Specificity
Specificity is an important criterion in diagnostic procedures. Specificity indicates the percentage of people without an illness who are actually identified by a test as being healthy. If, for example, the test correctly identifies 99% of the healthy people, it has a specificity of 99%.
Sensitivity
Sensitivity is an important criterion in diagnostic procedures. Sensitivity indicates the percentage of people with an illness who are actually identified by a test as being ill, i.e. the test result is positive. If, for example, the test picks up 90 out of 100 people who have the illness, it has a sensitivity of 90%. The remaining 10% are so-called false negatives.
Aerosol
An aerosol is a mixture of a gas and microscopic particles from a liquid or a finely dispersed solid. Steam and smoke are aerosols, for example. Droplets that are released when someone coughs, sneezes or vomits form an aerosol in the air.
Coronaviruses
Coronaviruses belong to the family Coronaviridae and were named after their characteristic crown-shaped appearance (the Latin word “corona” translates as wreath or crown). The enveloped viruses cause various illnesses in humans, ranging from the common cold to dangerous or even potentially fatal diseases.
COVID-19
This is the term for the medical condition triggered by SARS-CoV-2. The symptoms are non-specific and are similar to influenza, including fever, dry cough, shortness of breath, muscle aches and fatigue, among other things. In rare cases, people may cough up blood or phlegm or experience headaches and diarrhea. Since the pathogens mainly cause inflammation of the lower respiratory tract and can cause pneumonia, COVID‑19 is described as a pulmonary disease.
Epidemic
A highly clustered, temporary occurrence of an infectious disease in a localized area.
Ethanol
Ethanol is a short-chain, water-soluble alcohol. Along with 1-propanol and 2-propanol, ethanol is one of the most important alcohols used in hand sanitizers. Ethanol is the only active ingredient that is effective against non-enveloped viruses when used in high concentrations.
FFP Classes
The FFP classes are part of a classification system for particle filtering half-masks that protect against particulate pollutants such as dust, smoke and aerosol. The abbreviation FFP stands for “filtering face piece”. The half masks are standardized according to EN 149 and are divided into the three protection classes FFP1, FFP2 and FFP3. The FFP class depends on the total leakage and the filtration of particle sizes up to 0.6 μm. The total leakage is caused by the filter passage and possible leaks at the nose, chin or eyes.
FFP1 Masks
FFP1 masks protect against non-toxic and non-fibrogenic dusts. The total leakage may not exceed 25%. The masks must capture at least 80% of airborne particles up to a size of 0.6 μm and may be used if the occupational exposure limit value does not exceed 4 times the concentration.
FFP2 Masks
FFP2 masks protect against solid and liquid harmful dusts, smoke and aerosols. The total leakage may not exceed 11%. The masks must capture at least 94% of airborne particles up to a size of 0.6 μm and may be used if the occupational exposure limit value does not exceed 10 times the concentration.
FFP3 Masks
FFP3 masks protect against toxic and harmful dust, smoke and aerosols. The total leakage may not exceed 5%. The masks must capture at least 99% of airborne particles up to a size of 0.6 μm and may be used if the occupational exposure limit value does not exceed 30 times the concentration.
Herd Immunity
Herd immunity means that an entire population is protected from a contagious disease as a high percentage of the population is immune to it, whether that be through infection or vaccination. This means that even individuals who are not immune are protected because the pathogen cannot spread.
Hydrophilicity
Hydrophilicity means water-receptive and describes the property of substances to dissolve or absorb water when placed in water or other polar substances.
Hygienic hand disinfection
Hygienic hand disinfection refers to applying a sanitizer onto the hands in order to eliminate the transient (volatile) skin flora. For this purpose, approx. 3 ml of alcoholic preparation is placed in the palm of a dry hand and rubbed in for 30 seconds. According to the Robert Koch Institute, hygienic hand disinfection is considered to be the most effective single measure for interrupting chains of infection.
Hand Disinfection
Hand disinfection is a procedure that reduces the number of pathogens on your hands by using hand sanitizers.
