Housekeeping Personnel Research Articles

Enhancing Housekeeping Workforce Competency in the Hospitality Industry: A Comprehensive Training Approach

This study examines the influence of comprehensive training programs on the proficiency of housekeeping personnel in the hotel sector. Data were collected through semi-structured interviews, focus group discussions, and participant observations at different hotels using a qualitative study approach. The findings suggest that organized training programs have a substantial impact on improving technical skills, such as proficiency in advanced cleaning procedures and equipment handling, as well as enhancing soft skills, such as effective communication and customer service. The integration of several learning methods, including simulation-based training and virtual reality, was discovered to be extremely successful in involving workers and enhancing the acquisition of skills. Although faced with obstacles such as reluctance to change and limited resources, the use of proactive solutions, such as engaging staff in training development and providing ongoing professional development, effectively addressed these concerns. The results emphasize the need of a comprehensive training strategy that encompasses both technical and soft skills in order to enhance overall service quality and operational efficiency. Suggestions for future practice including consistently refreshing training material, involving personnel in the development process, and overcoming obstacles to implementation in order to maintain increases in housekeeping performance and visitor satisfaction

A study to assess knowledge, attitude, and practice towards major bloodborne diseases and needle-stick injury protocols among second-year nursing students in selected nursing colleges of pune city

Bloodborne pathogens, including Hepatitis B (HBV), Hepatitis C (HCV), and the Human Immunodeficiency Virus (HIV), are infectious microorganisms in human blood that can cause disease in humans. Needle sticks and other sharp related injuries may expose workers to bloodborne pathogens. Workers in many occupations, including first responders, housekeeping personnel in some industries, nurses, and other healthcare personnel, may be at risk for exposure to bloodborne pathogens. The objective of this study is to assess the knowledge, attitude, and practice of second-year nursing students regarding major bloodborne diseases and needle stick injury protocols and to find the association between knowledge, attitude, and practice scores with demographic variables. The quantitative approach to be used is a non-experimental descriptive study, and the sampling method to be used is non-probability purposive sampling. Structured questionnaires, Likert scales, and checklists are used as tools, and statistical methods include Karl Pearson's test for correlation between variables and the chi-square test to test the association. The majority of students have an average level of knowledge, a neutral attitude, and very good practice methods in clinical areas. They also have an average level of knowledge, a neutral attitude, and very good practice skills in clinical areas regarding the prevention and precaution of major bloodborne diseases and needle stick injuries. The correlation between knowledge and attitude scores is found to be negative, while the correlation between knowledge and practice scores is positive and the correlation between attitude and practice scores is negative.

The evaluation of electrolyzed water, sodium dichloroisocyanurate, and peracetic acid with hydrogen peroxide for the disinfection of patient room surfaces

Sporicidal disinfectants are necessary to control Clostridioides difficile and Candida auris. Novel application methods such as electrostatic sprayers may increase disinfection effectiveness. We employed a standardized protocol to assess 3 sporicidal disinfectants: electrolyzed water (EW), sodium dichloroisocyanurate (NaDCC) and peracetic acid/hydrogen peroxide (PAA/H2O2). The study was conducted at 2 New York City hospitals (1,082 total beds) over an 18-month period. The 3 chemicals were applied by housekeeping personnel following the hospital protocol; the use of electrostatic sprayers was incorporated into EW and NaDCC. In randomly selected rooms, 5 surfaces were sampled for microbial colony counts after cleaning. Data analyses were performed using negative binomial logistic regression. We collected 774 samples. NaDCC-disinfected surfaces had a lower mean colony count (14 colony forming units [CFU]) compared to PAA/H2O2 (18 CFU, P=.36) and EW (37 CFU, P < .001). PAA/H2O2 and EW had more samples with any growth (both P < .05) compared to NaDCC. NaDCC applied with wipes and an electrostatic sprayer had the lowest number of samples with no growth and <2.5 CFU/cm2 (difference not significant). The use of NaDCC for surface disinfection resulted in the lowest bacterial colony counts on patient room high touch surfaces in our study.

