scholarly journals Zero Healthcare-Associated COVID-19

2021 ◽  
Vol 1 (S1) ◽  
pp. s73-s73
Author(s):  
Moi Lin Ling ◽  
Molly How ◽  
Kwee Yuen Tan ◽  
Elaine Wee ◽  
Phoon Poh Choo ◽  
...  
Keyword(s):  
Migrant Workers ◽  
Infection Prevention ◽  
Tertiary Care ◽  
Healthcare Delivery ◽  
Personal Hygiene ◽  
Care Hospital ◽  
Service Staff ◽  
Medical Teams ◽  
Set Up ◽  
Healthcare Associated

Background: The ongoing COVID-19 pandemic tests the healthcare system in many ways. The scarcity of resources poses challenges to infection prevention (IP) practices. We describe our experience in managing such scarcity in our care of COVID-19 patients in the hospital as well as community settings. Methods: The hospital pandemic plan traditionally included only plans for healthcare delivery management within the hospital. However, on March 25, 2020, a decision was made by the Ministry of Health to set up swab isolation (SIFs) and community care facilities (CCFs) to meet the growing demand for isolation beds for migrant workers infected by COVID-19. The CCFs were located in convention halls and resort centers and the SIFs were located in facilities previously functioning as hotels. Mobile medical teams were activated to run clinics at the dormitories housing 200,000 migrant workers. The IP team of an acute- and tertiary-care hospital in Singapore was activated to oversee IP measures at facilities managed by medical teams from the hospital, with the goal of zero healthcare-associated COVID-19 cases among staff. Two IP leaders were set up to oversee the IP program at 8 dormitories, 4 SIFs, and 2 CCFs. In total, 12 IP staff and 15 infection prevention liaison officers (IPLOs) were deployed from 2 acute-care hospitals and 3 specialty centers to conduct training in hand hygiene and the use of personal protective equipment, and to conduct daily audits of compliance to practice guidelines. Education on personal hygiene was also given to patients in these facilities in at least 7 languages. In the SIFs and dormitories, IPLOs were recruited to perform daily audits and feedback to the IP team on issues related to IP at the sites. Results: Since our first COVID-19 patient on January 23, 2020, there has been no report of healthcare-associated COVID-19 within the hospital nor among the medical, administrative, and support service staff working in the external operation facilities. Daily audits showed an average of 99.4% compliance to IP guidelines. Conclusions: IPLOs or IP champions play a significant role in ensuring compliance to IP guidelines. This compliance allows the IP professional to focus on the evaluation of the IP program, managing IP consultations, and planning and implementation of the IP program in nontraditional healthcare settings. The key success factors of the program included the ability to contextualize the planning and implementation of IP programs in various settings, strong leadership support, cohesive teamwork, and effective communication at various levels.Funding: NoDisclosures: None

scholarly journals MICROORGANISMS VARIANTS FOR HEALTHCARE-ASSOCIATED INFECTIONS IN A SELECTED TERTIARY CARE HOSPITAL

2021 ◽  
pp. 22-25
Author(s):  
SARALA KS ◽  
NANDAKUMAR BS ◽  
NARENDRANATH V
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Secondary Data ◽  
Blood Stream ◽  
Microbial Flora ◽  
Healthcare Associated Infections ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Set Up ◽  
Healthcare Associated

Objective: Microorganisms are minute and can be only in microscope and these are not visible to naked eyes. Various types of microbe include bacteria, virus, fungi, and protozoa. These microorganisms are subclassified and these are disease causing leading to mortality and morbidity. Healthcare-associated infections (HAIs) arise from different variants of microbes and knowing the category of microbes for treating the diseases with specific antibiotics is important for better patient outcome. Methods: Using secondary data, all the patients who had HAI for 3 years were taken into consideration by considering the different variants of microorganisms. Results: Retrospective data collected for the period of 3 years the inpatients who got admitted for more than 48 h of duration, the data collected included the parameters for various microorganisms such as Bacilli, cocci, Klebsiella, Acinetobacter, and Aures, other micro-organisms such as Escherichia coli, Citrobacter, and Pseudomonas microorganisms. Bacilli group of microorganisms was more common for urinary tract infection, blood stream infection, and ventilator-associated pneumonia. Aures was more common among surgical site infection infections. Conclusions: Most of the patients who had an HAI had two or more different kind of microorganisms which are responsible for spreading infection. There is a need to control microbial flora in the hospital set up as the rate of HAI increases with microbial flora.

