Results of a Survey of Ventilator Circuit Practices in the United States

1984 ◽  
Vol 5 (7) ◽  
pp. 353-356 ◽  
Author(s):  
Donald E. Craven ◽  
Michael G. Connolly ◽  
Theresa A. Goularte

The responses to a survey of ventilator circuit practices published in Infection Control are shown in the Table. The majority of 249 individuals who responded were located in community hospitals or community teaching hospitals of 100 to 500 beds. Most of the hospitals changed ventilator circuits (tubing humidifying cascades and swivel adapters) every 24 hours or less. Interestingly, 30.1% of the hospitals indicated that “self-study” was used to determine the time interval of ventilator circuit changes. Our 1982 study of contamination in mechanical ventilators at 24 and 48 hours confirmed earlier observations that mechanical ventilators with cascade humidifiers do not generate small particle aerosols.

1992 ◽  
Vol 13 (5) ◽  
pp. 288-292 ◽  
Author(s):  
Michael D. Decker ◽  
William E. Scheckler

The purpose of this report is to describe the “Continuous Quality Improvement” (CQI) paradigm as adopted by one of the 30 largest hospital systems in the United States and to explore the implications for hospital epidemiology and infection control. Hospital epidemiology has its roots in the application of epidemiologic tools and principles to the problems of nosocomial infections. Key steps in the development of hospital epidemiology came from physicians in Great Britain and the United States who were part of the public health systems of those countries. In the United States, physicians trained in infectious diseases as a subspecialty occupy the position of hospital epidemiologist in most university, Veterans Affairs, and larger community teaching hospitals. Some of these individuals argue that hospital epidemiologists should continue to focus principally on infection control. Others are just as convinced that the premises and knowledge of epidemiology honed by experiences in infection control are very well suited to many other problems facing hospitals in the 1990s.


1982 ◽  
Vol 3 (5) ◽  
pp. 377-383 ◽  
Author(s):  
John M. Boyce ◽  
William A. Causey

AbstractAlthough several outbreaks of methicillin-resistant Staphylococcus aureus (MRSA) infections have been reported in recent years, the geographic distribution and frequency of MRSA infections in American hospitals is unknown. We conducted a questionnaire survey to determine the magnitude of the problem. Data from 261 hospitals were included in the survey. MRSA were reported by 145 hospitals located in 36 states. Large hospitals reported these organisms significantly more often than small hospitals (p<.001). University hospitals reported MRSA more often than community or community-teaching hospitals (p<.001 and p<.005, respectively). The number of hospitals reporting MRSA increased from 24 in 1975 to 112 in 1980 (p<.001). Our data suggest that MRSA are widely distributed geographically and that the number of hospitals with these organisms has increased dramatically since 1975.


2016 ◽  
Vol 42 (2-3) ◽  
pp. 393-428
Author(s):  
Ann Marie Marciarille

The narrative of Ebola's arrival in the United States has been overwhelmed by our fear of a West African-style epidemic. The real story of Ebola's arrival is about our healthcare system's failure to identify, treat, and contain healthcare associated infections. Having long been willfully ignorant of the path of fatal infectious diseases through our healthcare facilities, this paper considers why our reimbursement and quality reporting systems made it easy for this to be so. West Africa's challenges in controlling Ebola resonate with our own struggles to standardize, centralize, and enforce infection control procedures in American healthcare facilities.


Author(s):  
Anna Igorevna Filimonova

After the collapse of the USSR, fundamentally new phenomena appeared on the world arena, which became a watershed separating the bipolar order from the monopolar order associated with the establishment of the US global hegemony. Such phenomena were the events that are most often called «revolutions» in connection with the scale of the changes being made — «velvet revolutions» in the former Eastern Bloc, as well as revolutions of a different type, which ended in a change in the current regimes with such serious consequences that we are also talking about revolutionary transformations. These are technologies of «color revolutions» that allow organizing artificial and seemingly spontaneous mass protests leading to the removal of the legitimate government operating in the country and, in fact, to the seizure of power by a pro-American forces that ensure the Westernization of the country and the implementation of "neoliberal modernization", which essentially means the opening of national markets and the provision of natural resources for the undivided use of the Western factor (TNC and TNB). «Color revolutions» are inseparable from the strategic documents of the United States, in which, from the end of the 20th century, even before the collapse of the USSR, two main tendencies were clearly traced: the expansion of the right to unilateral use of force up to a preemptive strike, which is inextricably linked with the ideological justification of «missionary» American foreign policy, and the right to «assess» the internal state of affairs in countries and change it to a «democratic format», that is, «democratization». «Color revolutions», although they are not directly mentioned in strategic documents, but, being a «technical package of actions», straightforwardly follow from the right, assigned to itself by Washington, to unilateral use of force, which is gradually expanding from exclusively military actions to a comprehensive impact on an opponent country, i.e. essentially a hybrid war. Thus, the «color revolutions» clearly fit into the strategic concept of Washington on the use of force across the entire spectrum (conventional and unconventional war) under the pretext of «democratization». The article examines the period of registration and expansion of the US right to use force (which, according to the current international law, is a crime without a statute of limitations) in the time interval from the end of the twentieth century until 2014, filling semantic content about the need for «democratic transformations» of other states, with which the United States approached the key point of the events of the «Arab spring» and «color revolutions» in the post-Soviet space, the last and most ambitious of which was the «Euromaidan» in Ukraine in 2014. The article presents the material for the preparation of lectures and seminars in the framework of the training fields «International Relations» and «Political Science».


