Background
Method
Risk classification | |||||||
---|---|---|---|---|---|---|---|
variables | Hospital | NH^ | method | Outcome variable | Low | Intermediate | High |
Risk profile | |||||||
Severity of underlying diseases, according to the McCabe score | X | Prevalence survey (file research & interview) | The percentage per category is presented in the risk profile | N.A.& | |||
Independency scale according to Katz-score | X | Prevalence survey (file research & interview) | The percentage per category is presented in the risk profile | N.A. & | |||
indwelling medical devices, including venflon not in use | X | Prevalence survey (file research & interview) | Percentage (n=total number inclusions) | ≤ 15 | >15 and ≤50 | > 50 | |
X | ≤ 5 | >5 and ≤10 | > 10 | ||||
Antibiotic use | X | Prevalence survey (file research & interview) | Percentage (n=total number inclusions) | ≤ 15 | >15 and ≤50 | > 50 | |
X | ≤ 5 | >5 and ≤10 | > 10 | ||||
Rectal carriage of ESBL-Eǂ and CPEǂǂ | X | X | Prevalence survey (culture of faeces or perianal swab) | Percentage (n=total number patients of whom faeces was cultured) | ≤ 7 | >7 and ≤11 | > 11 |
Improvement plot | |||||||
Inappropriate use of medical devices | X | X | Prevalence survey (file research & interview) | Percentage (n=total number of patients with medical devices in use) | ≤ 15 | >15 and ≤25 | >25 |
Inappropriate use of antibiotics | X | X | Prevalence survey (file research & interview) | Percentage (n=total number of patients administered one or more antibiotics) | ≤ 15 | >15 and ≤25 | >25 |
Transmission of ESBL-E and CPE | X | X | Prevalence survey (molecular typing of ESBL-E and CPE) | Transmission = 2 or more identical ESBL-E and CPE with an epidemiological link | No transmission | No transmission | Transmission |
Hand hygiene non-compliance | X | Direct observations of hand hygiene moments per unit | % non-compliance overall (n>200 moments) | ≤ 40 | >40 and ≤60 | >60 | |
Environmental contamination | X | X | ATP detection on pre-defined surfaces/objects per ward. Per tested surface/object, RLU is converted to a score (1, 2, 3 or 4) | Total score per ward/setting (in case of multiple wards within 1 setting, breakpoints will be adjusted as needed) | ≤ 4 ≤ 3 | >4 and ≤12 >3 and ≤9 | >12 ZH >9 VH |
Shortcomings in infection control preconditions | X | X | 10 preconditions are observed per ward | Score from 1 to 10 | ≤ 1 | >1 and ≤3 | >3 |
Personal hygiene of healthcare workers | X | X | 20 nurses and other healthcare employees, per ward, were checked for compliance with the dress code. | Score from 1 to 20 (in case of less observations, breakpoints will be adjusted as needed) | ≤ 1 | >1 and ≤4 | >4 |
Risk profile
Improvement plot
Testpoints | Hospital | Nursing Home |
---|---|---|
Bedrail (twice, in two rooms) | X | X |
Over bed table | X | X |
Washstand | X | X |
Shower chair | X | |
Support bar in the toilet room | X | X |
Toilet seat (sitting area) | X | X |
Door handle nursing office | X | |
Patient alarm bell | X | |
I.V. pole (most frequently touched part of the pole) | X | |
Keyboard P.C. in the nursing office | X | X |
Telephone | X | X |
Control panel bedpan washer | X | |
Bedside commode | X | X |
Cabinet for medical supply & bandages | X | X |
Blood pressure cuff | X | |
Ear thermometer (ear tip) | X | X |
Glucometer | X | X |
Work surface of the bench for drug preparation | X | |
Keyboard computer on wheels (COW) | X | |
Table living room | X | |
Supply room “sterile” materials | X | |
Door handle living room | X | |
Patient lift, client handle | X |
Infection control preconditions | Hospital | Nursing Home |
---|---|---|
Trash bin(s) are closed and foot-operated (entire department) | X | X |
The (clean) linen is stored in a clean place, protected against dust and moisture | X | X |
The bed-pan washer meets the following requirement: Disinfection with steam or hot water of at least 80 ° C (for at least 60 s) | X | X |
Sterile medical devices (catheters, IVs) are kept in a closed cabinet | X | |
Sterile medical devices are kept separated in a closed cabinet | X | |
Medical supply and bandages are kept in closed cabinets | X | |
Needle waste container (UN3291) is presence | X | |
Halter aprons to protect clothing are present at the ward | X | X |
Surgical masks are present at the division | X | X |
Non-sterile gloves (NEN-EN 420 + A1, NEN-EN374, NEN-EN) are present in every patient room | X | |
Non-sterile gloves (NEN-EN 420 + A1, NEN-EN374, NEN-EN) are present in every ward | X | |
Hand alcohol (is present in every patient room and at point of care (EN1500) | X | |
No fabric chairs or benches are present in the patient and / or treatment room | X | |
No fabric chairs or benches are present in the common areas | X |
Infection control protocols |
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Accidental blood contact |
Collection and transport of waste and used linen |
Hand hygiene |
Pets (including assistance dogs) |
Infectious diseases healthcare workers |
Catheterization |
Legionella management plan |
Body care of the client |
Recommendation for prevention & control of influenza |
Recommendation for prevention & control of norovirus |
Recommendation for prevention & control of Scabies |
Recommendation for screening of Multi Drug Resistant Organisms (including screening of risk-population on admission#) |
Recommendation for prevention & control of MRSA (including screening of risk-populations on admission#) |
Storage of “sterile” materials |
Personal Protection Materials (PPM) |
Personal hygiene of healthcare workers |
Cleaning, disinfection and sterilization |
Administering medication |
Urination and bowel movement (defecation) |
Wound-care |