scholarly journals 775. Risk Factors for Healthcare Associated Central Line-Associated Bloodstream Infection (CLABSI) to Identify Novel Infection Prevention Areas - A Case-Control Study

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S484-S485
Author(s):  
Aung Myat Oo ◽  
Pin Hong Jin ◽  
Edwin Philip ◽  
Molly Kue Bien How ◽  
May Kyawt Aung ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bloodstream Infection ◽  
Infection Prevention ◽  
Case Control Study ◽  
Tertiary Care ◽  
Central Line ◽  
Case Control ◽  
Care Hospital ◽  
Healthcare Associated ◽  
Control Study

Abstract Background The International Nosocomial Infection Control Consortium surveillance reported Central line-associated bloodstream infection (CLABSI) rate of 4.1 per 1000 central-line days in 703 ICUs in 50 countries. Methods At the Singapore General Hospital (SGH) a 1,700-bed tertiary care hospital, we conducted a retrospective matched case control study over a 3-year period from 2018 to 2020, to identify risk-factors associated with the development of healthcare associated CLABSI in adult inpatients. Cases and controls were patients ≥18 years of age with central lines in situ for at least 48hrs from date of admission. Case definition was based on National Healthcare Safety Network (NHSN) framework to diagnose Bloodstream Infection (BSI) and CLABSI events. Controls had to be admitted within 30 days of the date of admission of the case patients and should not have developed CLABSI. Cases were matched to controls on a 1:2 ratio. Results 127 cases and 252 controls were included in the analysis. Cases and controls did not differ in age, gender, BMI, presence of diabetes mellitus or presently enforced infection prevention measures (e.g. Central line bundle care). More cases were receiving chemotherapy (10.2% versus 0.8%, p< 0.001), were on TPN (17.3% versus 8.3%, p=0.015) and had been admitted to critical care (73.2% versus 60.7%, p=0.017). Cases were also more likely to have peripherally inserted central venous catheters (37% versus 25%, p=0.017) and have the insertion done in the radiology department under radiological guidance (69.3% versus 55.2%, p=0.011). The median length of stay (LOS) was 44 days (IQR: 0 – 86.8) for cases and 19 days (IQR: 0 - 66.6) for controls (p< 0.001). Inpatient mortality was 25.2% (n=32) for cases 13.9% (n=35) for controls (p-value < 0.010). In multivariate analysis, receiving chemotherapy (OR 11.1, 95%CI: 2.2 – 54.3, p=0.003), being admitted to intensive care unit (ICU) (OR 2.0, 95%CI: 1.1 – 3.8, p=0.019), having a Peripherally Inserted Central Cather (OR 1.8, 95% CI 1.0-3.4, p=0.045), and being colonized with MRSA (OR 1.9, 95%CI: 1.2 – 3.2, p=0.013) were associated with healthcare associated CLABSI. Conclusion Novel approaches are required to reduce risk of healthcare associated CLABSI, focusing on interventions for chemotherapy administration, care within ICUs and PICC lines. Disclosures All Authors: No reported disclosures

Healthcare associated infections caused by non-fermenting Gram negative rods (NFGNR): six years of experience of a tertiary hospital

2013 ◽  
Vol 7 (2) ◽  
pp. 06-12
Author(s):  
Zahidul Hasan ◽  
Md. Kamrul Islam ◽  
Arifa Hossain
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Blood Stream ◽  
Tertiary Hospital ◽  
Healthcare Associated Infections ◽  
Care Hospital ◽  
Gram Negative ◽  
Acinetobacter Spp ◽  
Tract Infections ◽  
Healthcare Associated

