Reduction in Surgical Site Infections in Neurosurgical Patients Associated With a Bedside Hand Hygiene Program in Vietnam

2007 ◽  
Vol 28 (05) ◽  
pp. 583-588 ◽  
Author(s):  
Le Thi Arm Thu ◽  
Michael J. Dibley ◽  
Vo Van Nho ◽  
Lennox Archibald ◽  
William R. Jarvis ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hand Hygiene ◽  
Surgical Site Infections ◽  
Control Group ◽  
Antimicrobial Use ◽  
Hand Sanitizer ◽  
Neurosurgical Patients ◽  
Quasi Experimental ◽  
Postoperative Length ◽  
The Impact

Objective. We conducted an intervention study to assess the impact of the use of an alcohol-chlorhexidine-based hand sanitizer on surgical site infection (SSI) rates among neurosurgical patients in Ho Chi Minh City, Vietnam. Design. A quasi-experimental study with an untreated control group and assessment of neurosurgical patients admitted to 2 neurosurgical wards at Cho Ray Hospital between July 11 and August 15, 2000 (before the intervention), and July 14 and August 18, 2001 (after the intervention). A hand sanitizer with 70% isopropyl alcohol and 0.5% Chlorhexidine gluconate was introduced, and healthcare workers were trained in its use on ward A in September 2000. No intervention was made in ward B. Centers for Disease Control and Prevention definitions of SSI were used. Patient SSI data were collected on standardized forms and were analyzed using Stata software (Stata). Results. A total of 786 patients were enrolled: 377 in the period before intervention (156 in ward A and 221 in ward B) and 409 in the period after intervention (159 in ward A and 250 in ward B). On ward A after the intervention, the SSI rate was reduced by 54% (from 8.3% to 3.8%; P = .09), and more than half of superficial SSIs were eliminated (7 of 13 vs 0 of 6 in ward B; P = .007). On ward B, the SSI rate increased by 22% (from 7.2% to 9.2%; P = .8). In patients without SSI, the median postoperative length of stay and the duration of antimicrobial use were reduced on ward A (both from 8 to 6 days; P <.001) but not on ward B. Conclusions. Our study demonstrates that introduction of a hand sanitizer can both reduce SSI rates in neurosurgical patients, with particular impact on superficial SSIs, and reduce the overall postoperative length of stay and the duration of antimicrobial use. Hand hygiene programs in developing countries are likely to reduce SSI rates and improve patient outcomes.

scholarly journals The Use of Procalcitonin as a Sepsis Marker in a Community Hospital

2019 ◽  
Vol 3 (4) ◽  
pp. 545-552
Author(s):  
Nathalia De Oro ◽  
Maria E Gauthreaux ◽  
Julie Lamoureux ◽  
Joseph Scott
Keyword(s):  
Lactic Acid ◽  
Length Of Stay ◽  
Community Hospital ◽  
Unit Length ◽  
Hospital Setting ◽  
Control Group ◽  
Before And After ◽  
Quasi Experimental ◽  
Current Cutoff ◽  
The Impact

Abstract Background Procalcitonin (PCT) is a biomarker that shows good sensitivity and specificity in identifying septic patients. Methods This study investigated the diagnostic accuracy of PCT in a community hospital setting and how it compared to that of lactic acid. It explored the impact on patient care before and after PCT implementation regarding costs and length of stay. Two comparative groups were analyzed using an exploratory descriptive case–control study with data from a 19-month period after PCT implementation and a retrospective quasi-experimental study using a control group of emergency department patients diagnosed with sepsis using data before PCT implementation. Results Post-procalcitonin implementation samples included 165 cases and pre-procalcitonin implementation sample included 69 cases. From the 165 sepsis cases who had positive blood cultures, PCT had a sensitivity of 89.7%. In comparison, lactic acid's sensitivity at the current cutoff of 18.02 mg/dL (2.0 mmol/L) was 64.9%. There was a 32% decrease in median cost before and after PCT implementation, even with the length of stay remaining at 5 days in both time periods. Conclusions There was a significant decrease after the implementation of PCT in cost of hospitalization compared to costs before implementation. This cost is highly correlated with length of stay; neither the hospital nor the intensive care unit length of stay showed a difference with before and after implementation. There was a positive correlation between lactic acid and PCT values. PCT values had a higher predictive usefulness than the lactic acid values.

