The Hygiene Forum, organized for the first time by the Aesculap Academy in February 2024, offered the 160 participants a range of topics from nosocomial infections and hand hygiene to surgical wound infections and infection prevention.
Dr. Georg-Christian Zinn from the Bioscientia Center for Hygiene and Infection Prevention in Ingelheim discussed the unfortunately still inadequate hand hygiene. The healthcare sector is still a long way from the desired compliance rate of 80 percent. Good hygiene has long been a clear competitive advantage. “In order for hygiene rules to be followed, they must be sensible, clearly defined, known, feasible, accepted and promoted by managers and cost-effective,” explained Dr. Zinn and recommended not to work with pressure and punishments, but to focus on training, observation and feedback, control mechanisms, clear written protocols and friendly reminders when mistakes are noticed.
A similar attitude was also taken by Dr. Kristina Böhm, Chairwoman of the Federal Association of Doctors in the Public Health Service (BVÖGD), with regard to hygiene during outpatient surgery (AOP). When it comes to AOP facilities, construction work is particularly a critical point. “Practice owners often don’t think about the hygiene requirements. Early involvement of the health authority before the building application is submitted can even save costs,” emphasized Dr. Boehm. In AOP facilities there is often a lack of space, but also a lack of knowledge of the extensive and sometimes difficult to understand legal requirements. Nevertheless, Dr. Böhm: “The outpatient practice owners are required to keep themselves up to date.”
Priv.-Doz. reported on the study situation on risk factors for nosocomial infections. Dr. Seven Aghdassi from the Charité Hygiene Institute. According to data from the Hospital Infection Surveillance System (KISS), men generally have a higher risk of wound infections, especially during orthopedic and abdominal surgery. Women, on the other hand, are at greater risk during heart surgery. There is also a clear connection between the length of time transurethral urinary catheters are in place and the risk of a urinary catheter-associated urinary tract infection (CAUTI). “The conclusion is not surprising or revolutionary: you should avoid long periods of time in which urinary catheters are kept,” explained Dr. Aghdassi.
To avoid surgical site infections (SSI), it is important to improve compliance with known process parameters (avoidance of preoperative hair removal, correct preoperative skin disinfection, perioperative antibiotic prophylaxis, preoperative decolonization, oral intestinal decolonization and perioperative blood sugar control), reported Prof. Rami Sommerstein from the National Center for Infection Prevention Swissnoso at the University of Lucerne and Bern. In a pilot project at eight clinics, a 50 percent reduction in the SSI rate in implant surgery was achieved within two years, and 25 percent fewer deep and cavity wound infections occurred in intestinal surgery. The compliance rate for blood sugar measurements was noticeably low at just 40 percent. “This seems to be particularly difficult to implement as an interdisciplinary task,” said Prof. Sommerstein.
Incidentally, frequent hand disinfection does not harm the skin microbiome of healthcare professionals in the long term, explained Prof. Ulrike Seifert from the Institute for Medical Microbiology at the University Medical Center Greifswald – even with over 100 hand disinfections with ethanol-based hand disinfectant at (EHBR) per work shift. She found this out in a prospective exploratory study on the hand microbiomes of four nurses. “Even after 20 years of professional experience, the individual hand microbiome reconstitutes itself after work and especially after a long period of absence from work. So it remains relatively stable,” said Prof. Seifert.
On the other hand, disposable medical gloves are largely unnecessary, as Prof. Irit Nachtigall explained. The regional head of infectious diseases and ABS at the Helios Klinikum Bad Saarow warned: “Glove boxes in particular are often reservoirs of bacteria.” In addition, the moist environment in the glove causes skin damage and unnecessary environmental pollution. Above all, in their opinion, the use of gloves often results in less hand disinfection and thus an increased transmission of pathogens. Prof. Nachtigall therefore initiated the internal campaign “Helios leaves out the rubber” at the Helios hospitals in 2023, which was flanked by posters, flyers and stickers. “Immediately after the campaign, our use of hand sanitizer increased by 15 percent,” she said. “But in order to achieve a lasting effect, you have to keep at it.”
–> About the program: Forum Hygiene I 24 – 25 February 2025
