Author - Prof Judith Tanner

Are nail brushes and nail picks used during the surgical hand scrub effective?

Nail brushes and nail picks are routinely used during the surgical scrub. But there is no evidence to demonstrate their effectiveness.

Nail brushes and nail picks are routinely used during the surgical scrub to remove dirt from the surface of the nail and underneath the nails. Though their use is recommended in various national guidelines (1,2,3) there is no evidence to demonstrate their effectiveness. This is important as they have a cost implication. A packet containing a disposable brush and pick is around 0.40 GBP. Though this is relatively cheap, the numbers of brushes and picks used is high. A UK study found 92% of operating room nurses used a brush every time they scrubbed (4). The aim of this study was to determine the effect of nail brushes and nail picks on the number of bacteria on operating room nurses hands following a surgical scrub.

Study design

The randomised trial was carried out in three hospitals in England. 164operating room nurses were randomised to one of three intervention groups; 4% chlorhexidine...

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Author - Alexandra Wattwil

Serious risk of perforations in gloves – occurs in one in three operations

A perforation in a glove represents a major risk to both patients and staff.

When Gerd Ødegård Hagen read an announcement offering a grant for surveys aimed at increasing knowledge about surgical gloves, latex allergy or disinfectants, she decided to submit an application. Her aim was to take a closer look during surgery at the barrier between the hands of a person working in an operating room and the patient’s body fluids. This was to be achieved by examining the level of safety and the risks...

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Author - My Tiljestam

Lean Process helps improve patient health care

Health care can learn from industry and vice versa.

The Lean Process was first developed and implemented by the car manufacturer Toyota, during the period 1945–1970.
The idea behind Lean principles is to work with continuous improvement to achieve efficient processes in production or the provision of services. Toyota’s successful business has been recognised all over the world and the Lean Process has gradually spread to other industrial sectors. In recent years the Lean Process has also...

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Author - Dr Egil Lingaas

Keeping Expectations for Infection Control in Perspective

History shows that infectious diseases have always been present.

The seismic fall-out from the recent global credit crunch has shown that change, and even crisis, is a constant theme in the modern world. That is certainly true in the field of hospital-acquired infections, where there is no panacea to eradicate risk or any simple, “quick fixes” that we can turn to. As Professor Dinah Gould wrote in the previous issue of Exsero, “the prevention and control of HAI is likely to remain an enduring challenge in health care.”
History shows that infectious diseases have always been...

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