435 THE IMPACT OF COMPREHENSIVE GERIATRIC ASSESSMENT IN THE OUTCOMES OF OLDER ACUTE NEUROSURGICAL PATIENTS

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii8-ii13
Author(s):  
L Soutter ◽  
D Sivapathasuntharam ◽  
C Uff ◽  
S Yordanov
Keyword(s):  
Length Of Stay ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Older Patients ◽  
Clinical Pathways ◽  
Control Group ◽  
Clinical Approach ◽  
Neurosurgical Patients ◽  
Significant Difference ◽  
The Impact

Abstract Introduction As the population ages, an increasing proportion of the neurosurgical caseload is comprised of older patients. This trend is reinforced by technical advances and anaesthetic considerations within the field, allowing a higher proportion of patients eligible for surgery. Comprehensive geriatric assessment (CGA) is the gold standard clinical approach for evaluating older patients. Peri-operative care of older people (POPS) has provided strong evidence that CGA services can result in fewer post-operative complications. However, this evidence stems largely from trauma and orthopaedic surgery. Currently, there is little evidence of the impact CGA has on older neurosurgical patients. The study aimed to investigate whether CGA for older neurosurgical patients improved outcomes such as thirty-day mortality and length of stay. Methods A control group was established by collecting retrospective data for all acute neurosurgical patients over the age of 65. This was then compared with an intervention group who received CGA in the form of regular geriatric consultant reviews. 49 patients were recruited into each group. Results Analysis showed that the interventional group had a significantly higher mean age and level of frailty. They also had more confirmed complications with a significant difference in the diagnosis of pneumonia (p = 0.05) and hyponatremia (p = 0.015). Despite this, the thirty-day mortality was lower and average length of stay was on average two days shorter compared to the control group, although this did not reach statistical significance (p = 0.701). The study showed that more patients who received a CGA were discharged home (p = 0.209). Conclusion Our findings suggest that CGA input for older neurosurgical patients improves outcomes and should be incorporated routinely into neurosurgical clinical pathways.

The Impact of Visual Thinking Approach to Promote Elementary Students’ Problem Solving Skill in Mathemathics

2018 ◽  
Vol 1 (2) ◽  
pp. 98
Author(s):  
Muhammad Fendrik ◽  
Elvina Elvina
Keyword(s):  
Elementary Schools ◽  
Problem Solving ◽  
Elementary Students ◽  
Visual Learning ◽  
Control Group ◽  
Visual Thinking ◽  
Quasi Experimental ◽  
Student Skill ◽  
Mathematical Skill ◽  
The Impact

This study aims to examine the influence of visual thinking learning to problemsolving skill. Quasi experiments with the design of this non-equivalent controlgroup involved Grade V students in one of the Elementary Schools. The design ofthis study was quasi experimental nonequivalent control group, the researchbullet used the existing class. The results of research are: 1) improvement ofproblem soving skill. The learning did not differ significantly between studentswho received conventional learning. 2) there is no interaction between learning(visual thinking and traditional) with students' mathematical skill (upper, middleand lower) on the improvement of skill. 3) there is a difference in the skill oflanguage learning that is being constructed with visual learning of thought interms of student skill (top, middle and bottom).

scholarly journals Assessing the impact of the European resilience curriculum in preschool, early and late primary school children

2021 ◽  
pp. 014303432110250
Author(s):  
Celeste Simões ◽  
Anabela C. Santos ◽  
Paula Lebre ◽  
João R. Daniel ◽  
Cátia Branquinho ◽  
...  
Keyword(s):  
Mental Health ◽  
Intervention Group ◽  
Well Being ◽  
Primary School Children ◽  
Control Group ◽  
Physical And Mental Health ◽  
Quasi Experimental ◽  
Mental Health Difficulties ◽  
Prosocial Behaviours ◽  
The Impact

Resilience is an individual’s ability to adapt successfully to and persevere during and after significant challenges. Resilience programmes based on a socioemotional learning approach have been associated with an increase in protextive factors (e.g., prosocial competencies), improvements in physical and mental health, and a decrease in internalised and externalised symptoms. The present study aimed to evaluate the impact of the RESCUR curriculum implemented in Portuguese schools on students’ academic, behavioural, and socioemotional outcomes, based on child and teacher reports. Participants included 1,084 children (53.2% male) aged 3-15 ( M = 7.24, SD = 2.31). A quasi-experimental study compared outcomes for an experimental intervention group (AIG) with a waiting list control group (WG). The results showed the RESCUR programme decreased mental health difficulties while increasing both prosocial behaviours and well-being. In addition, academic performance increased for those in preschool after implementation. Both teachers and children consistently reported positive behavioural changes in resilience-related competencies after implementing RESCUR. Our findings contribute to the recent research on the potential of RESCUR to address key socioemotional competencies and improve relevant protextive factors. Study limitations and future recommendations are addressed.

