Hygiene Management System Research Articles

Efficacy and Safety of Automated Antiseptic Lavage and Suctioning of Oral, Oropharyngeal, and Subglottic Secretions (Vapcare) Among Ventilated Patients with COVID-19 Developing VentilatorAssociated Events During Hospitalization: A Prospective Randomized Open Blinded End-Point Study

Background: Globally, invasive mechanical ventilation is one of the many methods relied on by intensivists to treat patients diagnosed with COVID-19. In this population, substandard oral care and secretion management permit the colonization of pathogens in the oral cavity and aspiration of these microbeladen secretions is the leading cause of ventilator-associated pneumonia (VAP). This study was conducted to analyze the effects of VapCare, an automated and intelligent secretion clearance and oral hygiene management system for VAP prevention, compared to the manual process.

Health protection of a worker exposed to chemical agents in the work environment - biological monitoring in health risk assessment: legal regulations

One of the priorities in the field of occupational safety and health in the European Union (EU) is research on dissemination and application of scientific results, which results in changes in legislation on exposure assessment to chemical agents and risk estimation. The aim of this paper is to analyze the EU legislation on exposure assessment and risk estimation to chemical agents based on biological monitoring studies, in the context of workers' health protection, with reference to the occupational hygiene management system and standard. An analysis was made of the current legal regulations as well as recommendations and guidelines for biological monitoring studies in the assessment of workers' exposure to selected metals. A comparison was made between the regulations in force in Poland and in EU. The rationale for implementing biological monitoring tools in occupational health prevention as an additional tool to protect workers from chemical agents was evaluated. Med Pr. 2022;73(4):349-56.

굴양식업의 구조변화에 따른 재편 방향

The purpose of this paper is to investigate the characteristics of structural changes in oyster farming, and to explore the current issues and direction of restructuring. The oyster farming industry has grown rapidly since the 1970s, but production has plummeted since the late 1980s and stagnated until the 1990s. Since then, production has recovered, but since 2010, production has been increasing and decreasing year by year. At present, the immediate problem in the oyster farming industry is that the volatility of oyster production has stagnated or become serious. Second, it is becoming difficult to secure a stable labor force. Third, oyster consumption is shrinking due to changes in social structure and food consumption trends. Fourth, oyster safety is constantly occurring. Fifth, oyster farming is highly dependent on exports, but export countries and export items are limited. In order to improve the competitiveness of the oyster farming industry, the first step is to eliminate the overcrowding of oyster farming facilities, secure artificial seedlings, improve aquaculture methods, and switch to other aquaculture varieties. Second, we will discover new demand targets through high-quality product development and product promotion. Third, in order to ensure the hygiene and safety of oysters, we will establish a hygiene and safety management system from the harvesting stage to the distribution and consumption stage. Fourth, we should explore new markets through overseas market research and consumption trends related to oysters, development of advanced processing and health functional products.

STUDY OF THE IMPACT OF MEASURES OF THE HIERARCHY OF CONTROL ON OCCUPATIONAL RISK

The article analyzes the international and domestic experience in building a safety and hygiene management system. It is noted that the priorities in the process of ensuring safe and harmless working conditions for many developed countries are: revision and improvement of the legal framework for occupational safety and health, encouraging employers to ensure proper working conditions, and raising awareness of managers and employees on occupational safety and health. Recommendations for planning measures depending on the hazards present in enterprises and the results of risk assessment are contained in the documents of the International Labor Organization. Methods and methods of detection and assessment of risk factors can be chosen according to the characteristics of the workplace. Effective occupational risk reduction activities involve the implementation of a certain sequence of tools and management methods (control hierarchy), as specified in the international standard ISO 45001. It is proposed to use the following priorities for risk reduction: elimination of hazards, replacement of processes, operations, materials or equipment for less dangerous, the use of technical means and methods of management, reorganization of work and training of employees, administrative control of hazards, personal protective equipment. According to the results of the research, in the absence of resources for the implementation of measures of the highest priorities, the most effective approach was the combination of technical means and management methods, reorganization of work and training, as well as administrative control of hazards. To implement occupational health and safety management systems based on a risk-based approach, it is necessary, first of all, to develop and approve a methodology that determines the procedure for calculating occupational risk and ensure that the results of risk assessment are taken into account when planning preventive measures.

