Identifying the World Health Organization’s fifth moment for hand hygiene: Infection prevention in the operating room

Abstract

Background: The World Health Organization have designed the fifth of their ‘5 moments’ for hand hygiene to account for microbial transfer from patients to equipment in a narrow area around that patient, known as the patient zone. The study was prompted by emerging local confusion about application of the patient zone in the operating room (OR). Aim/Objectives: In two phases, we aimed to create a ‘5 moments’ style poster displaying an OR patient zone: phase 1, quantify equipment, in direct contact with the patient and, touched by non-scrubbed staff immediately after touching the patient; and phase 2, categorise equipment identified in phase 1 into patient zone and healthcare zone. An objective is to produce a ‘5 moments’ poster for the OR. Methods: The first phase used non-participant direct overt observation. In phase 2, phase 1 data were collaboratively assigned to patient zone or healthcare zone. Photography and graphic design were used to produce the OR ‘5 moments’ poster. Results: In 11 full-length surgeries, 20 pieces of equipment were in direct contact with the patient and 57 pieces of equipment were touched. In phase 2, a ‘5 moments’ poster showing an OR patient zone was designed. Discussion: Content of the patient zone was identified and displayed in a novel resource. Having shared understanding of the patient zone has potential to sustain hand hygiene compliance and equipment cleaning in the OR. Conclusion: Limitations in methods were balanced by collaboration with frontline staff. The study has been used as a teaching tool in the OR and similar settings.

Infection Prevention and Control practices; an exploratory qualitative study of experiences of health care providers and support staff at the University Teaching Hospital, Lusaka, Zambia

“…Application of the IPC guidelines developed by the Centre for Disease Control for reducing HAI form the basis for preventing transmission of micro-organisms within a hospital facility [1, 10]. Although the guidelines were not on site, participants for this study reported that they heard about IPC guidelines during their professional training and were familiar with them.…”

“…Application of the IPC guidelines developed by the Centre for Disease Control for reducing HAI form the basis for preventing transmission of micro-organisms within a hospital facility [1,10].…”

Hand hygiene in the operating room (OR)—(not) an issue?

“…Im Rahmen von Fortbildungen ist es wichtig, die Mitarbeiter bezüglich der Entwicklung eines Bewusstseins für Infektionsprozesse zu unterstützen, denn nur, wenn dieses Bewusstsein vorhanden ist, ergreifen sie selbstständig spezifische Schritte, um eine Infektion zu verhindern. Zum einen sind dazu Händehygienefortbildungen erforderlich, da das vermittelte Wissen das individuelle Verhalten der Mitarbeiter maßgeblich beeinflusst und existierende Wissenslücken geschlossen werden können [ 14 ]. Zum anderen kann eine Verhaltensänderung aber auch durch ein Feedback zur HHC und zu den Infektionsraten unterstützt werden.…”

Ophthalmology Consultation Plan in the Context of 2019-nCoV

“…Most ophthalmic operations are not general anesthesia, patients can continue to wear surgical masks during the operation; if it is general anesthesia, it is recommended to place a disposable filter between the tracheal intubation and the breathing circuit to reduce the pollution of the breathing circuit, the anesthesia machine Strictly disinfect after use ( 20 ).…”