ПОДХОД К РЕАЛИЗАЦИИ ПРОАКТИВНОГО УПРАВЛЕНИЯ РЕСУРСАМИ ПОДРАЗДЕЛЕНИЙ СУБЪЕКТОВ ТУРИСТИЧЕСКОГО КЛАСТЕРА

The tourist cluster has recently occupied one of the central places in the socio-economic system of the region. The lack of efficient methodology of managing the resources of the regional constituent entities (using the example of housekeeping service of the hotel) is an unsolved problem. The existing methods of management are ineffective in the conditions of modern activity of the hotel. The proposed solution is to use pro-active resource management methodology. The pro-active management methodology includes the following models: management of the housekeeping personnel, management of the laundry, forecasting the housekeeping resource requirements, support for the management decisions made by the housekeeping service manager. The developed methodology is used as a basis for PaUR web-based automated system. Machine learning methods were used to implement the model of forecasting the need for housekeeping resources, the main advantage of which is the operational retraining of models required due to the rapidly changing situation in the operational activities of the hotels. The use of the proposed methodology allows increasing the labor productivity of housekeeping service personnel, reducing costs, as well as using an open and effective system of staff motivation.

Effectiveness of a structured teaching program (STP) on cessation of tobacco chewing, on knowledge and attitude among female hospital housekeeping personnel - a pilot study.

To evaluate the effectiveness of a structured teaching program (STP) on: a) improving knowledge of female hospital housekeeping personnel regarding harmful impact of tobacco chewing and how to quit, and b) fostering an unfavorable attitude toward tobacco chewing. The STP focused on adverse health effects of tobacco chewing, myths and facts, and tobacco cessation. It was administered in regional language to female hospital housekeeping personnel (N=35) over three days. Post-assessments were conducted at 4 weeks following the last session of the STP. Current tobacco use was reported by 26% of the sample. Tobacco chewers (vs. non-chewers) were more likely to be significantly older, have elementary education, belong to nuclear family, have lesser knowledge regarding harmful effects, and have a more favorable attitude toward the practice of tobacco chewing. At the end of 4 weeks following the STP, participants significantly improved their knowledge regarding the harmful health impact of tobacco chewing and how to quit (p=0.001), and showed a significantly less favorable attitude toward tobacco chewing (p=0.001). Change in participants' knowledge scores was found to be negatively correlated with change in attitude scores, implying that increase in knowledge was associated with less favorable attitude toward tobacco chewing (r=-0.427, p=0.011). Findings provide preliminary evidence for the effectiveness of health education on harmful impact of tobacco chewing and how to quit, delivered through a STP, in improving knowledge and fostering an unfavorable attitude toward tobacco chewing, among female hospital housekeeping personnel.

Determination of occupational health and safety practices and the level of perception of safety culture from the perspective of housekeeping personnel in hospitals&lt;p&gt;Hastanelerde kurum ev idaresi personeli perspektifinden iş sağlığı ve güvenliği uygulamalarının ve güvenlik kültürüne ilişkin algı düzeylerinin belirlenmesi

