Randomized Prospective Study of the Impact of Three Needleless Intravenous Systems on Needlestick Injury Rates

1996 ◽  
Vol 17 (12) ◽  
pp. 803-808
Author(s):  
Paul B. L'Ecuyer ◽  
Elizabeth Owens Schwab ◽  
Elizabeth Iademarco ◽  
Norma Barr ◽  
Elizabeth A. Aton ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Tertiary Care ◽  
Control Area ◽  
Needlestick Injury ◽  
Pathogen Transmission ◽  
Needlestick Injuries ◽  
Injury Rates ◽  
Rate Ratios ◽  
And Control ◽  
The Impact

AbstractObjective:To determine the impact of three needleless intravenous systems on needlestick injury rates.Design:Randomized controlled trial.Setting:1,000-bed tertiary-care Midwestern hospital.Participants:Nursing personnel from general medical, general surgical, and intensive-care units.Interventions:From June 1992 through March 1994, a metal blunt cannula (MBC), two-way valve (2-way), and plastic blunt cannula (PBC) were introduced into three study areas, and needlestick injury rates were compared to three control areas using traditional needled devices.Results:24 and 29 needlestick injuries were reported in study and control areas. Intravenous-therapy-related injuries comprised 45.8% and 57.1% of injuries in each area. Thirty-seven percent and 20.7% of study and control area needlestick injuries were considered to pose a high risk of bloodborne infection. The 2-way group had similar rates of total and intravenous-related needlestick injuries compared to control groups. The PBC group had lower rates of total and intravenous-related needlestick injuries per 1,000 patient-days (rate ratios [RR], 0.32 and 0.24; 95°% confidence intervals [CI95], 0.12-0.81 and 0.09-0.61;P=.02 andP=.003, respectively) and per 1,000 productive hours worked (RR, 0.11 and 0.08; CI95, 0.01-0.92 and 0.010.69;P=.03 andP=.005, respectively) compared to controls.Conclusions:Needlestick injuries continued in study areas despite the introduction of needleless devices, and risks of bloodborne pathogen transmission were similar to control areas. The PBC device group noted lower rates of needlestick injuries compared to controls, but there were problems with product acceptance, correct product use, and continued traditional device use in study areas. Low needlestick injury rates make interpretations difficult. Further studies of safety devices are needed and should attempt greater control of worker behavior to aid interpretation.

scholarly journals Achieving equitable uptake of handwashing and sanitation by addressing both supply and demand-based constraints: findings from a randomized controlled trial in rural Bangladesh

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sarker Masud Parvez ◽  
Musarrat Jabeen Rahman ◽  
Rashidul Azad ◽  
Mahbubur Rahman ◽  
Leanne Unicomb ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Supply And Demand ◽  
Efficacy Trial ◽  
Experimental Conditions ◽  
Randomized Controlled ◽  
Link Type ◽  
Education Levels ◽  
Change Promotion ◽  
And Control ◽  
The Impact

Abstract Background Supply driven programs that are not closely connected to community demand and demand-driven programs that fail to ensure supply both risk worsening inequity. Understanding patterns of uptake of behaviors among the poorest under ideal experimental conditions, such as those of an efficacy trial, can help identify strategies that could be strengthened in routine programmatic conditions for more equitable uptake. WASH Benefits Bangladesh was a randomized controlled efficacy trial that provided free-of cost WASH hardware along with behavior change promotion. The current paper aimed to determine the impact of the removal of supply and demand constraints on the uptake of handwashing and sanitation behaviors across wealth and education levels. Methods The current analysis selected 4 indicators from the WASH Benefits trial— presence of water and soap in household handwashing stations, observed mother’s hand cleanliness, observed visible feces on latrine slab or floor and reported last child defecation in potty or toilet. A baseline assessment was conducted immediately after enrolment and endline assessment was conducted approximately 2 years later. We compared change in uptake of these indicators including wealth quintiles (Q) between intervention and control groups from baseline to endline. Results For hand cleanliness, the poorest mothers improved more [Q1 difference in difference, DID: 16% (7, 25%)] than the wealthiest mothers [Q5 DID: 7% (− 4, 17%)]. The poorest households had largest improvements for observed presence of water and soap in handwashing station [Q1 DID: 82% (75, 90%)] compared to the wealthiest households [Q5 DID: 39% (30, 50%)]. Similarly, poorer household demonstrated greater reductions in visible feces on latrine slab or floor [Q1DID, − 25% (− 35, − 15) Q2: − 34% (− 44, − 23%)] than the wealthiest household [Q5 DID: − 1% (− 11, 8%). For reported last child defecation in potty or toilet, the poorest mothers showed greater improvement [Q1–4 DID: 50–54% (44, 60%)] than the wealthier mothers [Q5 DID: 39% (31, 46%). Conclusion By simultaneously addressing supply and demand-constraints among the poorest, we observed substantial overall improvements in equity. Within scaled-up programs, a separate targeted strategy that relaxes constraints for the poorest can improve the equity of a program. Trial registration WASH Benefits Bangladesh: ClinicalTrials.gov, identifier: NCT01590095. Date of registration: April 30, 2012 ‘Retrospectively registered’.

