Monitoring perioperative antibiotic use by referring to each medical chart is time-consuming. Therefore, we developed a less labor-intensive method using the discontinuance rate of postoperative antibiotic from a health insurance claims database. We evaluated the pre- and postintervention impact using this method. All surgical operations and cardiac catheterization procedures involving perioperative antibiotic use were extracted from the health claims database. Standardization of perioperative antibiotics and their duration was introduced in April 2017. The pre- and postintervention periods were April 2014-March 2017 and October 2017-October 2021, respectively. The discontinuance rate of postoperative antibiotics on days 0 and 2 increased from 18.1% to 51.3% (p < 0.001) and from 63.5% to 80.3% (p < 0.001), respectively. Process metrics of perioperative antibiotic use calculated from the health claims database were easy to monitor and sustain our evaluation.

Methicillin-resistant Staphylococcus aureus (MRSA) was detected in surveillance cultures from 10 patients in neonatal intensive care units and growing care units (GCU) from January to May 2022. Genetic analysis was conducted using PCR-based open reading frame Typing (POT) to confirm horizontal transmission. Seven POT types were classified. Because MRSA of the same POT type was detected in some affected infants, environmental culture was performed, but MRSA was not detected. The possibility of horizontal transmission could not be ruled out for five isolates, but the route of infection was unknown for the remaining five isolates. Although a concern existed for infection transmission from family members, protective measures were taken during their visit, including the use of gloves and gowns, to prevent direct skin-to-skin contact. In addition, the mothers did not breastfeed.

We focused on expressed breast milk, a nonsterile material administered to the affected infants, and conducted culture tests on the expressed breast milk. MRSA was detected in the expressed breast milk of four of the five patients tested. Although the POT types of the four strains were all different, each matched the strains detected in the affected infants. These results indicated vertical transmission through expressed breast milk, leading to guidance on milking methods.

Educating healthcare staff about hand hygiene is crucial for preventing the transmission of communicable diseases in all healthcare facilities. To improve hand hygiene techniques, we conducted an educational program using videos and a new educational tool, known as the "fluorescent application area analysis tool. " Using this tool, we measured and scored the areas where fluorescent paint did not adequately spread or remained after hand washing. Following the educational videos, we conducted follow-up measurements and compared the results based on the job category.

Overall, 935 participants (128 physicians, 484 nurses, 56 nursing assistants, 93 other medical staff, and 174 administrative staff) were included. The results showed an increase in hand sanitization points for all occupations (nurses, physicians, and clerical staff; P < 0.01), whereas hand washing points decreased for all occupations except nursing assistants (nurses and clerical staff; P < 0.01). Notably, the educational intervention had a significant effect on hand sanitization.

Scores for hand washing were higher than those for hand disinfection in all occupations, indicating that the respondents had already mastered the hand washing technique. However, education focusing on the key points of hand disinfection techniques is required to further improve the scores. In an interoccupational comparison, we observed significant differences in scores for hand disinfection and hand washing, demonstrating that using the same educational material for all occupations may be ineffective. In a site-specific evaluation, hand disinfection exhibited high scores for the back of the hand, with no difference observed between the left and right hands. However, hand washing exhibited high scores for the palms and left hand, indicating differences in technique-related issues. The results of hand disinfection in the site-specific evaluation differed from those of previous studies. Therefore, the validity of the evaluation criteria for the "Fluorescent Application Area Analysis Tool" should be examined.