Frequency, Local Dynamics, and Genomic Characteristics of ESBL-Producing Escherichia coli Isolated From Specimens of Hospitalized Horses.

Previous research identified veterinary clinics as hotspots with respect to accumulation and spread of multidrug resistant extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (EC). Therefore, promoting the prudent use of antibiotics to decrease selective pressure in that particular clinical environment is preferable to enhance biosecurity for animal patients and hospital staff. Accordingly, this study comparatively investigated the impact of two distinct perioperative antibiotic prophylaxis (PAP) regimens (short-term versus prolonged) on ESBL-EC carriage of horses subjected to colic surgery. While all horses received a combination of penicillin/gentamicin (P/G) as PAP, they were assigned to either the “single-shot group” (SSG) or the conventional “5-day group” (5DG). Fecal samples collected on arrival (t0), on the 3rd (t1) and on the 10th day after surgery (t2) were screened for ESBL-EC. All isolates were further investigated using whole genome sequences. In total, 81 of 98 horses met the inclusion criteria for this study. ESBL-EC identified in samples available at t0, t1 and t2 were 4.8% (SSG) and 9.7% (5DG), 37% (SSG) and 47.2% (5DG) as well as 55.6% (SSG) and 56.8% (5DG), respectively. Regardless of the P/G PAP regimen, horses were 9.12 times (95% CI 2.79–29.7) more likely to carry ESBL-EC at t1 compared to t0 (p < 0.001) and 15.64 times (95% CI 4.57–53.55) more likely to carry ESBL-EC at t2 compared to t0 (p < 0.001). ESBL-EC belonging to sequence type (ST) 10, ST86, ST641, and ST410 were the most prevalent lineages, with blaCTX–M–1 (60%) being the dominant ESBL gene. A close spatio-temporal relationship between isolates sharing a particular ST was revealed by genome analysis, strongly indicating local spread. Consequently, hospitalization itself has a strong impact on ESBL-EC isolation rates in horses, possibly masking differences between distinct PAP regimens. The results of this study reveal accumulation and spread of multi-drug resistant ESBL-EC among horses subjected to colic surgery with different P/G PAP regimens, challenging the local hygiene management system and work-place safety of veterinary staff. Moreover, the predominance of particular ESBL-EC lineages in clinics providing health care for horses needs further investigation.

Assessment of Bacterial Pathogens and their Antibiotic Resistance in the Air of Different Wards of Selected Teaching Hospitals in Tehran.

Context:Exposure to bio-aerosols in a variety of environments has been of great interest due to the health effects on humans. Hospitals can be the reservoir of these biological agents because of the presence of infectious patients; which can lead to hospital infections and various occupational hazards. In this way, we assessed bacterial contamination in two teaching hospitals in Tehran.Aims:Our purpose in this study assessment of bacterial pathogens and their antibiotic resistance in the air of different wards of selected teaching hospitals in Tehran.Settings and Design:In this study, sampling was done according to NIOSH 0800.Methods and Material:This descriptive study was carried out in the different sections of two hospitals in Tehran. A total of 180 air samples were evaluated according to NIOSH 0800. In each section sampling was performed on the culture media in three stations including primary room, end room, and nursing position then the number of colonies counted. The zone of inhibition was measured in antibiotic disks to determine antibiotic resistance of samples.Statistical Analysis Used:Data analysis was performed using SPSS version 21. Initially, the data were normalized using the Kolmogorov–Smirnov test. The difference between the two hospitals was achieved with Mann–Whitney U test for un-normal distribution data.Results:Bacterial contamination in hospital 2 was significantly higher than the hospital 1(P < 0.001). The median number of colonies in hospital 1 was 129.87 (87.46–268.97) CFU/m3 and 297.97 (217.66–431.85) CFU/m3 for hospital 2. Bacterial contamination in the all of stations in hospital 2 and 87% of samples in hospital 1 was higher than the acceptable range of ACGIH (75 CFU/m3).Conclusions:High bacterial contamination may be related to a lack of hygiene management and poor ventilation system. It seems effective infection control processes, appropriate ventilation systems and supervision systems should be improved.

