Recently, alcohol-based hand rubs have become popular for hand hygiene. The alcohol-based hand rubs containing emollients are preferred to other forms, since frequent use of hand rubs may cause roughness of the hand skin. This study investigated the efficacy of an alcohol-based hand rub containing synthetic pseudo-ceramide for reducing the roughening of the hand skin.
The subjects used three alcohol-based hand rub formulae designed for health-care professionals over a period of three weeks. Each formula contained 0.2 w/v% benzalkonium chloride and 83 vol % ethanol. The SP formula (N=11) contained synthetic pseudo-ceramide as an emollient, the NF formula (N=10) contained NMF and propylene glycolas emollients, and the PL formula (N=10) contained no emollient. Clinical observations of skin appearance, measurement of skin conductance value and TEWL, and a questionnaire were administered 3 times, before use, after one week, and after two weeks of use. The SP formula improved the skin condition in 8 of 11 subjects, whereas no improvement in skin condition was observed in the subjects using the NF formula. The PL formula aggravated the skin condition of 6 of 10 subjects. Both the SP and the NF formulae were reported to have no sticky feeling and no inconvenience in usual operations after use.
The present study suggests alcohol-based hand rubs containing emollients are less likely to roughen the skin of the hands in comparison with hand rubs containing no emollient. In particular, the alcohol-based hand rub containing synthetic pseudo-ceramide appears to be ideal for use in handhygiene, because of the relative mildness, no sticky feeling, and ease of use.

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Influenza is a dangerous infection which could be disseminated easily in a hospital: failure of containment could result in severe loss of life. Dohgo Spa Hospital is a Center for Rheumatic Diseases with 240 beds which suffered an outbreak of influenza suddenly in 2002. Further spread was prevented by a simple measure: continuous wearing of surgical masks which were handed out to all occupants of the hospital. This precautionary measure against aerosol transmission has since been continued. No cases of influenza occurred in 2003 and only three cases in 2004. Therefore, this simple measure seems as efficacious as flu vaccination.

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[in Japanese]

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Training by the fit test and fit check are essential to use the N95 Filtering Facepiece Respirator. A survey of N95 respirator fitting with no guidance and group guidance including fit check and fit test was carried out to assess the importance of training. As a result, 48 of 79 health care workers working at “S” hospital could not fit the N95 respirator correctly. These health-care workers were divided into a guidance group and no guidance group. N95 respirator fitting was better in the guidance group (p<0.05), indicating the importance of training and the effectiveness of group guidance. However, 36% of the guidance group could not successfully fit the respirator. These health care workers need individual guidance and workers who cannot fit the N95 respirator should be provided with another type of respirator.

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Standardization of urinary catheter use is important to prevent symptomatic urinary tract (SUTI) infection in patients with acute neurological deficits. Also, the effect of sanitation on intermittent urinary drainage is unknown. We evaluated our algorithm for urinary catheter use, and abolition of sanitation on intermittent urinary drainage for the prevention of SUTI. Two historical controlled trials were performed in patients with neurological deficits. The incidence of SUTI was compared between two groups before and after introduction of the algorithm for urinary catheter use (Trial 1). The incidence of SUTI was compared between two groups with or without sanitation on intermittent urinary drainage (Trial 2). Trial 1 showed urinary catheter use increased from 10.4 to 12.8/100 patient days (p<0.001), but the incidence of SUTI decreased from 5.5 to 4.1/1000 patient days (p=0.275) after introduction of the algorithm for urinary catheter use. Trial 2 showed the incidence of SUTI was not significantly smaller in patients with sanitation (30 of 135 cases, 22 %) than without (13 of 50 cases, 26%).
Our two management protocols for the prevention of SUTI for patients with neurological deficits, algorithm for urinary catheter use and abolition of sanitation on intermittent urinary drainage, may be useful for prevention of SUTI. Prevention of SUTI in patients with neurological deficits, especially management of the urinary catheter and drainage, should be varied according to the individual characteristics.

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The cost-effectiveness of measures to prevent infection in cases of colon resection were analyzed in a hospital with surgical site infection (SSI) surveillance in patients undergoing colon resection admitted during the period of surveillance introduction (January to June 1999) and a period of stability (July to December 2002). The case attributes and type of infection were evaluated using medical records, nurses specializing in infection control were interviewed with regard to countermeasures against infection in each period, and the per-patient expense of countermeasures against infection and medical fees were calculated.
Major changes in countermeasures against infection from 1999 to 2002 were adherence to a determined duration of administration and type of antimicrobial agent and administration timing in accordance with a clinical path as well as incorporation of subcutaneous lavage with physiological saline. Per-person expenses for countermeasures against infection were reduced from 13, 898 yen in 1999 to 7, 008 yen in 2002 (reduction of 6, 890 yen). The difference in postoperative medical expenses between the infected group and the uninfected group was 738, 000 yen in 1999 and 528, 000 yen in 2002. The infection rate for cases of colon cancer surgery was 28.6% in 1999 and 17.1% in 2002. Per-person expenses required for measures to prevent infection were lower in the period of stability than in the period of surveillance introduction, suggesting that the measures were highly cost-effective.

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[in Japanese]

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The efficacy of influenza vaccination was examined by an anonymous questionnaire among vaccinees and non-vaccinees at 15 Health Welfare Centers in Chiba in March 2004. The 424 (male 148, female 224, unknown 52) vaccinees received influenza vaccine in November 2003. There were 82 non-vaccinees (male 29, female 38, unknown 15). During the following winter season after vaccination, febrile episodes were observed in 30/424 (7.1%) vaccinees (male 6, female 17, unknown 7) and 12/82 (14.6%) non-vaccinees (male 5, female 7). The difference between these figures was significant (chi-square test, p<0.05). Self reported local reaction (swelling) was observed in 18/148 (12.2%) male vaccinees and in 80/224 (35.9%) female vaccinees. There was a significant difference (p<0.001). The results indicated that influenza vaccine could decrease febrile episodes during the winter season, but the high incidence of local reaction in females should be considered.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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