search.noResults

search.searching

dataCollection.invalidEmail
note.createNoteMessage

search.noResults

search.searching

orderForm.title

orderForm.productCode
orderForm.description
orderForm.quantity
orderForm.itemPrice
orderForm.price
orderForm.totalPrice
orderForm.deliveryDetails.billingAddress
orderForm.deliveryDetails.deliveryAddress
orderForm.noItems
INF ECTION P R EVENTION


Urgent need to prevent aspiration risks


Elaine Waggott highlights the importance of reducing airborne pathogenic aerosol in the wake of COVID-19 and considers the potential infection risks in hospital facilities.


In the wake of COVID-19, the importance of reducing airborne pathogenic aerosol has been the subject of very high levels of public, media and Government attention. Unacceptable levels of sickness and deaths have become associated with poor hand hygiene, close contact with infected people and inadequate cleaning. In many countries, initiatives addressing education, cleaning and audit, together with compulsory reporting of infections, have brought about benefits leading (in some cases) to the reduction of headline rates of infections, such as methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile (C. difficile) and Legionnaires’ Disease. It is readily accepted now, that a common mode of transmission is contact between the patient, the staff and the environment. Inappropriate hand hygiene practice has been identified as a significant contributor to numerous outbreaks. Several studies have shown the impact of improved hand hygiene on the risk of healthcare-associated infection and multi-resistant pathogen cross-transmission. To date, most studies have focused on methicillin resistant Staphylococcus aureus.


Bacteria present on human skin can be considered as belonging to one of two groups: resident and transient flora. Transient flora colonises the superficial layers of the skin. It has a short-term persistence on skin, but a high pathogenic potential. It is usually acquired by healthcare workers during direct contact with patients or contaminated environmental surfaces


SEPTEMBER 2020


Example of an Angel Guard washbasin designed to limit the risk of aerosol and splashing.


adjacent to the patient and is responsible for most healthcare-associated infections and spread of antimicrobial resistance resulting from cross-transmission. Resident flora is attached to deeper skin layers and has a low pathogenic potential unless introduced into the body by invasive devices. It is also more difficult to remove mechanically. Hand hygiene decreases colonisation with transient flora and can be achieved either through hand washing or hand antisepsis.1 Studies have shown that outbreaks can be reduced by improved hand hygiene compliance and better cleaning of the environment. Transmission of infection by the air has often been less well investigated, leading sometimes to a complacency in this mode of transmission.


It has been proven already that Norovirus can be transmitted by aerosol and is difficult to contain in a hospital ward without sufficient single rooms with en-suite toilets. Now with the additional battle against COVID-19, the transmission by aerosol now needs to be urgently considered and the risks substantially reduced.


Although the direct transmission from


infected person/s is the primary source of aerosols and droplets, other scenarios such as medical procedures, surgeries2


,


fast-running tap water and toilet flushes3 also generate aerosols contaminated with infectious pathogens. The most common types of viruses causing infections in the respiratory tract through aerosol transmission are influenza viruses, rhinoviruses, coronaviruses, respiratory syncytial viruses (RSVs), and parainfluenza viruses.3,4


Three


modes in which the influenza virus can be transmitted have been postulated: aerosol transmission, droplet transmission, and self-inoculation of the nasal mucosa by contaminated hands.2 Historically, natural ventilation was seen to be beneficial in hospital wards and was part of hospital design. With the advent of sealed high-rise buildings and forced ventilation, expensive negative pressure rooms have sometimes been introduced to house patients with infections thought likely to be transmitted by aerosol.


Aerosols can be defined as liquid or solid


particles suspended in the air by humans, animals, instruments, or machines.


WWW.CLINICALSERVICESJOURNAL.COM l 33





Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56  |  Page 57  |  Page 58  |  Page 59  |  Page 60  |  Page 61  |  Page 62  |  Page 63  |  Page 64  |  Page 65  |  Page 66  |  Page 67  |  Page 68  |  Page 69  |  Page 70  |  Page 71  |  Page 72  |  Page 73  |  Page 74  |  Page 75  |  Page 76  |  Page 77  |  Page 78  |  Page 79  |  Page 80  |  Page 81  |  Page 82  |  Page 83  |  Page 84  |  Page 85  |  Page 86  |  Page 87  |  Page 88  |  Page 89  |  Page 90  |  Page 91  |  Page 92