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While insufficient disinfection continues to cause serious problems in healthcare, not enough technology is deployed to support the physicians. We built a mobile system (Hand-in-Scan) that performs the objective evaluation of the hand hygiene protocol applied. The equipment is primarily intended to support surgeons and hospital staff to reduce Healthcare-Associated Infection (HAI) rates. The use of the device is simple: a digital image of the hand is taken in a UV-enlightened environment, after a general hand washing procedure using an UV-marked alcoholic hand rub. Then, the images are automatically analyzed: a region growing algorithm is employed to segment the hand on the images and an artificial intelligence method computes the numeric results. The performance of the system was evaluated in various medical institutes and universities in four countries. Currently, the Hand-in-Scan Lite version is under development for the general public, to educate people about the importance of proper hand washing. The ability to objectively demonstrate the effectiveness of hand hygiene in any environment may have a significant impact on personal and institutional level infection control as well.

The forgotten swab is an incident which is covered by the media. It represents 56% of forgotten foreign bodies
in patients. The post-procedure section of the operating theatre patient safety checklist released by the French National Health Authority (HAS) states that the team should orally confirm the correct swab count. The practice to perform this count varies from one hospital to another and also within an establishment and the practices are generally uncomfortable .It is for this reason that we decided to test a swab-counter. This practical device allows for the efficient counting and centralisation of used swabs for subsequent transfer to an infectious clinical waste bag. All of the people questioned were unanimous about the quality of the swab count (Table 1 and 2). When asked the question, "would you change your current practices to use the swab-counter?", 100% of the people questioned replied "yes". This swab-counter offers real advantages to health care professionals, both from a functional and safety point of view. It meets the demands of the operating theatre patient safety checklist released by the French National Health Authority (HAS) by permitting a swab count confirmation at the end of a procedure. Having this product in the Operating Room allows safer management of the patient, improved comfort for users, and alignment of operating theatre practices.

In our hospital, sterilisation activities have been outsourced since January 2009. The choice to move to single use for some devices or even some instrument compositions due to reprocessing costs. Use of sterile single use metal instrumentation allows you to meet requirements on those lited in point 8g and 7e for V2010 certification. After authorisations were obtained from the certified French agencies (DRASS, ADEME), and in collaboration with our hospital waste collector, a special system allows only metals from used instrumentation to be treated. Various steps allow the contents of the collection receptacle to be separated from this receptacle and the biohazard waste to become inert residue, automatically emptied into a 1000 litre holding tank and then taken to the metal recuperator located near the pretreatment site. Given these results, we believe that all metal products considered biohazard waste and handled by the special channel established between the hospital and its service provider can be RECOVERED. It took two years to organise this circuit. While the users were sometimes confused when this plan was being set up, now they would no longer want to go back.

Introduction
Medications used in the operation room are often prescribed, prepared and administered by the anesthesiologist.
The anesthesiologist is required to prepare, label and administrate medications. This is a one man show and in the dynamic and hectic environment of operation room, the process is prone to errors and risks. Patient safety maybe compromised in many ways. Infection may be induced because of failure to follow aseptic techniques in medication preparation and administration. The anesthesiologist is exposed to needle stick injuries. Errors like inaccuracies in medication preparation, labeling or administration may occur. Other risks are related to narcotic abuse.

 aims
- To prevent medication errors in the process of anesthesia medication administration
- To prevent infection, induced by medication administration
- To better control and supervise narcotic administration
- To reduce health care workers exposure to needle stick injuries

Method
A multidisciplinary team has designed a system which is based of a case container, that comprises a variety of pre-prepared anesthesia medication, that are prepared, packed and labeled in a controlled environment in the pharmacy.

Results
Aseptic medication administration is a key factor in infection control and the prevention of catheter induced infection. The system has improved patient safety, narcotic control and users satisfaction.

Summary

The main evidence in favor of the provision of assistance for anesthesiologists, seems to be that single-handed anesthesiology generates higher anesthetic mortality than does a team work.
The main evidence in favor of the provision of assistance for anesthesiologists,  seems to be that single-handed anesthesiology generates higher anesthetic mortality than does a team work
Anesthesia medication containers system is a model of an active proactive approach to problem solving which is necessary for patient safety.

