References 1. Magill SS et al. (2018): N Engl J Med 379: 1732-1744. https://doi.org/10.1056/NEJMoa1801550 2. BARMER Krankenhausreport 2021. https://www.barmer.de/blob/339106/ff2b0b22a5770236 (accessed on 21.03.2024) 3. Suetens C et al. (2018): Eurosurveillance 23: 1800516. https://doi.org/10.2807/1560-7917.ES.2018.23.46.1800516 4. Haque M et al. (2018):Infect Drug Resist 11: 2321-2333. https://doi.org/10.2147/IDR.S177247 5. Senges C et al. (2024): Infection Prevention in Practice. 6:2:100364. https://doi.org/10.1016/j.infpip.2024.100364 6. Kuster S et al. (2021): Antimicrob Resist Infect Control 10: 93. https://doi.org/10.1186/s13756-021-00949-0 7. Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut. Händehygiene in Einrichtungen des Gesundheitswesens (2016): Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 9: 1189-1220. https://www.rki.de/DE/Content/Infekt/ Krankenhaushygiene/Kommission/Tabelle_Haendehyg_Rili.html (accessed on 21.03.2024) volume per disinfection [ml] B. neurology ward C. orthopaedic/surgical ward D. ICU E. surgical ICU F. surgical ICU >1 - 2 >2 - 3 >3 - 4 room type patient room bathroom hallway counter other A. other ward Figure 2: HRD usage on ward maps. All maps are exemplary, anonymised recreations of ward layouts. (A, B) Dispenser usage when multiple dispensers are available in patient rooms. (C, D) Dispenser usage on hallways and in patient rooms on orthopaedic/surgical wards and non-surgical ICUs and (E, F) on surgical ICUs. Circles represent WMDs and always touch the wall they are mounted to. Larger circles indicate more frequent usage, but circle sizes are not comparable between subfigures. Green/yellow/red circles indicate that on average >3 to 4 mL/>2 to 3 mL/>1 to 2 mL of ABHR were used per disinfection, respectively. ABHR, alcohol-based hand rub; HRD, hand rub dispenser; ICU, intensive care unit; WMD, wall-mounted dispenser. disinfection is most reliable when there is a risk of exposure to infectious agents. Dispensers placed in patients‘ rooms were most commonly used on surgical wards, presumably because contact with open wounds is unavoidable. In addition, the highest volume of rub per disinfection (3.6 mL) was found in treatment rooms. Consider dispenser placement and workflow for optimal use The results suggest that dispenser use is influenced by room type, as well as ward type and workflow. Therefore, neither simply increasing the number of dispensers nor optimising their placement may be the only solutions to improve HH compliance. Digital monitoring systems that provide accurate and location-specific usage data can be used to objectively analyse the overall picture. In the future, this could lead to more specific recommendations for groups of healthcare workers and room configurations. A. other ward B. neurology ward C. orthopaedic/surgical ward D. ICU E. surgical ICU F. surgical ICU patient room bathroom room type volume per disinfection [ml] KNOWLEDGE 19
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