Effectiveness of Hand Hygiene Promotional Program based on the WHO Multimodal Hand Hygiene Improvement Strategy, in Terms of Compliance and Decontamination Efficacy in an Indian Tertiary Level Neonatal Surgical Intensive Care Unit

Methicillin-Resistant Staphylococcus aureus Carriage among Neonate Mothers, Healthcare Workers, and Environmental Samples in Neonatal Intensive Care Units: A Systematic Review

“…Most of the studies were based in high-income countries (9 out of 16) and located in Europe (4 out of 16) and the Western Pacific Region (3 out of 16) ( Figure 2 and Table S3 ). HCWs were the most studied group (8 out of 16) [ 29 , 31 , 34 , 35 , 39 – 41 , 44 ], followed by environmental samples (6 out of 16) [ 30 , 32 , 35 , 37 , 38 , 43 ] and neonate mothers (4 out of 16) [ 31 , 33 , 36 , 42 ]. The reasons for testing for MRSA colonization in the included studies vary significantly, ranging from routine surveillance to specific medical interventions and responses to identified issues, such as pre- and posthand hygiene interventions, cleaning measures, admission due to preterm birth, and responses to ongoing MRSA detections in neonates.…”

“…Two German studies conducted in February-August 2010 and 2016 found a proportion of 1.25% (95% CI: 0.15-4.44) and 1.56% (95% CI: 0.19-5.53), respectively [ 39 , 41 ]. In India, a study conducted between July and August 2013 among general doctors and nurses tested MRSA prevalence pre- and posthand hygiene intervention [ 44 ]. Before handwashing, 9 out of 34 participants (26.47%, 95% CI: 12.88-44.36) were found to be colonized with MRSA.…”

Current approaches for preventing environment-associated contamination in healthcare facilities: a systematic literature review by open access database

“…Another system developed combines fans with germicidal filters that were installed in hospital lighting to improve the air quality of hospitals [ 39 ] Need to think about mitigation measures for COVID-19 beyond those depending on human behaviour (minimise time exposed to the virus, social distancing, and wear personal protection equipment). An example is the use of far-UVC lighting to disinfect in-room air that has proven effectiveness [ 42 , 45 ] Need to carry out assessments based on existing recommendations, guides, protocols, and tools to ensure hand hygiene, healthcare facilities hygiene, water quality, sanitation, organisation management, among others Layout and spatial organisation [ 47 ] Environmental design strategies can play a significant role in infection prevention and control. They can reduce problems related to poor isolation of the infectious ward; absence of spatial isolation of patients with COVID-19 from others; long-distance between essential parts; problems with the main entrance, waiting rooms, and emergency department; lack of vertical and horizontal circulations to transport patients with infectious diseases; lack of social distancing measures; improper clothing isolation and disinfection of equipment; inadequate resting places and eating conditions for treatment staff; among others [ 48 ] In general, safe measures adopted in COVID-19 pandemics decrease the perception of teamness and depending on how the changes are implemented, teamwork could be sacrificed [ 49 , 50 ] Need to balance face-to-face (physical visibility) and virtual service (telemedicine) and to study how isolation and reduced contact with family members or healthcare professionals impact the patients [ 50 ] Telemedicine allows for greater flexibility and resilience in the hospital environment [ 51 ] Possibility of using CFD simulations to properly organize the layout of environments, considering the effect of fans, air conditioners, and openings on aerosol contamination [ 46 ] Importance of coordinating the flow and the movements, the management of waiting, the materiality of the waiting room (layout, design, and furnishing), and questions related to the air, among other things, to prevent cross-infection and antimicrobial resistance Air curtain and air purification [ …”

“…This information is essential to environments where it is not possible to use other security measures, such as adequate ventilation, social distancing, among others. [45] evaluated and improved the hand hygiene of healthcare workers and the decontamination efficacy from a program based on the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy (MHHIS). An assessment of the Neonatal Surgical ICU infrastructure was done, along with some changes such as traditional to elbow-operated taps, display posters and reminders, training sessions, autoclaved single-use paper towels for hand drying, among others, that contributed to the result [45].…”

“…[45] evaluated and improved the hand hygiene of healthcare workers and the decontamination efficacy from a program based on the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy (MHHIS). An assessment of the Neonatal Surgical ICU infrastructure was done, along with some changes such as traditional to elbow-operated taps, display posters and reminders, training sessions, autoclaved single-use paper towels for hand drying, among others, that contributed to the result [45]. Similarly, Maina et al (2019) [42] assessed Water Sanitation and Hygiene (WASH) in 14 public hospitals in Kenya across four domains: organisation management, hygiene, sanitation, and water, creating and using the WASH Facility Survey Tool (WASH-FAST) that is based on WASH Facility Improvement Tool (WASH-FIT) of WHO and United Nations International Children's Emergency Fund (UNICEF) [42].…”