Becker's Clinical Quality & Infection Control

9 INFECTION CONTROL & PATIENT SAFETY Glove use may thwart hand hygiene, particularly among nurses By Megan Knowles T he use of examination gloves in hospitals may present a barrier to hand hygiene, especially among nurses, according to a study cited by Healio. According to the World Health Organization, ex- amination gloves should only be worn in certain scenarios, and hands should be washed before and aer putting gloves on. Evidence suggests inappropriate use of gloves was a significant cause of missed opportunities for proper hand hygiene in healthcare settings, the researchers wrote in Infection Control & Hospital Epidemiology. For the study, "hand hygiene performance of [healthcare professionals] providing hands-on in- patient care was measured by a validated observer using a 'secret shopper' method focused on wash- in and wash-out [hand hygiene] opportunities and instances where gloves were worn in lieu of [hand hygiene]," the researchers said. e researchers found hand hygiene compli- ance was about 74 percent for both wash-in and wash-out opportunities during the four-month study period, and the highest percentage of hand hygiene opportunities (41 percent) were per- formed by registered nurses, followed by licensed independent practitioners (16 percent), including physicians, physician assistants and advanced practice registered nurses. Forty-five percent of the wash-in episodes that lacked compliance with hand hygiene protocols were performed by registered nurses, and 44 per- cent of all wash-in episodes that lacked this com- pliance were performed by staff who wore gloves. ese episodes were seen more oen among registered nurses (47 percent), the study found. e researchers found several reasons healthcare professionals used gloves, such as protection and safety of staff and patients, availability of gloves and previous medical training. Hospitals may consider re-educating healthcare professionals about proper glove use and hand hygiene, the researchers said. n Machine learning can help predict hospital infection risk, study finds By Megan Knowles A machine learning algorithm can be used to predict patients' risk of contracting a potentially deadly hospital infection, according to a study published in Nature Communications and covered by Digit. The research team, which specializes in microbiology and genetics at Aalto University and University of Helsinki in Finland, developed a ma- chine learning algorithm by combining large-scale population genom- ics and measurements of relevant features of life-threatening bacteria that come from hospital bugs. The bacteria in the study, Staphylococcus epidermidis, are usually a part of normal human skin flora. They have recently become a key source of infections through indwelling medical devices and surger- ies like hip replacements. By using machine learning, the researchers successfully predicted patients' risk of developing an infection from the genomic features of the bacteria. The research is still in its beginning stages and could not determine whether all the members of the S. epidermidis population that colonize human skin asymptomatically can induce high-risk infections. However, the findings open a path for future technology to be included in infection diagnosis by identifying high-risk genotypes of bacteria during a patient's surgery. n Hand hygiene key to mitigating S. aureus transmission in the OR By Anuja Vaidya A study published in the American Journal of Infection Control ex- amined protocols for preventing the spread of Staphylococcus aureus pathogens in the operating room. Researchers from Iowa City-based University of Iowa Hospitals and Clinics identified and characterized the epidemiology of pathogenic S. aureus sequence types in the OR. They collected S. aureus isolates from three academic medical centers. Researchers found that S. aureus sequence type 5 is associated with in- creased strength of biofilm formation and increased risk of transmission and infection. The combination of ST 5 pathogenicity, an aging patient population and complex surgical procedures may explain the increase in the spread of antibiotic-resistant S. aureus pathogens in the community. They found patient skin surfaces and healthcare provider hands are sources of ST 5 pathogen transmission. Additionally, they found that OR environmental surfaces were linked with transmission. "The increase in the spread of S. aureus pathogens beyond the acute care setting is alarming, but we know that there are evidence-based practices that can address this critical patient safety issue," said Randy Loftus, MD, lead study author and an anesthesiologist at the University of Iowa Hospitals and Clinics. n

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