Recently non-fermenting Gram negative rods (NFGNR) are playing an important role in healthcare associated infections. This observational study in a tertiary care hospital of Dhaka city conducted during 01August 2007 to 30 June 2013 found that 34.8% isolated organisms from patients with healthcare associated infections were NFGNR. Majority (74.3 %) of these infections were occurring inside critical care areas. Pseudomonas and Acinetobacter together constituted 79.6% of the total NFGNR whereas Burkholderia cephacia complex (15.4%), Stenotrophomonas (4.3%) and Chryseobacterium species (0.7%) combined constituted remaining 20.4%. Out of total NFGNRs, Pseudomonas was responsible for highest number of catheter associated urinary tract infections (55.6%), ventilator associated pneumonia (46.3%), respiratory tract infection (65.8%) and surgical site infection (70.6%). Blood stream infection was predominantly caused by Burkholderia cephacia complex (33.5%) and Acinetobacter spp. (39.5%). Other than colistin most of the organisms were resistant to antibiotics commonly recommended for NFGNR.DOI: http://dx.doi.org/10.3329/bjmm.v7i2.19326 Bangladesh J Med Microbiol 2013; 07(02): 6-12

scholarly journals Providing safe care for patients in the coronavirus disease 2019 (COVID-19) era: A case series evaluating risk for hospital-associated COVID-19

2021 ◽  
pp. 1-7
Author(s):  
Elizabeth B. Habermann ◽  
Aaron J. Tande ◽  
Benjamin D. Pollock ◽  
Matthew R. Neville ◽  
Henry H. Ting ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Tertiary Care ◽  
Case Series ◽  
Adult Patients ◽  
Care Hospital ◽  
Strict Adherence ◽  
Large Tertiary Care ◽  
Healthcare Associated ◽  
Serology Testing ◽  
Pcr Test

Abstract Objective: We evaluated the risk of patients contracting coronavirus disease 2019 (COVID-19) during their hospital stay to inform the safety of hospitalization for a non–COVID-19 indication during this pandemic. Methods: A case series of adult patients hospitalized for 2 or more nights from May 15 to June 15, 2020 at large tertiary-care hospital in the midwestern United States was reviewed. All patients were screened at admission with the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) polymerase chain reaction (PCR) test. Selected adult patients were also tested by IgG serology. After dismissal, patients with negative serology and PCR at admission were asked to undergo repeat serologic testing at 14–21 days after discharge. The primary outcome was healthcare-associated COVID-19 defined as a new positive SARS-CoV-2 PCR test on or after day 4 of hospital stay or within 7 days of hospital dismissal, or seroconversion in patients previously established as seronegative. Results: Of the 2,068 eligible adult patients, 1,778 (86.0%) completed admission PCR testing, while 1,339 (64.7%) also completed admission serology testing. Of the 1,310 (97.8%) who were both PCR and seronegative, 445 (34.0%) repeated postdischarge serology testing. No healthcare-associated COVID-19 cases were detected during the study period. Of 1,310 eligible PCR and seronegative adults, no patients tested PCR positive during hospital admission (95% confidence interval [CI], 0.0%–0.3%). Of the 445 (34.0%) who completed postdischarge serology testing, no patients seroconverted (0.0%; 95% CI, 0.0%–0.9%). Conclusion: We found low likelihood of hospital-associated COVID-19 with strict adherence to universal masking, physical distancing, and hand hygiene along with limited visitors and screening of admissions with PCR.

scholarly journals Comparison of endoscopic activity before and during the covid pandemic at a tertiary care hospital in South Punjab

2021 ◽  
Author(s):  
Farooq Mohyud Din ◽  
Muhammad Asif Gul ◽  
Nouman Hameed ◽  
Rizwan Hameed ◽  
Yasir Zaidi ◽  
...  
Keyword(s):  
Gastrointestinal Bleeding ◽  
Tertiary Care ◽  
Healthcare Delivery ◽  
Absolute Number ◽  
Care Hospital ◽  
Common Indication ◽  
Endoscopic Procedures ◽  
Significant Difference ◽  
Internal Hemorrhoids ◽  
One Year

