Assessment of environmental contamination in the geriatric ward after visiting period

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Assessment of environmental contamination in the geriatric ward after visiting period

 

Author: Tang, Sze Chung Teresa
Title: Assessment of environmental contamination in the geriatric ward after visiting period
Degree: M.Sc.
Year: 2013
Subject: Older people -- Hospital care.
Health facilities -- Safety measures.
Infection -- Prevention.
Nosocomial infections -- Prevention.
Hong Kong Polytechnic University -- Dissertations
Department: Faculty of Health and Social Sciences
Pages: 141 leaves : color illustrations ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2761751
URI: http://theses.lib.polyu.edu.hk/handle/200/7849
Abstract: Background: Hospitals are institutions where hundreds of people work, visit or stay. There is little control over the number of visitors per patient and many studies show that visitors to patients can bring in micro-organisms. There have been no investigations on the level of contamination a visitor can cause to the environment around the patient which he or she is visiting. Visitors to patients usually perform social or offer care activities, including feeding, napkin changing or giving a bed bath to patients without washing their hands first. Those actions may contaminate the ward environment to some extent. Although routine cleaning of the ward is frequently carried out, studies have shown that bacteria such as Methicillin-resistant Staphylococcus aureus (MRSA) cannot be eliminated during routine cleaning. One study found potentially pathogenic bacteria in over 85% of the samples taken from general public areas such as escalator handrails and registration counters of a hospital. Aim and objectives: The objective of this study was to investigate if the number of visitors', their activities, demographics and the level of contamination on their hands were correlated with the environmental contamination inside the ward areas in areas around the patient that particular visitors were visiting. Specific objectives included investigating the difference between bacterial counts of the ward environment before and after the visiting period. Also, the difference between bacterial counts of visitors' hands before and after the visiting period was examined.
Methods: This was a prospective pre and post control study conducted in a geriatric unit using the Nightingale design of a rehabilitation hospital. Five environmental sampling sites, the upper side of the table, the underside of the table, the right lower corner of the bedside locker, and the middle of the bedrail near the patient's personal locker and the middle of the right side handle of the geriatric chair were chosen. Pre and post environmental samples, using a sterile swab dipped in normal saline were taken at exactly the same location pre and post the visiting period. The visitors' five fingers print samples were taken from their dominant hands unless they had any visible wounds on the skin, by imprinting their finger onto a nutrient agar plate for 10 seconds. All of the above specimens were transferred to The Hong Kong Polytechnic University laboratory for microbiological examinations within two hours. The swab samples were plated out using nutrient agar, and the colony forming unit was counted after incubation at 37°C for 48 hours. Results: Around the areas of patients with visitors, a total of 1871 Colony Forming Units per centimeter square (CFU/cm²) were isolated from 5 previously defined sites during the pre-visiting period. A total of 2228 CFU/cm2 were collected from the same 5 areas in the post-visiting period. There was a significant difference in the pre-and post-visit bacterial counts on the lockers (P <0.0001) and bedrails (P = 0.0004). Around the areas of patients without visitors, a total of 1334 CFU/cm² were isolated from the 5 previously defined areas in the pre-visiting period. A total of 1291 CFU/cm² were collected from the same 5 areas in post-visiting period. There was a significant difference in the pre- and post-visit bacterial counts on the bedrail (P = <0.0001), upper surface of bedside table (P = 0.0003) and locker (P = 0.0015). Neither the number of visitors, the total time spent with the patient, nor the number of activities the visitors engaged in correlated with the environmental bacterial count on any of the areas sampled. Conclusion: The finding that even areas around the patients who did not receive visitors had a significant level of bacterial growth after the visiting period may indicate that the patient or healthcare workers themselves may contaminate the environment, and reiterates the importance for both visitors and healthcare workers to avoid cross contamination when they are in the ward. It is important for patients, healthcare workers, as well as visitors to the ward to practise good hand hygiene.

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