Authors (including presenting author) :
Lee WM(1), Yip PY(1), Leung SY(1), Pilta K(1), Anita N(1), Mabel SCW(1), Jacqueline EL(1), Mable K(1), Maisie K(1), Josephine L(1), Chan CY(1), Chow CY(1)
Affiliation :
(1) Department of Paediatrics and Adolescent Medicine
Introduction :
Early 2020, a serious Methicillin-resistant Staphylococcus Aureus (MRSA) outbreaks in neonatal intensive care unit (NICU) occurred. The unit was overwhelmed by the speedy spread of MRSA in the cluster of NICU patients. Alarmingly, it has been the second time of MRSA outbreaks in recent 3 years. The definite route of transmission could not be clearly identified. In order to rectify the infection risks, a workgroup comprised of Nurses, doctors and representative from hospital infection control team as advisor was set up to explore the areas for improvement, a multidimensional approach for prevention and control infection was implemented, the theme of 4M1E (Man, Machine, Material, Method and Environment) was applied to make improvement.
Objectives :
1.) to identify the infection risks by analysis of the possible risks in 4M1E dimentions 2.)to develop a comprehensive guidelines in prevention and control infection 3.)to establish structural monitoring system in early identification of infection risk and staff compliance in infection prevention practice and make timely improvement 4.)to enhance environmental cleanliness
Methodology :
1. staff engagement in participate in the environmental cleanliness such as, standardization of storage setting, streamline all the storage and tidiness of patient bed unit including well-defined clean zone and patient zone 2. parents engagement in maintaining environmental cleanliness through education and involving them to perform bed unit hygiene 3. facilitate staff to perform hand hygiene by installation of easy-to-access hand rub in all working areas e.g. every bed unit and working table, consumble cupboards, mobile trolley, entrance of the ward area 4. establish patrol system to perform safety round, a well designed checklist was developed as tool 5. standardization of environment setting , routine disinfection round , role delineation in routine cleansing and clear workflow 6. enhance staff awareness through education and training
Result & Outcome :
Possible risk factors of nosocomial infection in the unit could be identified, namely, over-crowded patient environment, not standardization in all the patient area and storage set up, lapse in hand hygiene, lack of effective monitoring system and routine cleansing routine etc. The ward patrols system effectively identified the lapse area in infection control practice and reinforce staff compliance promptly. Environmental cleanliness could be sustained. Regular hand hygiene surveillance reflected good compliance.
