Clinical and nonclinical health care workers faced a similar risk of acquiring 2009 pandemic H1N1 infection.

Reporting of confirmed pandemic influenza A virus (pH1N1) 2009 infection was mandatory among health care workers in Hong Kong. Among 1158 confirmed infections, there was no significant difference in incidence among clinical versus nonclinical staff (relative risk, 0.98; 95% confidence interval, 0.78-1.20). Reported community exposure to pH1N1 was common and was similar in both groups.

Impact of laparoscopic colorectal resection on surgical site infection.

OBJECTIVES: This study aimed to identify the risk factors of surgical site infection (SSI) in elective colorectal resection and the strategy for prevention of SSI in modern era of colorectal surgery. BACKGROUND: The practice of colorectal surgery has undergone remarkable evolution recently because of application of laparoscopic resection. This could affect SSI in colorectal patients. An updated investigation of SSI under current practice of colorectal surgery would provide valuable information. METHODS: This was a prospective study of SSI on 1011 patients, who had elective colorectal resection in a university teaching hospital, during January 2002 to December 2006. Standard definition and postoperation follow-up of SSI were adopted through collaboration between surgeons and wound surveillance program of Infection Control Unit. Risk factors of SSI were evaluated. Logistic regression was used to perform multivariate analysis and decide independent risk factors of SSI. RESULTS: The overall rate of incisional SSI and organ/space SSI was 4.8% and 1.7%, respectively. Rate of incisional SSI in open and laparoscopic colorectal resection was 5.7% and 2.7%, respectively. Anastomotic leakage was the only factor that predicted organ/space SSI (P < 0.01). Independent risk factors of incisional SSI included blood transfusion [P = 0.047; odds ratio (OR) = 2.43; 95% confidence interval (CI): 1.0-5.9], anastomotic leakage (P < 0.01; OR = 6.5; 95% CI: 2.3-18.6), and open colorectal resection (P = 0.037; OR = 2.36; 95% CI: 1.1-5.3). CONCLUSION: In current practice of colorectal surgery, operative factors are more important than patient factors for SSI. Good surgical technique to reduce anastomotic leakage and reduce blood transfusion has paramount importance in SSI prevention. Laparoscopic surgery was associated with reduction of rate of SSI by more than 50% when compared with open surgery and would have a strong impact on the prevention of surgical infection.

A program to improve the hand hygiene compliance of Hong Kong preschoolers with an insight into their absenteeism.

BACKGROUND: Hand hygiene prevents cross-infection and is the most effective defense against contagious diseases. Preschoolers, without proper hand hygiene skills, are a vulnerable group to such diseases. The aim of this study was to evaluate whether hand hygiene compliance training of preschoolers in Hong Kong improves their hand hygiene knowledge and performance, and whether the training reduces their absenteeism resulting from influenza symptoms. METHODS: This was a quasi-experimental study with a pretest-posttest design. A total of 110 preschoolers participated in a program consisting of 4 training sessions on hand hygiene. Before and after the program, their hand hygiene knowledge was assessed by 10 true or false questions, and their handwashing skills were assessed by photos of their hands taken before and after handwashing. Before handwashing, a fluorescent stain gel was used to cover their hands. To determine whether a causal relationship existed between compliance and absenteeism, the preschoolers' absenteeism data were collected during a period of 3 months for analysis. RESULTS: Significant differences were found in hand hygiene knowledge on handwashing steps, duration, and after playing with toys. Percentage increases were recorded for 8 questions. There was significant improvement in hand hygiene performance on the fronts and the backs of fingers, thumbs, and fingertips (P < .05). The findings showed a decrease in absence rates with influenza symptoms for the month before (31%), during (30%), and after (25%) the completion of the program in all participating schools. DISCUSSION: After the training program, the participants' hand hygiene knowledge and performance considerably improved. They washed their hands more thoroughly and there was a significant reduction in absences owing to influenza. CONCLUSIONS: Good cooperation between schools and families is found to be important in helping students build positive attitudes and habits, even in performing simple routines like hand hygiene.

Impact of the first hand sanitizing relay world record on compliance with hand hygiene in a hospital.

Staff of a large hospital in Hong Kong attempted and set the first Guinness World Record for the most participants in a hand sanitizing relay in May 2014. After this event, average compliance with hand hygiene increased from 72% (95% CI, 70%-74%) in 2013 to 85% (95% CI, 83%-87%) in June-July 2014, and the conceptual understanding of good hand hygiene practices improved.

Effective personal protective clothing for health care workers attending patients with severe acute respiratory syndrome.

BACKGROUND: Optimal usability is crucial in providing protection for health care workers who are exposed to severe acute respiratory syndrome day and night while taking care of patients with the virus. No research study has yet tested the usability of personal protective clothing (PPC). METHOD: The study was carried out in 3 stages. PPC available in Hong Kong were sorted by their physical properties in the first stage. The second stage was a single-blinded study examining the different usability aspects of the PPC. The third stage was a simulated viral load test. RESULTS: Four types were identified: good water repellency and water resistance, poor air permeability (Type A PPC); good water repellency and air permeability, poor water resistance (Type B PPC); poor water repellency, poor water resistance, and fair air permeability (Type C PPC); and good water repellency, poor air permeability, and fair water resistance (Type D PPC). Type D PPC had a significantly higher number of contamination sites on the subjects' dorsum and palm. Type C PPC had the highest contamination over the trunk. Findings in the viral load test showed that there was a significant difference in the contamination of the face (t=4.69, df=38, P<.00) between 1 and 2 strokes. CONCLUSION: Type A PPC is effective in providing a desirable protective function against droplet splash, if a disposable PPC is required. Type C PPC, the surgical gown, is also appropriate, as the cost is low, air permeability is fair, and the level of possible hand contamination is lowest among the 4 groups in the current study.

Hand hygiene promotion and the participation of infection control link nurses: an effective innovation to overcome campaign fatigue.

Campaign fatigue was evident in a large hospital in Hong Kong when hand hygiene compliance remained just above 50% after 4 years of aggressive and varied promotional activities. A new innovative strategy was developed that directly involved the infection control link nurses both in formulating the strategy and in implementing the various proposed programs. The new strategy was successful in increasing hand hygiene compliance to 83%.