Skip to main content
Top
Published in:

Open Access 01-12-2024 | Brief Report

A multicentric survey and single-centre observational study of usage behaviour of sinks in intensive care: training is needed to minimize risk

Authors: Giovanni-Battista Fucini, Robert Abe, Elke Lemke, Petra Gastmeier

Published in: Antimicrobial Resistance & Infection Control | Issue 1/2024

Login to get access

Abstract

Introduction

Sinks have been introduced near patients to improve hand hygiene as part of infection prevention and control measures. However, sinks are a known reservoir for gram-negative bacterial pathogens in particular and their removal to prevent bacterial infections in intensive care patients is currently recommended by several international guidelines.

Methods

Healthcare workers (HCWs) in 15 intensive care units (ICUs) in Germany were given the opportunity to complete an anonymous survey on the use of sinks between August 2022 and January 2023. Observations were then made in three participating ICUs to determine the frequency and reason for contact with the sink.

Results

258 questionnaires were returned (nurses 87%). 90% found it useful to very useful to have a sink in the patient room, and 56% reported using it daily for hand hygiene. We observed 33 contacts between nurses and sinks over 17 h. In 20/33 (60%) cases, the sink was used for waste disposal. In 3/33 (10%) it was used for hand washing.

Discussion

Sinks are still used for daily care in intensive care units. Educational Interventions in existing buildings to minimise risk through “sink hygiene” (i.e. separation of sinks for water disposal and uptake) can make an important contribution to infection prevention.
Literature
1.
go back to reference Hayward C, Brown MH, Whiley H. Hospital water as the source of healthcare-associated infection and antimicrobial-resistant organisms. Curr Opin Infect Dis. 2022;35(4):339–45.CrossRefPubMed Hayward C, Brown MH, Whiley H. Hospital water as the source of healthcare-associated infection and antimicrobial-resistant organisms. Curr Opin Infect Dis. 2022;35(4):339–45.CrossRefPubMed
3.
go back to reference Valentin AS, et al. A prospective multicentre surveillance study to investigate the risk associated with contaminated sinks in the intensive care unit. Clin Microbiol Infect. 2021;27(9):e13479–134714.CrossRef Valentin AS, et al. A prospective multicentre surveillance study to investigate the risk associated with contaminated sinks in the intensive care unit. Clin Microbiol Infect. 2021;27(9):e13479–134714.CrossRef
4.
go back to reference Kearney A, Humphreys H, Fitzgerald-Hughes D. Infection prevention and control policy implementation for CPE: a cross-sectional national survey of healthcare workers reveals knowledge gaps and suboptimal practices. J Hosp Infect. 2024;145:148–54.CrossRefPubMed Kearney A, Humphreys H, Fitzgerald-Hughes D. Infection prevention and control policy implementation for CPE: a cross-sectional national survey of healthcare workers reveals knowledge gaps and suboptimal practices. J Hosp Infect. 2024;145:148–54.CrossRefPubMed
5.
go back to reference Guidelines R, Committee IHSI. Guidelines on Core Components of Infection Prevention and Control Programmes at the National and Acute Health Care Facility Level. Geneva: World Health Organization: ed. W.H. Organization; 2016. Guidelines R, Committee IHSI. Guidelines on Core Components of Infection Prevention and Control Programmes at the National and Acute Health Care Facility Level. Geneva: World Health Organization: ed. W.H. Organization; 2016.
6.
go back to reference Hopman J, et al. Reduced rate of intensive care unit acquired gram-negative bacilli after removal of sinks and introduction of ‘water-free’ patient care. Antimicrob Resist Infect Control. 2017;6:59.CrossRefPubMedPubMedCentral Hopman J, et al. Reduced rate of intensive care unit acquired gram-negative bacilli after removal of sinks and introduction of ‘water-free’ patient care. Antimicrob Resist Infect Control. 2017;6:59.CrossRefPubMedPubMedCentral
7.
go back to reference Shaw E, et al. Control of endemic multidrug-resistant Gram-negative bacteria after removal of sinks and implementing a new water-safe policy in an intensive care unit. J Hosp Infect. 2018;98(3):275–81.CrossRefPubMed Shaw E, et al. Control of endemic multidrug-resistant Gram-negative bacteria after removal of sinks and implementing a new water-safe policy in an intensive care unit. J Hosp Infect. 2018;98(3):275–81.CrossRefPubMed
8.
go back to reference Fucini GB, et al. Sinks in patient rooms in ICUs are associated with higher rates of hospital-acquired infection: a retrospective analysis of 552 ICUs. J Hosp Infect. 2023;139:99–105.CrossRefPubMed Fucini GB, et al. Sinks in patient rooms in ICUs are associated with higher rates of hospital-acquired infection: a retrospective analysis of 552 ICUs. J Hosp Infect. 2023;139:99–105.CrossRefPubMed
9.
go back to reference Kizny Gordon AE, et al. The Hospital Water Environment as a Reservoir for Carbapenem-resistant organisms causing hospital-acquired infections - a systematic review of the literature. Clin Infect Dis. 2017;64(10):1436–44.CrossRef Kizny Gordon AE, et al. The Hospital Water Environment as a Reservoir for Carbapenem-resistant organisms causing hospital-acquired infections - a systematic review of the literature. Clin Infect Dis. 2017;64(10):1436–44.CrossRef
10.
