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Promotion of successful hand hygiene practices in the intensive care units of a tertiary care hospital
Juhi Taneja, Bibhabati Mishra
July-September 2015, 3(3):130-133
Control of nosocomial infections is a major health concern in a hospital setting and hand hygiene is considered as the most important tool in nosocomial infection control.
This prospective study about the practice of hand washing by 106 HCWs (Health Care Workers) working in Intensive Care Unit (ICU) before and after patient contact in a tertiary care hospital was conducted to find out the hand washing compliance rate in ICU of GB Pant Institute of Postgraduate Medical Education and Research and the factors associated with noncompliance and to find out the impact of a task-orientated hand hygiene education and intervention program.
462 opportunities of hand hygiene were observed in the ICUs over 30 h. Adherence was found to be 52%. A positive intention to comply with hand hygiene was found among 94% of the respondents. Most respondents (78.2%) believed that they could improve compliance with hand hygiene on their own. Intervention included education on hand hygiene indications and technique, hand hygiene performance feedback, and discussion of the previous assessment of HCWs' beliefs toward hand hygiene. After intensive promotion of hand hygiene, observation sessions were performed on 98 nursing staff, which provided 425 opportunities of hand hygiene, and hand hygiene adherence was increased to 63% as an impact of measures taken.
The study revealed that hand hygiene compliance can be effectively increased among HCWs by regular reminders and surveys. Training programs on hand hygiene should be systematically planned, regularly conducted, and evaluated for staff nurses so as to keep them motivated.
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A review of prevention of surgical site infections in Indian hospitals based on global guidelines for the prevention of surgical site infection, 2016
A Arora, P Bharadwaj, H Chaturvedi, P Chowbey, S Gupta, D Leaper, GK Mani, SK S Marya, R Premnath, K Quadros, A Srivastava, A Tendolkar
January-April 2018, 6(1):1-12
While the global estimates of surgical site infection (SSI) have varied from 0.5% to 15%, studies in India have consistently shown higher rates ranging from 23% to 38%. The incidence of SSI may be influenced by factors such as pre-operative care, the theatre environment, post-operative care and the type of surgery. Many other factors influence surgical wound healing and determine the potential for, and the incidence of, infection. Therefore, the prevention of these infections is complex and requires the integration of a range of preventive measures before, during and after surgery. No standardised guidelines backed by evidence are currently established in India for the prevention of SSI. Hence, there is a need for an adaptable, executable National Guideline for low- and middle-income countries which includes India. An effort to draw out most doable and must doable action points to prevent SSI was undertaken by the panelists involved in this paper on the basis of recent global guidelines for the prevention of SSI.
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Microbial epidemiology and antimicrobial susceptibility profile of wound infections in out-patients at a level 1 trauma centre
Amit Kumar Gupta, Priyam Batra, Purva Mathur, Alphina Karoung, BT Thanbuana, Shiny Thomas, M Balamurugan, Jacinta Gunjiyal, Mahesh C Misra
July-September 2015, 3(3):126-129
Wound is a disruption of normal anatomic structure and function of the skin, and any infection in this constitutes wound infection. Wound infection delays wound healing, and it causes wound breakdown, leading to increased hospital stay, morbidity and mortality. Most of the published data available focus on surgical site infections. In the developing countries, however, wound infection is an important cause of hospital mortality and morbidity. No data are available on the microbial profile of the wounds presenting at our hospital.
This study was thus designed to describe the microbial epidemiology and the antimicrobial resistance profile of the wounds of the patients presenting to the OPD.
Methodology and results:
Retrospective review of records of all wound samples sent over 3 years from OPD was done. OPD sent 827 wound samples of 571 patients. Most common organism isolated was
[132 (35%)], followed by
[54 (14%)] and
[49 (13%)]. Of the 145 S. aureus strains, 43 (30%) strains were Methicillin Resistant Staphylococcus aureus, and none were resistant to vancomycin/line- zolid/teicoplanin. Gram-negative organisms were resistant to most antibiotics tested.
Wound healing is halted in the presence of prolonged inflammation such as due to infection. Presence of bacteria delays wound healing, but the presence of low number of microbes is required for wound healing. Absence of appropriate signs to guide treatment becomes a reason for prolonged indiscriminate use of antibiotics which leads to rapid emergence of resistant organisms. Data generated by our study would help in the formulation of antibiotic policy for OPDs and also help in checking inadvertent antibiotic usage.
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