Hand hygiene compliance is vital to healthcare-associated infection (HAI) prevention and control. But it is just one strategy within a multitude of strategies essential to the fight against HAIs. Two studies confirm the need for extreme vigilance over bacteria on hard surfaces, linens and scrubs.
According to a quasi-experimental study in the American Journal of Infection Control (AJIC), copper-impregnated composite hard surfaces and linens may help prevent HAIs in acute care hospital settings,. Researchers evaluated HAIs developed from multidrug resistant organisms (MDROs) and Clostridium difficile in acute care units of a community hospital. The study followed the hospital’s completion of a new clinical wing equipped with copper-impregnated composite hard surfaces and linens.
Conducted over a period of more than two years, the study confirmed that the new clinical wing had 78 percent fewer HAIs due to MDROs or C difficile, 83 percent fewer cases of C difficile infection, and 68 percent fewer infections due to MDROs.
Lesson Learned: Using self-disinfecting surfaces and linens can limit the transmission of MDROs and potentially reduce HAIs. However, these measures are no substitute for proper hand hygiene practices, as recommended by the WHO 5 Moments for Hand Hygiene guidelines, and other sound environmental hygiene practices.
Another study confirmed that deadly, antibiotic-resistant bacteria can end up on hospital scrubs.
Funded by the Centers for Disease Control and Prevention (CDC), the Duke University study reported that the sleeves and pockets of hospital scrubs and the rails on hospital beds are most likely to get contaminated with bacteria.
Researchers tracked the transmission of three antibiotic resistant bacteria, including MRSA, within hospital intensive care units (ICUs), where many infections are acquired.
Study results confirmed 22 transmissions of the same strain of bacteria. Of those transmissions, six, or 27 percent, were from patient to nurse, while another six were from the patient room to the nurse. Ten, or 45 percent, were from the patient to the patient room.
Among the most important implications of the Duke study are the following:
Minimize disease transmission risk beyond the ICU: Insist on rigorous hygiene and cleaning practices and set the highest standards of hand hygiene behavior. Nurses clothing, in particular, can become contaminated in the process of caring for patients.
Focus on most likely means of bacterial transmission: Confirmed bacterial transmission was most likely to occur from patients or surfaces in the patient room to nurses, or from patients to the care environment, according to the study. Transmission occurred during close to 20 percent of nursing shifts.
Focus on killer bacteria: Nurses’ clothing was contaminated with methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter baumannii during more than 10 percent of ICU shifts.
The evidence is in: There are many aspects to consider during the fight against costly and deadly HAIs. This includes thinking beyond hand hygiene compliance to other avenues for transmission. Healthcare professionals need to be aware of the importance of proper hygiene of hard surfaces, linens, clothing, patient rooms and the total environment of care to ensure HAI prevention and control.