Clostridium difficile Contamination of Blood Pressure Cuffs: A Call for a Closer Look at Gloving Practices in the Era of Universal Precautions

1996 ◽  
Vol 17 (3) ◽  
pp. 180-182
Author(s):  
Farrin A. Manian ◽  
Lynn Meyer ◽  
Joan Jenne

AbstractWe report an outbreak of Clostridium difficile-associated diarrhea at our medical center following adoption of Universal Precautions. Environmental cultures revealed unexpected contamination of blood pressure cuffs at a rate similar to that for bedside commodes (10% and 11.5%, respectively). An obser vational sur vey revealed that healthcare workers in the patient care areas not infrequently failed to remove their potentially stool-contaminated gloves prior to touching clean surfaces, which might have contributed to contamination of blood pressure cuffs.

1992 ◽  
Vol 13 (5) ◽  
pp. 265-271 ◽  
Author(s):  
Donna J. Haiduven ◽  
Tammy M. DeMaio ◽  
David A. Stevens

AbstractObjective:To decrease the numbers of needlesticks among healthcare workers.Design:All reported needlestick injuries at Santa Clara Valley Medical Center, San Jose, California, were reviewed, analyzed, and tabulated by the infection control department yearly from 1986 to 1990.Setting:A 588-bed county teaching hospital in San Jose, California, affiliated with Stanford University.Participants:All employees of Santa Clara Valley Medical Center who reported needlestick injuries on injury report forms.Interventions:From April to December 1987, more needle disposal containers were added to as many patient care areas and as close to the area of use as possible. Results of 1986, 1988, 1989, and 1990 analyses were communicated yearly to all personnel, extensive educational programs were conducted in 1987 and 1988, and educational efforts continued in 1989 and 1990.Results:In 1986, there were 259 needlestick injuries at our institution, 22% (32) from recapping. After needle disposal containers were added to all patient care areas, needlestick injuries for 1988 totalled 143, a 45% decrease in the total needlestick injuries and a 53% decrease in recapping injuries. Communication of results to all areas of the hospital and educational activities were started in 1987 and continued through the next 3 years. In 1989, there were 135 needlestick injuries, a decrease of 6% from 1988; recapping injuries decreased 40% from 1988. In 1990, there were 104 needlestick injuries, a 23% decrease since 1989, and a 33% decrease in recapping injuries. The total number of needlestick injuries from 1986 to 1990 decreased by 60%, and those injuries from recapping decreased by 81% to 89%.Conclusions:We have continued to monitor needlestick injuries, communicate findings to all personnel, and include needlestick prevention in educational programs. We contend that more convenient placement of needle disposal containers, communication of tidings, and education do decrease needlestick injuries in healthcare workers.


2008 ◽  
Vol 29 (2) ◽  
pp. 111-115 ◽  
Author(s):  
Jennifer L. Kuntz ◽  
Stephanie Holley ◽  
Charles M. Helms ◽  
Joseph E. Cavanaugh ◽  
Jeff Vande Berg ◽  
...  

Objective.To determine the effect of a pandemic influenza preparedness drill on the rate of influenza vaccination among healthcare workers (HCWs).Design.Before-after intervention trial.Setting.The University of Iowa Hospitals and Clinics (UIHC), a large, academic medical center, during 2005.Subjects.Staff members at UIHC.Methods.UIHC conducted a pandemic influenza preparedness drill that included a goal of vaccinating a large number of HCWs in 6 days without disrupting patient care. Peer vaccination and mobile vaccination teams were used to vaccinate HCWs, educational tools were distributed to encourage HCWs to be vaccinated, and resources were allocated on the basis of daily vaccination reports. Logit models were used to compare vaccination rates achieved during the 2005 vaccination drill with the vaccination rates achieved during the 2003 vaccination campaign.Results.UIHC vaccinated 54% of HCWs (2,934 of 5,467) who provided direct patient care in 6 days. In 2 additional weeks, this rate increased to 66% (3,625 of 5,467). Overall, 66% of resident physicians (311 of 470) and 63% of nursing staff (1,429 of 2,255) were vaccinated. Vaccination rates in 2005 were significantly higher than the hospitalwide rate of 41% (5,741 of 14, 086) in 2003.Conclusions.UIHC dramatically increased the influenza vaccination rate among HCWs by conducting a pandemic influenza preparedness drill. Additionally, the drill allowed us to conduct a bioemergency drill in a realistic scenario, use innovative methods for vaccine delivery, and secure administrative support for future influenza vaccination campaigns. Our study demonstrates how a drill can be used to improve vaccination rates significantly.


2019 ◽  
Vol 17 (6) ◽  
pp. 517-521 ◽  
Author(s):  
Julie Bulson, DNP, MPA, RN, NE-BC ◽  
Kenneth Shawl, BBA, RRT, NHDP-BC

Purpose: There is a lack of information regarding the physiological effects of healthcare workers performing patient care while wearing enhanced personal protective equipment (PPE). This study aimed to provide foundational data necessary to maintain the health and safety of healthcare workers while performing tasks wearing enhanced PPE related to patient care in a biocontainment unit.Design and method: This study is a descriptive study evaluating the physiological effects of conducting patient care while wearing enhanced PPE. Participant vital signs (blood pressure, body temperature, and oxygen saturation) were monitored pre-donning, throughout the transport, and post-doffing.Results: There is no statistically significant difference in the physiological measurements of any of the participants. The results consisted of: blood pressure (systolic p = 0.0659; diastolic p = 0.94345); oxygen saturation (p = 0.6233); and orally derived body temperature (p = 0.1093). Physical balance was subjectively measured by both the participant and the trained observer during the donning and doffing process. Results show no visible difference in balance between the donning period and the doffing period. Conclusion: This study demonstrated there were no physiological changes to the healthcare workers in this study performing patient care activities during patient transport and in a biocontainment unit while wearing the provided enhanced PPE. However, limitations of this study include: (1) it was conducted at one location within the Midwest; (2) with a small number of participants; and (3) only the enhanced ensemble of PPE was worn during testing. Therefore, the results may not be generalizable to other locations or levels of PPE.Clinical relevance: This study will help to guide assessment standards for healthcare workers providing care while wearing enhanced level PPE.