Abstract P186: A Randomized Preschool Trial To Promote Cardiovascular Health In Colombia: 18 Month Follow Up.

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Jaime Céspedes ◽  
German Briceño ◽  
Michael Farkouh ◽  
Rajesh Vedanthan ◽  
Martha Leal ◽  
...  
Keyword(s):  
Educational Intervention ◽  
Cardiovascular Health ◽  
Controlled Trial ◽  
Intervention Group ◽  
Educational Programs ◽  
Control Group ◽  
Active Lifestyle ◽  
And Control ◽  
The Impact

Introduction: Educational programs for children can increase uptake of healthy lifestyle behaviors. However, the impact of educational programs in preschool-aged children in low- and middle-income countries is not known. We conducted a five month educational intervention in preschool facilities (PF) in Bogota, Colombia, to assess changes in preschooler’s knowledge, attitudes and habits (KAH) towards healthy eating and living an active lifestyle. Methods: We conducted a cluster, randomized, controlled trial, and randomly assigned 14 PF in Bogota to a five-month educational intervention (7 PF) or to usual curriculum (7 PF). The intervention included classroom activities and use of printed material and videos. A total of 1216 pre-school children, 928 parents, and 120 teachers participated. A structured survey was used to evaluate changes in KAH with a weighted total score (WTS). The primary outcome was change in children's WTS, and the secondary outcomes were change in parents’ and teachers' WTS. The control PF were provided the intervention after the initial evaluation. To assess sustainability, we evaluated both intervention and control groups at 18 months. Results: At 6 months, children in the intervention group showed 10.9% increase in WTS vs. 5.3% in controls, p<0.001, after adjustment for cluster, sex, age and teachers' educational level. Among parents, the equivalent results were 8.9% and 3.1%, respectively, p< 0.001, and among teachers 9.4% and 2.5%, p=0.06. At the 18-month extended follow-up, both the intervention and control children showed a significant further increase in WTS, p<0.001 (Figure 1). In parents and teachers in the intervened group, there was no significant increase in WTS, p=0.7417, and p=0.1197. In the control group, there was an increase in WTS in teachers but not in parents, p=0.001, and p=0.4239. Conclusion: A preschool based intervention, aimed at changing KAH related to healthy diet and active lifestyle, is feasible, efficacious and sustainable up to 18 months in very young children in Colombia.

TO EVALUATE THE EFFECT OF PROPHYLACTIC USE OF TRENEXAMIC ACID ON BLEEDING DURING ELECTIVE LSCS. A STUDY CONDUCTED IN TERTIARY CARE HOSPITAL OF CENTRAL INDIA.

2021 ◽  
pp. 223-225
Author(s):  
Dhara Singh ◽  
Sujata bhargava
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Tertiary Care ◽  
Alternative Methods ◽  
World Health ◽  
Study Cohort ◽  
Care Hospital ◽  
Total Blood ◽  
And Control ◽  
The Impact

