Becker's Clinical Quality & Infection Control

23 INFECTION CONTROL & PATIENT SAFETY Are Hospital Sinks Doing More Harm Than Good? By Heather Punke H and hygiene is undeniably an essential element in any hos- pital infection control and prevention program. However, according to a STAT piece, sinks may actually be aiding in the spread of infection. First off, the water coming out of the sinks can be contaminated with bacteria. One clinician from Canada shared an anecdotal story of an infection outbreak eventually tied back to sinks in the intensive care unit — the sinks' faucets sent water straight down the drain, causing tiny drops of water to splash up into the air and on porous surfaces nearby, thereby spreading bacteria and causing infections. "Some of the stuff we've learned … is: Don't have the gooseneck [faucet] drain directly into the drain; have it drain off to the side of the bowl. Don't allow it to splash. Make sure it's deep enough that it can't splash on you and splash on your clothing. Make sure that the stuff around [the sinks] is waterproof," Michael Gardam, MD, director of infection control at Toronto-based University Health Network, told STAT. Beyond bacteria in the water, the other main infection control prob- lem with sinks is that their pipes and plumbing are the perfect place for bacteria to grow into biofilms. "Once you have the biofilms there, short of ripping the sinks and the piping out, it's impossible to get rid of," Alex Kallen, MD, who is with the CDC's division of healthcare quality promotion, told STAT. He did note it is yet unknown what role these biofilms can play in spreading infections, however. Because of issues inherent with sinks, many healthcare providers are turning to alcohol-based hand sanitizers to clean their hands instead. e CDC recommends healthcare providers use hand sanitizer in- stead of soap and water in most instances. In fact, it says to use hand sanitizer except in the following situations: • When hands are visibly dirty • Aer treating a patient with known or suspected exposure to Clostridium difficile or if the facility is experiencing an outbreak • Aer treating patients with known or expected norovirus • Aer known or suspected exposure to Bacillus anthracis • Before eating • Aer using a bathroom n Successfully Choosing New Hand Hygiene Products: 4 Key Points By Heather Punke H ospitals consider changing hand hygiene prod- ucts for a variety of reasons, including the oppor- tunity to upgrade the quality of soap or sanitizer while saving money or finding a product compatible with new electronic dispensers. But finding the right prod- uct can be a daunting task, especially when guidance is scarce. An article in the American Journal of Infection Control rec- tifies that issue, as infection control professionals from a Canadian hospital outlined key steps to a successful hand hygiene product switch. Here are four of those steps. 1. Evaluate available options. The authors recommend using the following criteria to find the right product: qual- ity, safety, serviceability, standardization, cost, availability of touch-free dispensers and capability of dispensers to interact with electronic hand hygiene compliance mon- itoring. "Touch-free dispensers are generally preferred by staff and have been shown to improve hand hygiene compliance," the authors wrote. 2. Connect with a GPO. Group purchasing organiza- tions are mainstays in the hospital supply chain arena, and GPOs tend to have researched and reviewed several products before making them available on their contract. Hospitals should connect with their GPO early in the pro- cess to ensure no delays in planning or implementation. 3. Gain stakeholder input. Change isn't always easy, but it can be easier when stakeholders feel involved in the process. "Eliciting product selection input from various stakeholders upfront will help to assure the success of the process and is known to assist in driving overall hand hygiene practice and compliance once implemented," according to the article. Stakeholders include infection prevention personnel, point-of-care staff, the installation company, the hand hygiene product vendor, housekeep- ing staff, facilities management staff, purchasing depart- ment and the GPO. 4. Map out dispenser locations. "In a facility with a significant footprint, meticulously mapping dispenser lo- cations is very important for keeping the project on track," the authors wrote. "A multidisciplinary approach, directly involving front-line staff, to analyze workflow patterns on a unit-by-unit basis is best in order to guide safe and convenient product placement and will ultimately assist in driving hand hygiene compliance." n The CDC recommends healthcare providers use hand sanitizer instead of soap and water in most instances.

• Cover