Chain of infection
The chain of infection describes the path of a pathogen from one host to another target organism.
Contact infection
Contact infection is the transmission of pathogens through direct physical contact (touch, injury, sexual contact, infectious droplets) with an infectious living organism.
Log10 Units
A log10 unit is a unit for measuring germ reduction by one power of ten.
MERS
MERS (Middle East Respiratory Syndrome) refers to an infection of the respiratory tract. The infection is triggered by the MERS coronavirus (MERS-CoV), which was identified for the first time in 2012. Healthy people usually only display mild, flu-like symptoms. However, particularly in people with chronic, pre-existing health conditions, very serious and sometimes fatal respiratory diseases may occur. Infections with MERS-CoV were predominantly reported in Saudi Arabia and other countries in the region. Dromedary camels are considered to be the reservoir of infection.
Pandemic
A pandemic is the transnational, worldwide spread of an infectious disease with high morbidity rates.
RNA
Ribonucleic acid (RNA) is a nucleic acid found in the cells of all living organisms. As an information carrier, RNA plays a vital role in converting genetic information into proteins.
SARS-CoV-2
In the past, coronaviruses sometimes have led to dangerous diseases such as Middle East Respiratory Syndrome (MERS) or Severe Acute Respiratory Syndrome (SARS). The novel coronavirus, which has been spreading since December 2019 and causes pneumonia, was named SARS-CoV-2 in February 2020 due to its close relationship to the SARS virus.
Droplet Infection
Droplet infection is the transmission of pathogens via small droplets that are released when someone speaks, coughs or sneezes and then these are inhaled by other people.
Viruses
Enveloped viruses have a lipid membrane, such as. B. HBV, HCV, HIV and influenza viruses. The lipid membrane of enveloped viruses can be destroyed by alcohols such as ethanol or 2-propanol. Enveloped viruses are more unstable to disinfectants than non-enveloped viruses. Enveloped viruses can be killed with disinfectants that have a limited range of virucidal activity.
Bare viruses have no lipid membrane. Enveloped viruses include, for example, enteroviruses, noroviruses, rota and adenoviruses. Unwrapped viruses are more stable against disinfectants than enveloped viruses. They can be killed with disinfectants that have a virucidal spectrum of activity.
Virucidal
The virucidal efficacy spectrum describes the effectiveness against enveloped and non-enveloped viruses.
The limited virucidal efficacy spectrum refers to the effectiveness against enveloped viruses. These include the new Coronavirus, SARS-CoV-2, as well as the human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV).
The limited virucidal PLUS efficacy spectrum refers to the effectiveness against enveloped viruses as well as the non-enveloped noroviruses, rotaviruses and adenoviruses.
The efficacy spectrum was introduced in 2016 in addition to the previously known virucidal efficacy spectra and limited virucidal agent. Disinfectants from the category limited virucidal agent PLUS inactivate all enveloped viruses as well as the non-enveloped noroviruses, rotaviruses and adenoviruses.
Noroviruses, rotaviruses and adenoviruses often cause outbreaks in hospitals, nursing homes and also in public institutions. Noroviruses, rotaviruses and adenoviruses belong to the group of non-enveloped viruses, but are easier for disinfectants to inactivate compared to other non-enveloped viruses due to their lower hydrophilicity.
WHO
The World Health Organization (WHO) was founded on April 7th as a specialized agency of the United Nations with its headquarters in Geneva. 194 countries are members of WHO, which coordinates international public health and global health issues on behalf of the United Nations. The WHO is tasked with developing and defining globally applicable norms and standards for areas relating to health, as well as unifying these and implementing them across the world. Important fields of action include the global coordination of national and international activities against communicable diseases such as AIDS, malaria, SARS and influenza, the initiation of global vaccination programs and activities against health risk factors such as smoking or being overweight.
The WHO employs more than 7,000 staff and is divided into 6 regions, each of which is managed by a Regional Office. The highest decision-making body of the World Health Organization is the World Health Assembly (WHA), which meets every year in Geneva.
