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Q: How can healthcare workers best curtail hospital-acquired infections?
"I am fairly new to infection control, but by studying and learning, Ihave discovered handwashing is the No. 1 line of defense for fighting nosocomialinfections. Since becoming an infection control nurse almost two years ago, amain component of my staff education has been hand hygiene. Physicians andnurses have the knowledge but laxity of practice overrides. Nurses complainabout high patient assignments that relate to time, (with) no time to washhands. If handwashing is done, it usually is not done properly. Proper handhygiene is one of the best methods to decrease the transmission of pathogens inhealthcare facilities. Vigorously washing of hands with soap and water is themost defensive way to help prevent nosocomial infections."
Sonya Kay Ehrhardt, RN
Infection Control Nurse, The Regional Medical Center of Orangeburg and CalhounCounties, S.C.
A: "I recommend compliance with four very basic and effectiveinfection control interventions:
1. Hand hygiene. Make every effort to keep hands free of cuts, hangnails orabrasions and cover those you already have. When soap and water are not readilyavailable, the Centers for Disease Control and Prevention (CDC) recommends usingwaterless antimicrobial hand gels. Limit hand jewelry to wedding bands andsimple, loose bracelets. Jewelry can prevent proper hand disinfection.Artificial fingernails have no place in any patient care area, particularly inICU, OR, NICU or ER.
2. Respiratory secretions. Every effort must be made to educate staff,visitors and families about containing coughs and sneezes in tissues,particularly when working or visiting in hospitals.
3. Personal habits. Make a conscious effort not to touch your eyes, nose ormouth. Healthcare workers (HCWs) can contract patients' infections and patientscan contract HCWs' infections. HCWs must keep their immune systems healthy bykeeping vaccinations up to date and leading healthy lifestyles.
4. Personal protective equipment (PPE). Know when to wear PPE (masks, gowns,gloves, etc.) and when and where to remove and properly dispose of usedequipment."
John "Bugs" Hunziker, MPS, MT, CIC
Administrative Manager, Environmental Infection Control/Education, St. Luke'sCornwall Hospital, N.Y.
A: "Everyone is interested in preventing hospital-acquiredinfections. An important consideration often overlooked is educating patientsand family in addition to hospital employees in the use of standard precautions.Handwashing, one of the most basic infection control practices, is a key inpreventing infection, particularly by secondary route (i.e., environmental andequipment). Appropriate work practices and engineering controls assist all usersin preventing the transmission of infection. Helping employees, patients andvisitors realize infection is a real risk and teaching how to protect againstthis risk is a step in the right direction. Good infection control practices,performed often and well, helps everyone stay healthy and is key to deterringhospital acquired infection."
Denise Leaptrot, CIC
Infection Control Coordinator, Coliseum Medical Centers, Macon, Ga.
A: "It is not a high-tech answer. Your mother told you to do itas a child, every public restroom has a sign reminding employees to do it and wehave a hospital competency on it ... you're your hands! It is commonsense, good hygiene and the No. 1 way to prevent the spread of infection in ahospital. Good handwashing keeps you from transferring contamination from yourhands to other areas of your body or surfaces with which you come in contact.Hepatitis B can live on what appears to be a clean, dry surface for seven daysjust waiting for you to make the transfer. Wash your hands and wrists thoroughlyunder running water using a nonabrasive soap. Wash under your rings andfingernails. Rinse completely. Dry with a paper towel. Discard it, then turn offthe faucet with another clean, dry paper towel. If possible, use a clean, drypaper towel to open the door. Set the example and stop the spread of infection.We are in the process of starting a handwashing awareness campaign using "GlitterBug."I can't wait to illuminate people who are eating and don't wash their hands.Hopefully, it will improve our compliance. I read that healthcare works thinkthey wash their hands 80 percent of the time, but when observed it is only 30percent to 40 percent of the time. We have a long way to go."
Dana McKelvain, RN
Infection Control Manager, Eastland Memorial Hospital, Eastland, Texas
A: "In the healthcare setting, each of us has the right to knowabout hazards that present a risk to us, but we also bear the responsibility toknow about risks to patients. Healthcare-acquired infections are considered atype of medical error, and like any other errors, they can be prevented ormanaged through education. Clinical and non-clinical healthcare workers can stopnosocomial infections in many ways, some obvious, others more subtle.
Learn about the types of infections occurring, patient risks for infectionand the role the environment and workers have in transmission of disease.Observe all recommended practices and procedures from handwashing tohousekeeping to sterilization procedures. The consequences for shortcuts areserious and should not be underestimated. Be an advocate for patient safety interms of freedom from infection. Question the choice of antibiotics or thecontinued need for a device such as a foley. Teach patients how they can preventdisease, including vaccination. Model safe practices. Get a flu shot annuallyand remind others. We should use every day in the healthcare workplace as anopportunity to apply our knowledge and skills toward infection prevention."
Patty Carson, BA, SM, (ASCP), CIC
Infection Control Practitioner, Cary Medical Center, Caribou, Maine
Compiled by Michelle Gardner