Удосконалення оперативного управління гігієною та безпекою праці на основі оцінки виробничого ризику

The research object is the methods of management of labor protection at enterprises. Approval of the “Concept for Reforming the System of Labor Protection Management in Ukraine” by the Cabinet of Ministers of Ukraine necessitates the establishment of a hygiene and safety management system based on a risk-oriented approach. The construction of the specified system requires a complex of theoretical and experimental research, intended to form the methodological support for identifying processes of hazard identification and occupational hazard assessmentThe purpose of the work is to provide grounds for the practical application of the approach to occupational hazard assessment. To complete the purpose, existing methods and approaches to the occupational hazard assessment have been analyzed, and an approach to the occupational hazard assessment is proposed, which is based on the use of statistics on indicators of occupational injuries with consideration of the branch affiliation of enterprises.Ref. 6, pic. 1

Effect of Smart Hand Hygiene Management System on hand hygiene compliance of Intensive Care Unit medical staff

Objective To explore the effect of Smart Hand Hygiene Management System on hand hygiene compliance of Intensive Care Unit (ICU) medical staff. Methods Using convenience sampling method, 106 medical staff in the comprehensive ICU of Tianjin First Central Hospital were selected as the research objects. By deploying Smart Hand Hygiene Management System, medical staff's hand hygiene before and after contacts with patients in the ward were collected automatically, and compliance was calculated. By engineering means, the first month (July, 2018) data collected after removing the system's prompting function was taken as the baseline level, and the month after the system's acousto-optic prompting function was added and working principle training (August, 2018) was taken as the intervening stage. Compare the hand hygiene compliance of selected medical staff before and after intervention. Results The hand hygiene compliance of medical staff was 85.62% after intervention, which was higher than 52.87% before intervention and the difference was statistically significant (P<0.01) . After intervention, the pre-operation compliance increased to 73.90%, and the post-operation compliance increased to 94.94%, which were all statistically different from those before intervention (P<0.01) . Conclusions The application of Smart Hand Hygiene Management System has a significant effect on improving the compliance of hand hygiene performance of medical staff, and the initiatives of performing hand hygiene of medical staff have been greatly improved. Key words: Intensive Care Unit; Hand hygiene; Compliance; Smart Hand Hygiene Management System

Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Acinetobacter baumannii among horses entering a veterinary teaching hospital: The contemporary "Trojan Horse".

Pathogens frequently associated with multi-drug resistant (MDR) phenotypes, including extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) and Acinetobacter baumannii isolated from horses admitted to horse clinics, pose a risk for animal patients and personnel in horse clinics. To estimate current rates of colonization, a total of 341 equine patients were screened for carriage of zoonotic indicator pathogens at hospital admission. Horses showing clinical signs associated with colic (n = 233) or open wounds (n = 108) were selected for microbiological examination of nostril swabs, faecal samples and wound swabs taken from the open wound group. The results showed alarming carriage rates of Gram-negative MDR pathogens in equine patients: 10.7% (34 of 318) of validated faecal specimens were positive for ESBL-E (94%: ESBL-producing Escherichia coli), with recorded rates of 10.5% for the colic and 11% for the open wound group. 92.7% of the ESBL-producing E. coli were phenotypically resistant to three or more classes of antimicrobials. A. baumannii was rarely detected (0.9%), and all faecal samples investigated were negative for Salmonella, both directly and after two enrichment steps. Screening results for the equine nostril swabs showed detection rates for ESBL-E of 3.4% among colic patients and 0.9% in the open wound group, with an average rate of 2.6% (9/340) for both indications. For all 41 ESBL-producing E. coli isolated, a broad heterogeneity was revealed using pulsed-field gel electrophoresis (PFGE) patterns and whole genome sequencing (WGS) -analysis. However, a predominance of sequence type complex (STC)10 and STC1250 was observed, including several novel STs. The most common genes associated with ESBL-production were identified as blaCTX-M-1 (31/41; 75.6%) and blaSHV-12 (24.4%).The results of this study reveal a disturbingly large fraction of multi-drug resistant and ESBL-producing E. coli among equine patients, posing a clear threat to established hygiene management systems and work-place safety of veterinary staff in horse clinics.

