Patient education model for increasing handwashing compliance.

BACKGROUND: A review of the literature on handwashing has documented the absence of research on the education of the patient as an intervention model for changing staff behavior regarding handwashing compliance. The primary objective of this project was to conduct a prospective control study of the effect of patient handwashing education on staff compliance with handwashing. METHOD: A prospective, controlled, 6-week intervention/control study was performed in 4 community hospitals in South Jersey. Each hospital served as its own control. Patients were educated within 24 hours of admission about the importance of asking their health care workers to wash their hands. Soap usage and handwashing was calculated by bed-days. Patient follow-up was conducted through telephone interviews 2 weeks after discharge. RESULTS: The patient handwashing education model increased soap usage by health care workers an average of 34% (P =.021); this increase was consistent across hospitals regardless of the initial soap usage rates. Of the patients interviewed, 81% read the materials provided, 57% asked health care workers whether they had washed their hands, and 81% of this 57% said they received positive responses. CONCLUSIONS: For the first time, our findings document that education of patients regarding their role in monitoring handwashing compliance among health care workers can increase soap usage and handwashing and provide sustainable reinforcement of handwashing principles for health care workers.

High incidence of false positives by a latex agglutination test for the diagnosis of Clostridium difficile associated colitis in compromised patients.

Detection of Clostridium difficile cytotoxin using cell culture assays for the diagnosis of antibiotic-associated colitis has been used for over a decade. Because the methodology is time consuming and cumbersome, a recently introduced commercial latex agglutination (LA) kit has attracted much attention. We compared the sensitivity and specificity of this method with the cytotoxic assay (CTA) using diarrheal stools from 652 patients at a referral tertiary care center. Specimens from 71 (10.9%) patients were found positive with CTA and 98 (15%) by LA. Of these, 67 stools were positive by both methods. Four specimens showed cytotoxicity but were negative by LA. Of the 31 patient specimens that were positive by LA but negative by CTA, 22 were obtained from leukemic bone marrow transplant and four from renal transplant patients [corrected]. Sixteen of these patients had Giardia lamblia (four), Salmonella enteritidis (three), Blastocystis hominis (five), Rotavirus (two), and Shigella boydii (two) in their stools [corrected]. No significant organisms were found in the rest of the LA-positive and CTA-negative specimens.

Differences in antimicrobial susceptibilities of clinical isolates in Saudi Arabia and the United States.

In vitro antimicrobial susceptibilities of 3,530 clinical isolates at King Faisal Specialist Hospital and Research Center (KFSH), in Riyadh, Saudi Arabia, were compared with those of 11,041 bacterial isolates at two hospitals of comparable size in the United States. The gram-negative bacteria, especially Escherichia coli, Proteus-Morganella group, Enterobacter sp, Serratia marcescens, and Pseudomonas aeruginosa were generally more resistant to ampicillin, carbenicillin, cephalosporin, gentamicin, piperacillin, and trimethoprim-sulfamethoxazole at KFSH than in the United States. A larger number of isolates of Klebsiella pneumoniae were more resistant to cephalosporin, chloramphenical, gentamicin, piperacillin, and trimethoprim-sulfamethoxazole at one of the tertiary care hospitals in the United States. Hemophilus influenzae and gram-positive cocci exhibited similar susceptibilities toward commonly used antibiotics at all three institutions.