Becker's Clinical Quality & Infection Control

Infection Control 10 Study: Don't Wash Hands Before Donning Gloves Study: Obesity Linked to C. diff Infection Risk By Ellie Rizzo E By Ellie Rizzo ngaging in hand hygiene before donning nonsterile gloves does not reduce bacterial counts on gloves, rendering that hand hygiene step unnecessary, according to research published in the American Journal of Infection Control. eing obese may increase the risk of developing a Clostridium difficile infection, according to research published in the Centers for Disease Control and Prevention journal, Emerging Infectious Diseases. B Researchers collected bacterial samples before gloving and after gloves were removed from two groups of healthcare workers in contact isolation intensive care units. One group of workers put on gloves directly, while the other group performed hand hygiene before gloving. Researchers identified 137 cases of the infection between November 2011 and April 2012 at Boston Medical Center, a regional safety-net hospital. Patients with C. diff were classified as having either community-onset or hospital-acquired infections. Bacteria colony counts were no different between groups. Within the community-onset group, obese patients accounted for 34 percent of C. diff cases, statistically higher than the Massachusetts state obesity average, which is 23 percent. The study concluded hand hygiene before gloving as recommended by the World Health Organization lacks evidence for its utility.  n "Engaging in hand hygiene before donning nonsterile gloves does not reduce bacterial counts on gloves." 24% of Healthcare Workers Carry C. diff on Hands After Disinfecting By Akanksha Jayanthi E ven after rubbing hands with alcohol after caring for patients infected with Clostridium difficile, 24 percent of healthcare workers still carried spores of the bacteria on their hands, according to a study published in Infection Control and Hospital Epidemiology. In the controlled study, healthcare workers followed four infection control measures when coming into contact with patients with C. diff. They placed patients in single rooms, wore disposable floor-length, longsleeved gowns and gloves, followed hand hygiene practices before putting on gloves and after removing gloves, and cleaned patient rooms daily with hypochlorite-based disinfectant. Zero percent of healthcare workers who did not come into contact with C. diff patients had spores on their hands. Researchers suggest more information is needed to understand C. diff transmission to better implement additional antimicrobial stewardship efforts. n Those with community-onset C. diff after exposure to a healthcare setting had higher rates of irritable bowl syndrome and lower rates of prior exposure to antibiotics than patients with hospital-acquired C. diff, suggesting obesity is independently associated with the development of a C. diff infection. n Study: 57% of Hospitalists Forgot About a Catheter By Ellie Rizzo T he finding that 57 percent of hospitalists report having forgotten about the presence of a patient's peripherally inserted central catheter is one of several that outline the variation in hospitalist experiences with catheters in a paper published in the Journal of Hospital Medicine. Researchers surveyed approximately 400 hospitalists with an online questionnaire on hospitalist experience and practice surrounding PICCs. Other study findings include: E • ighty-six percent of hospitalists had placed a PICC solely for venous access. • ighty-two percent of hospitalists had cared for a patient who specifiE cally requested a PICC. T • wenty-five percent of hospitalists had examined a PICC for external problems. F • orty-two percent of hospitalists thought between 10 percent and 25 percent of PICCs in their hospitals might be inappropriately placed or avoidable. n

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