Titel: Measurement of adherence to infection prevention measures in operating rooms as part of the HYGARZT Project
ID: 108/PRV
Art: Abstractautor
Session: Workshop 20
Basishygiene: Wissen alleine reicht nicht - auf die Umsetzung kommt es an (FG PR, StAG HY)

Referent: Jan Hoffmann (Köln)

Abstract - Text

Question In the HYGARZT Project the implementation and effectiveness of infection prevention and control (IPC) measures in operating rooms (OR) by infection prevention and control link practitioners (IPC-LP) will be investigated. The adherence with existing IPC measures (KRINKO requirements, 5 moments of WHO) was evaluated. Here, the results of the pilot phase are presented.

Method Adherence with existing IPC-measures (hand hygiene (HH), donning of personal protection equipment (PPE), private conversation, opening of the doors to the OR, entering and exiting of persons) was measured, according to staff group and staff function. Items on the checklist were based on findings of a systematic literature review. IPC measures were observed from the beginning of the preparation phase until the end of wound dressing. The findings were descriptively analyzed using "R" as software for statistics.

Results 95 surgical procedures were observed in three operation rooms. The duration between incision and suture was 57 min (± 42 min), the observation time was 82 min (± 38 min). Overall 1945 HH indications were identified. Adherence to HH during preparation before incision (without surgical hand disinfection) was 5,5% concerning surgeons, 13,1% concerning nursing staff respectively, 14,6% concerning surgeons, 19,8% concerning nursing staff after surgery respectively. Among all staff 69 HH was performed without indication. The correct donning of PPE was: surgical caps surgeons 78,9%, nursing staff 38,1% or surgical masks surgeons 92,2%, nurses 86%, respectively. In 31,6% of the procedures, private conversation was held, most of them (23,2%) were held by the surgical nurse, followed by the surgeon (22,1%). The doors to the OR were opened in 57 cases (60%) and in 30 cases (31,6%) persons entranced or leaved the OR.

Conclusion Maybe the OR suggests the staff, to be in a particularly clean area, where IPC measures might not be necessary, as in other parts of the hospital. A change in the awareness of the role of IPC measures in the staff is of vital importance to reduce nosocomial infections. Overall, the low adherence to single IPC measures, show targets for possible interventions. The increase of HH in OR will be an important aim. The correct donning of PPE and discipline to refrain private talking, as well as organizational changes in providing material or staff might constitute a potential for the prevention of nosocomial infections.