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   Table of Contents - Current issue
January-April 2021
Volume 9 | Issue 1
Page Nos. 1-33

Online since Friday, September 24, 2021

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Emerging issues and preventive measures for health care workers in the diagnostic field in coronavirus disease 2019 pandemic p. 1
Arshdeep Kaur, Madhu Sinha, Abhijit Das, Natasha Gulati, Manmohan Mehndiratta, Chandra Shekhar
Coronavirus disease 2019 caused by severe acute respiratory syndrome-CoV-2 is an emerging infectious disease first identified in Wuhan City, Hubei Province, China, which subsequently spread as a global pandemic posing a global threat. As per World Health Organisation worldwide around 38 lac people have been infected and 2.6 lac people have died from the disease and in India 59,662 people are infected with 1981 deaths by May 9, 2020. It is feasible that potentially infectious specimens may be submitted in our laboratory those are the impending source of infection to the laboratory personnel. Using imaging equipment on coronavirus confirmed/suspected patient/carriers is a serious hazard for healthcare providers because there is a risk that the virus could remain on the surface of the computed tomography scan machines or ultrasound (US) probes/patient bed/couch. Here, we have enlisted the rigorous biosafety measures which if executed appropriately can significantly drop the chances of spread of infection to health care workers in these diagnostic sections.
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Qualitative observational assessment of the recommended hand rubbing technique amongst young healthcare workers at an academic hospital p. 8
Mazin Barry, Raghad Alotaibi, Farah Alotaibi, Lama Alotaibi
Background: Hand hygiene (HH) is a major cornerstone in preventing hospital-acquired infections. The recommended six-step alcohol-based hand rubbing (ABHR) technique has not been qualitatively evaluated amongst young healthcare workers (HCWs) before. Methods: A cross-sectional observational study at an academic hospital was conducted in 2018; data collectors observed HCWs voluntarily perform ABHR, observing for the quality of the six steps of HH and recording the duration, and if they performed accessory removal then recorded total qualitative scores. Results: Three hundred and seventy-seven young HCWs were qualitatively observed, the mean age of participants was 24.1 years, 49.1% were female, only 10 (2.7%) completely fulfilled all six steps, 97.35% of HCWs had inadequate hand surface coverage and 69.23% did not achieve sufficient timing. The median scores, out of 12, for 3rd-, 4th- and 5th-year medical students, were 6.4, 7.2 and 7.5, respectively, while medical interns scored 7.4 and medical residents scored 7.5 (P = 0.016). Participants with previous HH training sessions scored higher with mean scores of 7.4 versus 6.3 (P ≤ 0.001). Conclusion: The quality of ABHR practised by young HCWs lacked the appropriate coverage of full hands surface coverage and inadequate duration of time, special training and follow-up on the quality of ABHR technique for HCWs early in their career is warranted.
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Hand hygiene compliance – Improvement with multimodal approach in intensive care unit setting p. 13
Saloni Garg, Shalini Malhotra, Patel Pritikumari, Amarjit Kaur, Nirmaljit Kaur, Nandini Duggal
Introduction: Healthcare associated infections (HCAIs) pose a significant risk to patient's health with increasing morbidity and mortality. A large portion of HCAI can be prevented by hand hygiene, but adherence to hand hygiene has been found to be very low. Methodolgy: This study was conducted to assess the rate of hand hygiene compliance during 'my five moments of hand hygiene' as per the WHO guidelines in our intensive care units and to implement multimodal intervention strategies to improve hand hygiene compliance. Results: The average compliance amongst all HCWs in both ICUs was 45.7% before sensitisation which increased to 85.4% after sensitisation using multimodal strategies. Conclusion: Multimodal Intervention strategies such as the one we employed had a good impact in improving compliance in our ICU and these improvements can be easily duplicated in healthcare settings across the country.