Infection Prevention and Control Education for Environmental Services Workers (ESW): “Cleaner is Safer – ESW on the Front-line of Infection Prevention”

Background Studies suggest that improving environmental cleaning and disinfection reduces pathogen transmission and prevents healthcare-associated infections (HAIs). We designed and administered an educational program for hospital ESW based on findings from a 2015 knowledge, attitudes, and practices survey.Methods An interactive 5-part educational program was given to front-line ESW at 5 acute care hospitals from 7/16 to 3/17 using principles of adult learning theory. Audience response system (ARS), videos, demonstrations, role-playing, and graphics were used to illustrate concepts and emphasize the rationale for HAI prevention strategies. Topics included HAIs, hand hygiene, isolation precautions, personal protective equipment, daily and discharge cleaning, and strategies to overcome common challenges and barriers. Evaluation included ARS questions, written evaluations, and assessment of daily cleaning before and after education using the 3M™ Clean-Trace™ Hygiene Management System. Clean surfaces were those with <250 relative light units detected. Chi-square tests were performed, where appropriate.ResultsOn average, 357 (range: 303-391) ESW attended each of the 5 program components. Most participants rated the presentations as ‘excellent’ or ‘very good’ (93%) and agreed they were useful (95%). After the program, participants indicated they were more comfortable donning/doffing PPE (91%), performing hand hygiene (96%), and better understood the importance of disinfecting high-touch surfaces (96%). The frequency of effective cleaning of high-touch surfaces in occupied patient rooms significantly improved following education (Table).Conclusion A novel educational program, designed using adult learning theory, that addressed ESW’s self-identified challenges was well-received and appears to have resulted in learning, behavior change, and improved daily cleaning. Future research will assess program sustainability and long-term impact on hospital cleanliness and patient outcomes.SurfacePercentage of surfaces identified as clean (%)Pre-interventionPost-intervention Absolute % change Toilet seat85883Toilet flush608222Overbed table298758*Bed rail85042*Call box56560*Visitor chair05959**P < 0.05.Disclosures All authors: No reported disclosures.

A review of HACCP and the South African abattoir hygiene management system towards integration

Integrating management systems is a common practice today. This is done particularly to save costs in the continued management of implemented systems. In South Africa, the hygiene management system (HMS) is regulated for application at abattoirs to manage food safety hazards during processing. Similarities have been noted between the HMS and the hazard analysis critical control point (HACCP) system. Some facilities have certified HACCP and/or ISO 22000 system in place in addition to the HMS. Little research has been done on how whether or not these systems can be integrated. As part of an ongoing empirical study, this paper presents a theoretical framework for the integration of HACCP with the HMS. It also presents central points of integration, i.e., the management of critical control points as well as integration of pre-requisite programs (PRPs).

A review of HACCP and the South African abattoir hygiene management system towards integration

A review of HACCP and the South African abattoir hygiene management system towards integration

Dairy production system type and critical points of contamination

Current milk production includes a large diversity between systems, which generates difficulties in defining a microbiological standard. The adapted practical and hygienic-sanitary management methods are diverse and introduce great complexity into the production systems. Based on this scenario, the objective of this study was to evaluate the types of dairy production systems of western Parana and to quantify Staphylococcus sp in three critical points in the dairy cattle production systems: the milking machines, milkers’ hands, the cooling tanks and raw milk. A total of 35 samples of refrigerated raw milk were collected, and a questionnaire referring to hygienic and sanitary management was administered. All of the data were collected during the period from September to October 2012 and involved 35 properties in the municipality of Marechal Cândido Rondon – PR. From these data, five groups were formed based on cluster analysis (CHA). The multiple correspondence analysis (MCA) presented in the first two dimensions, CP1 (81.43%) and CP2 (36.87%), showed the relevance of the variables used, which are sanitary and production management methods, and contamination and control of mastitis, respectively (CP1 and CP2). We found average contamination with 9.9 x 101 CFU/cm2, 2.2x104 CFU/cm2, 28 CFU/ cm2 and 3.8x103 CFU/mL; for milking machines, milkers’ hands, cooling tanks and milk, respectively. The results reveal the presence of staphylococcal agent in dairy production systems regardless of the adopted hygiene and health management protocols. The guidance, planning and adaptation of hygiene and health management systems can significantly improve the microbiological quality of the milk produced, both qualitatively and quantitatively