Background: Recent guidelines of the World Health Organization (WHO) indicated administering tranexamic acid (TXA) in order to treat postpartum bleeding (PPH). Therefore, nding low-cost and lowrisk alternative methods to control obstetric bleeding is of great importance. The present study aimed to evaluate the prophylactic effect of TXA on bleeding during and after the LSCS. In addition, it was attempted to explore the impact of TXA as a safe and inexpensive method for decreasing bleeding during and after CS so that to decrease the hazard of blood transfusion or hysterectomy in these patients. Material and Methods: This prospective study conducted on 100 women in Department of Obstetrics &gynecolgy for one year period. They were divided in two groups: Cases: (n=50; women receiving prophylactic Tranexamic Acid) and Control: (n=50; women receiving saline). Estimated the amount of blood loss during surgery. The amount of blood loss during surgery were calculated Estimation of weight of dry towels and mops before autoclaving is noted. Results: Most common age group among Cases and Control was 26-30 years .%. Mean age among cases group (26.69±7.51 years) was signicantly lesser compared to control study cohort (29.75±7.72). Post operativehemoglobin level was signicantly higher among Case (11.26±12.03) as compared to Control (8.56±1.01). Comparing post operative complications revealedno signicant changes. Use of topical hemostatics was higher among the control (77%) as compared to Cases (57%). Conclusion: Prophylactic treatment with TXA in relation to elective LSCS reduces the overall total blood loss, and the risk of reoperations owing to postoperative hemorrhage as revealed by higher hemoglobin level among cases.

Facial Trauma During the COVID-19 Pandemic

2021 ◽  
pp. 194338752110537
Author(s):  
Kiranya E. Tipirneni ◽  
Amanda Gemmiti ◽  
Mark A. Arnold ◽  
Amar Suryadevara
Keyword(s):  
New York ◽  
Tertiary Care ◽  
University Hospital ◽  
Facial Trauma ◽  
Common Mechanism ◽  
Valuable Insight ◽  
Central New York ◽  
Incident Rate ◽  
Rate Ratios ◽  
The Impact

Study Design Retrospective cohort study. Objective The purpose of this study is to evaluate the impact of the COVID-19 global pandemic on the regional trends in facial trauma at a tertiary care, level 1 trauma center in Central New York. Methods The study sample was derived from the population of patients who presented with facial trauma to the emergency department at the Downtown and/or Community Campuses of SUNY Upstate University Hospital between March 1, 2020, and May 15, 2020, and compared to two historical controls in 2018 and 2019. Descriptive and bivariate statistics were calculated for study variables in each cohort. Poisson regression was used to compare incident rate ratios (IRR) with 95% confidence intervals with significance set at P < .05. Results Sixty five patients presented during the COVID-19 pandemic, while 83 presented in 2019 and 95 in 2018. For the study period, the most common mechanism was assault in 47.7%. IRR was significantly lower than in 2018 (IRR = 1.46, P = .018), but not significantly different from 2019 (IRR = 1.28, P = .14). During lockdown, IRR was significantly decreased compared to 2019 (IRR = 1.84, P = .0029) and 2018 (IRR = 2.16, P < .001). Conclusion The volume of facial trauma seen in Central New York appears undeterred in the absence of “shelter in place” orders. Analysis of pandemic and regional trauma variations can offer valuable insight for improved resource allocation to better prepare for potentially high-risk procedures.

Needlestick injuries: the role of safety-engineered devices in prevention

2020 ◽  
Vol 29 (14) ◽  
pp. S22-S30 ◽  
Author(s):  
Andrew Paul Jackson ◽  
Leo Andrew Almerol ◽  
Jackie Campbell ◽  
Louise Hamilton
Keyword(s):  
Healthcare Workers ◽  
Medical Literature ◽  
Substantial Reduction ◽  
Needlestick Injury ◽  
Needlestick Injuries ◽  
Clinical Interest ◽  
Percutaneous Exposure ◽  
The Impact

The first documented mention of a needlestick injury (NSI) in the medical literature appeared in 1906. Despite growth in academic and clinical interest for NSI prevention, a global report identified that approximately 3 million healthcare workers have suffered percutaneous exposure to blood-borne pathogens. Legislation is an important component of NSI prevention. Unfortunately, the impact of legislation may not always reduce the incidence of NSI as much as expected. Safety-engineered device (SED) implementation has demonstrated a substantial reduction in NSI rates compared with non-SEDs. More importantly, passive SEDs are 10 times less likely to be connected with an NSI incident

scholarly journals Something Stinks! Finding Ways to Manage Noxious Odours in the Operating Room and Other Clinical Settings A Randomized Controlled Trial

2021 ◽  
pp. 229255032110084
Author(s):  
Lindsay Bjornson ◽  
Aaron C. Van Slyke ◽  
Marija Bucevska ◽  
Rebecca Courtemanche ◽  
Jeffrey Bone ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Controlled Trial ◽  
Clinical Settings ◽  
Upper Respiratory Tract ◽  
Surgical Masks ◽  
Significant Difference ◽  
Olfactory Preferences ◽  
And Control ◽  
The Impact ◽  
Better Than

