Authors (including presenting author) :
CHOW SM(1),AU-YEUNG YWA(1), WUT OL(1), KWOK HY(1)
Affiliation :
(1) Cardiothoracic Surgery, Queen Elizabeth Hospital
Introduction :
An 84-year-old male patient was transferred to Department of Cardiothoracic Surgery of Queen Elizabeth Hospital from other hospital on 16th September 2022. In routine screening, he was found to have Candida Auris in urine but without any signs and symptoms of infection. Although application of strict contact precaution to patients and staff were enhanced, most of the environmental screening shown being contaminated by Candida Auris leading to total 18 patients were infected. Therefore, ward H7 was closed for deep cleansing and disinfection for 2-week was done. Training for proper cleansing method and hand hygiene for all staff and continuous monitoring of cleansing technique of supporting staff were implemented to prevent further spread of the Candida Auris.
Objectives :
1. To prevent the spread of Candida Auris in clinical area
2. To ensure proper cleansing technique by supporting staff especially for high-touched area of furniture and equipment
3. To ensure the detergent and disinfectant dilution suggested by infection control team were strictly followed
4. To keep correct use of color-coded environmental cleansing equipment to prevent cross contamination
5. To enhance hand hygiene compliance among all staff
6. To improve the awareness of care of patient with contact precaution, e.g. proper use of PPE when necessary
Methodology :
1. Provide a 30-mins talk to supporting staff on • Cleansing of high-touched area of equipment and furniture • Specific instruction of the detergent and disinfectant dilution for Candida Auris in the clinical area • Correct use of color-coded environmental equipment • Proper hand hygiene technique
2. Use an environmental hygiene audit form from infection control team for in-house audit
3. Pre- test and post-test assessment
4. Enhance the cleanliness and tidiness in workplace by “5S” method
5. Use a “yellow card” to alert supporting staff which is “dirty item” used by patient and needs cleansing
6. Assess the cleansing technique by florescent stain UV assessment for each supporting staff on different equipment and furniture
7. Enhance hand hygiene audit on 5 moments
8. Patient cleansing and sampling chart was designed to ensure patient disinfection schedule was followed before routine Candida Auris screening was collected on time by nursing staff
Result & Outcome :
From 12/2022 to 1/2023, a total of 7 supporting staff were selected for the training. All of them are 100% passed the post-test after the training. The result showed that it is useful to use training system to enhance staff’s knowledge and followed by compliance checking record to assess the staff’s performance regularly. In conclusion, reinforcement of hand hygiene and proper cleansing techniques are the main strategy for minimize the risk of further outbreak in our department.
