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Hand Hygiene Rates Plummet When Staff Think No One's Watching

Your hand hygiene compliance rates may be lower than you've believed, for a simple reason. Ask yourself: Do your providers know when they're being watched?

Researchers at Santa Clara Valley Medical Center in San Jose, Calif., logged more than 4,600 observations in the second half of 2015. Observers consisted of 5 infection prevention nurses who were known to staff as well as 15 volunteers who were not. When providers knew they were being watched, their compliance rates were more than 30% higher than when they didn't.

"This was not a result that we expected to see," says Nancy Johnson, MSN, CIC, infection prevention manager at Santa Clara. "We have rolled out many changes as a result. Moving forward, the medical center's monitoring will be conducted by unknown observers."

The Santa Clara study was presented at this year's 43rd Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC).

Jim Burger

Study: General Anesthesia Safe for Young Children

You can administer general anesthesia to your littlest patients without fear of impacting their cognitive function later in life, according to a study published in JAMA.

Researchers identified 105 children younger than 3 years who underwent inguinal hernia repair, then later tested the children's IQ scores and neurodevelopmental abilities when they were between 8 and 15 years old — the age range when impairments related to anesthesia administration can become apparent. When the researchers compared the cognitive function of the children with a single exposure to anesthesia with similarly-aged siblings who were not exposed to anesthesia at any point in their lives, they discovered no difference in IQ scores and neurodevelopment between the groups.

"The potential neurotoxicity of anesthetic agents commonly used in general anesthesia has been one of the most pressing concerns in pediatric surgery in the past decade," says study author Guohua Li, DrPH, MD, a professor of anesthesiology at Columbia University's College of Physicians and Surgeons in New York City. "Our findings should be reassuring to millions of parents whose young children need to undergo surgical procedures under general anesthesia each year."

While the findings are promising, the study's authors cautioned that more research is needed to assess anesthesia's effects on young girls (most of the study's participants were boys), what repeated and prolonged exposure to anesthesia would do to young children and what effects of anesthesia might have on children with serious medical conditions.

Daniel Cook

Can UV Light Kill MRSA Without Harming Skin?

Ultraviolet (UV) light is known to kill drug-resistant organisms, but it is considered biologically harmful to human skin. A new study, however, has discovered that a narrow wavelength of UV light might be able to safely kill MRSA detected on a patient without damaging exposed skin.

Researchers at Columbia University Medical Center tested the particular wavelength, known as far-UVC light, on hairless mice, whose skin reacts similarly to humans' when exposed to UV rays. They found that far-UVC light could not penetrate through the outer, dead layer of skin to harm the live skin cells below, but it could penetrate and kill bacteria and viruses living on the skin. As a result, they theorize that the light could be used during surgery to help prevent SSIs.

"We've known for a long time that UV light has the potential to reduce surgical site infections, because UV can efficiently kill all bacteria, including drug-resistant bacteria and even so-called 'superbugs,'" says David J. Brenner, PhD, senior author of the study. "Unfortunately, it's not possible to use conventional germicidal UV light when people are around because it's a health hazard to patients and medical personnel."

"What we showed in our earlier work is that far-UVC light is as effective at killing MRSA as conventional germicidal UV light — and now with this new research, we have demonstrated that far-UVC kills bacteria but without risk of skin damage," he says.

Kendal Gapinski

InstaPoll: Local Anesthetics for IV Starts

Do you numb for needlesticks? The IV start is often the one thing that patients complain of most. Tell us in this week's InstaPoll what kind of local anesthetic you use — lidocaine, cream or spray — as a part of your IV start routine to reduce patients' pain and discomfort.

More than two-thirds (68%) of the 302 readers who answered last week's poll transport patients to the OR on a stretcher. More than one-fifth (21%) responded that patients walk back, presumably those having non-invasive procedures like cataract surgery or colonoscopy. The results:

How do you typically transport patients to the OR?

  • stretcher 68%
  • stretcher-chair 10%
  • wheelchair 1%
  • they walk 21%

Dan O'Connor

News & Notes
  • Michigan considers CRNA autonomy CRNAs working as part of a patient's surgical team would be able to administer anesthesia without an MD anesthesiologist's supervision under a bill approved by a Michigan senate committee this week. While state nursing and hospital groups praise the legislation's potential to increase rural patients' access to care, physicians warn that it puts patients at risk in the event of complications.
  • Listening to an injured knee The cracking and popping of a worn-down knee can offer clues to the extent of its damage and possible solutions, say engineering researchers from the Georgia Institute of Technology, who have developed a wearable technology to listen to these signals. A knee band equipped with miniature microphones and vibration sensors measures and graphs the sounds from inside, and could help physicians chart a course for repair and recovery.
  • Mandatory central sterile certification for Tennessee As of Jan. 1, 2017, sterile processing technicians in Tennessee will be required to attain occupational certification in order to get a job in clinical facilities. The requirement was passed by the state's legislature and signed into law this spring. Tennessee joins Connecticut, New Jersey and New York in mandating central sterile certification. A similar proposal is currently under consideration in Massachusetts.