Defining a control point for the South African abattoir hygiene management system

The hygiene management system (HMS) was regulated for South African red meat and poultry abattoirs in mid-2000. It is a basic food safety management system. The HMS requires identification of control points (CPs) where critical limits must be established and control measures set in place. However, a CP has not been defined in legislation and no guidelines are available on how to identify them. Given this gap, the development of meaningful control measures may present a challenge to implementers of the HMS. A conceptual analysis of CPs within the context of food safety was done in relation to ISO 22000:2005, SANS 10330:2007, ISO 10049:2011 and HMS standards. This was done to formulate a meaningful definition for HMS-based CPs because they are a central feature of food safety systems in general, towards providing assurance of safe food. A definition was presented for a CP within the context of the HMS in this paper as well as how it relates to control in comparison with contemporary food safety systems. Results may be used to inform HMS implementation guidelines for abattoirs.

A hazard analysis methodology for the South African abattoir hygiene management system

Purpose – Hazard analysis critical control point (HACCP) systems facilitate a preventative and systematic approach to control food safety hazards through critical control points (CCPs). Hazards are prevented, eliminated or reduced to acceptable levels. The regulated South African abattoir hygiene management system (HMS) has adopted HACCP principles. Control points (CPs) represent the central feature of control within the HMS. However, there are no guidelines to conduct hazard analysis within the HMS. There is also no guideline to identify CPs. The purpose of this paper is to present a hazard analysis methodology that may be used at South African abattoirs to overcome these shortcomings. Design/methodology/approach – A review of SANS 10330:2007 (HACCP) and the regulated HMS standards was undertaken. A generic HACCP plan was developed for a hypothetical bovine processing abattoir. A proposed hazard analysis methodology was used to analyse generic hazards to determine its significance. Thereafter, CCPs were identified using the CCP decision tree. This was done to enable meaningful comparison between HACCP-based CCPs and HMS-based CPs. The hazard analysis methodology suggested by the Codex Alimentarius Commission (CAC) namely, the two dimensional health risk assessment model used to assess the significance of food safety hazards was used as a benchmark. Findings – The management of CPs in a HMS plan is similar to control contemplated in a HACCP plan. It was found that regulated CPs are not specifically stated as CPs, they need to be identified. Also, not all regulated CPs addressed the significant hazards that were identified using the proposed methodology in this paper. Managing only regulated CPs in the HMS plan may likely offer limited control over hazards. Therefore, hazards analysis is important to identify significant hazards and in turn, CPs that provide more comprehensive control within the HMS in addition to exercising control using only regulated CPs. It was observed that there are no decision criteria available to identify CPs, unlike HACCP. It was proposed that because CPs are defined similar to CCPs, that the CCP decision tree be used to identify CPs. Originality/value – A hazard analysis methodology was proposed to develop the HMS as well as steps towards its development. A decision guideline was also presented to facilitate extracting CPs from regulations. Important definitions lacking in regulations, and relating to the HMS, have also been proposed in this paper. More robust HMSs may be developed by identifying regulated CPs as well as identifying them through hazard analysis.

Microbes versus microbes: control of pathogens in the food chain.

Foodborne illness continues as a considerable threat to public health. Despite improved hygiene management systems and increased regulation, pathogenic bacteria still contaminate food, causing sporadic cases of illness and disease outbreaks worldwide. For many centuries, microbial antagonism has been used in food processing to improve food safety. An understanding of the mode of action of this microbial antagonism has been gained in recent years and potential applications in food and feed safety are now being explored. This review focuses on the potential opportunities presented, and the limitations, of using microbial antagonism as a biocontrol mechanism to reduce contamination along the food chain; including animal feed as its first link. © 2014 Society of Chemical Industry.