This study was planned and conducted to determine the occupational health and safety practices and the level of perception of safety culture from the perspective of housekeeping personnel in hospitals. The population of the study consists of housekeeping personnel at 14 hospitals who accepted to participate in the study from all hospitals affiliated to the TR Ministry of Health and universities with more than 50 inpatient bed availability in Ankara city center apart from the hospitals specialized in certain fields, military hospitals and private hospitals within the boundaries of Ankara province. The proportional sampling method was used in the determination of the number of personnel to participate in the study from each hospital that agreed to participate in it and the study was carried out with 400 housekeeping personnel. A questionnaire form was prepared with 'Safety Culture Scale' and 'Employee Health and Safety Culture Scale' to collect the data in the study. The housekeeping personnel who have received education in the field of “health and safety at work” comes first among the personnel almost all of which have received in-service training. It was identified that 10,3 % of the personnel participating in the study had experienced occupational accidents. It was stated that 53,8 % of the housekeeping personnel who had experienced occupational accidents had these accidents while ‘collecting waste’, when the types of the accidents experienced by those who had had occupational accidents were examined, it was concluded that while the personnel ‘exposed to sharp object injuries’ took the first place. While a statistically significant difference (p&lt;0,05) was found between the perception levels related to the ‘Safety Culture’ and ‘Employee Health and Safety Culture’ of the housekeeping personnel and the opinions of the personnel on the state of attaching importance to the applications related to health and safety at work by the hospital administration, the condition of receiving education on the use and maintenance of the equipment, accident protection and the use of cleaning products, there was no statistically significant difference (p&gt;0,05) between gender, age, total service period, education level, marital status, service period at the hospital of employment, the condition of experiencing occupational accidents at the hospital of employment, the reason of the accident experienced, general opinions related to the reasons of occupational accidents, cleaning methods, the condition of receiving education on infection control, sanitation and personal hygiene. ÖzetBu araştırma hastanelerde çalışan kurum ev idaresi personeli perspektifinden iş sağlığı ve güvenliği uygulamalarının ve güvenlik kültürüne ilişkin algı düzeylerinin belirlenmesi amacıyla planlanmış ve yürütülmüştür. Araştırmanın evrenini Ankara il sınırları içinde bulunan 50 yatak kapasitesinin üzerindeki tüm T.C. Sağlık Bakanlığı’na ve üniversitelere bağlı çalışmayı kabul eden hastaneler oluşturmaktadır. Araştırmanın örneklemini, çalışmaya katılmayı kabul eden hastanelerden 400 kurum ev idaresi personeli oluşturmaktadır. Veri toplamak amacıyla “Güvenlik Kültürü Ölçeği” ile “Çalışan Sağlığı ve Güvenliği Ölçeği” kullanılarak anket formu oluşturulmuştur. Kurum ev idaresi personelinin% 10,3’ ünün iş kazası geçirdiği belirlenmiştir. İş kazası geçiren personelin yarıdan biraz fazlası ‘atıkları toplarken’ kaza geçirmiş olup, geçirilen kaza tipleri arasında; ‘kesici delici alet yaralanmalarını’ belirtenler ilk sırada yer almaktadır. Kurum ev idaresi personelinin ‘Güvenlik Kültürü’ ile ‘Çalışan Sağlığı ve Güvenliği Kültürü’ne ilişkin algı düzeyleri ile personelin hastane yönetiminin iş sağlığı ve güvenliği ile ilgili uygulamalarına önem verme durumuna ilişkin görüşleri, araç gereçlerin kullanımı ve bakımı, kazalardan korunma ve temizlik maddelerinin kullanımı konularına ilişkin eğitim alma durumu arasında istatistiksel olarak anlamlı farklılık (p&lt;0,05) bulunurken; cinsiyet, yaş, toplam hizmet yılı, öğrenim düzeyi, medeni durum, çalıştığı hastanedeki hizmet yılı, çalıştığı hastanede iş kazası geçirme durumu, geçirilen iş kazasının nedeni, genel olarak iş kazalarının nedenine ilişkin görüşleri, temizlik yöntemleri, enfeksiyon kontrolü ve sanitasyon ile kişisel hijyenle ilgili eğitim alma durumları arasında istatistiksel olarak anlamlı farklılık (p&gt;0,05) bulunmamıştır.

A Performance Measurement Model Minimizing Housekeeping Personnel Costs

The personnel cost of a housekeeping department mostly has the largest percentile among the costs of personnel who do not have a direct interaction with the customers. This fact makes housekeeping personnel costs the very first component that has to be decreased. Because of this, it is an important issue to minimize housekeeping costs and make an effective housekeeping schedule for hotels especially luxury hotels. This paper proposes a fuzzy score-based performance measurement model to manage the number of workers recruited for the housekeeping department which focuses on the minimization of total human resources costs. The steps of the model utilize time studies, expert opinions and past data. The proposed model is applied to a real case, and the results show that the proposed model has significant improvements on the performance of the department while decreasing the total human resources costs of housekeeping department and the requirement for the seasonal workers. The model results in less human resources turnover ratios and less customer complaints on room cleanliness.

Living Longer, Living Well

Living Longer, Living Well

Occupational Injuries Prone to Infectious Risks amongst Healthcare Personnel in Kuwait: A Retrospective Study