Author(s):  
Fabiana Rezer ◽  
Hélio Penna Guimarães ◽  
Grazia Maria Guerra

Objective: to describe scientific evidence on the implementation and control of the device for measuring invasive blood pressure (IBP). Methods: integrative review of the literature, based on Latin American and Caribbean Literature in Health Sciences (LILACS), Scientific Electronic Library Online (SciELO), PubMed, through the Descriptors in Health Sciences (DeCS) and the Medical Subject Headings (MesH): hemodynamic; monitoring; blood pressure; invasive. Articles were selected in English, Portuguese and Spanish, published between 2009 and 2018. The search resulted in a sample of 10 articles. Results: The articles were analyzed and presented in 4 thematic groups according to the information they provided regarding the puncture of the IBP catheter, being: 1- Indications for IBP catheter puncture; 2 -Contraindications and complications resulting from the use of the IBP catheter; 3 -Most indicated puncture sites; 4- Implementation and maintenance of IBP catheter. Conclusion: Further research may contribute to patient care with an IAP device, as well as assisting physicians and nurses in patient care, reducing the risks and potential adverse events of the IAP.


2020 ◽  
Author(s):  
Wanhua Xie ◽  
Yunhe Gao ◽  
Weichi Tan

BACKGROUND In the conventional method, the blood pressure values of pregnant women were measured by nurses in the obstetrics outpatient clinics, and then were entered into the computer system.The pregnant women should wait for long time to complete this process.We hypothesized that the self-service blood pressure measurement by pregnant women could be a better option rather than measuring the blood pressure by nurses. OBJECTIVE This study aimed to analyze the effect of self-service blood pressure measurement in obstetrical outpatient clinic on waiting time, satisfaction of pregnant women and outpatient volume, and provide reference for the optimization of outpatient service processes. METHODS This was a cross-sectional study. The waiting time and satisfaction degree of pregnant women, as well as the outpatient volume in the Obstetrics Outpatient Clinic were compared on the use of self-service blood pressure measurement system with the conventional method. A total of 519 pregnant women in the obstetrics outpatient clinics of Guangzhou Women and Children’s Medical Center in China participated in the satisfaction survey. The sample means were compared with t-test. RESULTS Compared to wait a longer queue for blood pressure measured by nurses, after using the self-service blood pressure measurement system, the waiting time of pregnant women for blood pressure measurement was significantly reduced from (18.57±9.68) min to (2.39±1.96) min (P<0.001). In addition, the satisfaction degree of pregnant women was significantly increased (P<0.001), and the monthly outpatient volume was significantly increased (P=0.02,P<0.05). CONCLUSIONS This study showed that after implementation of self-service blood pressure measurement, the waiting time of the pregnant women for blood pressure measurement was decreased significantly, while the satisfactory degree and outpatient flow were increased significantly, improving the cost-effectiveness.Therefore, this method is worth to be popularized in clinical practices. Relevance to clinical practice: How to use medical intelligence in clinical practices, replace manual works by self-service devices to address the high outpatient flow, high work load of medical personnel, and improve the experience of patients in seeking medical services are the most concerned issues by both patients as well as hospital managers.This study demonstrated that the self-service blood pressure measurement as a promising strategy in clinical practices and provided reference for the optimization of outpatient service processes. CLINICALTRIAL This study was approved by the Ethics Committee of the Guangzhou Women and Children’s Medical Center (approval number:SFE-KL-46401; Supplementary file 4). All the pregnant women included in this study signed the informed consent form.


Author(s):  
Cam Le ◽  
Erik Lehman ◽  
Thanh Nguyen ◽  
Timothy Craig

Lack of proper hand hygiene among healthcare workers has been identified as a core facilitator of hospital-acquired infections. Although the concept of hand hygiene quality assurance was introduced to Vietnam relatively recently, it has now become a national focus in an effort to improve the quality of care. Nonetheless, barriers such as resources, lack of education, and cultural norms may be limiting factors for this concept to be properly practiced. Our study aimed to assess the knowledge and attitude of healthcare workers toward hand hygiene and to identify barriers to compliance, as per the World Health Organization’s guidelines, through surveys at a large medical center in Vietnam. In addition, we aimed to evaluate the compliance rate across different hospital departments and the roles of healthcare workers through direct observation. Results showed that, in general, healthcare workers had good knowledge of hand hygiene guidelines, but not all believed in receiving reminders from patients. The barriers to compliance were identified as: limited resources, patient overcrowding, shortage of staff, allergic reactions to hand sanitizers, and lack of awareness. The overall compliance was 31%; physicians had the lowest rate of compliance at 15%, while nurses had the highest rate at 39%; internal medicine had the lowest rate at 16%, while the intensive care unit had the highest rate at 40%. In summary, it appears that addressing cultural attitudes in addition to enforcing repetitive quality assurance and assessment programs are needed to ensure adherence to safe hand washing.


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