Tag Archives: Hand Hygiene

Hand-Washing aka Hand Hygiene Patient Education Proves Successful To Reduce C.diff. Infections

HandHygiene #1 Prevention

Hand-Washing aka hand hygiene Remains #1 In Infection Prevention In Every Setting.

“Despite evidence to suggest that [hand hygiene] is important in preventing infection, hospitalized patients are often not provided the opportunity to clean their hands,” due to mobility and cognitive obstacles as well as lack of education, investigators wrote.

Education on patient hand hygiene significantly reduced the incidence of Clostridium difficile infection at University of Pittsburgh Medical Center Mercy Hospital.

First, they conducted baseline surveys to assess patient hand hygiene, which showed patients needed more opportunities to wash their hands. Then nurse educators provided staff with an educational presentation on the importance of patient hand hygiene for preventing infection, which included specific times they should encourage and assist patients with hand hygiene. Staff then provided education and assistance to newly admitted patients, and researchers conducted additional surveys after implementation of this intervention.

During the first phase of the study involving just four medical-surgical nursing units, patient hand hygiene education increased significantly after the intervention (P < .0001). Overall, 97 follow-up surveys showed the proportion of those who received hand hygiene education increased from 34% to 64%, the opportunities provided for hand hygiene increased from 60% to 86%, and the average number of times hand hygiene was performed daily increased from 2.7 to 3.75.

After expanding the intervention to the whole hospital in the second phase of the study, 189 follow-up surveys showed that patient hand hygiene education increased from 48% to 53%. Meanwhile, overall opportunities for hand hygiene remained unchanged from 68%, and daily frequency of patient hand hygiene did not change significantly (mean, 2.4 vs. 2.6 times per day).

Notably, CDI rates dropped significantly during the 6 months following hospital-wide implementation.

“[Standardized infection ratio] P values for Q2 and W3 (0.0157 and 0.0103, respectively) were significantly lower than expected (P .05),” investigators wrote. “The Q4 SIR, however, showed an increase to 0.3844 over the 2 preceding quarters.”

They concluded that these findings showed patient hand hygiene “should be considered a potential addition to CDI prevention measures in hospitalized patients.” – by Adam Leitenberger

Source:  https://www.healio.com/gastroenterology/infection/news/online/%7B0ea95c50-ddec-4259-a229-5979fde9d8af%7D/patient-handwashing-cuts-c-difficile-rate-in-hospital

Antibiotics; The Main Source Of C. diff. Epidemic Found Through Most Recent UK Study

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As published by

University of Leeds  UK

 

Restricting the use of a common antibiotic was more important than a high profile ‘deep clean’ of hospitals in massively reducing UK antibiotic resistant Clostridium difficile, a major study found.

“These findings are of international importance because other regions such as North America, where fluoroquinolone prescribing remains unrestricted, still suffer from epidemic numbers of C. diff infections.”

http://www.leeds.ac.uk/news/article/3978/overuse_of_antibiotics_the_main_cause_of_c_diff_epidemic

The study concluded that overuse of antibiotics like ciprofloxacin led to the outbreak of severe diarrhea caused by Clostridium difficile (C.diff) that hit headlines from 2006 onward. The outbreak was stopped by substantially reducing use of ciprofloxacin and related antibiotics.

Inappropriate use and widespread over prescribing of fluoroquinolone antibiotics such as ciprofloxacin in fact allowed C. diff bugs that were resistant to the drug to thrive, because non-resistant bugs in the gut were killed off by the antibiotic, leaving the way clear for rapid growth of resistant C. diff.

Concerns about hospital ‘superbugs’ which had become resistant to common antibiotics resulted in the announcement of a program of “deep cleaning” and other infection control measures in the NHS in 2007.

The study, by the University of Leeds, University of Oxford and Public Health England published today in The Lancet Infectious Diseases, found that cases of C. diff fell only when fluoroquinolone use was restricted and used in a more targeted way as one part of many efforts to control the outbreak.

