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Infection Control Experts Debate the Advances in Antisepsis and How They Will Benefit Patients
be increasingly inclined to seek information about the risks and Educating patients through clear information should be essential, with
consequences of HCAIs and will expect healthcare professionals to include practical information being provided about the most suitable products
instructions about self-help measures they can undertake before admission for whole-body washing, where to obtain such products and how to use
to hospital to reduce the risks of HCAIs. Staff who work in pre-surgical them effectively.
assessment clinics are ideally placed to undertake this work.
As can be seen from the comments made by Dr Rowland Hill, moderator
From discussions during the second and third round table meetings, it of all three round table meetings, this remains an area for further thought
was agreed that well-controlled clinical trials need to be undertaken as a and action. “Infection prevention and control activities have to be
priority to establish whether whole-body washing effectively reduces the embedded into everyday practice and applied consistently by everyone. A
number of colony-forming units on the skin and/or surgical site combined approach to the issue may be what is required from healthcare
infections. It was also agreed that it was essential to ensure that all health professionals, to not only agree on best practice, but also to agree on
workers recognise that skin is a source of pathogens and that practical educational materials that can be provided to the general public in
ways to reduce risks of infection should be sought. balanced and measured ways.“ ■
Finally, the round table discussions recommended that a debate on the The RSM Round Table Series will be available from January 2009. If you
role of whole-body washing should take place within the context of would like a free copy please contact
onhand@indigompr.co.uk or
patient choice, in line with current government policy in the UK.
4
natasha.quinn@molnlycke.com
1. Coia JE, et al., J Hosp Infect, 2006;63(Suppl):S1–44. 3. Merle V, et al., J Hosp Infect, 2005;60:169–71. chronic disease management in the 21st century, London:
2. Guinan M, et al., Am J Hosp Infect Control, 2005;33:E217. 4. Department of Health, The expert patient: a new approach to Stationary Office, 2001.
Recent Literature from the Round Table Experts
Choosing the Right Surgical Glove: Managing and Leading the Infection
An Overview and Update Prevention Initiative
Tanner J Pellowe C
Br J Nurs, 2008;17(12):740–44. J Nurs Manag, 2007;15(6):567–73.
This article provides an overview of the important role surgical gloves This article discusses the national response to health care-associated
play within surgical routine and updates the reader on recent infection and in particular the response of nurses to this significant
advances in materials and practice, in order to best prevent the two- threat to quality care. The article concludes that while health care-
way transmission of pathogens between surgical team and patient. associated infection remains a government priority, trusts will find it
The article provides information on latex-associated allergies, glove difficult to meet the demands of the Code of Practice and fulfill other
materials, gloving methods and glove protection, enabling government priorities. The implications for nursing management
practitioners to choose the most appropriate glove for them. ■ include that managers need to be aware of the extent of the problem,
its causes and the initiatives both nationally and locally to address the
Surgical Site Infection, Preoperative Body Washing situation so that they can maintain support for these initiatives. ■
and Hair Removal
Tanner J, Khan D Hand Hygiene Technique
J Perioper Pract, 2008;18(6):232, 237–43. Gould D, Drey N
This article discusses the prevalence of infection following surgery, Nurs Stand, 2008;22(34):42–6.
with estimates suggesting that one in 20 patients develop infection This article discusses the importance of good hand hygiene
following surgical procedure, costing the NHS approximately techniques, and the acknowledgement of such in current guidelines,
£1billion each year (SSHAIP 2004). The article discusses the most but conversely how they are seldom incorporated into research
common bacterial causes of surgical site infections and two practices studies and audits designed to increase compliance. The article
which aim to help eradicate them, preoperative body washing and concludes that as a result, numerous unanswered questions remain
preoperative hair removal. ■ concerning this aspect of hand hygiene. ■
Surgical Hand Antisepsis to Reduce Interventions to Improve Hand Hygiene Compliance
Surgical Site Infection in Patient Care
Tanner J, Swarbrook S, Stuart J Gould DJ, Drey NS, Moralejo D, Grimshaw J, Chudleigh J
Cochrane Database Syst Rev, 2008;(1):CD004288. J Hosp Infect, 2008;68(3):193-202.
This article primarily reviews the effects of surgical hand antisepsis on This article focuses on hand hygiene as the most effective method of
the number of surgical site infections in patients. Ten trials were preventing healthcare-associated infection but that ultimately health
included in this review, following an extensive literature and data search workers perform it poorly. The article discusses studies that have
by the authors. The article conclusions include that alcohol rubs are as investigated the effectiveness of interventions to increase hand
effective as aqueous scrubs and that there is no evidence to suggest hygiene compliance short and longer term and to determine their
that any particular alcohol rub is better than another. Some studies success in terms of hand hygiene compliance and subsequent effect
suggest that chlorhexidine gluconate based aqueous scrubs are more on rates of healthcare-associated infection. This review concludes
effective than povidone iodine based aqueous scrubs in terms of the that interrupted time-series studies may offer the most rigorous
numbers of colony forming units on the hands. There is no evidence approach to assessing the impact of interventions to increase hand
regarding the effect of equipment such as brushes and sponges. ■ hygiene compliance. ■
EUROPEAN INFECTIOUS DISEASE 109
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