03 Department of Clinical Microbiology

This case has got three challenges represented

1) How might we invent a mask for hospital staff that is breathable and capable of holding back microorganisms?

Case description

The following is an argumentation for the development of a transparent mask to cover nose and mouth for use in care of patients.

All masks available worldwide for this purpose are non-transparent. This is a great challenge in the care of patients because the contact the staff can have with the patient is challenged when they wear a non-transparent mask. The patient can only see a part of the face of the staff, which makes it difficult to identify the person who takes care of you and it is not possible to see the mouth and see/”read” what the person says.  The staff is often mentioning this challenge – the “bad” contact with the patient – as at reason for not wearing a mask.

This can have a consequence in relation to compliance of the general infection precautions, which involves use of a mask when there is a risk of droplets and splash, and pose a risk of transmission of microorganisms; for instance, in a birth situation, where there is a great risk of droplets and splash. But also in all other situations where this risk is present.      

Methicillin resistant staphylococcus aureus (MRSA) and other resistant microorganisms are rapidly increasing based on the past few years. Patients, who have these microorganisms, are often put in isolation, for shorter or longer time, when they are admitted to a hospital. When a patient is isolated in a hospital the staff are requested to ware isolation equipment, incl2uding a mask, in some occasions. This means that the patient for days or weeks will only meet staff with masks.

This problem would be eased if the staff had access to a transparent mask. There is a great potential in this product both for the patients and the staff and also economically since it would be the first product of its kind.

The product challenge is that the mask has to be breathable and capable of holding back microorganisms according to the regulative in this area – see below.  

There are several types of masks. The two most used are type II and type II R.  The minimum levels for these two are:

  • Type II (called a surgical mask):
    • Liquid repellent and has as the primary purpose to protect the patient
    • Bacterial filtration resistance: BFE 98 %
    • Breathing resistance: 29,4 Pa
    • Existing types are with or without a visor
  • Type II R:
    • Has a total liquid barrier and has as the primary purpose to protect both the patient and the personnel
    • Bacterial filtration resistance: BFE 98 %
    • Breathing resistance: 49 Pa
    • Existing types are with or without a visor

Masks that are used now meets the requirements of the following standards, which will be a requirement :

  • EN 14683
  • EN 149

Contact information

 

  • Name (s) Helle Pries Kristiansen, Infection Control Nurse
  • Address Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark.
  • Phone 2912-0791

2) How might we create a learning and training facility that visualises the transmission of bacteria?

Case description

In the hospitals of today there is a growing need for isolation of patients because of the bacteria developing resistance to antibiotics. Some years as well we see the need of isolation because of well known viruses as Noro or Influenza.

To isolate a patient is a very difficult issue with a great variety in the compliance from different groups of hospital staff. When you isolate there is a need for all the staff to be familiar with the methods used (from cleaning staff to doctors) or you will create the opposite effect. There is also the need to know the basics in how to move and behave in an isolation room. The problem is in this issue not the airborne diseases but contact isolation, because it is the most common issue and a problem that involves all departments in a hospital.

A training facility to facilitate these issues and methods would be a good place for learning and training methods in this area.

A training facility with the equipment of a hospital room and the possibility to visualize the issues with bacteria, virus etc. by light, color etc. could be the difference in a set up where there is a need of personal protection equipment – how and where to put it on and more important: how and where to take it off, as studies shows that you may contaminate your uniform or/and skin if you do it the wrong way. How to get rid of your dirty instruments etc. It is quite simple, but the staff tends to make it more difficult than needed, probably because they get insecure.

Is it possible to make the invisible visible in a sort of training facility?

In the building of a new hospital the infection control team is planning a new procedure, which means the collection of all of these procedures will take place in a single room – not involving the corridor outside. A visual training facility would help a lot.

Contact information

  • Name (s) Lise Andersen, Infection control nurse
  • Address Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark.
  • Phone 51640841
  • E-mail lise.andersen@rsyd.dk

3) How might we create a learning and training facility that illustrates the issue with bacteria at a modern hospital?

Case description

One of the big issues in a modern hospital is the role of cleaning. It is highly opinionated subject that often leads to a difference of opinion – often based on an individual opinion. At the same time, it is often personnel with the least education and who are lowest in the hierarchy.

In the years to come it is evident that the role of the environment in infection control will grow – among other things because of the development of resistant bacteria. At the same time there is also a continuing need to do things smarter and cheaper though. So there is a need for the cleaning staff to understand the role of cleaning methods as a correct infection control method – not only to make visual clean but also to prevent infections through the environment.

A training facility to facilitate these issues and methods would be a good learning- and training for this group where learning by doing is an issue.

A training facility with the equipment of a hospital room and the possibility to visualize the issues with bacteria, virus etc. by light, colour etc. could be the difference in a world where the cleaning staff is not only fighting against the visual dirt but also the invisible bacteria. What happens if you move the wrong way or don’t change the cloth or don’t do your hand hygiene or/and change your gloves?

Is it possible to make the invisible visible in a sort of training facility?

Contact information

  • Name (s) Lise Andersen, Infection control nurse
  • Address Department of Clinical Microbiology, Odense University Hospital, Odense, Denmark.
  • Phone 51640841
  • E-mail lise.andersen@rsyd.dk

 

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