The restriction of fluoroquinolones resulted in the disappearance in the vast majority of cases of the infections caused by the antibiotic-resistant C. diff, leading to around an 80% fall in the number of these infections in the UK (in Oxfordshire approximately 67% of C. diff bugs were antibiotic-resistant in September 2006, compared to only approximately 3% in February 2013).

In contrast, the smaller number of cases caused by C. diff bugs that were not resistant to fluoroquinolone antibiotics stayed the same. Incidence of these non-resistant bugs did not increase due to patients being given the antibiotic, and so were not affected when it was restricted.

At the same time, the number of bugs that were transmitted between people in hospitals did not change. This was despite the implementation of comprehensive infection prevention and control measures, like better hand-washing and hospital cleaning in this case.

The study’s authors therefore conclude that ensuring antibiotics are used appropriately is the most important way to control the C. diff superbug.

The authors note that it is important that good hand hygiene and infection control continues to be practiced to control the spread of other infections.

The study analyzed data on the numbers of C. diff infections and amounts of antibiotics used in hospitals and by GPs in the UK.

More than 4,000 C. diff bugs also underwent genetic analysis using a technique called whole genome sequencing, to work out which antibiotics each bug was resistant to.

Co-author Derrick Crook, Professor of Microbiology, University of Oxford said: “Alarming increases in UK hospital infections and fatalities caused by C. diff made headline news during the mid-2000s and led to accusations of serious failings in infection control.

“Emergency measures such as ‘deep cleaning’ and careful antibiotic prescribing were introduced and numbers of C. diff infections gradually fell by 80% but no-one was sure precisely why.

“Our study shows that the C. diff epidemic was an unintended consequence of intensive use of an antibiotic class, fluoroquinolones, and control was achieved by specifically reducing use of this antibiotic class, because only the C. diff bugs that were resistant to fluoroquinolones went away.

“Reducing the type of antibiotics like ciprofloxacin was, therefore, the best way of stopping this national epidemic of C. diff and routine, expensive deep cleaning was unnecessary. However it is important that good hand hygiene continues to be practiced to control the spread of other infections.

“These findings are of international importance because other regions such as North America, where fluoroquinolone prescribing remains unrestricted, still suffer from epidemic numbers of C. diff infections.”

Co-author Prof Mark Wilcox, Professor of Microbiology, University of Leeds, said: “Our results mean that we now understand much more about what really drove the UK epidemic of C. diff infection in the mid-2000s.

“Crucially, part of the reason why some C. diff strains cause so many infections is because they find a way to exploit modern medical practice.

“Similar C. diff bugs that affected the UK have spread around the world, and so it is plausible that targeted antibiotic control could help achieve large reductions in C. diff infections in other countries.”

The funding for the study came from the UK Clinical Research Collaboration, (Medical Research Council, Wellcome Trust, National Institute for Health Research); NIHR Oxford Biomedical Research Centre; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antibiotic Resistance, University of Oxford in partnership with Leeds University and Public Health England; NIHR Health Protection Research Unit in Modelling Methodology, Imperial College London in partnership with Public Health England; and the Health Innovation Challenge Fund.

Further information:  Source:

Contact Sophie Freeman in the University of Leeds

press office on 0113 343 8059 or email s.j.freeman@leeds.ac.uk

 

C. diff. Awareness Across the Globe

cdiffawarenessribbon

Beginning November 1st,

join the C Diff Foundation in

“Raising C. diff.  Awareness.”

Let’s begin with promoting C. difficile prevention to share in witnessing a decrease in C. difficile infections worldwide.

Ways to PREVENT acquiring a C. diff. infection:

HAND-WASHING remains the #1 course of action in infection prevention.

Knowing how and when to wash hands is also important.

Correct Hand-washing steps to follow:

  • Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
  • Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
  • Scrub your hands for at least 30 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
  • Rinse your hands well with water.
  • Dry your hands using a clean towel.
  • Turn off faucets with a clean dry towel, and wipe hands with a clean dry towel.

WHEN is it a good time to wash hands?

