IMPLEMENTACIÓN 1 Desarrollo del sprint

P81

Impact of social media campaign: 5th may global hand hygiene day

Tcheun-How Borzykowski, Ermira Tartari, Daniela Pires, Didier Pittet WHO collaborating centre for Patient Safety, Infection Prevention &Control, University Hospitals of Geneva, Genève, Switzerland

Correspondence:Tcheun-How Borzykowski

Introduction:Social media has emerged as a valuable tool engaging health care workers (HCWs) worldwide to celebrate the World Health Organization (WHO) SAVE LIVES: Clean Your Hands global annual campaign.

Objectives:To describe the impact of social media (especially Twitter) interventions in engaging HCWs to build a momentum on the annual WHO call for action to sustain hand hygiene (HH) improvements.

Methods:Each year the WHO SAVE LIVES: Clean Your Hands cam- paign launches a call for action with a different theme in response to the global burden of health care associated infections and antibiotic resistance. The campaign aims to raise awareness and bring HCWs together in support of HH improvement globally. A campaign toolkit is made available on the WHO IPC webpages with resources to be used from health care facilities and countries worldwide. Hashtags such as #safesurgicalhands, #safeHANDS are made available for use in social media during the campaign to encourage commitment and a global reach. Symplur.com was used to generate data from the Twitter platform and a marketing company provided a landing page to collect photos shared with the hashtag promoting 5th May campaign.

Results:The impact of social media has been unique and unprece- dented action has been reported. The safe hands campaign in 2015, using the hashtag #safeHANDS was a great success with a global reach of 55 million. The volume of conversations on the social net- works (especially Twitter) started growing from April 20 with a peak of 12’000 messages using the hashtag #safeHANDS on the 5th _of

May. More than 6,200 photos have been published on the photo wall and shared through Twitter and Instagram with the hashtag #safe- HANDS. The impact of the campaign has further increased, with an estimated reach of 98 million worldwide in 2016, from use of the #safesurgicalhands hashtag between April - July 2016. 15,000 photos have been shared. The campaign had a global impact with partici- pants across the world. 19,217 health care facilities from 177 countries have registered to support the 5th of May campaign.

Conclusion:The use of social media holds promise to maintain a global momentum around the annual HH campaign. This proved to be a unique platform allowing HCWs to connect and engage in real time on a global scale.

Disclosure of Interest

None Declared.

P82

Evaluation of the degree of compliance of hand hygiene recommendations in pediatric care areas of a third level hospital

Juan G. Mora Muriel, Ginger G. Cabrera Tejada, Carmen M. Benito Miralles, Marina D. C. Lopez-Bajoz Mesa, Victor M. Soler Molina, Patricia García Shimizu, Concepción García González, Jose Sanchez Payá

Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL - Fundación FISABIO), Alicante, Spain

Correspondence:Ginger G. Cabrera Tejada

Antimicrobial Resistance and Infection Control2017,6(Suppl 3):P82

Introduction:In our center, the Pediatric Care Areas (PCA) are among those with a higher Degree of Compliance of Hand Hygiene Recom- mendations (DCHHR).

Objectives: The objective of the present study is to evaluate the DCHHR, and the factors associated with it, in the PCA of a third level hospital.

Methods:Observational cross-sectional study of a surveillance pro- gram by direct observation of the DCHHR during the daily activity of the health workers during the years 2005-2016. The outcome variable is DCHHR, and as explanatory variables: Area of Pediatric Care, years, age, sex, estate and use of pocket size alcohol-based hand rub solu- tion (PAS). For the association study, the Chi-square test was used, and to quantify the magnitude of the association, the Odds Ratio (OR) was calculated with its 95% confidence intervals (95% CI). The adjusted OR was calculated using a logistic regression model. The level of statistical significance wasp<0.05.

