Objective: To define and validate the optimal consumption of alcoholic preparation for ophthalmic day hospitals based on the minimum opportunities for hand hygiene (HH) required during the care provided in the Diagnostic Imaging Center and the Surgical Center of an ophthalmic day hospital. Method: An applied research was developed between May and July 2021. To conduct the research, six phases were defined: 1) Establishment of the conceptual structure; 2) Mapping the minimum opportunities for HH; 3). Validation of the mapping of minimum opportunities; 4). Calculation of the ideal minimum consumption of alcoholic preparation for HH; 5) Comparison of results with the institution’s data. 6). Development of the guide. Nineteen health professionals participated in this study between the validation stages in the institution and validation with specialists. Results: We identified that the minimum consumption of alcoholic preparation is: 63 mL/surgical patient undergoing local anesthesia, 126 mL/surgical patient submitted to local anesthesia with sedation, 123 mL/surgical patient submitted to general anesthesia, 15 mL/patient submitted to unprepared examination, 21 mL/patient submitted to prepared examination, and 57 mL/patient submitted to examination with contrast. Discussion: The profile of the patient, the institution, and the care provided may directly influence the number of opportunities for HH, which, in turn, directly impacts the reference of alcohol preparation consumption. Therefore, a single goal cannot translate the need for all of them. This condition refers to the need to determine specific consumption goals by patient profile and procedure so that the alcohol preparation consumption indicator effectively reflects the quality of care achieved in HH.
Background: Hospital-acquired infections are a significant cause of morbidity and mortality in healthcare settings among patients and healthcare workers, including clinical students. The frequent exposure of students during their clinical postings to various sources of infections emphasizes the need for adherence to standard precautions (SP). This study aimed to assess the knowledge and practice of SP among the clinical students of the College of Medicine, University of Ibadan, Nigeria. Methods: A descriptive cross-sectional study was conducted. Data on sociodemographic, domains of SP knowledge and practice, and source of students’ knowledge were collected via a self-administered online questionnaire. Categorical variables were compared using Chi-square and Z tests, while numerical data were analyzed with Mann–Whitney and Kruskal–Wallis tests. Logistic regression identified predictors of the assessed SP knowledge and practice domains. SPSS v20 was used for data analysis, and P < 0.05 was used as the statistical significance level. Results: Among 371 clinical students, 55.8% were MBBS students, 78.7% were Christians, and 80.6% were aged 21–25 years. Participants’ overall knowledge score was average, and 131 (36.1%) students scored ≥ 29 (out of 36 points) which was considered an acceptable level of knowledge. The overall practice score was average with a mean practice score of 11.76 (± 2.50) out of 17. Participants’ main sources of knowledge were self-learning and the school curriculum. Logistic regression revealed that participants’ knowledge correlated with gender, year of study, and prior knowledge, while practice correlated with age and department. Conclusion: The students’ average knowledge and practice and significant reliance on self-learning of SP is alarming. We recommend that universities and medical colleges integrate early and continuous SP education and training into medical curriculum.
Background and objective: Healthcare-associated infections (HAIs) are a serious threat to patient safety. They cause substantial morbidity and mortality across various healthcare settings, including neonatal intensive care units (NICUs). This study was undertaken to determine the incidence of HA bloodstream infection (HA-BSI) in the NICU of a tertiary care hospital. Methodology: Data were collected in a systematic manner based on the Centers for Disease Control and Prevention (CDC) guidelines for the surveillance of HAI for a period of 1 year (Jan–Dec, 2022). The HAI rate was calculated using the following formula: No. of cases/No. of patient days × 1,000. Result: Among the 1,085 admitted neonates, the incidence of HA-BSI was 15.80/1,000 patient days. HAI was seen in neonates having mean birth weight 1,722.5 ± 113.906 g, mean gestational age 29.6 ± 1.38, and mean duration of hospital stay 13.8 ± 4.081 days. Among the 80 cases of HA-BSI, recognized pathogens were 22 (27.5%) Klebsiella pneumoniae, 16 (20%) non-albicans Candida, 13 (16.25%) methicillin-sensitive Staphylococcus aureus, 10 (12.5%) Candida albicans, 10 (12.5%) Acinetobacter baumannii, 4 coagulase-negative staphylococci, 3 (3.75%) methicillin-resistant Staphylococcus aureus, 1 (1.25%) Escherichia coli, and 1 (1.25%) Enterococcus. The mortality rate was 56.78%. Conclusion: The predominance of K. pneumoniae and A. baumannii as causative pathogens suggests the need of stringent infection control measures and targeted antimicrobial strategies to reduce the burden of HAI and improve patient outcomes.
Background: Aspergillus species are common environmental fungi known to cause Aspergillosis, often presenting as an invasive infection in individuals with a compromised immune system. It is transmitted by the inhalation of Aspergillus spores and contributes to healthcare associated infections in hospitalised patients. Since these patients spend most of the day in their hospital beds, the presence of Aspergillus spores in such settings puts the patient at risk of inhaling aerosolised spores leading to infections. Objective: To determine the prevalence, distribution, and factors associated with Aspergillus contamination of hospital bed rails. Design: This laboratory-based cross-sectional study was carried out at the University College Hospital, Ibadan, Southwest Nigeria, between May and June 2023. In all, 100 beds which were occupied by patients in 13 wards were included in this study. The left and right rails of beds were swabbed and processed for the detection of Aspergillus species using fungal culture and microscopy. A checklist was used to assess selected infection prevention and control measures in the wards. Results: The total number of bedrails with Aspergillus isolated across all the wards where samples were taken was 56 (28.0%). Aspergillus niger was the most prevalent specie (64.2%) followed by Aspergillus flavus (30.4%), then Aspergillus fumigatus (5.4%). The prevalence of Aspergillus contamination was related to the level of sanitation and proximity to construction activity. Conclusion: To reduce the risk of Aspergillus infections in hospitalised patients, adequate infection prevention and control measures including thorough cleaning and disinfection should be strictly adhered to.
Background: Healthcare-associated infections (HAIs) pose a major threat to critically ill intensive care unit (ICU) patients. Limited data on HAIs in Indian ICUs necessitated this study at a tertiary care hospital in North India. Objective: To determine the incidence, distribution, and causative agents of HAIs, assess their antibiotic susceptibility profile, and evaluate the impact of infection prevention and control (IPC) measures. Design: This prospective study was conducted in the ICU settings of a tertiary care centre. Bloodstream infections (BSIs), central line-associated bloodstream infections (CLABSIs), urinary tract infections (UTIs), and catheter-associated urinary tract infections (CAUTIs) were defined according to standard definitions. The incidence and device utilisation ratio (DUR) were calculated. Identification and susceptibility were determined via BacT Alert and VITEK-2 Compact System. IPC compliance, including hand hygiene and central line insertion practices (CLIP), was monitored as per checklist. Results: Overall BSI rates of 12.85 per 1,000 patient-days, CLABSI at 22.11 per 1,000 central line-days, and CAUTI at 1.77 per 1,000 urinary catheter-days were recorded. The DUR was calculated to be 0.44 and 0.6 for CLABSI and CAUTI respectively. Burkholderia cepacia (52.8%) was the predominant CLABSI pathogen, while Acinetobacter spp. (22.2%) was the most common CAUTI pathogen. Hand hygiene compliance improved from 40% in 2019 to 70% in 2023, CLIP adherence increased from 30 to 75%, CLABSI and CAUTI rate reduced from 19.66 to 8.59 and 8.66 to 0.75, respectively. Conclusion: The study highlights the need for stringent IPC measures, robust antibiotic stewardship, and continuous surveillance to mitigate HAIs.