Risk Priority Number: A Measuring Instrument for Hygienic Management on Broiler Farms, Reflecting Their Campylobacter Status

Hygiene management is essential for rearing Campylobacter free broiler flocks. In this study, several hygiene factors (e.g., thinning, water supply, stable cloths, stable condition, stable environment, etc.) are categorized and aggregated in a developed risk priority number (RPN). This number is measuring the quality of hygiene management of a broiler farm with one single value (range: 801–4005 points), the higher the RPN, the better is the hygiene status. The distribution of the values is left skewed and none of the 53 examined Austrian broiler farms reached the maximum. Cecal samples (n = 610) from broilers at the point of slaughter determined the Campylobacter status of the farms. Farms with a high RPN consistently produced more Campylobacter free batches than farms with a low RPN. Ranking of the broiler farms based on their RPN was significantly correlated with their microbiological results for Campylobacter detection (Spearman’s correlation coefficient = 0.646). The risk priority number is an easy tool for the assessment and measurement of the hygiene management system at a broiler farm. Besides the educational benefits of the RPN, benchmarking against the mean value or the maximum is possible.

Assessing continual improvement of South African meat safety systems

PurposeContinual improvement within management systems is essential to ensure the continued relevance of implemented systems and to mitigate stagnant and ineffective systems. South African abattoir managers utilise a regulated food safety system called the hygiene management system (HMS) to manage the safe processing of meat. The extent to which the HMS supports continual improvement is not clear as there is no specific requirement to demonstrate continual improvement within implemented systems. The aim of this paper is to provide this clarification by developing a framework of compliance criteria for continual improvement (CI) benchmarking the ISO 9000 series.Design/methodology/approachThis study attempted to provide this clarification by developing a framework of compliance criteria for continual improvement (CI) benchmarking the ISO 9000 series. Thereafter the HMS requirements were assessed against these criteria to determine whether or not any gaps existed within the HMS requirements in support of continual improvement. This study adopted a qualitative approach where a review of standards formed the basis of the study.FindingsThis study demonstrates that the HMS is designed to support process stability. Further, the HMS requirements are sufficient to facilitate management of meat safety at abattoirs. However there are important gaps within the HMS in support of prevention as a means of continual improvement. The author postulates likely consequences of such gaps during implementation and management of the HMS.Originality/valueThis study emphasises the importance of fundamental principles in quality management underpinning basic improvement mechanisms of corrective and preventative action towards improvement. It also provides a basis for further empirical research into the extent to which improvement is made within implemented HMSs at abattoirs.

Continual improvement within South African abattoir Hygiene Management Systems

PurposeThe Hygiene Management System (HMS) is a regulated basic food safety system applicable to registered South African abattoirs. There is however, no specific requirement within the HMS that specifies continual improvement (CI). Continual improvement within management systems is critical to ensure that these systems remain relevant, efficient and effective over time. The purpose of this research is to determine the extent to which the HMS requirements facilitate CI and to suggest, if necessary, an approach on how the concept may be realized in practice.Design/methodology/approachThis study was conducted in two parts. The first part of the study developed continual improvement criteria benchmarking the ISO 9000 series. These criteria were then compared against the HMS requirements to determine the theoretical extent to which the HMS supports continual improvement. The second part of the study empirically tested the existing requirements of the HMS that support continual improvement.FindingsThis research demonstrates that the HMS is, first designed to support CI to a limited extent and second is not, in practice, implemented towards CI.Originality/valueThis paper presents regulators with gaps that exist within the present regulated HMS requirements in support of CI. It also provides abattoir managers with broad guidelines on how their implemented HMS can be designed towards CI. The research results may foster improvement within the regulated requirements of the HMS and implementation thereof towards improved handling and processing of safe meat at South African abattoirs.

ISO/IEC 17020 accreditation of Gauteng Veterinary Services: a systems approach towards managing food safety in South Africa

Consumers worldwide demand safe food that is produced in facilities that meet high quality and safety standards. There has been an evolution in legislative control regarding the safe processing of meat in South Africa. Legislation has been amended in order to strengthen government control of safe meat production. Abattoirs are legally compelled to implement the hygiene management system (HMS), a documented and auditable basic food safety system that is audited using a tool known as the Hygiene Assessment System. Reliability and credibility of audit findings is critical in providing a high degree of assurance to the public regarding the production of safe meat. Gauteng Veterinary Services (GVS), South Africa, improved this reliability by implementing the ISO/IEC 17020 management system. This paper reviews the systems approach adopted by GVS to quality assure the processing of safe meat at abattoirs in the Gauteng Province of South Africa.