Results:We analyzed a total of 8704 observations in which HH was recommended. The DCHHR was: 52.0% in Surgery, 73.8% in Oncol- ogy, 61.4% in Infants, 61.9% in Schoolchildren, 73.2% in Neonatology, 70.2% in ICU-Neonatal, 61.7% in ICU-Pediatric, 51.8% in ER, 63.0% in Hospital Day Oncology. The magnitude of the association with the DCHHR was: Oncology,ORa = 2.7(2.2-3.5); Infants,ORa = 1.5(1.2- 1.8); Schoolchildren,ORa = 1.5(1.3-1.9); Neonatology,ORa = 2.9(2.4- 3.4); UCI-Neonatal,ORa = 2.5(2.0-3.0);UCI-Pediatric,ORa = 1.5(1.2-1.8); Urgencies,ORa = 1.0 (0.8-1.3);Oncology-Day Hospital,ORa = 1.6(1.3- 1.9); Years(2009-2012),ORa = 1.2(1.0-1.3); Years(2013-2016),ORa = 1.1(1.0-1.3);Age(<35 years),ORa = 0.8(0.8-0.9); Gender(Male),ORa = 0.7(0.6-0.9); State(Nursing),ORa = 0.9(0.8-1.0); State(Nursing Assist- ant), ORa = 0.8(0.7-0.9); (Other),ORa = 0.3(0.2-0.5); use of PAS (Yes),- ORa = 2.2(1.9-2.4).

Conclusion:The DCHHR in PCA are among the highest of the center, being approximately 65%. The area of Oncology, Neonatology, ICU- Neonatal and the use of the pocket size alcohol solution for the accomplishment of the HH are the variables that, once adjusted by the rest of variables, greater magnitude of association have with the Degree of Compliance of Hand Hygiene Recommendations.

Disclosure of Interest

None Declared.

P83

Promotion of hand hygiene: the experience of asst Gaetano Pini-CTO

Antonio Piscitelli, Paola Navone

Orthopaedic Institute ASST Gaetano Pini/CTO, Milan, Italy

Correspondence:Paola Navone

Antimicrobial Resistance and Infection Control2017,6(Suppl 3):P83

Introduction:

Hand hygiene is the primary preventive measure in terms of cost- effectiveness of care-associated infections (CAI). In 2005, the WHO proposed the "Global Patient Safety Challenge" campaign, with the aim of reducing the overall incidence of CAI, through multimodal programs and strategies, interactive training tools and standardised methods for monitoring compliance.

Objectives:

On the basis of project Rimani, sponsored by the Health and Social Care Authority of Emilia-Romagna, the Orthopaedic Institute ASST Pini/CTO has implemented a project which seeks to increase compli- ance with hand hygiene by healthcare staff.

Methods:

A multidisciplinary work group was created to prepare the project doc- uments. Starting from 5th April 2015, twenty operational units were asked to produce information and training material. On 5th May, during a Conference, a committee selected the three best works. The material was distributed on a monthly basis to the various departments. In addition to the training, the specifically trained operators of the Medical Monitoring Department carried out direct hand washing tests, filling out appropriate checklists. Non-compliance relating to the technique recorded in 2014 and 2015 was compared and a statistical analysis was conducted using Student's t-test for paired data.

Results:

Three tests were carried out in 2014. 99 cases were monitored and 5 non-compliance cases reported concerning the execution of the pro- cedural steps, the running time and closing the tap with one’s hands at the end of the wash.

In 2015 two tests, involving 30 operational units, were carried out. 60 observations were performed, and no non-conformities emerged concerning the technique. Statistical analysis showed a significant re- duction between the 2014 and 2015 non-compliances (P= 0.000).

Conclusion:

The results obtained agree with the main findings in literature. The comparison between the 2014 and 2015 tests shows a trend im- provement in the wash technique. This confirms the effectiveness of a multidisciplinary approach and recognises the active and participa- tory involvement suggested by the WHO.

References

Nobile M.*, Conti C.**, Bastianelli A.*, Piscitelli A.°, Calori G.M.*, Navone P.* * Orthopaedic Institute, ASST Pini/CTO, Milan, Italy

** Medicine and surgery, University of Milan, Italy

° Specialization School, Hygiene and Preventive Medicine, University of Milan, Italy

Disclosure of Interest

None Declared.

