Authors (including presenting author) :
Wong NM (1), Lau KF(1), Ning KY (1), Ng CH(1), Lau WK(1)
Affiliation :
(1) Orthopaedics & Traumatology, Princess Margaret Hospital
Introduction :
Hospital-acquired Methicillin-Resistant Staphylococcus Aureus (MRSA) and Multi-Drug Resistant Organisms (MDRO) resulting in increased medical expenditure, poor patient prognosis and health status, longer length of stay in hospitals. Therefore, using several infection control measures is important to eradicate the rate of hospital-acquired MRSA & MDRO. Concerning the increasing rate of hospital-acquired MRSA and MDRO in wound specimen and environmental sampling in Orthopaedics & Traumatology Department in PMH from 2018 to 2019, the Continuous Quality Improvement (CQI) project on MRSA/MDRO reduction was held to improve current practice on wound care and environmental hygiene.
Objectives :
(1) To enhance current practice on wound care among nursing staff.(2) To improve environmental hygiene and hand hygiene in O&T department. (3) To reduce the rate of hospital-acquired MRSA/MDRO in O&T department in 2020. (4) To raise staff awareness on important of hand and environmental hygiene on prevention of MRSA / MDRO.
Methodology :
(1) Measures that focus on improving practice on wound care: (1.1) Designated a dressing trolley (with contact precaution signage) for contact precaution cases; (1.2) Instructed all staff to use Clinell universal wipes for cleansing the designated dressing trolley before and after use; (1.3) Designed new signage and poster to remind all staff to maintain good hand hygiene before taking out dressing materials. (2) Measure that focus on improving environmental hygiene: (2.1) Designed new poster in water dispenser to remind all staff and patient to perform hand hygiene before taking water; (2.2) Carried out environmental hygiene assessment by using UV powder in Aug 2020 and Dec 2020, areas to be assessed included all trolleys, dressing materials cupboard and water dispensers.
Result & Outcome :
After the CQI project, nursing staff are used to use the designated trolley for wound dressing for MRSA/MDRO patients and use Clinell wipes to clean the trolley.To evaluate the environmental hygiene, environmental assessment was conducted two times for comparison.The percentage of uncleansed area was 40% in the first assessment, whereas those was 10% in the second assessment. This indicated that there is improvement on staff habits on infection control and their awareness on environmental hygiene. Moreover, according to the reports from Infection Control Team in 2020, there were 18 cases of newly acquired MRSA, whereas there were 25 cases in 2019, the dropping rate was 28%. For the newly acquired MDRO cases, the numbers of case were similar in 3Q2019(9) and 3Q 2020(10).Finally, based on the above outcomes, it is concluded that this CQI project would contribute in reducing hospital-acquired MRSA/MDRO in O&T department.
