Standard Precautions in Infection Control

New HARTMANN SCIENCE CENTER symposium series successfully launched:
Basic hygiene in motion

5/4/2022

Basic hygiene measures continue to be the basis for avoiding nosocomial infections. The COVID-19 pandemic has once again clearly demonstrated how important these are, as therate of healthcare-associated infections has risen in 2020 probably partly due to the more vulnerable patient clientele. A survey of hospital staff conducted as part of our holistic prevention concept MISSION: INFECTION PREVENTION (M: IP®) also revealed that three-quarters of respondents consider nosocomial infections to be one of the main existential threats to hospitals over the next 10 years. This makes it all the more important to keep basic hygiene on the move in order to constantly improve it and develop new approaches to infection prevention. Against this background, our new symposium series was launched online on November 11, 2021. In the two-hour kick-off event with the motto “Basic hygiene in motion – Approaches to infection prevention“ (German version only), Professor Andreas Widmer (Swissnoso National Centre for Infection Prevention, member of the World Health Organisation WHO), Dr Tobias Kramer (Charité Berlin, Aktion Saubere Hände) and Professor Johannes Knobloch (Hospital Hygiene Department, University Medical Centre Hamburg-Eppendorf) provided insights into the current study situation. They also gave the participants practical measures for improved hygiene in healthcare facilities.

National minimum standard for infection prevention becomes binding in Swiss hospitals

Professor Andreas Widmer, who was the first to speak, has been promoting infection prevention in Swiss hospitals for over 25 years with the Swissnoso National Centre. In his opinion, at least 35% of nosocomial infections could be prevented with appropriate measures. Even though the theoretical knowledge has been available for a long time, until now there have often been structural and financial barriers that made implementation difficult or prevented it. For this reason, Swissnoso – based in part on a study of the number of hand disinfectant dispensers in Swiss hospitals – has drawn up a minimum standard for infection prevention, which has recently come into force in Swiss hospitals. This provides for at least two disinfectant dispensers per bed in non-intensive care units to facilitate hand hygiene compliance – significantly more than the number required by the German Robert Koch Institute. However, the minimum standard is not a recommendation, but obligatory for hospitals. If they do not implement it, Widmer says, this could even mean the closure of the clinic. Swissnoso is now supporting hospitals in establishing the minimum standard.

Hand hygiene especially important when handling personal protective equipment

As medical coordinator for “Aktion Saubere Hände”, Dr Tobias Kramer specialises in the topic of hand disinfection in patient care. In his lecture, he gave an insight into developments during the pandemic and its challenges, among other things. In Germany, hand hygiene compliance was already at a relatively high level before the pandemic, but according to Kramer, problems can still arise from glove contamination, possible misuse or the disinfection of disposable gloves, which is only indicated in exceptional cases. A study showed that hands are often not disinfected before using gloves or that gloves are not changed when indicated. There is therefore a clear need for improvement here, which is why the HAND-KISS module now also asks about the use of gloves. In this way, it can be recognised whether the failure to achieve compliance was due to this, and improvements can be made.

Dr Tobias Kramer: “If you observe compliance on COVID wards, you see a different way of working than before the pandemic. Personal protective equipment (PPE) is worn permanently and must be used correctly for personal protection and that of the patients. Nevertheless, even when caring for (potentially) infectious patients, we see that the PPE is sometimes adjusted in the meantime and then we go back to the patients. There is room for improvement.”

Transmission through surfaces possible – cleaning and disinfection essential

Professor Johannes Knobloch also emphasised that while hand hygiene remains a key measure against nosocomial infections, it is not sufficient as the sole measure. Rather, hospital hygiene should be multimodal and consist of various concerted strategies. Because surfaces can also be contaminated with pathogens, good cleaning and disinfection is essential. Since there is no international guideline on routine cleaning and disinfection of surfaces in healthcare facilities, in 2021, Knobloch published practical recommendations on this together with a European working group. This describes, for example, the underlying risk assessment, which is based on the vulnerability of the patients, the probability of transmission and the risk profile of the potential pathogens. "High-touch” surfaces such as lift buttons and keyboards, for example, are particularly contaminated and should be cleaned frequently. A distinction must also be made between routine and targeted disinfection, responsibilities must be defined, training of cleaning staff must be ensured and cleanliness must be assessed on a regular basis.

Professor Johannes Knobloch: “We need multimodal measures to improve cleaning so that insufficient final disinfection - especially after problematic pathogens - does not increase the risk for subsequent patients. For this, we have to say goodbye to the idea of "more surface area in less time". We need good cleaning by people who know what they are doing and are able to perform the correct cleaning steps."

Great interest in the kick-off event reflects the relevance of the topic

At the end of the virtual symposium, Dr Jan Schröder (HARTMANN SCIENCE CENTER) presented the results of the skin and mucous membrane tolerance of our new surface disinfectant Bacillol® 30 Sensitive and showed that no clinically relevant changes occurred in any of the parameters of the skin or mucous membrane when it was used. All in all, the successful kick-off event was very well received and once again highlighted the relevance of the topic. For us at HARTMANN, this means: We would like to offer you similar events in the future, which – if possible – are also aimed at an international audience.

Use surface disinfectants safely. Always read label and product information before use. Classification (REGULATION (EG) No. 1272/2008) Bacillol® 30 Sensitive: Flammable liquids category 3 - H226: Flammable liquid and vapor. Eye irritation category 2 - H319: Causes serious eye irritation.

Sources:

  1. Kuster S, et al. Handrub dispensers per acute care hospital bed: a study to develop a new minimum standard. Antimicrob Resist Infect Control. 2021; 10: 93. https://doi.org/10.1186/s13756-021-00949-0
  2. Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut (RKI). Händehygiene in Einrichtungen des Gesundheitswesens. Bundesgesundheitsbl. 2016; 59: 1189–1220. https://www.rki.de/DE/Content/Infekt/Krankenhaushygiene/Kommission/Downloads/Haendehyg_Rili.pdf?__blob=publicationFile
  3. Imhof R, et al. Gloves use and possible barriers - an observational study with concluding questionnaire. GMS Hyg Infect Control. 2021; 16: Doc08. https://doi.org/10.3205/dgkh000379
  4. Assadian O, et al. Practical recommendations for routine cleaning and disinfection procedures in healthcare institutions: a narrative review. J Hosp Infect. 2021; 113: 104–114. https://doi.org/10.1016/j.jhin.2021.03.010

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