P84

Adherence and knowledge of hand hygiene in six acute care hospitals

Milena Sorrentino1, Gaetano Liotta2, ANNA RITA MARUCCI1, CARLA FERRARA1_{, GIOVANNI GALEOTO}1_{, SALVATORE MORETTA}2_,

JULITA SANSONI1

1_{SAPIENZA UNIVERSITA' DI ROMA, ROMA;}2_{ASL CASERTA, CASERTA, Italy}

Correspondence:Milena Sorrentino

Antimicrobial Resistance and Infection Control2017,6(Suppl 3):P84

Introduction:Safety care is crucial in health care during economic constrain and rationalization of resources. Interventions to identify gaps between evidence based nursing/medicine and clinical practice are necessary. Multidrug resistant microorganisms, requires strategies for infection control (IC). Hand hygiene (HH) is one of the best prac- tice to control germs or bacteria spread.

Objectives:The aim of this study is to evaluate adherence and know- ledge of healthcare professionals (HCPs) in an acute care hospital in order to correct bad practices.

Methods: The sample of the study is represented by HCPs of six acute care hospitals in southern Italy. The framework is supported by the social cognitive theory. A validated questionnaire was used to in- vestigate HH beliefs, practices and knowledge. Ethical issues were considered for the study. Data were processed in SPSS.

Results: Out of the 716 HCPs respondents to the questionnaire, 86% considered HH an important measure for hospital acquired infection control. Some critical issues emerged: only 39% (P< 0,0001) of HCWs consider themselves at risk of contracting an in- fection, 55% they claim to wash their hands before preparing in- fusion therapy and only 42% always wash their hands before contact with the patient.

Our sample has demonstrated a poor knowledge how correctly use alcohol based solutions, only 20% HCPs it does not use the alcohol solution if your hands are visibly dirty. Low adherence emerged mainly linked to overcrowding and excessive workloads.

Conclusion:The results of this study show a lack of knowledge re- garding the use of alcoholic solution by HCPs making it essential in the short term the implementation training events. Current and fu- ture implications should concern changing practice environments that will take into consideration not only multimodal interventions for HCPs but also organization and structure in order to increase ad- herence and impact on patient safety. Limitations of this study are self-assessment with a possible overestimation of the data and sam- ple isolation since the case of hospitals owned by a single health institution.

Disclosure of Interest

None Declared

P85

Evaluation of compliance with 'bare below the elbows' policy on the correctness of hand hygiene in medical staff of polish healthcare facilities

Emilia Szumska1, Dorota Rozkiewicz2, Elzbieta Oldak2, Michal Zablocki1

1_{Medilab Sp. z o.o.;}2_{Medical University, Bialystok, Poland}

Correspondence:Emilia Szumska

Antimicrobial Resistance and Infection Control2017,6(Suppl 3):P85

Introduction:In the last decade it is important to pay attention to 'bare below the elbows' (BBE) dress code in medical staff exercising direct patient’s care.

Objectives: The aim of this study was to determine whether the medical staff was following the rules of BBE policy and how non- compliance with BBC rules affects hand disinfection correctness.

Methods:Directly after hand hygiene training session, we asked par- ticipants to disinfect their hands with alcohol-based preparation which is fluorescent under UV light. External observer noted if every member fulfilled the rules of BBE: short sleeves, no watch, no jewelry, unpainted nails, no artificial nails. Otherwise, received the informa- tion about following aspects: gender, job seniority, occupation, place of work. This study comprised 4202 people; 72,1% > nurses, 27,9% physicians. Among of them 3762 were working in hospital, 343 in clinic and 97 in long term care facilities.