Objective: The study aimed at determining the prevalence of incident occupational exposure to blood and other potentially infectious materials (OPIM) among healthcare personnel (HCP) during 2010 and at evaluating the factors associated with these incidents. Subjects and Methods: An epidemiological, retrospective, record-based study was conducted. All self-reported incidents of occupational exposure to blood and OPIM among HCP from all healthcare settings of the Kuwait Ministry of Health during 2010 were included. Results: The total number of the exposed HCP was 249. The prevalence of incident exposure was 0.7% of the HCP at risk. Their mean age was 32.31 ± 6.98 years. The majority were nurses: 166 (66.7%), followed by doctors: 35 (14.1%), technicians: 26 (10.4%) and housekeeping personnel: 22 (8.8%). Needle stick injury was the most common type of exposure, in 189 (75.9%), followed by sharp-object injury, mucous-membrane exposure and contact with nonintact skin. The majority of needle stick exposures, i.e. 177 (93.7%), were caused by hollow-bore needles. Exposure to blood represented 96.8%, mostly during drawing blood and the insertion or removal of needles from patients [88 (35.4%)] and when performing surgical interventions [56 (22.6%)]. Easily preventable exposures such as injuries related to 2-handed recapping of needles [24 (9.6%)] and garbage collection [21 (8.4%)] were reported. Exposures mainly occurred in the inpatient wards [75 (30.1%)] and operating theaters [56 (22.6%)]. Among the exposed HCP, 130 (52.2%) had been fully vaccinated against hepatitis B virus (HBV). Conclusion: Needle stick injuries are the most common exposure among HCP in Kuwait, and nurses are the most frequently involved HCP category. A good proportion of exposures could be easily prevented. HBV vaccination coverage is incomplete.

Effect of oil gum massage therapy on common pathogenic oral microorganisms - A randomized controlled trial.

Objectives:(i) To assess reduction in Streptococcus mutans and Lactobacillus species count in saliva sample after ten minutes of oil gum massage therapy (massage of gingival tissues) per day for three weeks with sesame oil, olive oil, and coconut oil in three different groups of subjects. (ii) To compare the efficacy between three different oils and the “gold standard” chlorhexidine gel. (iii) To assess reduction in gingival scores and plaque scores of study subjects.Materials and Methods:Study design – Single center, parallel design, and triple blind randomized clinical study with four treatment groups. Participants: 32 of the 40 study subjects working as housekeeping personnel at Kasturba Hospital, Manipal; aged 18-55 years completed the three-week study period. Interventions: Subjects were randomly assigned to massage their gingiva everyday for three weeks with sesame oil, olive oil, coconut oil (tests), and Chlorhexidine gel (control). Oral health status and paraffin stimulated saliva samples were obtained at baseline and after three weeks of oil gum massage therapy. Outcome measures: Microbial culture, plaque index, and gingival index. Statistical analysis: Paired t test and Kruskal Wallis test.Results:There was a significant reduction in mean Streptococcus mutans count, Lactobacillus count, plaque scores, and gingival scores in all four groups after the study. However, there was no significant difference found in percentage reduction of these variables between the four groups.Conclusion:These oils can be used as valuable preventive agents in maintaining and improving oral health in low socioeconomic status population. However, it is recommended that further research should be conducted in other populations with a larger sample and longer duration of follow-up period.

Epidemiology of sharp injuries – Prospective EPINet data from five tertiary care hospitals in India – Data for 144 cumulated months, 1.5 million inpatient days

AimsSharp injuries (SIs) jeopardize the safety of healthcare workers and are avoidable. This prospective multi-centric study aimed at understanding the epidemiology of sharp injuries in India. This study comes as a sequel to our earlier study, conducted at the same hospitals. MethodsThe cumulated prospective data of 144 months collected from five participating hospitals during the years 2008–2013 and analysed using the EPINet format. ResultsDuring the study period of 2008–2013, there were more than 1.5 million inpatient (IP) days, and 666 SIs (0.43 SIs/1000 IP days) were observed. The data from June 2008 through May 2009 was named data A and from June 2009 through June 2011 as data B. The data in its entirety and the comparison of data A and B was made. The cumulated data showed that the SIs in the patient's room decreased from 0.9 to 0.2 SIs/1000 IP days (27.8%–14.3%). This observation was made in the data from all the participating hospitals; possibly due to providing sharps disposal cans by patient bedside, in addition to aforementioned awareness and educational activities. The SIs among nurses doubled (from 0.01 to 0.02/1000 IP days) and increased among housekeeping personnel. ConclusionSIs caused during the period commencing from completion of injection to disposal decreased in all the participant hospitals, suggesting that the healthcare workers handled the sharps appropriately; however, probably due to wrong disposal, personnel involved in waste disposal got more injuries. Safety engineered devices are not implemented in Indian hospitals despite data supporting their use decreasing SIs.