Introduction: Coronavirus disease 2019 (COVID-19) has resulted in dramatic changes to healthcare delivery. Endoscopic activity has had frequent disruptions during this pandemic. The objective of the study was to see the influence of pandemic over the endoscopic activity. Methods: This retrospective analysis of endoscopic activity was undertaken at Nishtar Hospital Multan. Procedural analysis was done in the three months immediately after covid lockdown (1st April till 30th June 2020) and was compared to a similar period one year back. Results: Five hundred and fifty-four (68.5%) patients underwent endoscopic procedures during the three months of pre-COVID era, while this number reduced to half (n=255, 31.5%) patients during the covid pandemic. Even though the absolute number of Esophagogastroduodenoscopies (EGDs) reduced during the pandemic, patients were more likely to undergo EGDs during the COVID pandemic in contrast to the era before the pandemic (79% versus 66%, p = 0.002). The most common indication for EGD was upper gastrointestinal bleeding (UGIB). The percentage of EGDs done for UGIB rose from almost 60% to 80% during the covid pandemic (p < 0.001). The most common findings were esophageal varices and portal gastropathy (non-significant difference during and before the pandemic). Percentage of ERCPs done for obstructive jaundice doubled during the COVID pandemic (33% versus 65%, p = 0.002).The most common indication for sigmoidoscopy or colonoscopy was lower gastrointestinal bleeding. However, no significant difference was found before and during the covid pandemic (41.7% and 45.8% respectively, p=0.72). Internal hemorrhoids were the most common endoscopic finding. Colon cancer diagnosis reduced from 10% to undetected during the pandemic period. Conclusion: COVID pandemic resulted in a considerable reduction in all types of endoscopic procedures. The majority of procedures were done for emergency indications like gastrointestinal bleeding. Rates of cancer detection were significantly reduced. MeSH: Endoscopy, COVID-19, Gastroenterology

scholarly journals Epidemiological characterization of dermatophytes at a tertiary care hospital in Eastern Uttar Pradesh, India

2019 ◽  
Author(s):  
Ankur Kumar ◽  
Vandana Upadhyay ◽  
Amresh K. Singh ◽  
Jayesh Pandey
Keyword(s):  
Low Socioeconomic Status ◽  
Fungal Infections ◽  
Tertiary Care ◽  
Uttar Pradesh ◽  
Common Species ◽  
Personal Hygiene ◽  
Clinical Samples ◽  
Care Hospital ◽  
Direct Microscopic Examination ◽  
Superficial Mycosis

Background and Purpose: Superficial mycosis is more prevalent in tropical and subtropical countries, such as India. Regarding this, the present study was conducted to determine the epidemiology of superficial mycosis and identify the most common dermatophytic species in this region. Materials and Methods: For the purpose of the study, a total of 220 skin scraping, nail, and hair root specimens were collected. Direct microscopic examination was performed using potassium hydroxide mount. Additionally, the samples were inoculated onto Sabouraud dextrose agar (SDA) and dermatophyte test medium (DTM). The fungal colony of each isolates was stained with lactophenol cotton blue mount, and observed under microscope for species identification. Results: Out of 220 isolates, 172 samples, obtained from 108 males 64 females, were positive for skin fungal infections by either KOH mount or culture. Furthermore, 113 isolates were identified as dermatophytes, while 59 samples were found to be non-dermatophytes. Among the dermatophytes isolated from different clinical samples, Trichophyton verrucosum (42/113, 38%) was the most common species, and Tinea corporis was the most common infection (36.2%). Conclusion: As the findings indicated, dermatophytes had an isolation rate of 78%, which is higher than normal. This can be due to the fact that the majority of the patients were from a rural background (71.7%) with a low socioeconomic status and poor personal hygiene who were exposed to climatic changes.

