A study of the effectiveness of daily skin cleansing and enhanced environmental cleaning around hospitalized patients including those colonized with Methicillin-resistant Staphylococcus aureus in a mixed specialty ward

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A study of the effectiveness of daily skin cleansing and enhanced environmental cleaning around hospitalized patients including those colonized with Methicillin-resistant Staphylococcus aureus in a mixed specialty ward

 

Author: Lam, Yin Ha Olivia
Title: A study of the effectiveness of daily skin cleansing and enhanced environmental cleaning around hospitalized patients including those colonized with Methicillin-resistant Staphylococcus aureus in a mixed specialty ward
Degree: M.Sc.
Year: 2013
Subject: Nosocomial infections -- Prevention.
Staphylococcus aureus -- Prevention.
Hospitals -- Sanitation.
Hong Kong Polytechnic University -- Dissertations
Department: Faculty of Health and Social Sciences
Pages: xv, 90 leaves : ill. ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2580975
URI: http://theses.lib.polyu.edu.hk/handle/200/6925
Abstract: Background: Hospital-acquired infections (HAIs) are common causes of morbidity and mortality among hospitalized patients. Methicillin-resistant Staphylococcus aureus (MRSA) is an important cause of hospital-acquired infections in many countries. Evidence is accumulating that contaminated environmental surfaces also make an important contribution to the epidemic and endemic transmission of MRSA. Aim and objectives: The study aimed to evaluate the effect of different bath regimes and environmental cleaning methods on contamination of the surroundings of MRSA and non-MRSA patients, in order to generate recommendations to improve clinical practice. There are three objectives in this study: (1) To determine effect of different bathing regimes by estimating differences in bacterial load and Staphylococcus aureus (SA) and MRSA contamination levels in the environment of patients receiving daily or alternate day bathing. (2) To determine if there is a difference in levels of environmental contamination around patients with different MRSA status before and after environmental cleaning. (3) To determine the efficacy of twice daily environmental cleaning with alcohol wipes and daily environmental cleaning with chemical disinfectant with disposable wipes. Method: A prospective study was conducted in a mixed specialty ward for three months. A total 52 patients were recruited, of whom 8 patients were used on two separate occasions. According to their status of MRSA history, 30 patients were assigned to MRSA group, 30 patients were assigned to non-MRSA group. Paired environmental samples were collected from each patient in two groups at their bedside rail and call bell to measure environmental surface contamination including colony count, Staphylococcus aureus (SA) count and Methicillin-resistant Staphylococcus aureus (MRSA) count before and after environmental cleaning.
Result: The study result indicated that there was no significant difference between daily or alternate day bathing with different bathing methods, however the colony count was significant reduced after environmental cleaning in two groups. When comparing the result of SA, 1 out of 60(1.7%) SA was isolated at call bell and 7 out of 60 (11.7%) SA was isolated from bedside rail before environmental cleaning. After environmental cleaning, nil SA was isolated from call bell, only 1 out of 60 (1.7%) SA was isolated from bedside rail. When comparing the result of MRSA, 3 out of 60 (5%) MRSA was isolated from call bell and 4 out of 60(6.7%) MRSA was isolated from bedside rails before environmental cleaning. After environmental cleaning, only 1 out of 60 (1.7%) MRSA was isolated from call bell and 1 out of 60 (1.7%) MRSA was isolated from bedside rails. Based on the result, that colony count, SA count and MRSA count of two groups displayed a significant reduction after environmental cleaning, indicates that both types of existing environmental cleaning methods are effective. Conclusion: In light of the study result, which indicated that effective cleaning of hospital environment is able to eliminate environmental contamination. Moreover, such a practice could minimize direct transmission of pathogen between patients; or could reduce indirect transmission of pathogen to patient during patient care is being carried out by contaminated hands or gloves of healthcare workers. As a result, effective cleaning also contributes to reduce risk of hospital-acquired infection. In order to minimize the risk of cross-contamination during environmental cleaning procedure, exclusive use of disposable disinfectant wipes or paper towels is encouraged. This clinical practice is vital when there is an outbreak of MRSA in the workplace.

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