Infection control practices in facilities for highly infectious diseases across Europe

SummaryBackgroundThe management of patients with highly infectious diseases (HIDs) is a challenge for healthcare provision requiring a high level of care without compromising the safety of other patients and healthcare workers.AimTo study the infection control practice in isolation facilities participating in the European Network for Highly Infectious Diseases (EuroNHID) project.MethodsA survey was conducted during 2009 of 48 isolation facilities caring for patients with HIDs in 16 European countries. Checklists and standard evaluation forms were used to collect and interpret data on hand hygiene, routine hygiene and disinfection, and waste management.FindingsForty percent of HIDs had no non-hand-operated sinks or alcohol-based antiseptic distributors, while 27% did not have procedures for routine hygiene, final disinfection, or safe discarding of non-disposable objects or equipment. There was considerable variation in the management of waste and in the training of housekeeping personnel. EuroNHID has developed recommendations for hand hygiene, disinfection, routine hygiene, and waste management.ConclusionsMost aspects of hand hygiene, routine hygiene and disinfection, and waste management were considered at least partially adequate in the majority of European isolation facilities dedicated for the care of patients with HIDs. But considerable variability was observed, with management of waste and training of housekeeping personnel being generally less satisfactory.

Changes in measles seroepidemiology of healthcare workers in southern Taiwan

To assess the measles seroepidemiology of healthcare workers (HCWs), from 2004 to 2009 all newly recruited staff at a university hospital in Taiwan, were tested for specific immunoglobulin G antibodies for measles virus using enzyme-linked immunosorbent assays. A total of 1584 HCWs were included. The positivity rate of measles antibody for physicians and nurses was about 90%. The positivity of measles antibody in different age groups was 78·1%, 93·9% and 94·2% for 20-29, 30-39 and ≥40 years age groups, respectively. Equivocal results were more frequent in the 20-29 (17·1%) years age group. A lack of antibody against measles was reported for 66 (4·2%) of those tested. Medical student (8·3%) and housekeeping personnel (5·3%) had the greatest lack of antibodies. This study demonstrates the waning measles immunity in younger HCWs in Taiwan, which poses the potential risk of nosocomial transmission of measles. Periodic surveillance and revaccination of susceptible HCWs is recommended.

GINA and Preemployment Criminal Background Checks

One day in spring of 2009, Rules Committee of The University of Akron Board of Trustees made a small but significant addition to a new Employee Background Review Policy that university administration had proposed. The policy, modeled on an Ohio law requiring criminal background checks for all K--12 public school employees in Ohio, would require blanket criminal background checks for all prospective UA employees, excluding student employees. (1) The board added an additional requirement unique to standard criminal record policies: discretion of University of Akron, any applicant may be asked to submit fingerprints or DNA sample for purpose of a federal criminal background (2) This new policy was approved by board and enacted on August 30, 2009. As per university policy, rule was passed without faculty review and went largely unnoticed until adjunct instructor Matt Williams, vice president of New Faculty Majority, a national coalition advocating on behalf of part-time and adjunct faculty, resigned in protest on October 24, 2009, triggering local, national, and international news coverage. An editorial in Akron Beacon Journal protested that the swab-for-a-job plan at UA represents a unique and unwarranted intrusion into personal privacy and raises potent discrimination issues, (3) and on October 28th American Civil Liberties Union issued a press release declaring its outrage over idea that employers might consider themselves entitled to our most private, personal genetic information. (4) On November 5, 2009, The University of Akron faculty senate--citing privacy and legal concerns, questioning breadth of DNA sample requirement, and emphasizing threat it poses to reputation of university--passed a resolution requesting that board of trustees reconsider new provisions. Also on November 5, 2009, university's Office of General Counsel stated it would recommend that rule 3359-11-22 (B)(3) be amended to read: Certain positions at The University of Akron, if required by law or contract, will be subject to both state of Ohio and federal criminal background checks regardless of how long preferred candidate has resided in Ohio. The candidate may be required by law enforcement agency to provide additional information for purposes of conducting criminal background check. (5) Since neither Ohio nor federal law enforcement agencies routinely screen subjects of criminal background checks against state or federal DNA fingerprint databases, this suggestion would effectively retract policy and make it just another story from a university famous for odd academic employment practices (like requiring department chairs to be in their offices from 8 a.m. to 5 p.m. each workday! (6)). But was UA policy wrong on legal or ethical grounds? And if so, would backing off on DNA sampling provision right its wrongness? The Rules Committee thought it was simply updating accepted fingerprinting practices prescribed in Ohio law. Its view was that DNA identification would eventually eclipse fingerprinting as standard technology for criminal background checks, because Ohio is moving toward mandatory DNA identification and sampling in booking of all arrestees. (7) At least for university personnel whose jobs give them access to valuable equipment, student living quarters, and faculty offices, some might find practice of preemployment screening against databases of known felons and sex offenders simply prudent. And if we are going to be fair about it, they could argue, we should treat all university employees alike in this regard, rather than more heavily burdening security and housekeeping personnel, who are disproportionately likely to be from minority groups or groups with low socioeconomic status. In retrospect, incident at UA highlights some interesting questions about privacy protections that employees deserve in an era of heightened anxieties about institutional security and applicability of protections they already enjoy to DNA-based forms of identification. …

