Indications for hand and glove disinfection in Advanced Cardiovascular Life Support: A manikin simulation study.
ACLS (Advanced Cardiovascular Life Support)
BLS (Basic Life Support)
CPR - cardiopulmonary resuscitation
glove disinfection
hand disinfection
hospital acquire infection
infection prevention
life support
Journal
Frontiers in medicine
ISSN: 2296-858X
Titre abrégé: Front Med (Lausanne)
Pays: Switzerland
ID NLM: 101648047
Informations de publication
Date de publication:
2022
2022
Historique:
received:
22
08
2022
accepted:
05
12
2022
entrez:
23
1
2023
pubmed:
24
1
2023
medline:
24
1
2023
Statut:
epublish
Résumé
There are no investigations on hand hygiene during cardiopulmonary resuscitation (CPR), even though these patients are at high risk for healthcare-associated infections. We aimed to evaluate the number of indicated hand hygiene per CPR case in general and the fraction that could be accomplished without delay for other life-saving techniques through standardized observations. In 2022, we conducted Advanced Cardiovascular Life Support (ACLS) courses over 4 days, practicing 33 ACLS case vignettes with standard measurements of chest compression fractions and hand hygiene indications. A total of nine healthcare workers (six nurses and three physicians) participated. A total of 33 training scenarios resulted in 613 indications for hand disinfection. Of these, 150 (24%) occurred before patient contact and 310 (51%) before aseptic activities. In 282 out of 310 (91%) indications, which have the highest impact on patient safety, the medication administrator was responsible; in 28 out of 310 (9%) indications, the airway manager was responsible. Depending on the scenario and assuming 15 s to be sufficient for alcoholic disinfection, 56-100% (mean 84.1%, SD ± 13.1%) of all indications could have been accomplished without delaying patient resuscitation. Percentages were lower for 30-s of exposure time. To the best of our knowledge, this is the first study investigating the feasibility of hand hygiene in a manikin CPR study. Even if the feasibility is overestimated due to the study setup, the fundamental conclusion is that a relevant part of the WHO indications for hand disinfection can be implemented without compromising quality in acute care, thus increasing the overall quality of patient care.
Sections du résumé
Background and aim
UNASSIGNED
There are no investigations on hand hygiene during cardiopulmonary resuscitation (CPR), even though these patients are at high risk for healthcare-associated infections. We aimed to evaluate the number of indicated hand hygiene per CPR case in general and the fraction that could be accomplished without delay for other life-saving techniques through standardized observations.
Materials and methods
UNASSIGNED
In 2022, we conducted Advanced Cardiovascular Life Support (ACLS) courses over 4 days, practicing 33 ACLS case vignettes with standard measurements of chest compression fractions and hand hygiene indications. A total of nine healthcare workers (six nurses and three physicians) participated.
Results
UNASSIGNED
A total of 33 training scenarios resulted in 613 indications for hand disinfection. Of these, 150 (24%) occurred before patient contact and 310 (51%) before aseptic activities. In 282 out of 310 (91%) indications, which have the highest impact on patient safety, the medication administrator was responsible; in 28 out of 310 (9%) indications, the airway manager was responsible. Depending on the scenario and assuming 15 s to be sufficient for alcoholic disinfection, 56-100% (mean 84.1%, SD ± 13.1%) of all indications could have been accomplished without delaying patient resuscitation. Percentages were lower for 30-s of exposure time.
Conclusion
UNASSIGNED
To the best of our knowledge, this is the first study investigating the feasibility of hand hygiene in a manikin CPR study. Even if the feasibility is overestimated due to the study setup, the fundamental conclusion is that a relevant part of the WHO indications for hand disinfection can be implemented without compromising quality in acute care, thus increasing the overall quality of patient care.
Identifiants
pubmed: 36687411
doi: 10.3389/fmed.2022.1025449
pmc: PMC9853186
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1025449Informations de copyright
Copyright © 2023 Bushuven, Bansbach, Bentele, Bentele, Gerber, Reinoso-Schiller and Scheithauer.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Resuscitation. 2017 Apr;113:87-89
pubmed: 28212839
J Hosp Infect. 2016 Nov;94(3):268-272
pubmed: 27597264
Indian J Anaesth. 2018 May;62(5):381-384
pubmed: 29910497
Cardiovasc Res. 2021 Nov 1;117(12):e159-e161
pubmed: 34718465
Circulation. 2020 Oct 20;142(16_suppl_2):S469-S523
pubmed: 33081526
Front Med (Lausanne). 2022 Jul 14;9:939187
pubmed: 35911405
World J Surg. 2013 Jun;37(6):1277-85
pubmed: 23435679
N Engl J Med. 2019 Nov 7;381(19):1831-1842
pubmed: 31693806
Antimicrob Resist Infect Control. 2022 Dec 2;11(1):147
pubmed: 36461038
Indian J Crit Care Med. 2011 Oct;15(4):209-12
pubmed: 22346031
Am J Infect Control. 2014 Aug;42(8):926-8
pubmed: 25087148
J Infect Dev Ctries. 2021 Dec 31;15(12):1923-1928
pubmed: 35044952
Resuscitation. 2018 Aug;129:76-81
pubmed: 29885353
J Hosp Infect. 2007 Sep;67(1):9-21
pubmed: 17719685
J Hosp Infect. 2009 Dec;73(4):305-15
pubmed: 19720430
Antimicrob Resist Infect Control. 2013 Apr 04;2(1):13
pubmed: 23556425
Infection. 2014 Dec;42(6):991-7
pubmed: 25100555
Int J Environ Res Public Health. 2022 May 09;19(9):
pubmed: 35565171
Cardiol J. 2020;27(5):497-506
pubmed: 32419128
J Hosp Infect. 2013 Feb;83 Suppl 1:S11-6
pubmed: 23453170
Br J Clin Pharmacol. 2021 Feb;87(2):386-394
pubmed: 32198938
J Hosp Infect. 2021 May;111:6-26
pubmed: 33744382
J Neurosci Nurs. 2016 Jun;48(3):160-5
pubmed: 27049715
J Med Ethics. 2011 Aug;37(8):454-5
pubmed: 21772037
Injury. 2017 Jan;48(1):165-170
pubmed: 27568844
Infect Control Hosp Epidemiol. 2009 Jul;30(7):611-22
pubmed: 19508124
Infect Control Hosp Epidemiol. 2017 Dec;38(12):1430-1434
pubmed: 29081301
JAMA. 2000 Apr 5;283(13):1715-22
pubmed: 10755498
Paediatr Anaesth. 2018 Dec;28(12):1071-1077
pubmed: 30375106
J Health Psychol. 2017 Jan;22(1):89-100
pubmed: 26253651
Best Pract Res Clin Anaesthesiol. 2011 Jun;25(2):251-62
pubmed: 21550549
Europace. 2014 Dec;16(12):1752-8
pubmed: 25061228
Antimicrob Resist Infect Control. 2022 Jul 6;11(1):93
pubmed: 35794648
J Patient Saf. 2022 Dec 1;18(8):e1226-e1230
pubmed: 35796585
Acta Biomed. 2022 Jul 01;93(3):e2022260
pubmed: 35775749