Let’s keep Delta a safe environment: how disinfection & hygiene is ensured throughout the hospital Dr Yves De Gheldre Laboratoire de microbiologie Equipe Opérationnelle d’Hygiène Hospitalière ospital Group
INTRODUCTION ➢ How is hygiene achieved throughout the hospital ospital Group
INTRODUCTION ➢ Patient ✓ Prevention, management and control of infection ➢ Environment ✓ Cleaning procedure ✓ Air managment ✓ Environment microbiological controls ➢ Material ✓ Disinfection, sterilization, single use ✓ Microbiological controls ➢ Hospital linen & dishes & wastes ✓ Cleaning procedure ospital Group
HCW Patient Material Environnement Linen Dishes Wastes ospital Group
CHIREC – SITE DELTA ospital Group
CHIREC – SITE DELTA Presentation ➢ 104.000 m² ➢ 8 floors (3 with care units) ➢ 577 beds (63% single rooms) ➢ 28 operating rooms ➢ 18 intensive care beds ospital Group
CHIREC – SITE DELTA Presentation ➢ 23.500 standard admissions in 2018 ➢ 26.000 one-day admissions in 2018 ospital Group
CHIREC – SITE DELTA Presentation ➢ ~ 410 HCW ➢ ~ 450 doctors ✓ 49 specialities ✓ 49 x n procedures … ospital Group
Hygiene organization and Hospital Hygiene Operationnal Team ospital Group
HH-AR du 26 avril 2007 Defines ➢ Composition of hygiene comity ➢ Missions of HC ➢ Working of HC ➢ Responsabilities of HC ➢ Funding of HH ospital Group
HYGIENE COMITY CHIREC ➢ 3 local HC (1 HC/site) and 1 global HC ospital Group
HYGIENE COMITY CHIREC ospital Group
HYGIENE COMITY CHIREC How does it work ➢ 4 meetings/y for each HC ➢ EOHH ➢ Application of national and international recommendations ➢ Information to the HCW ➢ Continuous education ✓ HCW (meetings and Intranet support) ✓ HC members (congres and locoregional hygiene plateforms) ➢ External and consequently internal control via quality/performance indicators (audit) ➢ MDRO national and consequently local surveillance ospital Group
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IQ Results 2017 86/100 ospital Group
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INFORMATION CHIREC INTRANET ospital Group
Prevention Patient Control Management ospital Group
PATIENT ➢ Prevention of nosocomial infections / Health Care Associated Infections ✓ Basic hygiene procedures ✓ Specific hygiene procedure ✓ Control emergence of MDRO ✓ Control acquisition/spread of MDRO ospital Group
BASIC HYGIENE PROCEDURES ospital Group
SPECIFIC HYGIENE PROCEDURES Care bundles
SPECIFIC HYGIENE PROCEDURES Care bundles ospital Group
PREVENTION / CONTROL / MANAGMENT OF MDRO ospital Group
MDRO Multi Drug Resistant Organism ➢ MRSA ➢ VRE ➢ BSLE ➢ CPE ospital Group
Carbapenemases (VIM, NDM, OXA-48, ..) ESBLs (CTX-M, TEM, SHV, ..) Penicillinase Wild type (TEM-1, SHV-1) 2000 1970 1990 1940
MDRO PREVENTION Management of antimicrobial policy ➢ MRSA ➢ VRE ➢ BSLE ➢ CPE
MDRO CONTROL Detection of carriers / Isolation ospital Group
MDRO CONTROL Detection of carriers / Isolation ospital Group
MDRO CONTROL STOP P to P SPREAD ospital Group
MDRO MANAGMENT Health care (Kine, Rx) ➢ Stop isolation procedure ➢ Transfer ➢ Rest house ➢ At home ➢ Family ➢ Local statistics ➢ AB resistance ✓ Nosocomial acquisition ✓ Epidemics if any ➢ Obligatory national recording ➢ ospital Group
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P 25 < Delta < P 50
Cleaning Environment Air Controls ospital Group
HYGIENE & DISINFECTION OF THE ENVIRONMENT n = 65 workers ospital Group
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HYGIENE & DISINFECTION OF THE ENVIRONMENT ospital Group
EUROPEAN STANDARDS ospital Group
EVERYWHERE EXCEPT ➢ Operating room ➢ Intensive Care Unit ➢ Emergency ➢ AMP EOHH defines products ➢ Neonatal Care Unit Dedicated mops & wipes Single use mops & wipes ➢ « Infected room » ➢ Epidemic ospital Group
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BELGIAN STANDARDS ospital Group
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Disinfection Material Sterilization Single use Controls ospital Group
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Linen Dishes Waste ospital Group
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CONCLUSION 2.97 ETP ospital Group
CONCLUSION Hygiene is a continuous process requiring all HCW and occuring in a multi process world ospital Group
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