Authors (including presenting author) :
Yeung KNK(1), Leung SSY(1), Yiu MF(1),Ho YC(1), Tam LC(1), Au Yeung W M (1), Heung KP(1),Lee SL(1),Look KC(1),Wan TC(1), Wong SC(1) Wong VSL(1).
Affiliation :
(1) Lai King Building (LKB), Department of Medicine & Geriatrics, PMH
Introduction :
Candida auris (C. auris) was a multidrug-resistant pathogen that will cause invasive infections, high mortality, widespread contamination, colonization among patients and health care workers and hospital outbreaks. LKB R5N was converted to admit C. auris patients in KWC since 23 Nov 2020.In order to provide standard infection control and prevent further outbreak of C auris, enhancement of infection control of Candida Auris was implemented.
Objectives :
To enhance Infection control measures in LKB in managing C. auris in LKB, below theme is focused.
1. Standardize infection control workflow
2. Environmental cleansing and disinfection
3. Staff support and monitoring 4. Nursing procedure workflows
Methodology :
Methodology
1.Surveillance & Cohort
1.1 develop workflows in admitting/transfer/discharge C. auris patients in LKB
1.2 Implement biweekly patient screening in all patients in LKB
1.3 Designated team include medical staff, PT, OT and nurse in cohort ward
1.4 Designated equipment for common shared items
1.5 Use disposable consumable
1.6 Use disposable bed mattress cover, pillow cover and shower bath trolley cover 1.7 Use color coding and signage for segregation
2. Enhance environmental cleansing and disinfection
2.1 Disinfect used equipment and environment cleansing by Trisel fuse 3 times per
day
2.2 Use UVDI disinfection to clinical area routinely and terminal disinfection
2.3 Installation of UV air disinfector
2.4 Supervision on environment and equipment cleaning procedure by environmental
sampling and fluorescent stain (UV) monitoring
2.5 Improve and sustain ward environment by 5S activity annually
3. Enhance Staff compliance on infection control
3.1 In-service training on Infection control on C auris by ICN to all discipline
involved
3.2 Reinforcement on hand hygiene (HH) with 5 moments and bare below elbow and PPE 3.3 Conduct (HH) slogan competition on 16-24 Jan 2021. Total 42 LKB staff
participated
3.4 Designated infection control patrol nurse to promote culture
3.5 Regular audit
3.6 Working clothes was introduced
4.Review nursing procedures workflows
4.1 Set up work group to revise workflows on 6 common nursing procedures,
4.2 Identify good practice nurse as trainer to promulgate the standard of practice
to all ward staff
4.3 Perform audit in each nursing procedure to ensure compliance in July 2022 – Feb 2023
Result & Outcome :
Gradually decrease in environmental contamination rate of C auris from 5.5% in 4Q 2020 to 4.88% in 20213Q. There is a significant improvement after review of 6 common nursing procedure with 0.57% in 3Q 2022.
Hand hygiene compliance rate increase from 88.92% to 93.05 from 2Q 2020 to 3Q 2022.
Significantly improve from 88.92% to 92.58% after hand hygiene slogan competition. Ongoing hand hygiene compliance is greater than 90%.
