INTRODUCTION Healthcare-associated infections cost the UK National Health Service £1 billion per annum. Poor hand hygiene is the main route of transmission for methicillin-resistant Staphylococcus aureus (MRSA), leading to increased mortality and morbidity for infected patients. This study aims to quantify MRSA infection rates and compliance of alcohol gel application at the entrance to a surgical ward and assess how a simple intervention affects compliance. SUBJECTS AND METHODS Compliance was assessed via a discretely positioned close-surveillance camera at the ward entrance. Footage was reviewed to monitor compliance of all persons entering the ward over a 12 -month period . RESULTS For the initial 6 months, mean alcohol gel compliance was 24% for all persons entering the ward. After this period, a conspicuous strip of bright red tape was positioned along the corridor approaching the ward entrance. The red line continued up the wall to an arrow head pointing to the two alcohol gel dispensers on the wall. Mean compliance over the subsequent 6 months significantly improved to 62% ( P 0.05). There were two cases of MRSA bacteraemia in the initial 6 months and no cases in the following 6 months with the red line in situ . CONCLUSIONS This study demonstrates how a simple intervention significantly improves hand-hygiene compliance with associ ated eradication of MRSA.

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Infection-free surgery: how to improve hand-hygiene compliance and eradicate methicillin-resistant Staphylococcus aureus from surgical wards.

BACKGROUNDReported infection rates for Mohs micrographic surgery (MMS) range from less than 1% to 3.5%.OBJECTIVETo determine whether lower infection rates are possible for MMS with a consistently applied infection-control regimen.METHODSA series of 832 consecutive patients with 950 tumors undergoing

Heightened infection-control practices are associated with significantly lower infection rates in office-based Mohs surgery.

Ethanol in pre-surgical hand rubs: concentration and duration of application for achieving European Norm EN 12791

Background. The World Health Organization (WHO) has published “Guidelines on Hand Hygiene in Health Care” recommending 2 hand rub formulations based on 80% vol/vol ethanol or 75% vol/vol isopropanol for local production in healthcare settings where commercial products are not available or are too expensive. Previous investigations have shown that neither formulation meets the efficacy requirements of European norm (EN) 12791, which is the most stringent available norm for surgical hand rub preparations. Even when modified with approximately 5% higher alcohol content, the formulations proved to be inferior to the reference of the norm when measured after 3 hours.Objective. Because the high glycerol content of the formulations was suspected to negatively influence their efficacy, additional investigations were performed with varying glycerol content.Methods. Modified formulations with higher alcohol concentration (mass instead of volume percentage) and lower glycerol concentration (0.725% instead of 1.45%) ...

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G. Gnant

Papers

Surgical hand disinfection using alcohol: the effects of alcohol type, mode and duration of application