Clean Care is Safer Care

Case study

Queen Giovanna - ISUL University Hospital, Bulgaria

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Submitted by:

Professor Nassya Hadjieva
Microbiology Department, Queen Giovanna - ISUL University Hospital,
Sofia, Bulgaria

What type of health-care facility or organization are you?

Queen Giovanna - ISUL University Hospital, situated in Sofia, Bulgaria.

What was the situation at your facility with respect to hand hygiene and HAI before you initiated the hand hygiene initiatives?

In our hospital, medical and non medical workers discuss many problems concerning health care-associated infections (HCAI) with the microbiology department. Hand hygiene is the cornerstone of infection prevention policy and there is a video lesson for infection prevention by rational hand washing models.

We survey HCAI, multidrug resistant bacteria such as MRSA, MRSE, ESBL producing Escherichia coli and Klebsiella pneumoniae, Pseudomonas spp. and Acinetobacter spp.

The hospital departments are supervised by hospital inspectors (epidemiologist, IC doctors and IC nurses) to improve hand washing techniques and to reduce HCAI.

A monthly bulletin with HCAI data in the hospital departments is prepared.

What were the goals of your initiative?

The goal was to improve hand hygiene methods with implementation of new disinfectant and supplies. The video lessons targetted different departments in the hospital (ICU, surgical, pediatrics). Medical personnel and children (with their parents) from the Child Oncology Department were all target groups.

What actions have you planned or already put in place to improve hand hygiene at your facility?

Video lessons were prepared for visitors, health care personnel, students and patients showing hand hygiene techniques. The video lessons were in PDF format and had many pictures and illustrations. The lessons are planned every Monday with IC nurses.

Did you encounter any particular problems while planning and implementing your strategy?

The key barrier was the lack of awareness about the importance of hand hygiene in the community.

What were the outcomes of your initiatives?

Data from the hospital microbiology laboratory shows that S. aureus isolation rates from personnel’s hand cultures decreased from 10% to 6%.

What were your key learning points?

Boxes are placed in the hospital for feedback from visitors, patients and health-care workers. The feedback will be used to inform action plans for the next years.

What are your future directions?

The hospital plans to continue hand hygiene education for patients, visitors to the ICU and oncology departments and for new personnel. The programme is to be introduced to all hospital departments. New video lessons on microbiology for non-specialists, such as how "good" and "bad" bacteria work are also planned.