A Comparison of Adherence Rates to Guidelines for Contact Precautions between Healthcare Workers Performing Low-Risk and High-Risk Activities for Body Fluid Exposure to Patients with Multidrug-Resistant Organisms
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Abstract
Abstract:
This descriptive study aimed to compare the adherence rates to guidelines for contact precautions between healthcare workers performing low-risk and high-risk activities for body fluid exposure to patients with multidrug-resistant organisms (MDROs). The guidelines for contact precautions included hand hygiene, gowning, and gloving. Convenience sampling was used to recruit a sample of healthcare workers who performed tasks in a medical semiintensive care unit. Non-participatory action observation with random sampling was conducted a total of 560 times consisting of 330 times of high-risk activities and 220 times of low-risk activities. The high-risk or low-risk activities were classified based on how much healthcare workers have been exposed to body fluid of patients with MDROs. Data were analyzed with descriptive statistics and the chi-square test. The results revealed that healthcare workers’adherence rates to guidelines for contact precautions (washing hands, gowning, and gloving) in low-risk activities for body fluid exposure were significantly lower than in high-risk activities among patients with MDROs both before and after providing care. Thus, the relevant authorities should also pay attention to controlling the spread of MDROs in low-risk activities for body fluid exposure to prevent this gap and make it more effective to control the spread of MDROs.
Keywords: Adherence rate, Guidelines for contact precautions, Multi-drug resistant organisms, Body fluid exposure
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บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในรามาธิบดีพยาบาลสาร ถือเป็นลิขสิทธิ์ของวารสาร หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่หรือเพื่อกระทำการใด ใด จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษรจากรามาธิบดีพยาบาลสารก่อนเท่านั้น
References
Ling ML, Apisarnthanarak A, Madriaga G. The burden of healthcare-associated infections in Southeast Asia: a systematic literature review and meta-analysis. Clin Infect Dis. 2015;60(11):1690-9.
Alp E, Damani N. Healthcare-associated infections in intensive care units: epidemiology and infection control in low-to-middle income countries. J Infect Dev Ctries.2015;9(10):1040-5.
MacVane SH. Antimicrobial resistance in the intensive care unit: a focus on gram-negative bacterial infections.Intensive Care Med. 2017;32(1):25-37.
World Health Organization. Antimicrobial resistance:global report on surveillance: World Health Organization;2014.
Brotfain E, Borer A, Koyfman L, Saidel-Odes L, Frenkel A, Gruenbaum SE, et al. Multidrug resistance Acinetobacter bacteremia secondary to ventilator-associated pneumonia:risk factors and outcome. Intensive Care Med.2017;32(9):528-34.
Thaden JT, Li Y, Ruffin F, Maskarinec SA, Hill-Rorie JM, Wanda LC, et al. Increased costs associated with bloodstream infections caused by multidrug-resistant Gram-negative bacteria are due primarily to patients with hospital-acquired infections. Antimicrob Agents
Chemother. 2017;61(3):e01709-16.
Siegel JD, Rhinehart E, Jackson M, Chiarello L.Management of multidrug-resistant organisms in health care settings, 2006. Am J Infect Control. 2007;35(10Suppl2): S165-93.
Apisarnthanarak A, Buppajarntham A, Mundy LM.National survey of infectious diseases physicians on prevention practices for multidrug-resistant Acinetobacter baumannii in Thailand. Infect Control Hosp Epidemiol.2016;37(4):489-91.
Tacconelli E, Cataldo M, Dancer S, De Angelis G, Falcone M, Frank U, et al. ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients. Clin Microbiol Infect. 2014;20:1-55.
Otter JA, Mutters NT, Tacconelli E, Gikas A, Holmes A.Controversies in guidelines for the control of multidrugresistant Gram-negative bacteria in EU countries. Clin Microbiol Infect. 2015;21(12):1057-66.
Anderson DJ, Weber DJ, Sickbert-Bennett E. On contact precautions: the good, the bad, and the ugly. Infect Control Hosp Epidemiol. 2014;35(3):222-4.
Dhar S, Marchaim D, Tansek R, Chopra T, Yousuf A,Bhargava A, et al. Contact precautions more is not necessarily better. Infect Control Hosp Epidemiol.2014;35(3):213-9.
Clock SA, Cohen B, Behta M, Ross B, Larson EL. Contact precautions for multidrug-resistant organisms: current recommendations and actual practice. Am J Infect control.2010;38(2):105-11.
Manian FA, Ponzillo JJ. Compliance with routine use of gowns by healthcare workers (HCWs) and non-HCW visitors on entry into the rooms of patients under contact precautions. Infect Control Hosp Epidemiol. 2007;28(3):337-40.
Punpop M, Malathum P, Malathum K. Adherence of healthcare workers toward the contact precaution guidelines for patients with multidrug-resistant organisms in a tertiary care hospital. Rama Med J. 2018;41(4):56-64.
Rock C, Thom KA, Masnick M, Johnson JK, Harris AD,Morgan DJ. Frequency of Klebsiella pneumoniae carbapenemase (KPC)-producing and non-KPCproducing Klebsiella species contamination of healthcare workers and the environment. Infect Control Hosp
Epidemiol. 2014;35:426–9.