go back to reference WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care. 2009: Geneva. WHO Guidelines on Hand Hygiene in Health Care: First Global Patient Safety Challenge Clean Care Is Safer Care. 2009: Geneva.
11.
go back to reference World Health Organisation. HAND HYGIENE FOR ALL INITIATIVEImproving access and behaviour in health care facilities. 2020. World Health Organisation. HAND HYGIENE FOR ALL INITIATIVEImproving access and behaviour in health care facilities. 2020.
12.
go back to reference Grabowski M, et al. Characterizations of handwashing sink activities in a single hospital medical intensive care unit. J Hosp Infect. 2018;100(3):e115–22.CrossRefPubMed Grabowski M, et al. Characterizations of handwashing sink activities in a single hospital medical intensive care unit. J Hosp Infect. 2018;100(3):e115–22.CrossRefPubMed
13.
go back to reference Hopman J et al. Reduced rate of MDROs after introducing ‘water-free patient care’ on a large intensive care unit in the Netherlands. Antimicrobial Resistance and Infection Control, 2015. 4(SUPPL. 1). Hopman J et al. Reduced rate of MDROs after introducing ‘water-free patient care’ on a large intensive care unit in the Netherlands. Antimicrobial Resistance and Infection Control, 2015. 4(SUPPL. 1).
14.
go back to reference Denkel LA, et al. Effect of antiseptic bathing with chlorhexidine or octenidine on central line-associated bloodstream infections in intensive care patients: a cluster-randomized controlled trial. Clinical Microbiology and Infection; 2022. Denkel LA, et al. Effect of antiseptic bathing with chlorhexidine or octenidine on central line-associated bloodstream infections in intensive care patients: a cluster-randomized controlled trial. Clinical Microbiology and Infection; 2022.
15.
go back to reference Bleasdale SC, et al. Effectiveness of chlorhexidine bathing to reduce catheter-associated bloodstream infections in medical intensive care unit patients. Arch Intern Med. 2007;167(19):2073–9.CrossRefPubMed Bleasdale SC, et al. Effectiveness of chlorhexidine bathing to reduce catheter-associated bloodstream infections in medical intensive care unit patients. Arch Intern Med. 2007;167(19):2073–9.CrossRefPubMed
16.
go back to reference Corne P et al. Daily chlorhexidine bathing in a medical intensive care unit: Effects on healthcare-associated infections and on acquisition of multidrug-resistant bacteria. Annals of Intensive Care, 2016. 6(SUPPL. 1). Corne P et al. Daily chlorhexidine bathing in a medical intensive care unit: Effects on healthcare-associated infections and on acquisition of multidrug-resistant bacteria. Annals of Intensive Care, 2016. 6(SUPPL. 1).
17.
go back to reference Pybus S, Inkster T. Implementation and barriers to waterless care: a questionnaire study of infection prevention and control practitioners, clinicians, and engineers. J Hosp Infect. 2024;152:122–5.CrossRefPubMed Pybus S, Inkster T. Implementation and barriers to waterless care: a questionnaire study of infection prevention and control practitioners, clinicians, and engineers. J Hosp Infect. 2024;152:122–5.CrossRefPubMed
18.
go back to reference KRINKO. Anforderungen Der Hygiene an abwasserfuhrende Systeme in Medizinischen Einrichtungen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2020;63(4):484–501.CrossRef KRINKO. Anforderungen Der Hygiene an abwasserfuhrende Systeme in Medizinischen Einrichtungen. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2020;63(4):484–501.CrossRef
19.
go back to reference Waydhas C, et al. [DIVI-Recommendations on the infrastruture of adult intensive care units]. Med Klin Intensivmed Notfmed. 2023;118(7):564–75.CrossRefPubMed Waydhas C, et al. [DIVI-Recommendations on the infrastruture of adult intensive care units]. Med Klin Intensivmed Notfmed. 2023;118(7):564–75.CrossRefPubMed
20.
go back to reference Fucini GB et al. [The structural and spatial design of German intensive care units from the point of view of infection control measures: Survey among ICU-KISS participants]. Med Klin Intensivmed Notfmed, 2023: pp. 1–11. Fucini GB et al. [The structural and spatial design of German intensive care units from the point of view of infection control measures: Survey among ICU-KISS participants]. Med Klin Intensivmed Notfmed, 2023: pp. 1–11.
21.
go back to reference Cloutman-Green E, et al. The important role of sink location in handwashing compliance and microbial sink contamination. AM J INFECT CONTROL. 2014;42(5):554–5.CrossRefPubMed Cloutman-Green E, et al. The important role of sink location in handwashing compliance and microbial sink contamination. AM J INFECT CONTROL. 2014;42(5):554–5.CrossRefPubMed
22.
go back to reference Pirzadian J, et al. Limiting spread of VIM-positive Pseudomonas aeruginosa from colonized sink drains in a tertiary care hospital: a before-and-after study. PLoS ONE. 2023;18(3):e0282090.CrossRefPubMedPubMedCentral Pirzadian J, et al. Limiting spread of VIM-positive Pseudomonas aeruginosa from colonized sink drains in a tertiary care hospital: a before-and-after study. PLoS ONE. 2023;18(3):e0282090.CrossRefPubMedPubMedCentral
Metadata
Title
A multicentric survey and single-centre observational study of usage behaviour of sinks in intensive care: training is needed to minimize risk
Authors
Giovanni-Battista Fucini
Robert Abe
Elke Lemke
Petra Gastmeier
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Antimicrobial Resistance & Infection Control / Issue 1/2024
Electronic ISSN: 2047-2994
DOI
https://doi.org/10.1186/s13756-024-01493-3