  • Before, during, and after handling and preparing food.
  • Upon Entering a Patient’s room and Before Existing a Patient’s room.
  • Before and after eating.
  • Before and after patient care.
  • Before and after treating a cut or wound.
  • Before  exiting a restroom.
  • After changing diapers.
  • After blowing your nose, coughing, or sneezing.
  • After petting a pet or any livestock animals.
  • After touching garbage.
  • AND OFTEN.

Limit Antibiotic Use — Discuss Symptoms With Healthcare Providers.

The Centers of Disease Control and Prevention recommends infection control protocols be shared between healthcare professionals and long-term facility administrators for the safety of the patient, visitors, and other patient’s safety.

Question the necessity of antibiotics to treat symptoms.  Unnecessary use of antibiotics raises the risk of acquiring a C. difficile infection.  Remember antibiotics do not effect viruses.  Healthcare professionals; confirming a bacterial infection before prescribing antibiotic course of treatment is advised.

Take the Antibiotic “Resistance Fighter” Pledge

How to be a resistance fighter:  Limit the use of Antibiotics! Understand that antibiotics are only effective against bacteria and not viruses: colds, flu and most coughs are caused by viruses and will get better on their own.  Treat your flu and cold symptoms and let your immune system fight the virus.  Antibiotics will not help you get better quickly, and may give you side effects such as diarrhea and thrush. They can also lead to acquired C. diff. infections. They won’t stop your virus spreading to other people only YOU can do that with good hand hygiene.  Don’t ask for antibiotics , instead ask your doctor about the best way to treat your symptoms.   If you are prescribed antibiotics ask your doctor about the risks and benefits and always take them exactly as prescribed. Never take someone else’s antibiotics, always speak with your Primary Care Physician (PCP) or healthcare professional when symptoms linger or worsen.

Let us all take the “Resistance Fighter” Pledge and feel free to share the pledge with            everyone you know

I will not expect antibiotics for colds and flu as they have no effect on viruses.
I will take antibiotics as directed IF I am prescribed them, and not ask for them.
I will practice good hygiene, making hand washing #1, and help stop giving germs a free ride.

Now we can ALL spread knowledge, not infections and encourage others to join the fight against antibiotic resistance.

“Get Smart: Know When Antibiotics Work” CDC Campaign :

Get Smart About Antibiotics Week has been an annual effort to coordinate the work of CDC’s Get Smart: Know When Antibiotics Work campaign, state-based appropriate antibiotic use campaigns, non-profit partners, and for-profit partners during a one week observance of antibiotic resistance and the importance of appropriate antibiotic use. The campaign organized its first annual Get Smart About Antibiotics Week in 2008. CDC’s Get Smart campaign, housed in the National Center for Immunization and Respiratory Diseases, collaborated with state-based appropriate antibiotic use campaigns and non-profit and for-profit partners. The success of the pilot year was measured by 1) dissemination of educational materials and messages, 2) partner satisfaction, and 3) media interest. A robust evaluation of the pilot week determined that each of these goals was met and exceeded. This was followed by other successful Get Smart About Antibiotics Week observances.

During November 14-20th, 2016 —  the Annual Get Smart About Antibiotics Week will be observed. As in past years, the effort will coordinate work of CDC’s Get Smart: Know When Antibiotics Work campaign, state-based appropriate antibiotic use campaigns, non-profit partners, and for-profit partners during a one week observance of antibiotic resistance and the importance of appropriate antibiotic use. As with the past observances, messages and resources for improving antibiotic use in  healthcare settings from CDC’s Get Smart for Healthcare campaign will be included. Get Smart for Healthcare is a program housed in CDC’s National Center for Emerging and Zoonotic Infectious Diseases.

  • Ask your physician questions such as, “Do I really need an antibiotic?”
  • Bacteria only, not viruses (common cold, flu), can be killed by antibiotics.
  • Complete the entire course of prescribed antibiotics, even if you feel better midway through.

Antibiotic resistance occurs when bacterial changes reduce or eliminate an antibiotic’s ability to kill the bacteria.

