framework for improving hand hygiene through a root-cause analysis.

A Quality Improvement Initiative to Provide Timely Central Vascular Access in a Neonatal Intensive Care Unit

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Kimberly Kristoff ◽  
Rui Wang ◽  
David Munson ◽  
Kevin Dysart ◽  
Stracuzzi Lauren ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Neonatal Intensive Care Unit ◽  
Vascular Access ◽  
Neonatal Intensive Care ◽  
Quality Improvement Initiative
Sign in / Sign up

Export Citation Format

Share Document