Wounded personnel returning from Afghanistan and Iraq are often colonized or infected with Multi‐Drug Resistant Organisms (MDRO), likely due to nosocomial transmission in and out of the combat zone. All reviewed facilities had established IC programs, but these were staffed by personnel with limited IC experience, often without perceived adequate time dedicated to perform their duties, and without uniform levels of command emphasis or support. Proper hand hygiene between patients was not always ideal. Isolation and cohorting of patients to decrease MDRO colonization and infection varied among facilities. Review of standard operating procedures found variability among institutions and in quality of these documents. Application of US national and theater-specific guidelines and of antimicrobial control measures also varied among facilities.
As in the United States, the observed practice of hand hygiene before and after each patient encounter was less than perfect. The authors have concluded that: “Monitoring of hand hygiene compliance using a standard collection tool should be performed.”