Implementation of a safety program for handling hazardous drugs in a community hospital

The implementation of a safety program for handling hazardous drugs in a community hospital is described. A committee of representatives of the departments of pharmacy, nursing, human resources, safety, radiology, performance improvement, employee health, and environmental services and members of the hospital administration was formed to formally address the management of hazardous drugs in a community, not-for-profit, adult hospital in Omaha, Nebraska. Published guidelines and regulations were reviewed to determine the hospital's compliance with the handling of hazardous drugs. A knowledge deficit regarding the risk and severity of occupational exposure to hazardous drugs was identified. A formal education plan was immediately implemented providing inservice education to all staff who may come into contact with hazardous drugs. Each drug was electronically tagged in the hospital computer system. The nitrile gloves used in the pharmacy were switched to a brand tested for resistance to chemotherapy drug permeation. The use of personal protective equipment for all health care workers who may come into contact with hazardous drugs was also instituted. Waste stream management was addressed, and a new waste stream was identifed and implemented to address chemicals regulated by the Resource Conservation Recovery Act. Nursing, pharmacy, and housekeeping personnel were extensively educated on the different waste streams and the importance of segregating waste at the point of use. All gloves for housekeeping and laundry service staff were replaced with hazardous-drug-rated nitrile gloves. A gap analysis allowed a multidisciplinary team to establish a safety program for managing hazardous drugs in a community hospital.

The lack of Crimean-Congo hemorrhagic fever virus antibodies in healthcare workers in an endemic region

We aimed to detect antibodies against Crimean-Congo hemorrhagic fever virus (CCHFV) in healthcare workers (HCWs) in an endemic region. The study was conducted in a tertiary care hospital that had cared for CCHFV infected patients in the period 2002-2003. The sera from the HCWs were collected one month after the last admitted hospital case (October 2003), and sent to the Pasteur Institute, Lyon, France to be studied for CCHF IgM and IgG by ELISA. The total number of HCWs included in the study was 75; the median age was 30, 68% of the subjects were female, and 83% of the HCWs were at risk of exposure to the body fluids of patients. Only one HCW from the group without risk of exposure was CCHF IgG positive. The adherence rate to universal precautions was high. In conclusion, a lack of CCHFV transmission from patients to HCWs was observed. This result could be related to the high rate of compliance to the universal precautions, which are sufficient to protect against CCHFV infection.

