1. 44% complete reduction After disinfection
Title of the Poster Presentation Placed Here
Authors of the Poster Presentation Placed Here Institutional and/or Graduate School of Biomedical Sciences Affiliation Placed Here
Realistic simulation in hand hygiene campaign: Measuring of environment contamination through Relative Light Unit. Paula Regolin, Adenilde Andrade, Adriana Costa e Silva, Ana Paula Maia, Beatriz Quental, Joseanne Lima, Juliana Monteiro Viroli, Maysa Bonfleur Alves, Ivan, França
A C Camargo Cancer Center
GAP 2015 Conference
Introduction
The magnitude and scope of the health care-associated infection (HCAI) burden worldwide appears to be very important and greatly underestimated. Based on an improved awareness of the problem, infection control must reach a higher position among the first priorities in national health programmes, especially in developing countries. (1)
Hand hygiene (HH) is the most simple and effective way to prevent HCAI. Cross-transmission of organisms occurs through contaminated hands. Factors that influence the transfer of microorganisms from surface to surface and affect cross-contamination rates are type of organism, source and destination surfaces, moisture level, and size of inoculum. (1)
Understanding hand hygiene practices among Health Care Workers is essential in planning interventions in health care. The point of care is the place where three elements come together: the patient, the HCW, and care or treatment involving contact with the patient or his/her surroundings. The concept embraces the need to perform hand hygiene at recommended moments exactly where care delivery takes place. Point-of-care products should be accessible without having to leave the patient zone.(1)
Continuous education of health care workers and HH campaigns are spread by World Health Organization, (WHO) as a good way to reach this public.
According to the CDC/ HICPAC system, is strongly recommended for implementation and strongly supported by well-designed experimental, clinical, or epidemiological studies, a educational and motivational HH promotion programmes for HCWs, focus specifically on factors currently found to have a significant influence on behaviour, and not solely on the type of hand hygiene products, with a multifaceted and multimodal strategy that also include education and senior executive support for implementation. (2)
Organizing an effective formal educational programme requires considerable time and effort, but it remains essential to effect changes in staff behaviour. (1)
Methods
AC Camargo Cancer Center is a 361-bed oncology reference hospital in São Paulo, Brazil. The HH campaign is held every six months by infection control team, with different types of HH approaches. In the second half of 2014, a realistic simulation hospital bed was the scene to reinforce the HH five moments of WHO, specially the first and fifth moments, in which the participant chose any place of the scene to collect a swab rub before and after disinfection with didecyl dimethyl ammonium chloride and polyhexamethylene biguanide hydrochloride, and then measured through Relative Light Unit (RLU), proving the presence or absence of organic substance. All data were placed in excel spreadsheet and sent to hospital statistical sector for further analysis .
Conclusion
An effective disinfection of surfaces depends on the material from which it is made and the product contact time with the surface, in addition to local friction. It has been statistically shown the reduction of contamination (p<0,001), even in a realistic simulation. Different approaches in HH campaigns call people attention and reinforce education for adults.
The infection Control Team have twice a year the legacy of HH campaigns, to call people attention, but in fact is a challenge of everyday life, with continuous education of health care workers.
Organizing an effective formal educational programme requires considerable time and effort, but it remains essential to effect changes in staff behaviour. (1)
Results
A realistic simulation hospital bed was the scene of our HH campaign. Employees freely elect a place to collect samples. Those were collected with 45 participants on 90 different situations (45 before and 45 after disinfection), and the site of more choice was the bed rail (26 samples). (fig.3) The average before decontamination was ( ) and after was 6.5 ( ), showing significant reduction of contamination (p<0,001).(fig.1)
All places chosen by participants were high-touch surfaces. On the Grill bed, specially on lever bed was found the highest contamination level ( RLU). (fig.3)
After disinfection of the site, 44.4% of samples showed complete reduction of the organic matter .
During the campaign were trained 626 employees, with a total of 256 health care workers . (fig4)
44% complete reduction After disinfection
Fig. 2 Comparing the reduction of contamination in RLU on every sample.
References
1) WORLD HEALTH ORGANIZATION - WHO. Guidelines on Hand Hygiene in Health Care Available Online in < >
2) CDC – Healthcare Infection Control Practices Advisory Committee (HICPAC) Available online in
Fig. 3 Places chose by participants .
Fig. 4 Employees participation
Fig. 1 Comparing of a average rate between before and after disinfection of the area.