Results: BBE compliance was observed in 2227/4202 (53%) of em- ployees, statistically significant more often in nurses (1676/3031;55,3%) in comparison to doctors (551/1171; 47,1%) (p = 0.0000). The same correlation was showed in all of the analyzed medical facilities. Among the doctors, the job seniority did not influence on frequency of BBE compliance (<10 years-51,7%, >10 years- 48,3%; p = 0.2523), whereas nurses working >10 years presented BBE compliance deter- mined at level 77,4%. Only in 24,5% (135/551) physicians with BBE and 26,9% (451/1676) nurses with BBE incorrect hand disinfection procedure was showed. The group of No BBE was represented by 47% (1975/4202) of all employees. Artificial nails and rings were ob- served statistically significant more often in group of nurses in com- parison to physicians (45,2% and 32,1% vs3 3,7% and 26,5%; respectively). Doctors statistically more often wore watches (44,0% vs 21%) and sheets with long sleeves (48,7% vs 16,8%) (p < 0.05) than nurses. In group of No BBE, 43,3% represents improper procedure of hand hygiene.

Conclusion:It was found that compliance with BBE policy has a close relationship to proper hang hygiene performance.

Disclosure of Interest

None Declared

P86

Effect of the world health organization multimodal hand hygiene improvement strategies on healthcare associated infections prevalence in 14 tertiary hospitals in Malaysia

Suraya A. Husin1_{, Yew Fong Lee}1, 2_{, Noor Amelia Abd Rashid}1_,

Affaf Azizan1, Puteri Fajariah1, Nor Farah Bakhtiar1, Suhaily Othman1, Rohana Omar1

1

Ministry of Health, Kuala Lumpur, Malaysia;2Institute of Global Health and Infection Control Program, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland

Correspondence:Yew Fong Lee

Antimicrobial Resistance and Infection Control2017,6(Suppl 3):P86

Introduction:In 2005 the World Health Organization (WHO) launched the First Global Patient Safety Challenge,“Clean Care Is Safer Care”, with the objective to reduce Healthcare Associated Infections (HCAI) and cross transmission of antimicrobial resistant (AMR) pathogens. On 15thMay 2006, Malaysian Minister of Health pledged and signed a statement of commitment towards this First Global Patient Safety Challenge and has since adopted the WHO’s multimodal HH im- provement strategies.

Objectives:To assess the trend of HH compliance rate after the im- plementation of WHO’s multimodal HH improvement strategies and to associate the trend of HH compliance rate with the trend of HCAI prevalence rate in Malaysia.

Methods: 14 public state hospitals (tertiary hospitals) throughout Malaysia were involved in the WHO multimodal HH improvement strategies implementation. The strategies were based on WHO’s rec- ommendation that included ‘adoption of alcohol based hand rub’,

‘education’, ‘surveillance’, ‘facility improvement’, ‘reminders at work- place’,‘commitment from stakeholders’and‘leadership by example’. The trend of HH compliance and HCAI rates were obtained from 2008 to 2015. The HH compliance rates were measured quarterly using the WHO’s“Your 5 Moments for Hand Hygiene”audit tool. The HH opportunities observed for these hospitals were based on the

number of patient beds (range: 400 to 750 HH opportunities) for every quarter. The total HCAI rate and types of common infections were also observed six monthly throughout this 8-year period via a hospital-wide point prevalence survey.

Results: Overall HH compliance rate has shown gradual increment from 56.6% in 2008 to 79.8% in 2015. The HCAI prevalence rate over these years has progressively reduced from the baseline of 3.2 to 1.6 per 100 patients surveyed in 2008 and 2015 respectively. The 41% in- crease in HH compliance rate corresponded to the 50% reduction of HCAI prevalence rate.

Conclusion:The implementation of the WHO_’s multimodal HH im- provement strategies has successfully increased the HH compliance. The increased HH compliance was associated with the reduction of HCAI prevalence in Malaysia.

Disclosure of Interest

None Declared

P87

Hand Hygiene Self-Assessment Framework (HHSAF) survey of 23 hospitals in Sarawak, Malaysia

Yew Fong Lee1,2, Suraya A. Husin1, Walter Zingg2, Hock Hin Chua3, Mary W. Ago3_{, Fatin A. Ibrahim}3_{, Loke Meng Ong}1_{, See Yin Wong}3_,

MaryLouise McLaws4, Didier Pittet2

1_{Ministry of Health, Kuala Lumpur, Malaysia;}2_{Institute of Global Health}

and Infection Control Program, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland;3_{Sarawak General Hospital,}

Kuching, Malaysia;4University of New South Wales, Sydney, Australia

Correspondence:Yew Fong Lee

Antimicrobial Resistance and Infection Control2017,6(Suppl 3):P87

Introduction:Located in South-East Asia, Sarawak is one of a Malay- sian state of Borneo with 2.6 million population whose income is middle to high. In March 2017, 23 public healthcare facilities in Sarawak participated in a survey to monitor the World Health Organization (WHO) Hand Hygiene Self-Assessment Framework (HHSAF).