The Association of Professionals in Infection Control and Epidemiology (APIC)  recommends the following:

  • Take antibiotics only and exactly as instructed by your healthcare provider.
  • Only take antibiotics prescribed for you.
  • Do not save or share antibiotics prescribed to you.
  • Do not pressure your healthcare provider to prescribe you antibiotics.

C. diff. Testing:  When a patient presents symptoms (diarrhea with abdominal cramping/pain, fatigue, fever) ordering a C. difficile stool test to rule out a C. diff. infection is beneficial, especially if the patient has been treated with antibiotics within ninety-days.

Environmental Safety:  Disinfecting a patient’s room, treated for a positive C. difficile infection, with a bleach or Federal EPA registered spore-killing product will help eliminate      C. difficile spores from being spread to another patient’s room.  Environmental safety is also an important matter in home-care.  Cleaning all high-touch areas in both long-term and acute care facilities, and home environments will help decrease the spread of this infection.  (High-touch surfaces: light switches, door knobs/handles, bed-side commodes, bathroom hand rails, commode, sink and sink handles, counter-tops, floors, bath-tubs, showers, canes, wheel-chairs, and all medical equipment in a patient’s room).

Personal Protection: ISOLATION: Visitors and Environmental professionals, wear proper personal protection equipment when treating and cleaning areas/rooms of a     C. difficile patient.  (gloves, gowns, shoe coverings, protective eye wear if using using spray solutions).

Patient Isolation:  Contact Precautions: Protect the patient and others by keeping a C. difficile patient in isolation in long-term and acute care facilities.  This will prevent the spread of infection to others and other areas within the facilities.

Communication:  If a patient is being transferred from either a long-term or acute care facility, communicate to the facility intake personnel the patient’s C. diff. infection and necessary infection control protocols to be implemented for the patient and other patient’s safety.

The CDC has been sharing public announcements regarding the use of Antibiotics for both healthcare professionals and patients alike.  Colds, Ear and Sinus symptoms may be caused by a virus, not bacteria.  Taking antibiotics to treat a virus makes antibiotic medications less effective when they are needed while raising the risk of acquiring a C. difficile infection.  Limit the use of Antibiotics to reduce the risk of acquiring a C. difficile infection  (Bacterial infections and the treatment of symptoms will be determined and should be followed by the treating healthcare professionals). * November 17-23rd, 2014 join the CDC’s Get Smart: Know When Antibiotics Work campaign.

“None of us can do this alone…..all of us can do this together”

For additional C. difficile information, review the Infection Prevention categories available on the website :   http://www.cdifffoundation.org

 

 

 

Sources: CDC

Hand Washing aka Hand Hygiene While On a Journey

washhands2

“Spring Break” is upon us and it’s the perfect time for a road-trip!

 

Traveling is one of the most important times to pay close attention to “infection prevention.”

Being prepared can help.

During a recent journey along the east coast, in the USA, a few of the Foundation members had the opportunity to visit an array of public restrooms along the way.

As we are aware, public restrooms can be a challenge and a real eye-opening experience. Many of the facilities fell short in monitoring their supplies along with the monitoring of over-all cleanliness of their restroom.

During the road trip, along various interstates, back roads, and local towns, we began to assess the establishment’s public facilities based on the following criteria:

* Cleanliness.

* Supplies offered.

* Electronic hand drying devices vs traditional supplies.

* Cleaning/Room monitoring log.

As the journey continued the restroom grading system became the topic of conversation discussing the vast ways establishments can maintain a safe, clean, and friendly environment for their visitors.  There were also discussions on how a traveler can be prepared by carrying supplies to ensure their own safety when utilizing public facilities.

The following is a list of a few supplies easily kept in a small bag during travel times:

* A small container of liquid soap (preferably one without the anti-bacterial ingredients).

* A few paper towels dampened with bleach or pack a EPA Registered cleaning product to clean the commode and high-touch areas.  It is good safety practice to store the paper towels in a sealed plastic container.  Other cleaning (Germicidal/Disinfectant) product wipes should remain in their original container or sealed separately in a plastic container.   Never mix two cleaning wipes/products together or store in the same container.

* Sheets of T.P. or a small roll.

* Sheets of dry paper towels to turn off water faucets and dry hands.

