Where do the germs live in your environment? April 2010 Shelly Padgett, BSN, RN Nurse Educator, 7N, Central Monitoring, and Cardiac Access Center

Transcription

1 Where do the germs live in your environment? April 2010 Shelly Padgett, BSN, RN Nurse Educator, 7N, Central Monitoring, and Cardiac Access Center

2 Survey Thank you for your participation in a recent survey sent out asking you to select areas on 7N that you wanted to culture.

3 Why did we do this? To support the National Handwashing Campaign and a national initiative by the Joint Commission of Hospital Accreditation to reduce the risk of healthcare associated infections. To provide evidence for the need for strict handwashing. To aid in creating an environment that fosters peer pressure as it relates to handwashing.

4 Hospital Acquired Infections: Afflict 3 million people annually Including 100,000 deaths annually Perkins, Cheryl. Problematic Hand Sanitation Can Lead to Healthcare Acquired Infections, Virgo Publishing, Retrieved from

5 Pathogen Transmission Cycle This cycle enables germs from patient s contaminated surroundings to be transported back and forth between all surfaces, including patients and healthcare workers. Perkins, Cheryl. Problematic Hand Sanitation Can Lead to Healthcare Acquired Infections, Virgo Publishing, Retrieved from

6 Types of Transmission Healthcare worker comes in contact with an infected patient, does not perform adequate hand hygiene, and transfers the pathogen by touching another patient (Animate). An object(i.e. stethoscope) is contaminated through contact with an infected patient, is not properly disinfected and is used on another patient (Inanimate). The hands of an infected patient touch and contaminate an object (i.e. bedside table or call light), which is then touched by a healthcare worker who does not perform hand hygiene before touching another patient (Animate and Inanimate interaction). Stoessel, Kathleen B. Hand Hygiene: Challenges and Strategies, Virgo Publishing,

7 Survey Results Based on the survey results of 28 respondents, we cultured the following areas on 7N: 1. Breakroom Keypad (67.9%) 2. Computer Keyboard (53.6%) 3. Bedside Table (50%) 4. Stethoscope (42.9%) 5. Admin Rx Scanner (39.3%) 6. Pager (35.7%) 7. Call Light (32.1%) 8. Blue Supply Cart Handle and locks (21.4%) 9. RN/CP Hands (Leadership selection) 10. RN/CP Fingernails (Leadership selection)

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9 The Microbiology lab provided us with the proper technique for culturing, allowed us to use the incubator in their lab, and provided an analysis of our results.

10 We incubated our cultures for 24 hours at 35⁰C (95⁰)

11 Findings Coagulase negative staphylococci (CNS) grew in all of our cultures There are over 40 recognized species of CNS Most common pathogen is S. epidermidis #1 cause of nosocomial bacteremia Hubner, J. Goldman. Coagulase Negative Staphyloccocci: Role as Pathogens. Annu Review Medicine. 1999; 50: pubmed.gov Johns Hopkins ABX Guide

12 Findings Bacillus grew in the culture from the computer keyboard A gram positive rod shaped spore forming bacteria The most well known disease caused by bacilli is anthrax Another type of bacillus can cause food poisoning US Food and Drug Administration

13 Bacillus Staph

14 Staph

15 Staph

16 Staph

17 Staph

18 Hand Hygiene Is recognized as the single most important practice to reduce the transmission of infectious agents in the healthcare setting.

19 VUMC Hand Hygiene Policy Hand Hygiene IC Was created to provide guidelines to promote hand-hygiene practices and reduce transmission of pathogenic microorganisms to patients and staff. Manual/Hpolicy.nsf/AllDocs/625F61A93 549BAF286256CD800745C18

20 Policy Hand hygiene measures are the single most important prevention strategy for avoiding Healthcare Associated Infections (HAI). Faculty/house staff/staff engaged in direct patient contact adhere to the following guidelines regarding handhygiene practices. These practices are consistent with the Centers for Disease Control and Prevention (CDC) recommendations.

21 Policy Decontaminate hands at the following times: a. Upon reporting for work b. Before and after each patient contact. c. Before gloving d. After glove removal e. Before and after each patient contact e. After handling contaminated objects f. Before handling medications h. Before eating i. After using the restroom j. When leaving the facility

22 Policy Wash with soap and water 1. When hands are visibly soiled. 2. Use soap and water after caring for patients on Contact Precautions for suspected or confirmed C. difficile or other spore-forming organisms. 3. The physical action of washing hands with soap and water is recommended by the CDC because alcohols have poor activity against spores.

23 Policy If hands are not visibly soiled: 1. Use an alcohol-based hand rub to decontaminate hands 2. When using an alcohol-based hand rub, apply product to the palm of one hand and rub hands together, covering all surfaces of hands and fingers, until hands are dry 3. Pay special attention to fingertips and nailbeds

24 Please sign your Handwashing Pledge between May 12 May 19 Starting right now I will: Perform hand hygiene before and after entering patient rooms. I will ask other care givers I know or work with to do their part to end the spread of nosocomial infection. I I pledge to perform hand hygiene before and after entering a patient room. I will do my part to put an end to nosocomial infection by applying appropriate peer pressure to colleagues who fail to protect patients by performing hand hygiene. Signature: Date:

25 Hand Hygiene Expectations 1.Perform hand hygiene upon ENTRY & EXIT from the Patient Environment. 2.Any use of alcohol product or soap and water is considered compliant. Use Soap and Water: 1.When hands are visibly dirty 2.After contact with a patient or their environment if the patient has Clostridium difficile (C. Diff). 3.You will know the patient has C. Diff by the sign located on the patient s door that looks like this:

26 References: LMS Learning Module; Hand Hygiene: Challenges to Reduce Healthcare Acquired Infections by Perioperative Services, Vanderbilt University Medical Center Perkins, Cheryl. Problematic Hand Sanitation Can Lead to Healthcare Acquired Infections, Virgo Publishing, Retrieved from Stoessel, Kathleen B. Hand Hygiene: Challenges and Strategies, Virgo Publishing, AORN 2009 Perioperative Standards and Recommended Practices, Recommended Practices for Surgical Hand Antisepsis/Hand Scrubs, Recommendation I VUMC Hand Hygiene Policy: IC Manual/Hpolicy.nsf/AllDocs/625F61A93549BAF286256CD800745C18