scholarly journals Device associated and surgical site infections, quality indicators in a tertiary care hospital: A 5 year study

2021 ◽  
Vol 9 (3) ◽  
pp. 132-146
Author(s):  
Bilolikar AK ◽  
Banerjee J ◽  
Thomas KM
Keyword(s):  
Quality Indicators ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Central Line ◽  
Bench Mark ◽  
Care Hospital ◽  
Statistical Tool ◽  
Hospital Infection Control ◽  
Control And Prevention ◽  
Healthcare Associated

Purpose: In the present study, an attempt is made to understand the pattern of HAIs (Healthcare Associated Infections) [device associated infections such as Catheter Associated Urinary Tract Infection (CAUTI), Ventilator Associated Event (VAE), Central Line-Associated Bloodstream Infection (CLABSI) & Surgical Site Infection (SSI) by analyzing statistical tool of quality indicators] and to establish a bench mark for HAIs in a single hospital for a period of 5 years. Methods: The Microbiologist & ICN’s conduct rounds in ICU’s & wards and collect data for active surveillance. The details of culture positive samples are collected by Microbiologist from the laboratory for passive surveillance. The surveillance forms (active & passive) capture details of individual patients. The data collection forms are prepared and updated as per Centers for Disease Control and Prevention (CDC), National Healthcare Safety Network (NHSN) guidelines. The data is analyzed and presented in the meeting of Hospital Infection Control Committee meeting & discussed with clinicians. Results: The cumulative (5 years) CAUTI rate is 0.45, VAE is 2.42, CLABSI is 1.35 & SSI is 0.21. HAI rates were highest for VAE (2.42/1000 ventilator days), the next was CLABSI (1.35/1000 central line days), followed by CAUTI (0.45/1000 urinary catheter days). SSI rate was 0.21/ 100 surgeries. Conclusions: Before the study was started, the benchmark were 2 for CAUTI, 5.5 for VAE, 3 for CLABSI and 2 for SSI. We could able to reduce the baseline benchmark and established our new benchmark as 1 for CAUTI, 3 for VAE, 2 for CLABSI and 1 for SSI that can be used in developing HAI prevention policies by the institution.

scholarly journals Evaluation of rational drug use pattern using WHO prescribing indicators in a medical intensive care unit of a tertiary teaching hospital in Kerala, India

2017 ◽  
Vol 6 (6) ◽  
pp. 1328
Author(s):  
Shobha P. ◽  
Messaline Sunitha
Keyword(s):  
Tertiary Care ◽  
Care Hospital ◽  
Prescribing Practices ◽  
Essential Drug ◽  
Prescribing Pattern ◽  
Respiratory Problems ◽  
Essential Drug List ◽  
Drug List ◽  
Tertiary Teaching ◽  
Set Up

Background: ICU patients are exposed to more number of life saving drugs and face drug related problems like therapeutic failure, drug interactions and frequent adverse drug reactions. The cost of ICU hospitalisation and money spent on medicines is also a huge burden on these patients. A study of prescribing pattern in an ICU set up will serve as a medical audit to monitor and evaluate the prescribing practices to make it more rational and cost effective.Methods: A prospective observational study was carried out in a medical ICU of a tertiary care hospital. All the inpatients admitted in the medical ICU during the study period of 2 months were included in the study. The data obtained from the case sheets were used to assess the prescribing pattern and rationality of drug use.Results: A total of 101 patients were admitted in 2 months. The most common illness for which the patients (22) were admitted was respiratory problems. Average number of drugs per prescription was 6.9. Cardiovascular system (23.9%) drugs were the most frequently prescribed. Pantoprazole (77) was the single most commonly prescribed drug. 40% of the drugs were prescribed from the essential drug list. The average cost of medicines incurred per person in our study was 5126.33 in INR.Conclusions: Polypharmacy and unwanted prescription of proton pump inhibitors can be avoided by prescribing more generics and drugs from essential drug list.

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