Objectives: The hospital can be saturated with noxious smells. Anecdotally, medical staff apply products to surgical masks to lessen the impact of these smells. This study aimed to determine the odour-masking ability of 4 inexpensive and convenient products. Methods: A randomized, single-blinded crossover study was conducted in Vancouver, Canada. Participants, 19 to 30 years old, were invited to participate. Participants with active allergies, upper respiratory tract infection, alteration to sense of smell, or failure of olfactory screen were excluded from the study. An experimental odour was used in lieu of a noxious surgical odour. After smelling the experimental odour without barriers, participants were re-exposed to the odour using 5 surgical masks in randomized order. Each mask was lined with a test product (cherry lip balm, tincture of benzoin, Mastisol, mint toothpaste, and control [plain mask]). Participants rated the effectiveness of products at masking the experimental odour from 0 to 100 (0 = completely ineffective, 100 = completely effective). Participants also rated the pleasantness of the products, recorded if the products made them feel unwell, and identified their preferred product overall. Results: Eighty participants were included in the study (33 male, 47 female), averaging 24.2 years of age. Mean odour-masking effectiveness for cherry lip balm was 66.5 (±24.6), tincture of benzoin: 62.6 (±25.0), Mastisol: 61.3 (±23.9), mint toothpaste: 57.5 (±27.4), and control: 21.9 (±21.8). All products performed better than the control ( P < .001), but there was no significant difference in performance between products. Cherry lip balm was the most preferred odour-masking product (29 participants), followed by mint toothpaste (22), Mastisol (14), tincture of benzoin (10), and control (5). Conclusions: All tested products demonstrated equivalent odour-masking abilities. If health care professionals choose to use an odour-masking product, they should consider their own olfactory preferences.

scholarly journals The impact of FFP3 respirators on the blood saturation of intensive care unit medical staff.

2021 ◽  
Author(s):  
Izabela Wojtasz ◽  
Krystyna Jaracz ◽  
Pawel Sobczynski ◽  
Artur Druzdz ◽  
Danuta Dyk ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mixed Model ◽  
Controlled Trial ◽  
Well Being ◽  
Normal Ranges ◽  
Care Workers ◽  
Reliable Solution ◽  
And Control ◽  
The Impact

Abstract BackgroundRecent studies support the effectiveness of filtering facepiece class 3 respirators (FFP3) during the COVID-19 pandemic in terms of protecting both health care workers (HCWs) and patients. However, wearing FFP3 respirators together with personal protective equipment (FFP3/PPE) could increase the feeling of discomfort or could even cause hypoxia. This study aims to investigate whether wearing an FPP3/PPE during work in the intensive care unit (ICU) affects the blood saturation (SpO2), the heart rate (HR), and the well-being of HCWs, as depicted by a score scale.MethodsThe study included a group of 21 volunteers, staff nurses, students and consultants (including 16 females (76%), with a median age of 23 years (interquartile range 21-27), range 20-59 years).We applied a counterbalanced crossover design—a self-controlled trial. Each subject served as his own control and performed the test two times: they wore the FFP3/PPE for a three-hour shift in the ICU and then did not wear the FFP3/PPE for 3 hours. To record the SpO2 and HR in real time, we used a Nellcor PM10N (Coviden, USA) portable monitoring system. Additionally, every 30 minutes during the shift and control run, each subject completed a questionnaire concerning their well-being, with a score scale to evaluate for headaches, shortness of breath, perspiration, fatigue, and thirst.ResultsThe mixed model demonstrated that working with an FFP3/PPE compared to not working with an FFP3/PPE caused a significant, but still within normal ranges, influence on the level of SpO2, with a mean decrease of -1.43%. The highest reduction in the SpO2 was 2.29%, and occurred after 150 minutes of work. We also found a significant increase in the HR at 60, 90, and 120 minutes after starting work. All of the score scales of the well-being markers increased consecutively but were moderate during the shift while wearing the FFP3/PPE; the side effects were mainly fatigue, thirst, and sweating.ConclusionWe assume that a 3 hour shift rhythm –, i.e., three hours of working in the FFP3/PPE in the ICU, followed by rest or working without an FFP3/PPE is a safe and reliable solution.