Keynote webinar | Spotlight on menopause

Menopause can have a significant impact on the body, with effects ranging beyond the endocrine and reproductive systems. Learn about the broader systemic effects of menopause, so you can help patients in your clinics through the transition.   

Prof. Martha Hickey
Dr. Claudia Barth
Dr. Samar El Khoudary
Developed by: Springer Medicine
Watch now

Keynote webinar | Spotlight on adolescent vaping

  • Live
  • Webinar | 29-01-2025 | 18:00 (CET)

Growing numbers of young people are using e-cigarettes, despite warnings of respiratory effects and addiction. How can doctors tackle the epidemic, and what health effects should you prepare to manage in your clinics?

Watch it live: Wednesday 29th January, 18:00-19:30 CET
 

Prof. Ann McNeill
Dr. Debbie Robson
Benji Horwell
Developed by: Springer Medicine
Join the webinar

Keynote webinar | Spotlight on modern management of frailty

Frailty has a significant impact on health and wellbeing, especially in older adults. Our experts explain the factors that contribute to the development of frailty and how you can manage the condition and reduce the risk of disability, dependency, and mortality in your patients.

Prof. Alfonso Cruz-Jentoft
Prof. Barbara C. van Munster
Prof. Mirko Petrovic
Developed by: Springer Medicine
Watch now

A quick guide to ECGs

Improve your ECG interpretation skills with this comprehensive, rapid, interactive course. Expert advice provides detailed feedback as you work through 50 ECGs covering the most common cardiac presentations to ensure your practice stays up to date. 

PD Dr. Carsten W. Israel
Developed by: Springer Medizin
Start the cases

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Read more