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    Hand Hygiene Compliance in Some Intensive Care Units of Turkey: Results of Multicentre Asklepeion Study
    (Galenos Yayincilik, 2018) Onal, Aye Uyan; Aksoy, Firdevs; Azak, Emel; Koc, Meliha Meric; Ceviker, Sevil Alkan; Hatipoglu, Cigdem Ataman; Gozukucuk, Ramazan; Sehmen, Emine; Ugurlu, Kenan; Senol, Gunes; Durmus, Gul; Mert, Habibe Tulin Elmaslar; Alay, Handan; Koc, Filiz; Caglayan, Derya; Dikis, Demet; Korkmaz, Nilay Bilgili; Kucuker, Nilgiin Deniz; Kepeli, Nurhayat; Ulusoy, Behiye; Barik, Sukran Askit; Pullukcu, Husnu; Sipahi, Hilal; Arda, Bilgin; Ulusoy, Sercan; Sipahi, Oguz Resat
    Introduction: Hand hygiene is one of the most cost-effective infection control measures. In this multicenter Study we analysed the hand hygiene compliance observation results of 15 hospitals in Turkey. Materials and Methods: This study was performed in intensive care units (ICUs) of 15 hospitals (Eight terriary-care educational hospitals, six state hospitals and one private hospital) from 11 cities from six regions of Turkey The observations were made by infection control practitioners according to the World Health Organization - Five Moments for Hand Hygiene (WHO-5) indications rule for hand hygiene and overall compliance rates were calculated. Observations were unblinded (healthcare professionals knew that they were observed). The study period included 2015 and 2016 calendar years. Results: There was a statistically significant increase in hand hygiene compliance rates in 2016 versus 2015. The overall number of hand hygiene indications and compliance in 2015 and 2016 were 60071/78116-76,9% and 66551/83607-79,6% (p=0.0001), respectively. Nurses were the most compliant group in both years. The highest compliance was in after body fluid exposure indication (88.2%-2015 and 91.4%-2016) while the lowest compliance was in before patient contact indication (61.3%-2015 and 65%-2016). Conclusion: The presented data suggest that under unblinded observations, hand hygiene compliance seems to be in relatively acceptable rates in Turkey. Centers with compliance rates below 50 percentile rates in any of the 5 moments should increase efforts to enhance compliance in that indication.
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    Managing adult patients with infectious diseases in emergency departments: international ID-IRI study
    (Taylor & Francis Ltd, 2020) Erdem, Hakan; Hargreaves, Sally; Ankarali, Handan; Caskurlu, Hulya; Ceviker, Sevil Alkan; Bahar-Kacmaz, Asiye; Alsalman, Jameela
    We aimed to explore factors for optimizing antimicrobial treatment in emergency departments. A single-day point prevalence survey was conducted on January 18, 2020, in 53 referral/tertiary hospitals in 22 countries. 1957 (17%) of 11557 patients presenting to EDs had infections. The mean qSOFA score was 0.37 +/- 0.74. Sepsis (qSOFA >= 2) was recorded in 218 (11.1%) patients. The mean qSOFA score was significantly higher in low-middle (1.48 +/- 0.963) compared to upper-middle (0.17 +/- 0.482) and high-income (0.36 +/- 0.714) countries ( P < 0.001). Eight (3.7%) patients with sepsis were treated as outpatients. The most common diagnoses were upper-respiratory (n = 877, 43.3%), lower-respiratory (n = 316, 16.1%), and lower-urinary (n = 201, 10.3%) infections. 1085 (55.4%) patients received antibiotics. The most-commonly used antibiotics were beta-lactam (BL) and BL inhibitors (n = 307, 15.7%), third-generation cephalosporins (n = 251, 12.8%), and quinolones (n = 204, 10.5%). Irrational antibiotic use and inappropriate hospitalization decisions seemed possible. Patients were more septic in countries with limited resources. Hence, a better organizational scheme is required.