scholarly journals Impact of the COVID-19 shutdown on orthopedic trauma numbers and patterns in an academic Level I Trauma Center in Berlin, Germany

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246956
Author(s):  
Tazio Maleitzke ◽  
Matthias Pumberger ◽  
Undine A. Gerlach ◽  
Carolin Herrmann ◽  
Anna Slagman ◽  
...  
Keyword(s):  
Trauma Center ◽  
Control Period ◽  
Orthopedic Trauma ◽  
Injury Patterns ◽  
Total Patient ◽  
Academic Level ◽  
Level I ◽  
Rate Ratios ◽  
And Control ◽  
The Impact

Background The COVID-19 pandemic led to the implementation of drastic shutdown measures worldwide. While quarantine, self-isolation and shutdown laws helped to effectively contain and control the spread of SARS-CoV-2, the impact of COVID-19 shutdowns on trauma care in emergency departments (EDs) remains elusive. Methods All ED patient records from the 35-day COVID-19 shutdown (SHUTDOWN) period were retrospectively compared to a calendar-matched control period in 2019 (CTRL) as well as to a pre (PRE)- and post (POST)-shutdown period in an academic Level I Trauma Center in Berlin, Germany. Total patient and orthopedic trauma cases and contacts as well as trauma causes and injury patterns were evaluated during respective periods regarding absolute numbers, incidence rate ratios (IRRs) and risk ratios (RRs). Findings Daily total patient cases (SHUTDOWN vs. CTRL, 106.94 vs. 167.54) and orthopedic trauma cases (SHUTDOWN vs. CTRL, 30.91 vs. 52.06) decreased during the SHUTDOWN compared to the CTRL period with IRRs of 0.64 and 0.59. While absolute numbers decreased for most trauma causes during the SHUTDOWN period, we observed increased incidence proportions of household injuries and bicycle accidents with RRs of 1.31 and 1.68 respectively. An RR of 2.41 was observed for injuries due to domestic violence. We further recorded increased incidence proportions of acute and regular substance abuse during the SHUTDOWN period with RRs of 1.63 and 3.22, respectively. Conclusions While we observed a relevant decrease in total patient cases, relative proportions of specific trauma causes and injury patterns increased during the COVID-19 shutdown in Berlin, Germany. As government programs offered prompt financial aid during the pandemic to individuals and businesses, additional social support may be considered for vulnerable domestic environments.

A Randomized Controlled Trial of the Effects of Group Conversation Treatment on Monologic Discourse in Aphasia

2021 ◽  
pp. 1-15
Author(s):  
Elizabeth Hoover ◽  
Gayle DeDe ◽  
Edwin Maas
Keyword(s):  
Randomized Controlled Trial ◽  
Narrative Analysis ◽  
Group Treatment ◽  
Controlled Trial ◽  
Primary Outcome Measure ◽  
Control Group ◽  
Percent Correct ◽  
Randomized Controlled ◽  
And Control ◽  
The Impact

Purpose Evidence has shown that group conversation treatment may improve communication and reduce social isolation for people with aphasia. However, little is known about the impact of conversation group treatment on measures of discourse. This project explored the impact of conversation treatment on measures of monologic discourse. Method In this randomized controlled trial, 48 participants with chronic aphasia were randomly assigned to dyadic, large group, or control conditions. Conversation group treatment was provided for 1 hr, twice per week, for 10 weeks. Discourse samples were collected and coded at pretreatment, posttreatment, and 6-week maintenance. There were three narrative tasks: (a) Comprehensive Aphasia Test (CAT) picture description, (b) Cat Rescue Picture, and (c) Cinderella retell. All narratives were coded using the percent correct information units (percent CIUs), the CAT standardized narrative analysis method, and the complete utterance (CU) method. Results No significant changes were observed on percent CIU, which was the primary outcome measure. The treated groups demonstrated improvement on aspects of the CU method following treatment, whereas the control group did not. Significant changes were observed for other CIU measures and the CAT standardized narrative analysis in both the treated and control groups. Conclusions The results suggest that the CU measures were more sensitive to the effects of conversation treatment in monologic discourse compared to CIU and CAT measures. Changes were more common in absolute rather than relative values, suggesting that conversation treatment impacts the overall amount of language produced rather than efficiency of production.

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