Loan instruments are a range of instrument sets which are provided by various companies, addressing individual patient needs and surgeon preference. These instrument sets are transferred, according to demand, from one hospital to another. The practice  is often  a risk factor for infection because of inadequate time frame for reprocessing and decontamination protocol not being followed. Inadequate instructions for decontamination processes and lack of training may lead to contamination due to inadequate disassembly and cleaning of complex instruments.

This presentation will:

Introduce the problem and the current worldwide situation.

Present practical solutions and initiatives for safe management of loan instruments.

Display our comprehensive  loan instruments management system

Medications used in the operation room are often prescribed, prepared and administered by the anesthesiologist.
The anesthesiologist is required to prepare, label and administrate medications. This is a one man show and in the dynamic and hectic environment of operation room, the process is prone to errors and risks. Patient safety maybe compromised in many ways. Infection may be induced because of failure to follow aseptic techniques in medication preparation and administration. The anesthesiologist is exposed to needle stick injuries. Errors like inaccuracies in medication preparation, labeling or administration may occur. Other risks are related to narcotic abuse.

Objectives: Surgical site infections (SSI) are common in sternotomy and saphenous vein harvest wounds. In 2007 a prospective pilot study in our institution showed an infection rate of 23.1% following saphenectomy, a higher rate than reported in most studies. Therefore work processes regarding both the vein harvest and sternotomy were overhauled. We have evaluated the infection-rate following these changes.

Material and methods: A prospective study including 246 consecutive patients (191 males, 55 females, age 66.5 vs. 67 yrs) who underwent cardiac surgery in Landspitali between Nov. 2008 and Nov. 2009. The most common procedures were CABG/OPCAB (60.1%), AVR (11.4%) and AVR+CABG (13.4%). Incisions were assessed on postoperative. Day 2-4 and 6-7 and all patients contacted by telephone 30 days postoperatively. The definition by CDC was used for defining a wound infection. Patients with and without infection were compared.

Results: Overall, 31 patients were diagnosed with SSI (12.6%), 16 following sternotomy (6.5%), thereof 5 deep infections with mediastinits (2%). Nineteen patients (10.3%) were diagnosed with SSI after 184 saphenectomies, 90% of them superficial. The median time to diagnosis of SSI was 24 and 20.5 days for saphenectomy- and sternotomy-wounds, respectively. Only 20% and 41.7% were diagnosed during hospitalisation. Hospital stay was significantly longer for patients with SSI (mean 17.6 vs. 11.5).

Conclusion: Wound infections are twice as common following saphenectomy compared to sternotomy. Since 2007, the infection rate following saphenectomy has dropped from 23.1% to 10%, but the incidence of deep sternal wound infections (2.0%) is similar to previous reports (2.5%) in our institution.

Given the difficulties currently encountered with antibiotic treatment, other solutions need to be found. Phagotherapy is an anti-bacterial treatment that uses the lytic activity of
bacteriophages, a special virus, to combat bacteria. This principle, discovered in 1915-17, was widely used for therapeutic purposes as of 1919, up until to the discovery
of antibiotics. In the ‘40s, owing to very variable results, phagotherapy was abandoned.

Bacteriophages specifically destroy the target bacteria, whether resistant to antibiotics or not. They multiply in the course of treatment in the presence of the « target » bacteria,
and disappear once the patient is cured. Phagotherapy can be used independently or at the same time as antibiotics.
We shall describe the advantages and disadvantages of phagotherapy, our personal experiences and the conditions for re-introducing phagotherapy. The increasing prevalence of antibiotic-resistant microbial species has led scientists to re-investigate therapies that were commonly used before antibiotics were discovered. The medicinal properties of honey have been recognized since antiquity. Honey has been used by several civilizations as a wound dressing to treat infected wounds and promote healing.

Modern studies have recently confirmed the bactericidal nature of some honeys against several types of bacteria (Gram+ and Gram-), including antibiotic-resistant
strains. The antimicrobial activity of honey is attributed to a combination of several mechanisms, which are not likely to lead to the emergence of resistant strains.
Based on the current clinical context and the existing scientific knowledge, Melipharm has undertaken to implement a technology platform to screen and select
antibacterial honeys from several floral origins in order to develop medical devices that are antibacterial and promote wound healing.