Adherence observations of health care workers (HCW) revealed deficiencies in the use of recommended personal protective equipment (PPE) among HCW caring in COVID-19 and non-COVID-19 wards during the first period of the SARS-CoV-2 pandemic in a university hospital in Germany. The adherence to wearing surgical face or FFP2-masks and disinfecting hands prior to donning and after doffing the PPE was significantly higher in COVID-19 wards However, there was no total adherence of 100% in COVID-19 wards.

Background Prevention of hospital-acquired infections, in the clinical field of orthopedics and traumatology especially surgical site infections, is one of the major concerns of patients and physicians alike. Many studies have been conducted proving effective infection prevention measures. The clinical setting, however, requires strategies to transform this knowledge into practice. Question/purpose As part of the HYGArzt-Project (“Proof Of Effectivity And Efficiency Of Implementation Of Infection Prevention (IP) Measures By The Physician Responsible For Infection Prevention Matters In Traumatology/Orthopedics”), the objective of this study was to identify effective implementation strategies for IP (infection prevention) measures in orthopedics and trauma surgery. Methods The systematic review was conducted following PRISMA guidelines. A review protocol was drafted prior to the literature search (not registered). Literature search was performed in MEDLINE, SCOPUS and COCHRANE between January 01, 1950 and June 01, 2019. We searched for all papers dealing with infection and infection control measures in orthopedics and traumatology, which were then scanned for implementation contents. All study designs were considered eligible. Exclusion criteria were language other than English or German and insufficient reporting of implementation methods. Analyzed outcome parameters were study design, patient cohort, infection prevention measure, implementation methods, involved personnel, reported outcome of the studies and study period. Results The literature search resulted in 8414 citations. 13 records were eligible for analysis (all published between 2001 and 2019). Studies were primarily prospective cohort studies featuring various designs and including single IP measures to multi-measure IP bundles. Described methods of implementation were heterogeneous. Main outcome parameters were increase of adherence (iA) to infection prevention (IP) measures or decrease in surgical site infection rate (dSSI%). Positive results were reported in 11 out of 13 studies. Successful implementation methods were building of a multidisciplinary team (considered in 8 out of 11 successful studies [concerning dSSI% in 5 studies, concerning iA in five studies]), standardization of guidelines (considered in 10/11 successful studies [concerning dSSI% in 5 studies, concerning iA in seven studies]), printed or electronic information material (for patient and/or staff; considered in 9/11 successful studies [concerning dSSI% 4/4, concerning iA 5/5]), audits and regular meetings, personal training and other interactive measures as well as regular feedback (considered in 7/11 successful studies each). Personnel most frequently involved were physicians (of those, most frequently surgeons) and nursing professions. Conclusion Although evidence was scarce and quality-inconsistent, we found that adhering to a set of implementation methods focusing on interdisciplinary and interactive /interpersonal work might be an advisable strategy when planning IP improvement interventions in orthopedics and traumatology.

Adherence observations of health care workers (HCW) revealed deficiencies in the use of recommended personal protective equipment (PPE) among HCW caring in COVID-19 and non-COVID-19 wards during the first period of the SARS-CoV-2 pandemic in a university hospital in Germany. The adherence to wearing surgical face or FFP2-masks and disinfecting hands prior to donning and after doffing the PPE was significantly higher in COVID-19 wards However, there was no total adherence of 100 per cent in COVID-19 wards.

Adherence observations of health care workers (HCW) revealed deficiencies in the usage of recommended personal protective equipment (PPE) among HCW caring on COVID-19 and non-COVID-19-wards during the first period of SARS-CoV-2 pandemic in a university hospital in Germany. The adherence wearing surgical face or FFP2-masks, and disinfecting hands prior donning and after doffing of PPE was significantly higher in COVID-19-wards. However, the adherence on COVID-19-wards clearly failed 100 per cent.

Zusammenfassung Ziel der Studie Die COVID-19 Pandemie hat erhebliche gesellschaftliche Auswirkungen. Die Transmissionsvorbeugung in der Bevölkerung beinhaltet u. a. das Tragen von textilen Mund-Nasen-Bedeckungen. Voraussetzung des Schutzeffekts ist der korrekte Maskeneinsatz, wobei Anwendungsfehler selbst unter medizinischem Fachpersonal beobachtet wurden. In der vorliegenden Arbeit wurde analysiert, welche Masken im öffentlichen Raum als Mund-Nasen-Bedeckung zum Einsatz kamen, ob der Einsatz korrekt erfolgte und welcher Art die beobachteten Anwendungsfehler waren. Methodik Es erfolgte eine prospektive Beobachtungsstudie in Bereichen, für die eine textile Mund-Nasen-Bedeckungspflicht nach der Coronaschutzverordnung NRW galt. Ergebnisse Zwischen dem 07.05.2020 und 13.05.2020 wurden 2721 Personen in maskenpflichtigen Bereichen beobachtet. Die Gesamtcompliance zu Mund-Nasen-Bedeckungen betrug 97,2%. Am häufigsten kam der chirurgische Mund-Nasen-Schutz (MNS) (44,9%) zum Einsatz, gefolgt von Stoffmasken (39,8%), FFP-Masken (7,1%) sowie Schals (5,4%). Keine Maske trugen 2,8% der Beobachteten. In 30,4% der Fälle wurde die Mund-Nasen-Bedeckung fehlerhaft getragen. Die häufigsten Anwendungsfehler fielen in die Kategorien „Maske unter der Nase getragen“ (41,4%) und „Nasenbügel nicht angepasst“ (20,8%). Der MNS wurden deutlich häufiger fehlerhaft eingesetzt als die übrigen Masken- Typen (p<0,001). Schlussfolgerung In der vorliegenden Untersuchung zeigte sich eine hohe Gesamtcompliance der Bevölkerung von 97% zum Einsatz von Mund-Nasen-Bedeckungen im Rahmen des COVID-19 Pandemie- Managements. Die Masken wurden in 30% der Fälle fehlerhaft genutzt. Hieraus ergibt sich die Notwendigkeit einer gezielten, intensivierten Wissensvermittlung zur Maskenanwendung an die Bevölkerung, die die beobachteten Defizite berücksichtigt.