2021 ◽  
Vol 12 ◽  
Author(s):  
Ting Ai ◽  
Glenn Adams ◽  
Xian Zhao

Why do people comply with coronavirus disease 2019 (COVID-19) public health guidance? This study considers cultural-psychological foundations of variation in beliefs about motivations for such compliance. Specifically, we focused on beliefs about two sources of prosocial motivation: desire to protect others and obligation to society. Across two studies, we observed that the relative emphasis on the desire to protect others (vs. the obligation to the community) as an explanation for compliance was greater in the United States settings associated with cultural ecologies of abstracted independence than in Chinese settings associated with cultural ecologies of embedded interdependence. We observed these patterns for explanations of psychological experience of both others (Study 1) and self (Study 2), and for compliance with mandates for both social distancing and face masks (Study 2). Discussion of results considers both practical implications for motivating compliance with public health guidance and theoretical implications for denaturalizing prevailing accounts of prosocial motivation.


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Saqib A Chaudhry ◽  
Iqra N Akhtar ◽  
Wei Huang ◽  
Ameer E Hassan ◽  
Mohammad Rauf A Chaudhry ◽  
...  

Background: Carotid revascularization procedure, carotid endarterectomy (CEA) and carotid stent placement (CAS), are some of the most common procedures performed in United States and expected to change due to wider adoption of CAS. We performed this study to determine the changes in utilization of CEA and CAS in United States using nationally representative data. Methods: We used the National Inpatient Sample (NIS) from 2005 to 2014 to assess the changes in utilization of CEA and CAS over last 10 years in patients with symptomatic and asymptomatic carotid artery stenosis. NIS is the largest all payer dataset that includes diagnoses, admissions and discharge, demographics, and outcomes data of patients admitted to short stay non-Federal hospitals in the United States. We analyzed patterns of changes in utilization in various subsets of patients with carotid artery stenosis. Results: A total of 1,186,182 patients underwent carotid revascularization procedures during study period; 1,032,148 (87.1%) and 154,035 (12.9%) were CEA and CAS, respectively. The overall carotid revascularization procedures decreased over last 10 years (11.1% in 2005 to 8.4%in 2014, trend test p <.0001). Carotid revascularization in symptomatic patients increased (7.64% in 2005 to 11.01% in 2014, trend test p <.0001) while it decreased in asymptomatic patients (92.36% in 2006 to 88.99% in 2014, trend test p <.0001). There was an overall decrease in CEA (11.6% in 2005 to 8.3% in 2014, trend test <.0001) while in CAS remained unchanged (8.1% in 2005 to 8.9% in 2014, p=NS). There was an increase in carotid revascularization in teaching hospitals (40.9% in 2005 to 67.1% in 2014, trend test p <.0001) while decrease in non-teaching hospitals (50.9% in 2006 to 27.1% in 2014, trend test p <.0001). There was a decrease in carotid revascularization procedures in patients aged ≥80 years (19.8% in 2005 to 18.7% in 2014, trend test p <.0001) and CEA (19.6% in 2006 to 18.8% in 2014, trend test P<.0001) and CAS (21.2% in 2006 to 18.6% in 2014, trend test p=<.0001). Conclusion: Although CAS is increasing in a disproportionate manner within patient subgroups in United States, overall carotid revascularization procedures have decreased for unclear reasons.


Author(s):  
Jeffrey Van Blarcom ◽  
Andrew Chevalier ◽  
Benjamin Drum ◽  
Sarah Eyberg ◽  
Elizabeth Vukin ◽  
...  

PEDIATRICS ◽  
1989 ◽  
Vol 83 (5) ◽  
pp. 804-804
Author(s):  
STANLEY A. PLOTKIN

Dr Halsey has brought to my attention that a sentence in the human immunodeficiency virus (HIV) infection control statement (AAP News, September 1988) and perinatal statement (Pediatrics 1988;82:941-944) might be misinterpreted as advocating artificial feeding for HP/-infected infants in developing countries. It was our intention to advocate the use of artificial feeding by HIV-infected mothers only in the United States and other developed countries where safe water and hygienic practices are the norm. In other countries, the advantages of breast milk outweigh the possible risk of transmission to the newborn.


1990 ◽  
Vol 11 (12) ◽  
pp. 639-642 ◽  
Author(s):  
John M. Boyce

AbstractIn the period 1975 to 1981, methicillin-resistant Staphylococcus aureus (MRSA) emerged as an important nosocomial pathogen in tertiary care centers in the United States. To determine if the prevalence of this organism has continued to increase, a questionnaire was sent to hospital epidemiologists in 360 acute care hospitals. A total of 256 (71%) of the 360 individuals responded. Overall, 97% (246/256) of responding hospitals reported having patients with MRSA in the period 1987 through 1989. Respondents in 217 hospitals provided estimates of the number of cases seen in 1987, 1988 and 1989. The percentage of respondents reporting one or more patients with MRSA increased from 88% in 1987 to 96.3% in 1989 (p = .0008). The percent of respondents reporting large numbers (≥50) of cases per year increased from 18% in 1987 to 32% in 1989 (p = .0006). Increasing frequency of large outbreaks was observed in community, community-teaching, federal, municipal and university hospitals.


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