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Change in perception regarding the use of Biometric devices at a tertiary care hospital in view of COVID-19 p. 17
Saloni Garg, Arvind Achra, Narendra Kumar Tiwary, Kirti Nirmal, Stuti Kansra Arora, Anuradha Shulania, Nandini Duggal
Background: Fingerprint biometric systems are used to identify personnel, grant authorised access and maintain attendance of staff at most places. Despite their many benefits, biometric devices are potential sources of transmission due to contamination from multiple touches by various users. Due to the COVID-19 pandemic, there have been massive shift in infection control practices specially hand hygiene. This study was conducted to understand the attitude and practices of healthcare workers (HCWs) they are likely to follow when biometric devices come to use again. Materials and Methods: The study was conducted using a self-designed questionnaire given to HCWs in different departments of the hospital in the form of a written form by our infection control nurses. The study was conducted for 5 days. The questionnaire was based on various attitudes and practices before and after the COVID-19 outbreak. Results: Overall 304 participants filled the questionnaire, which comprised 85 (28%) doctors, 117 (38.4%) nurses and 102 (33.6%) other staff. Before the emergence of COVID-19, 114 (37.5%) participants felt touching biometric devices is more dangerous than touching other common items such as doorknobs, elevator buttons, countertops and staircase railings which now increased to 183 (60.2%) after the COVID-19. Earlier 77% of participants felt that hand sanitisers should be installed near biometric devices, but now 95.7% feel the need of hand sanitisers near the biometric devices and want to use them. Conclusion: This improvement in hand hygiene might be a result of increased awareness through educational programmes and mass media during the COVID-19 pandemic. Hand sanitisers should be installed near biometric devices before restarting their use which will reduce the risk of contamination of biometric devices by pathogenic organisms.
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Perception of patient safety culture amongst healthcare personnel in a tertiary care hospital p. 22
Keval Singh Meena, Asha P Shetty
Background: Patient safety in healthcare includes the safety of both patients (clients) and healthcare providers. It emphasizes reporting, analysis and prevention of medical errors that often lead to adverse health events and thus it becomes one of the most important aspects needed in a hospital setting. Purpose: The study aimed to assess the perception of patient safety culture amongst healthcare personnel in a tertiary care hospital. Methodology: A descriptive research design was selected as an appropriate method; 380 participants were selected through convenience sampling technique, including physicians, nursing officers and other technical staff. The setting for the study was all departments of a tertiary care hospital, All India Institute of Medical Sciences, Bhubaneswar. The Hospital Survey on Patient Safety Culture, a self-administered questionnaire, was used to assess the perception of patient safety culture. Results: The data were entered into SPSS version 20. The overall response rate in the present study was 84%. The average composite response rate was 57.37%. The dimension of 'teamwork within the unit', 'organisational learning' and 'feedback and communication error' showed the maximum positive responses 81.25%, 79.91% and 70.61%, respectively. Conclusion: Professional practice is a priority to promote patient safety culture amongst healthcare personnel. To have homogeneous patient safety culture amongst all healthcare professional, it is essential to increase awareness about patient safety amongst healthcare personnel and motivate them to participate in the service.
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Step wise protocol for body wash in critically ill patients in intensive care units: An area/culture oriented approach p. 28
Kulbeer Kaur, Surinder Kaur, Shamanth Adekhandi Shankarnarayan, Nishi Shylla, Neha Jain, Manisha Biswal, Kajal Jain
Background: During active surveillance done by Biswal et al. in 2017, to investigate fungal colonisation and infection in the trauma intensive care unit, several flaws were recorded in patient body wash protocol. Candida auris colonisation was rapidly increasing due to improper body washing. Several patients admitted eventually got colonised with C. auris at different body sites, predominantly in axilla and groin. Aims: To devise a novel and simplified chlorhexidine-based body wash protocol to eradicate bacterial and fungal colonisers. Materials and Methods: A detailed, systematic, standard and practical protocol for body wash depending on the specific work culture and resource availability is required to ensure standard nursing care. Therefore, a simplified chlorhexidine based, step wise body wash protocol to eradicate fungal colonisers which can be implemented and followed in every hospital setting was designed. This new protocol was implemented in the trauma intensive care unit (ICU) for 1 month. Successful implementation of the decolonisation procedure was assessed based on the feedback obtained from the nursing staff. Results: The newly devised chlorhexidine based body wash protocol was successfully able to decolonise C. auris from the body sites such as axilla and groin of ICU patients. Easy and simplified protocol could be followed by nursing staff as well as patient attendants. Nursing staff provided positive feedback in implementing and following the new protocol. Conclusion: The protocol can be easily implemented in any hospital settings with minimum resources. This new protocol can significantly reduce fungal and bacterial colonisation and hospital acquired infections.
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