Implementation of multiple rehabilitation strategies to manage the outbreak of Candida Auris in hospital setting

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Abstract Description
Submission ID :
HAC1290
Submission Type
Authors (including presenting author) :
Wong HY (1), Mok YT (1), O HH (1), LEUNG YYC (1)
Affiliation :
(1)Physiotherapy Department, Princess Margaret Hospital
Introduction :
Candida Auris (C.Auris) is a multidrug-resistant infection and places a great threat to hospitals in case of outbreaks. Since 2019, Lai King Building (LKB) ward R5N has converted to isolation ward receiving C.Auris patients. Decolonization was regularly performed and rehabilitation was carried out to infirmary cases twice weekly and medical cases daily during weekdays. Besides, in view the outbreak of the C.Auris in LKB R4N in March 2022 and in Yan Chai Hospital (YCH) in September 2022, most of the infected cases were transferred to LKB R4N for isolation. To manage the C.Auris outbreak these years, multi-disciplinary contributions are needed. As a result, this article aims to introduce the inputs of physiotherapy department in Lai King Building in preventing further spreading of the fungal infection.
Objectives :
To evaluate the effectiveness and feasibility of the infection control measures in physiotherapy department in rehabilitation to C.Auris infected patients.
Methodology :
Infection Control Measures:
1. To assign and provide infection control measures training to designated professional staff and supporting staff work in ward R4N and R5N.
2. Designated staff has to wear working clothes while performing rehabilitation to C.Auris cases.
3. To perform rehabilitation to cases in the order from non-infected cases to equivocal cases to infected cases in R4N and R5N.
4. To disinfect equipment before and after use with Tristel Fuse by supporting staff.
5. Strictly complied with the hand hygiene measures.
6. To perform audit of infection control measure by experienced physiotherapists.

Rehabilitation Measures:
1. To purchase new sets of rehabilitation equipment to ensure no shared use between non-infected, equivocal and infected patients. The equipment was stored in designated area assigned by ward.
2. Despite the infirmary setting of R4N and R5N, we adjusted our service provision to perform active rehabilitation to medical cases transferred from YCH. These patients were included in 365 program (weekend and holiday rehabilitation program) of stroke rehabilitation and will be the last attended cases at weekends.
3. Despite the suspension of main gym and mini gym training, we located some indicated equipment such as motomed, static bike and electrical stimulation to ward. Rehabilitation training would be done at bedside instead.
Result & Outcome :
1. Experienced physiotherapist conducted one audit to staff working in R4N during the outbreak period. There were no reported violation of infection control measures.
2. During the surveillance period in R4N from 18/03/2022 to 18/07/2022, there were no reported violation of infection control measures by infection control nurses concerning staff from physiotherapy department. The outbreak was under control in August 2022 with no further newly detected infected patients.
3. There were 10 involved staff in designated team and they have completed the staff feedback questionnaires. All of the respondents showed satisfaction on the infection control measures and showed confidence in performing the inflection control measures. The results of the questionnaires were shown in Appendix I.
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