Tertiäre Prävention von Berufsdermatosen

Zusammenfassung Hintergrund: Die Indikation zur stationären tertiären Prävention bei Berufsdermatosen ist gegeben, wenn ein objektiver Zwang zur Unterlassung der schädigenden Tätigkeit droht. Frühere Untersuchungen haben gezeigt, daß mit einer tertiären Präventionsmaßnahme bei 2/3 solcher Patienten ein langfristiger Berufsverbleib erzielt werden kann. Berufspezifische Daten zur Wirksamkeit der tertiären Prävention liegen bislang nicht vor. Patienten und Methodik: Wir analysierten unser Patientenkollektiv des Jahres 2002 berufsgruppenspezifisch bezüglich Diagnosen, früherer und aktueller Therapie und klinischem Erfolg der tertiären Präventionsmaßnahme. Ergebnisse: Bei den 296 Patienten wurde in 91 % der Fälle primär ein Kontaktekzem der Hände diagnostiziert (75 % primär irritativ bedingte Handekzeme (37 % kumulativ‐toxische Handekzeme, 38 % irritativ‐provozierte atopische Handekzeme, 16 % primär allergische Handekzeme). Klinisch relevante Typ‐IV‐Sensibilisierungen wurden insgesamt in 42 % der Fälle konstatiert, überwiegend im Sinn sekundär aufgepfropfter allergischer Kontaktekzeme. In über 83 % konnte eine vollständige bis weitestgehende Abheilung erzielt werden.Klinisch relevante Sensibilisierungen waren am häufigsten bei Friseuren (66 %). Die Angehörigen der Reinigungsberufe gaben am häufigsten (60 %) eine regelmäßige Kortikosteroid‐Vorbehandlung an; wir dokumentierten bei dieser Berufsgruppe am häufigsten sowohl eine Kortisonentzugssymptomatik (53 %) als auch eine Hautatrophie der Hände (23 %). Schlußfolgerung: Die Daten zur tertiären Prävention von Berufsdermatosen geben Hinweise auf Optimierungsmöglichkeiten der ambulanten Therapie und bezüglich Berufsgruppen‐typischer Risikofaktoren. Die unterschiedlichen Kenndaten der Kollektive der einzelnen Berufsgruppen und die unterschiedlichen Ansprechraten auf die tertiäre Präventionsmaßnahme basieren zumindest teilweise auf Unterschieden in der derzeit gehandhabten Sekundärprävention.

Postoperative Deep Surgical Site Infections in Orthopedic Surgeries

ISSUE: The Baltimore VA Medical Center, a 110-bed university-affiliated acute-care hospital, is a division of the VA Maryland Health Care System (VAMHCS). In reviewing surgical site infections (SSIs) following total hip replacement (THR) and total knee replacement (TKR) surgery, the infection rates exceeded the NNIS median rate. PROJECT: In March 2001, a multidisciplinary performance team was established to address the SSI rate in TKA and THR. There was a review of the CDC Guidelines for Prevention of SSI and the AORN Standards. Several joint replacements were observed, monitoring surgical technique and OR practices including dressing change technique on the surgical unit. Infections were reviewed for any commonalities or trends. Antibiotic prophylaxis was reviewed. Staffing was assessed. The team implemented the following actions: instituted pre-operative CHG baths for all patients undergoing joint replacement, developed an electronic CHG quick order template, required use of electric clippers for hair removal, conducted monitors for timing of prophylactic antibiotic administration, evaluated the OR air handling system, reviewed sterilization procedures including use of flash, scheduled education for SPD and housekeeping personnel, removed reusable props for positioning patients, established operating room rounds, and assessed staffing patterns for housekeeping and SPD. RESULTS: Infection rates were risk-adjusted for length of surgery, wound class, and ASA code. The overall risk-adjusted SSI rate prior to implementation of Best Practices was 11 per 100 procedures (6/54) for THR and 4.3 per 100 procedures (3/69) for TKR. After implementation the rates decreased to 0 for THR and to 4.2 for TKR. Antibiotic prophylaxis increased from 74% to 87%.

Compliance with methicillin-resistant Staphylococcus aureus precautions in a teaching hospital

Background: Nosocomial transmission of methicillin-resistant Staphylococcus aureus (MRSA) occurs primarily through the contaminated hands of health care workers who do not follow appropriate precautionary measures. This study investigates various factors associated with compliance with MRSA precautions during routine patient care. Methods: This observational study took place at a teaching hospital in Montreal, Canada. Nurses (184), physicians (41), occupational therapists and physical therapists (19), orderlies (102), housekeeping personnel (28), other health care workers (65), and visitors (49) were anonymously observed. Compliance with MRSA precautions was measured according to appropriate use of gowns and gloves as well as hand hygiene. Results: In 488 observations, the average compliance was 28%. In multivariate analysis, in comparison with nurses, compliance was lower among physicians (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.14 to 0.86), orderlies (OR, 0.37; CI, 0.2-0.69), visitors (OR, 0.2; CI, 0.08-0.49), housekeeping personnel (OR, 0.06; CI, 0.01-0.47), and other types of health care workers (OR, 0.39; CI, 0.18-0.85), but was higher among occupational and physical therapists (OR, 11.7; CI, 2.55-53.8). Conclusions: Compliance with MRSA precautions is low. The only significant predictor of MRSA compliance was the professional category of the health care worker. (Am J Infect Control 2002;30:430-3.)

No time for hand-me-downs

No time for hand-me-downs