Question

 

Among post surgical Tesio catheter patients in the acute dialysis unit, does the implementation of traditional handwashing with soap and water, as compared to alcohol based hand sanitizers, help decrease the rate of SSIs?

What tangible and intangible resources will be needed to implement your project?

What improved outcomes do you anticipate will occur that could indicate the project produced a successful return on investment (ROI) of these resources?

How will you communicate your plan for change with key decision makers so that they will support the allocation of the resources you are seeking?

Answer 1

Decreased number of healthcare-associated infections are directly related to compliance to hand hygiene measures. There are many methods to reduce the nosocomial infections like SSIs in hospitals, they include the soap-and-water hand washing and rubbing hands with alcohol-based sanitizers. The lack of compliance with hand hygiene in healthcare settings is secondary to inconvenience, lack of time, and skin irritation. A method that can minimize the factors of noncompliance can decrease healthcare-associated infections. Implementation of a long-acting sanitizer may minimize the costs in comparison with other methods. Considering the costs of healthcare related infections the methods to improve hand sanitation is cheap.1

The alcohol-based solutions are rapidly effective and their easy accessibility at the bedside makes it an ideal substitute for traditional hand washing. Increased hand hygiene compliance minimizes the rates of nosocomial infection. In general alcohol-based solutions are better than the conventional hand washing. 2

The proper vascular access to provide good dialysis adequacy is essential to the success of dialysis. Adequate dialysis influences patient survival and morbidity. The durability and associated complications are the factors determining the successful use.3

In order to study the effectiveness of different hand sanitizing methods, a standardized research project is needed. The project report must be in detail and the prior approval should be obtained from the responsible authorities by providing the detailed report, including the methods in consideration, the monetary values, the testing methods, population under consideration etc. The cost of managing healthcare related infections are too high in comparison with the cost of methods to reduce the number of nosocomial infections. The project report should be communicated with all the details to the responsible authorities for its success.

1. http://www.woundsresearch.com/article/randomized-controlled-trial-antiseptic-hand-hygiene-methods-outpatient-surgery-clinic

2. Emmanuelle Girou, Sabrina Loyeau, Patrick Legrand, Françoise Oppein, Christian Brun-Buisson, Efficacy of handrubbing with the alcohol based solution versus standard handwashing with antiseptic soap: randomised clinical trial, BMJ. 2002 Aug 17; 325(7360): 362.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC117885/

3. NKF-K/DOQI Clinical Practice Guidelines for Vascular Access: update 2000. Am J Kidney Dis 2001; 37 [Suppl 1]: S137–S181