*  Attempt to open the restroom door with an elbow or use a dry paper towel to pull the door handle open in order to keep hands clean and not re-introduce germs onto the hands.

Was there a favorite rest stop/establishment along the way?  Yes.

McDonalds restrooms were found to be acceptable and met the needs of the travelers. Their establishments focus on cleanliness, offered an adequate supply of soap with automated towel dispenser or hand dryers, and facility monitoring logs in place. Their organization also displayed signs over the sinks promoting hand hygiene, a public safety announcement for both staff, and visitors.

The public restrooms at rest-stops along I-95 were impressive with their focus on cleanliness, adequately filled soap containers, and hand dryers available in each restroom with the elimination of a main door to enter/exit the facility.  Once the hands are washed/dried the reintroduction to harmful germs upon exiting the public area from a door handle is eliminated.

There were a number of unacceptable facilities located in local discount stores, some food stores, food chain eateries, and quick-mart stations.  Their sinks were not automated with motion sensors and many with two handles, empty paper towel dispensers and automatic hand drying equipment unavailable. Many restrooms were without cleaning monitoring logs promoting safety and cleanliness to the staff (food handlers), and visitors alike.

We appreciate the availability and use of public restrooms during  long commutes, when on vacations, and time away from home.  Most establishments offer adequate supplies to eliminate, and  prevent the spread of harmful germs, however;  it is always best to be prepared.  The next time a journey is planned, do not forget to pack the supplies needed for a public restroom visit that will keep you and your family safe.

The journey and hand-washing experiences become part of the adventure.  Take the opportunity to report negative experiences to the management and help change a negative into a positive for the next person visiting.

Remember to take that twenty second hand-washing break before exiting a restroom, before/after eating, before/after entering a patient’s room, after changing diapers, before/after handling food, and during the day.   Let’s stop giving germs a free ride.

Here’s to everyone’s good health!

Below you will find links available for Public Restroom locators offered by Charmin, one app for an iPhone, and an app for an Android Phone. 

http://www.charmin.com/find-public-restrooms.aspx?utm_source=msn&utm_medium=cpc&utm_campaign=Charmin_Search_Desktop_Lifestyle_SoS+App&utm_term=restroom%20app&utm_content=SvExifYv_restroom%20app_p_2095916800&sctp=ppc&scvn=bing&scsrc=bing_search&sckw=na

* App For iPhone

https://itunes.apple.com/us/app/restroom-bathroom-toilet-finder/id311896604?mt=8

* App For Android

https://play.google.com/store/apps/details?id=com.bto.toilet

WHO Healthcare-Associated Infection Pledge 2015

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C Diff Foundation Pledges Continued Support to Reduce Healthcare-Associated Infections
The C Diff Foundation continues to recognize the serious disease burden and significant economic impact that healthcare-associated infections places on patients and the health care systems throughout the world.

 

Considering that the majority of these infections are treatable and preventable, appreciating the momentum that the Global Patient Safety Challenge program of the WHO World Alliance for Patient Safety is bringing to reduce healthcare-associated infection at the global level.
Emphasizing that a unique opportunity exists to reverse the incidence of healthcare-associated infections, members of the C Diff Foundation shares and pledges……..
To work together to witness a reduction in healthcare–associated infections through the following actions:
• Acknowledging the importance of healthcare-associated infections;
• Developing or expanding ongoing campaigns at national or sub-national levels to promote and improve hand-washing (aka hand hygiene) methods among health care providers;
• Making reliable and validated information available on healthcare-associated infections at community and district levels to foster appropriate actions;
• Sharing experiences and, where appropriate, available surveillance data, with the WHO World Alliance for Patient Safety;
• Consider the use of WHO strategies and guidelines to tackle healthcare-associated infection, in particular in the areas of hand-washing (aka hand hygiene), raise awareness of antibiotic stewardship, and environmental procedure safety.