Source:
Bundesministerium für Gesundheit. https://www.bundesgesundheitsministerium.de/service/begriffe-von-a-z/w/weltgesundheitsorganisation-who.html.
Hygienemanagement
03.11.2021
Hand Hygiene Lessons Learned
COVID-19 has increased the willingness of employees to practice hand hygiene in health institutions. Much remains to be done to ensure that this trend continues and also results in falling infection rates, even after we’ve moved past COVID-19.
The most important facts:
- The increase in hand hygiene compliance at the start of the pandemic was a temporary phenomenon. The high compliance rates dropped again over time.
- The highest rates are recorded AFTER contact with a patient and are mainly driven by the desire to protect oneself rather than to protect patients.
- Gloves and long-sleeved clothing are important barriers to achieving good hand hygiene.
- Intervention programs to intensify hand hygiene are more efficient and sustainable than the threat of COVID-19.
100% hand hygiene compliance. What experts around the world hardly think possible has become reality at the National University Hospital in Singapore: Influenced by COVID-19, the staff’s willingness to disinfect their hands, which was already very good at 85%, rose to 100%. The largest hospital in the country, with 1,800 beds, evaluated the data both by measuring how much disinfectant was used and also by directly observing all “5 Moments for Hand Hygiene.” Several studies report increased hand disinfection rates among hospital staff in the early stage of the pandemic.
From a standard procedure to a daily habit?
Could hand hygiene, a standard procedure, have become a daily habit that people do without thinking thanks to the COVID-19 pandemic? According to the studies, the picture is rather mixed. In some studies, hand hygiene increased significantly at the start of the pandemic, but then decreased again and often even settled at a rather low level. It’s also worth comparing the moments when hand disinfection is carried out. From September 2019 to November 2020, Huang et. al investigated hand hygiene compliance in an infectious disease ward with 25 single rooms using an electronic monitoring system with a sensor. Time points for observing compliance were when entering the room, when providing care at the patient’s bedside and when leaving the room.
Patient protection was not the main focus
The authors found that the rate of hand hygiene upon entering the room, interpreted as the “before patient contact” moment, decreased over time. Compliance when leaving the room, interpreted as the “after patient contact” moment, increased by 13.73% during the first wave of COVID-19, decreased by 9.87% during the post-lockdown period, and then increased again by 2.82% during the second wave of the pandemic. The authors believe that the most important factor in the increase in hand hygiene was the employees’ desire to protect themselves from infections. Marie Stangerup’s team found out that the compliance rate is falling again despite the fact that the pandemic has not been declared over: A research team from Denmark conducted an observational study on a surgical ward between January 2019 and December 2020. One phase of the study consisted of an intervention program with employee meetings and presentations and discussions of anonymous hand hygiene compliance data. The analyses showed that hand hygiene compliance was at 58% during the intervention program that was run prior to the pandemic but dropped to 34% during the pandemic.
Conclusion:
Interventions and feedback remain indispensable tools to ensure that improvements in hand hygiene do not drop again. Employees quickly fall back into old routines as soon as intervention programs are stopped. On top of this, to ensure a high level of hand hygiene compliance, the management teams must remain committed to the issue of hand hygiene.
TIP: To achieve good hand hygiene, the basic conditions must also be right: Studies show that there is still room for improvement when it comes to placing dispensers at the point of care.
Checklists: Proper placement of dispensers at the point of care
1.) Dispenser placement in the OR
2.) Dispenser placement in the ER
3.) Dispenser placement in ICU
4.) Dispenser placement in General Wards
Sources:
Huang F et al. (2021) Journal of Hospital Infection 111: 27.-34
Moore LD et al. (2021) American Journal of Infection Control 49: 30−33
Stangerup M et al. (2021American Journal of Infection Control 49: 1118-1122
Thomas BW et al. (2009). JAOA; 109 (5): 263-267
Azim S et al. (2016). American Journal of Infection Control; 44 (7):772-776
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