Reducing HCAIs: one Trust’s journey

SUZANNE CALLANDER reports on one Trust’s journey to reduce HCAI rates. She looks at some of the successful programmes that have been implemented by the Trust’s ward hygienist team and the technology that was employed to help achieve their reduction goals.

There is plenty of evidence to show the importance of effective cleaning of noncritical equipment in breaking the chain of healthcare-associated infections (HCAIs). Because hospital personnel often touch non-critical equipment and then proceed to care for patients, without washing their hands or changing gloves, it does represent a significant disease transmission risk.

In 2010 Creamer et al1 published the results of a study which aimed to establish whether healthcare workers’ (HCWs) fingertips were contaminated with MRSA in a clinical hospital setting. The study was conducted in an acute tertiary referral hospital on four MRSA wards that were part of a larger research study on MRSA epidemiology and four other wards which were not included. The fingertips of 523 HCWs were sampled on 822 occasions. The type of hand hygiene agent used, if any, and the immediate prior activity of the HCW were recorded. Overall, 5% of fingertips from the 523 HCWs were found to be MRSA-positive; 6% after clinical contact, 10% after contact with the patient’s environment and 4% after no specific contact. MRSA was recovered on 3% of occasions after use of alcohol hand rub, 6% after using a 4% chlorhexidine detergent, 3% after hand washing with soap and water, and 5% when no hand hygiene had been performed. MRSA was recovered from HCWs on seven of the eight wards. MRSA was more frequently present on fingertips on the four non-study wards versus the four MRSA-study wards, 7%, 1%, respectively.