We will work with health professionals and associations worldwide:
-To promote the highest standards of practice and behavior to reduce the risks of healthcare-associated infection;
-To foster and sustain collaboration with research institutions, training schools, educational centers, universities, healthcare settings, and agencies of other WHO Member States to ensure full utilization of knowledge and experience in the field of healthcare-associated infection.
-To encourage senior management support and role-modeling from key staff to promote the implementation of interventions to reduce healthcare-associated infections.
C Diff Foundation
May 5, 2015

 

For more information about Clean Care is Safer Care, please contact the team at savelives@who.int

 

Hand-washing (aka hand-hygiene) Helps Stop The Spread Of Germs

HAVE YOU TAKEN A 20 – 30 SECOND HAND-WASHING BREAK?

Correct hand-washing technique keeps you and others safe:

 

  • Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
  • Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
  • Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
  • Rinse your hands well under clean, running water.
  • Dry your hands using a clean towel or air dry them

WHEN TO WASH YOUR HANDS:

  • Before, during, and after preparing food
  • Before eating food
  • Before and after patient care in any setting
  • Before and after treating a cut or wound
  • After using the toilet and before exiting the restroom
  • After changing diapers or cleaning up a child who has used the toilet
  • After blowing your nose, coughing, or sneezing
  • After touching an animal, animal feed, or animal waste
  • After handling pet food or pet treats
  • After touching garbage
  • After visiting an outpatient setting (Physicians office/Dentist office/Clinic)
  • After shopping
  • Before and after handling food
  • After traveling on public transportation
  • Any any time hands are soiled

 

What is the difference?
Hand hygiene . A general term that applies to either
handwashing, antiseptic handwash, antiseptic hand rub, or
surgical hand antisepsis.
Handwashing . Washing hands with plain (i.e., non-antimi-
crobial) soap and water.
Guideline for Hand Hygiene in Health-Care Settings
Recommendations of the Healthcare Infection Control Practices
Advisory Committee and the HICPAC/SHEA/APIC/IDSA
Hand Hygiene Task Force
Vol. 51 / RR-16
Activity of Antiseptic Agents Against
Spore-Forming Bacteria
The widespread prevalence of health-care–associated diarrhea                                                            caused by Clostridium difficile and the recent occurrence
in the United States of human Bacillus anthracis infections                                                                    associated with contaminated items sent through the postal
system has raised concern regarding the activity of antiseptic
agents against spore-forming bacteria. None of the agents
(including alcohols, chlorhexidine, hexachlorophene,
iodophors, PCMX, and triclosan) used in antiseptic handwash
or antiseptic hand-rub preparations are reliably sporicidal
against Clostridium spp. or Bacillus spp. (120,172,224,225).
Washing hands with non-antimicrobial or antimicrobial soap
and water may help to physically remove spores from the sur-
face of contaminated hands. HCWs should be encouraged
to wear gloves when caring for patients with
C. difficile – associated diarrhea (226). After gloves are removed, hands
should be washed with a non-antimicrobial or an antimicro-
bial soap and water or disinfected with an alcohol-based hand
rub. During outbreaks of C. difficile-related infections, washing                                                              hands with a non-antimicrobial or antimicrobial soap and
water after removing gloves is prudent. HCWs with suspected
or documented exposure to B. anthracis-contaminated items also should be encouraged to wash their hands with a non-antimicrobial or antimicrobial soap and water
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C. diff. and Healthcare-Associated Infections Discussed Live on C. diff. Radio

CdiffRadioPost

#CdiffRadio

C Diff Foundation, Sponsor, with Founder            Nancy C. Caralla, Executive Director and               Dr. Chandrabali Ghose, Chairperson of the Research and Development Community will be broadcasting live on Tuesdays delivering the most up-to-date information pertaining to a leading super-bug/ Healthcare Associated Infection (HAI),  C. difficile, with additional HAI’s, and a variety of related healthcare topics.

Topic experts will be joining your hosts to discuss prevention, treatments, clinical trials, and environmental safety products on a global level.

Tune in Tuesdays beginning March 3rd at 11 AM Pacific Time (2 PM Eastern Time, 7 PM UK) on the VoiceAmerica network  http://www.voiceamerica.com/show/2441/c-diff-spores-and-more