Huslage K, Rutala WA, Sickbert-Bennett E, Weber DJ.A quantitative approach to defining “high-touch” surfaces in hospitals. Infect Control Hosp Epidemiol.2010;31(8):850-3.
Chang NN, Reisinger HS, Schweizer ML, Jones M,Chrischilles E, Chorazy M, et al. Hand hygiene compliance at critical points of care. Clin Infect Dis. 2021;72(5):814–20.
Brusselaers N, Vogelaers D, Blot S. The rising problem of antimicrobial resistance in the intensive care unit. Ann Intensive Care. 2011;1(1):47.
Pittet D, Allegranzi B, Boyce J, Experts WHO. The World Health Organization guidelines on hand hygiene in health care and their consensus recommendations. Infect Control Hosp Epidemiol. 2009;30(7):611-22.
McCambridge J, Witton J, Elbourne DR. Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects. J Clin Epidemiol.2014;67(3):267-77.
Gagne D, Bedard G, Maziade P. Systematic patients’ hand disinfection: impact on meticillin-resistant Staphylococcus aureus infection rates in a community hospital. J Hosp Infect. 2010;75(4):269-72.
Dancer SJ. Control of transmission of infection in hospitals requires more than clean hands. Infect Control Hosp Epidemiol. 2010;31(9):958-60.
Smith S, Young V, Robertson C, Dancer S. Where do hands go? An audit of sequential hand-touch events on a hospital ward. J Hosp Infect. 2012;80(3):206-11.
Kramer A, Schwebke I, Kampf G. How long do nosocomial pathogens persist on inanimate surfaces? A systematic review. BMC Infect Dis. 2006;6(1):130.
Weinstein RA, Hota B. Contamination, disinfection, and cross-colonization: are hospital surfaces reservoirs for nosocomial infection? Clin Infect Dis. 2004;39(8):1182-9.
Tajeddin E, Rashidan M, Razaghi M, Javadi SS, Sherafat SJ, Alebouyeh M, et al. The role of the intensive care unit environment and health-care workers in the transmission of bacteria associated with hospital acquired infections. J Infect Public Health. 2016;9(1):13-23.
Morgan DJ, Rogawski E, Thom KA, Johnson JK,Perencevich EN, Shardell M, et al. Transfer of multidrugresistant bacteria to healthcare workers’ gloves and gowns after patient contact increases with environmental contamination. Crit Care. 2012;40(4):1045.
Stiefel U, Cadnum JL, Eckstein BC, Guerrero DM, Tima MA, Donskey CJ. Contamination of hands with methicillinresistant
Staphylococcus aureus after contact with environmental surfaces and after contact with the skin of colonized patients. Infect Control Hosp Epidemiol.2011;32(2):185-7.
Boyce JM, Pittet D. Guideline for hand hygiene in healthcare settings: recommendations of the Healthcare Infection
Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infect Control Hosp Epidemiol. 2002;23(S12):S3-40.
Almaguer-Leyva M, Mendoza-Flores L, Medina-Torres AG, Salinas-Caballero AG, Vidaña-Amaro JA, Garza-Gonzalez E, et al. Hand hygiene compliance in patients under contact precautions and in the general hospital population. Am J Infect control. 2013;41(11):976-8.
Mitchell R, Roth V, Gravel D, Astrakianakis G, Bryce E,Forgie S, et al. Are health care workers protected? An observational study of selection and removal of personal protective equipment in Canadian acute care hospitals. Am J Infect control. 2013;41(3):240-4.
Fuller C, Savage J, Besser S, Hayward A, Cookson B, Cooper B, et al. “The dirty hand in the latex glove”: a study of hand hygiene compliance when gloves are worn.Infect Control Hosp Epidemiol. 2011;32(12):1194-9.
Eveillard M, Joly-Guillou M-L, Brunel P. Correlation between glove use practices and compliance with hand hygiene in a multicenter study with elderly patients. Am J Infect control. 2012;40(4):387-8.
Katherason SG, Naing L, Jaalam K, Mohamad NAN,Bhojwani K, Harussani NDSH, et al. Hand decontamination practices and the appropriate use of gloves in two adult intensive care units in Malaysia. J Infect Dev Ctries.2010;4(02):118-23.
Monistrol O, Calbo E, Riera M, Nicolás C, Font R, Freixas N, et al. Impact of a hand hygiene educational programme on hospital-acquired infections in medical wards. Clin Microbiol Infect. 2012;18(12):1212-8.
Morgan DJ, Liang SY, Smith CL, Johnson JK, Harris AD,Furuno JP, et al. Frequent multidrug-resistant Acinetobacter baumannii contamination of gloves, gowns, and hands of healthcare workers. Infect Control Hosp Epidemiol.2010;31(7):716-21.
Doebbeling BN, Pfaller MA, Houston AK, Wenzel RP.Removal of nosocomial pathogens from the contaminated glove. Ann Intern Med. 1988;109(5):394-8.
Harris A, Morgan D, Pineles L, Perencevich E, Barnes S.Deconstructing the relative benefits of a universal glove and gown intervention on MRSA acquisition. J Hosp Infect.2017;96(1):49-53.