Patient Safety and Infection Control

ORIGINAL ARTICLES
	Objective assessment of hand hygiene: When we see it, we believe it!	p. 67
	Shikha Ranjan, Dhivya Venkatesan, Ramya Devi DOI:10.4103/jpsic.jpsic_10_18   Background: Hand hygiene is the fundamental and leading measure to prevent the spread of antimicrobial resistance and to reduce hospital-acquired infections. Several strategies are recommended to increase the compliance for hand hygiene practice; however, health-care worker (HCW) compliance with optimal practices remains low in most settings. Aim: This study aims to assess the efficacy of hand hygiene practice in HCWs at our hospital, and to demonstrate objective result of their practices, followed by a questionnaire-based study to assess their attitude towards hand hygiene, and effect of workshop on their hand hygiene practice pattern.Materials and Methods: Participants were asked to disinfect their hands using a hand rub solution mixed with the fluorescent dye. Photos were taken under an ultraviolet lamp. A self-designed questionnaire was given to all the participants. Results: A total of 94 HCWs participated in the hand hygiene workshop. Only 11.11% nurses (6/54) and 17.5% doctors (7/40) were able to use disinfectant solution with complete coverage of hand areas. Incomplete coverage of dorsum of hand was more common than that of palms. About 84.21% doctors (32/38) and 80% nurses (36/45) wanted to participate in such hand hygiene workshop in future with majority of them opting for frequent workshop. All the participants admitted that such workshop changed their attitude towards their practice pattern. Conclusion: It is important to carry out hand hygiene training programmes regularly to achieve increased compliance with hand hygiene practices. This study also emphasises that an objective technique of demonstration has a greater effect in changing professional's attitude towards hand hygiene.
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	An analysis of health economics related to hospital-associated infections: A prospective case–control analysis of 7-year data from a tertiary referral corporate hospital in India	p. 73
	Murali Chakravarthy, Raj Gore, Navin Yellappa, Antony George, Sukanya Rangaswamy, Rajathadri Hosur, Sumant Pargaonkar, Chidananda Harivelam, Priyadarshini Senthilkumar, Tejaswini Saravanan, Suganya Arul Rose DOI:10.4103/jpsic.jpsic_20_18   Objective: Healthcare associated infections cause significant morbidity, mortality and escalation of cost of care. It is the responsibility of all concerned to work towards reducing this potentially preventable increase in morbidity, mortality and cost caused by healthcare associated infections. Such data in Indian subcontinent has been studied sparingly. The objective of this study was to understand the degree of the cost escalation, morbidity and mortality associated with healthcare associated infections. Design: This prospective case controlled observational study was carried out from the year 2007 onwards. All the infections that occurred unto 2014 were included. Cost, morbidity and mortality of two similar matched controls for each infected case were chosen.Setting: Tertiary referral hospital. Participants: All patients with healthcare associated infections and twice that number as control. Interventions: None. Main outcome measure: Escalation of cost, morbidity and mortality due to healthcare. Results: There were five hundred fifteen infections during the study period. The escalation of cost due to infection was $ 4611. The mean mortality in the infected group was 8.75% in contrast to 2.5 in the non infected group. The mortality due to central line associated blood stream infection and ventilator associated pneumonia was more than 30% each. The length of stay in the intensive care unit was 8 days in the infected group in contrast to 2.27 days in the non infected group. Length of stay in the hospital was 33.5 days in the infected patients in contrast to 10.3 days in the non infected group. Conclusions: Healthcare associated infections caused escalation of cost, length of stay in the intensive care unit and hospital. Mortality in the infected cohort was more in contrast to the controls.
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	A cross-sectional pilot survey of sharp injuries among dental students in a tertiary care dental hospital in Lucknow, India	p. 78
	Rhythm Bains, Vivek K Bains, Reema Kumari DOI:10.4103/jpsic.jpsic_22_18   Aim: This study aims to estimate the frequency of sharp injuries among the post-graduate and undergraduate dental students and evaluate their knowledge regarding the needle-stick/sharp injuries, proper handling and disposal of sharp waste. Methodology: A written questionnaire containing questions regarding frequency of sharps injury, source of injury, status of immunisation and knowledge regarding handling and disposal of sharps waste was personally distributed to the participants and collected on the same day. Informed consent was obtained from the participants, and the purpose of the study was explained to them. The data obtained was statistically analysed. Percentage distribution of responses for Bachelor of Dental Surgery (BDS) and Master of Dental Surgery (MDS) students was recorded. Furthermore, the comparison of responses for BDS and MDS was analysed using the t-test. Chi-square test was used to find the significance difference between responses by BDS and MDS students. Results: The results of the present questionnaire study revealed that 38.5% (10/26) post-graduate students and 37.2% (16/42) undergraduate respondents had a history of sharps injury (P = 0.917). Most common reason for the injury among post-graduates was recapping of needles 84.6% (22/26) followed by endodontic instruments 11.5% (3/26) and use of probes/explorer 3% (1/26). Among the undergraduates, the most common source of injury was again recapping of needles 97.7% (42/43), followed by endodontic instruments 2.3% (1/43). Conclusion: Both undergraduates and post-graduates reported with history of sharps injury, though the difference among them was not significant. Needle-stick or sharps injury can prove to be fatal, and as dental students have an early clinical exposure, they should be trained early in their curriculum regarding correct disposal and handling of sharps.
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	A study of microbial flora of mobile phones used by health-care professionals in a tertiary care hospital in North India	p. 83
	Gurjeet Singh, Raksha Singh DOI:10.4103/jpsic.jpsic_19_18   Context: Mobile phones give all the advantages to its users but it also acted as a house for harbour the bacteria and causing health hazard that should not be over looked. Aim of study was study the prevalence of bacterial and fungal pathogens on mobile phones and their identification. Aims: 1. To study the prevalence of bacterial and fungal pathogens on mobile phones. 2. Identification of bacterial and fungal pathogens to species level.Settings and Design: The study was conducted in the Department of Microbiology, N. C. Medical College and Hospital, Israna, Panipat. Methods and Material: A total of 100 mobile phones were randomly sampled with sterile moistened swabs from doctors, nurses, laboratory technicians and attendants working in the hospital on the days of sampling. Statistical Analysis Used: Statistical analysis was done using SPSS 20.0 v. Descriptive analysis was done to estimate the percentage of microorganisms and Chi Square test was done to assess the difference in proportions. Level of significance was taken at p<0.05 Results: Total 100 mobile phones of health care professional were swabbed to check microbial flora harboured on mobile phones. Out of 100 mobile phones 79 (79%) were found with contaminated with microbial flora. Conclusions: Mobile phones may act as carrier for cross contamination among patients and dental personnel. Simple cleaning with isopropyl alcohol reduced the microbial load of the cellular phones. Hence it is recommended that dental colleges should develop strict guidelines concerning cell phone use and hygiene.
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PERSPECTIVE
	Needle-stick injury: A perspective	p. 90
	Padma Srikanth, Yazhini Ravi, Shyamala Mani DOI:10.4103/jpsic.jpsic_16_18
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LETTER TO EDITOR
	ABC's of hand hygiene: An aid to improve adherence	p. 93
	Chepsy C Philip, Shilpa Abraham, Amrith Mathew, M Joseph John DOI:10.4103/jpsic.jpsic_21_18
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