Power Point Presentation Evidence Base Assignment

This presentation builds upon and utilizes information gathered and reported in the first two assignments (RUA). Suggestions for implementation of outcomes on preventing (HAIs) should clearly and delineate the following.

A) Measurable outcome 1 slide

B) Feasibility issues 1 slide

Strategies for the implementation of measurable outcomes

2 slides with speaker notes including in-text citations

1 Reference slide of both articles used.

Articles to be used are attached

ORDER CUSTOM, PLAGIARISM-FREE PAPER

Alcohol sanitizers have not been demonstrated to reduce hospital-acquired infections over handwashing alone in controlled, well- designed clinical studies. A major reason for this may be the failure of traditional alcohol sanitizers to provide any residual, or persistent, activity. Any lapse in hand hygiene protocol then leaves patients and staff open to transmitting pathogens. The purpose of the study was to determine whether a persistent sanitizer would reduce hospital-acquired infection in a hospital setting as compared to handwashing alone. Materials and Methods: A controlled, crossover study was conducted in three wards of a hospital over the course of three months. Two months were assigned as control periods, while the third month the test product was added. More than 6,000 patient-days were evaluated. Hospital staff were given a questionnaire to determine overall satisfaction with the product. The product used was a persistent, alcohol-based hand sanitizer (Zylast Antiseptic, 76% v/v ethyl alcohol) Results: Control data showed that the hospital had a standard hospital-acquired infection rate of 23.1% across the three wards. No hospital-acquired infections were reported during use of the Antiseptic. The product was well tolerated by the staff and improved skin condition. Conclusion: The Antiseptic was demonstrated to significantly (p < 0.0005) reduce the hospital-acquired infection rate as compared to handwashing alone and is well-tolerated in a healthcare setting. The novel, persistent product has the ability to significantly reduce hospital-acquired infection and improve patient care in medical facilities. Power Point Presentation Evidence Base Assignment

Key words: Hospital-acquired infection, benzethonium chloride, antiseptic, Zylast, nosocomial infection, persistent, hand hygiene

Introduction

Hospital-acquired infections (HAIs) are a serious danger to patients, particularly as a growing percentage of these infections are resistant to antibiotics (Hawkey and Jones, 2009). Between five and ten percent of patients admitted will acquire an infection while in the hospital (Centers for Disease Control and Prevention, 2002). The increased resistance to antibiotics has made treatment costs even higher; HAIs cause nearly 100,000 deaths annually in the United States, (Centers for Disease Control and Prevention, 2002) as well as 10% of admitted patients in developing countries (World Health Organization, 2013).

Much of the spread of nosocomial infection in hospitals is linked to a lack of compliance in hand hygiene. While the United States Centers for Disease Control (CDC) recommends handwashing for 1-2 minutes, multiple studies have shown that the actual duration among heathcare workers is often less than 15 seconds (Quraishi, McGuckin and Blals, 1984). Even with the presence of alcohol-based sanitizers in convenient locations near patient rooms and in hallways, compliance with hand hygiene is only 40% (Erasmus, 2010). Skin irritation from repeated washing or the drying of the skin with traditional alcohol-based sanitizers may play a large role in the failure to comply with hand hygiene protocol among healthcare workers, as nearly 85% of healthcare workers have reported dry, cracked, or irritated skin as the result of hand hygiene products (Centers for Disease Control and Prevention, 2002).

However, improvements in compliance with hand hygiene protocols do not necessarily result in a reduction in the rate of HAIs in hospitals. In one study, compliance improved from 38% to 69% as a result of introducing a hand sanitizer in addition to handwashing alone, but the authors concluded, ‘This improvement in the hand hygiene adherence rate was not associated with detectable changes in the incidence of healthcare-associated infection’ (Rupp, 2008). Another study monitored hand hygiene and pathogen transmission, concluding there was “no correlation between the transmission rates of nosocomial pathogens…and hand hygiene compliance” (Eckmans, Schwab et. al, 2006).

A major limitation of traditional alcohol-based sanitizers is the inability to provide persistent protection against transient germs; once the product evaporates, antimicrobial activity no longer exists (Centers for Disease Control and Prevention, 2002). In other words, hands can immediately become recontaminated when they come into contact with a surface containing bacteria or viruses, leaving patients unprotected when healthcare workers do not adhere to hand hygiene protocol. The United States Food and Drug Administration states in their Tentative Final Monograph, ‘Persistence, defined as prolonged activity, is a valuable attribute that assures antimicrobial activity during the interval between washings, and is important to a safe and effective healthcare personnel handwash’ (FDA, 1994).

For these reasons, multiple clinical studies have proven that the addition of a traditional, alcohol-based hand sanitizer does not reduce infection rates in hospital settings when compared to handwashing alone (Rupp et al, 2008; Parienti et al, 2002) and may increase the risk of infection for patients by up to 33.4% (Doebbeling et al, 1992; Larsen et al, 2005). Another study in long-term care facilities showed that facilities that relied on a traditional alcohol sanitizer were six times more likely to have a disease outbreak than ones that rely on handwashing alone (Blaney et al, 2011).

The purpose of this clinical study is to examine the ability of a novel hand sanitizer with persistent antimicrobial activity against transient bacteria to reduce the rate of infection in a hospital setting. The novel antiseptic product used in this trial has demonstrated rapid, broad-spectrum kill in the FDA-specified time-kill testing, showing an average reduction of >99.999% within 15 seconds of the 25 different microorganisms tested (Czerwinski et al, 2014). The active ingredients have been shown to persistently pass the Surgical Scrub test as well as the Healthcare Personnel Handwash Test as described in the FDA Tentative Final Monograph (Shintre et al, 2006). After being applied to human skin and allowed to dry in the in-vivo Cup Scrub test, the Antiseptic destroyed more than 99.9% of a transient pathogen (E. coli) on contact at 20 minutes, 1 hour, and 6 hours after application (BioScience Laboratories, 2014). In contrast, a standard alcohol sanitizer had no effect at any of the timepoints tested. The test product Power Point Presentation Evidence Base Assignment