Objectives:To obtain a situation analysis of HH promotion and prac- tices within an individual health-care facility; to reflect the existing re- sources and achievements in HH.

Methods:The state of Sarawak offers a total of 3978 patient beds with one ID physician for the state and 38 IPC nurses (1 per 105 beds in average). Infection control professionals from 23 public health care facilities were invited to email their HHSAF survey results to the state IC unit. Based on the facility’s score, it is allocated to one of the four levels of progress within the HH improvement continuum.

Results: Of the 23 surveyed public healthcare facilities, four were major specialist hospitals, five minor specialist hospitals, 11 non- specialist hospitals and three special care institutes (psychiatric, lep- rosy and heart). The overall mean score indicated an advanced level of progress (score 434) as defined by the WHO HHSAF. Most facilities were at intermediate (26%) or advanced levels (74%) of progress. The average score for leadership criteria in 17 advanced healthcare facilities was 17 (range: 9-20). 18% of the advanced level facilities did not qualify for the leadership level due to the lack of‘Reminders in the workplace’. The lowest mean score (score 333) was recorded in a non-specialist hospital while the highest was recorded in a major specialist hospital (score 498). The lowest scores were identified for the‘Institutional safety climate for hand hygiene’and the‘Reminders at workplace’.

Conclusion:The survey helps to ensure that the necessary infrastruc- ture is in place to allow health-care workers to practice HH. An in- novative state-wide hand hygiene poster competition will be held during in May 2017, in parallel to the WHO Hand Hygiene Day in healthcare (5thMay 2017); posters will be used as reminders in these facilities.

Disclosure of Interest

None Declared.

P88

Hand hygiene levels of Philippine Hospitals: an application of the World Health Organization (WHO) Hand Hygiene Self-Assessment Framework

Nicolo Andrei A. Añonuevo

INFECTION PREVENTION AND CONTROL, ASIAN HOSPITAL AND MEDICAL CENTER, Alabang, Philippines

Antimicrobial Resistance and Infection Control2017,6(Suppl 3):P88

Introduction:The caring hands of the healthcare workers play a sig- nificant role for the transfer of the opportunistic microorganisms, thus the development of HAIs. With this, the patient is at risk at the presence of a healthcare worker who should provide the best care.

Objectives:This study is a pilot attempt in the Philippines to deter- mine the level of compliance on hand hygiene based on the Hand Hy- giene Self-Assessment Framework of the World Health Organization.

Methods:This study utilized descriptive-evaluative, descriptive com- parative, and descriptive-correlational research designs and looked into the level of compliance to hand hygiene among the respon- dents using purposive sampling in NCR Philippines. Standard Hand Hygiene Self-Assessment Framework adapted from WHO was utilized on this study.

Results:Majority of the respondents were registered nurses with the Degree of Bachelor of Science in Nursing with 38 percent or 40 out of 106. In addition, based on category, majority of the respondents are full time Infection Prevention and Control Nurses with 71 percent or 75 out of 106 with length of hospital experience ranging from 1-5 years. Based on location, majority of the hospitals are located in Quezon City with 23 percent or 24 out of 106 and these hospitals are Level 3, General Hospitals with 30 percent or 32 out of 106. Majority of these hospitals are Philhealth accredited and privately owned with 69 per- cent or 71 out of 106.

The level of compliance to HHSAF in terms of System Change, Education and Training, Evaluation and Feedback, Reminders in Workplace, and In- stitutional Safety Climate is Intermediate Hand Hygiene Level which means that appropriate hand hygiene promotion and strategy is in place and hand hygiene practices have improved in most of the hospitals who participated on this study.