The impact of a multimodel approach to designing a new orthopedic department

2020 ◽  
pp. 1-6
Author(s):  
Elad Keren ◽  
Abraham Borer ◽  
Lior Nesher ◽  
Tali Shafat ◽  
Rivka Yosipovich ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Antibiotic Stewardship ◽  
Infection Prevention ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Antibiotic Use ◽  
Prevention Measures ◽  
Orthopedic Department ◽  
Before And After ◽  
The Impact

Abstract Objective: To determine whether a multifaceted approach effectively influenced antibiotic use in an orthopedics department. Design: Retrospective cohort study comparing the readmission rate and antibiotic use before and after an intervention. Setting: A 1,000-bed, tertiary-care, university hospital. Patients: Adult patients admitted to the orthopedics department between January 2015 and December 2018. Methods: During the preintervention period (2015–2016), 1 general orthopedic department was in operation. In the postintervention period (2017–2018), 2 separate departments were created: one designated for elective “clean” surgeries and another that included a “complicated wound” unit. A multifaceted strategy including infection prevention measures and introducing antibiotic stewardship practices was implemented. Admission rates, hand hygiene practice compliance, surgical site infections, and antibiotic treatment before versus after the intervention were analyzed. Results: The number of admissions and hospitalization days in the 2 periods did not change. Seven-day readmissions per annual quarter decreased significantly from the preintervention period (median, 7 days; interquartile range [IQR], 6–9) to the postintervention period (median, 4 days; IQR, 2–7; P = .038). Hand hygiene compliance increased and surgical site infections decreased in the postintervention period. Although total antibiotic use was not reduced, there was a significant change in the breakdown of the different antibiotic classes used before and after the intervention: increased use of narrow-spectrum β-lactams (P < .001) and decreased use of β-lactamase inhibitors (P < .001), third-generation cephalosporins (P = .044), and clindamycin (P < .001). Conclusions: Restructuring the orthopedics department facilitated better infection prevention measures accompanied by antibiotic stewardship implementation, resulting in a decreased use of broad-spectrum antibiotics and a significant reduction in readmission rates.

scholarly journals Effectiveness of “Hand Hygiene Fun Month” for Kindergarten Children: A Pilot Quasi-Experimental Study

2020 ◽  
Vol 17 (19) ◽  
pp. 7264
Author(s):  
Lorna Kwai Ping Suen ◽  
Janet Pui Lee Cheung
Keyword(s):  
Experimental Study ◽  
Hand Hygiene ◽  
School Health ◽  
Intervention Group ◽  
Kindergarten Children ◽  
School Level ◽  
Control Group ◽  
Hygiene Practices ◽  
Quasi Experimental ◽  
Experimental Group

Early childhood is a formative period during which healthy habits are developed, including proper hand hygiene practices. The aim of this quasi-experimental study was to determine the effectiveness of a 4-week series of educational sessions that consider the cognitive developmental stage of children on increasing their knowledge and promoting hand hygiene practices. The intervention group (n = 33) observed the hand hygiene program, whereas another group served as the waitlist control (n = 20). Creative activities were planned for the illustration of hand hygiene concepts in terms of “right moments”, “right steps”, and “right duration”. Hand sanitizer coverage was evaluated using a hand scanner. After the intervention, the experimental group had higher knowledge level toward hand hygiene than the control group (p < 0.001). Significant improvements in hand hygiene performance at the left palm and dorsum (p < 0.05), right palm (p < 0.05), and overall hand coverage (p < 0.05) were observed in the experimental group. The study demonstrated that the knowledge and proper hand hygiene (HH) practice of children can be positively influenced by the use of an age-appropriate education program. The results of this study have implications for school health educators and parents for promoting HH practices among children at home and at the school level.

Palliative medicine consultation impacts DNR designation and length of stay for terminal medical MICU patients

2011 ◽  
Vol 9 (4) ◽  
pp. 401-406 ◽  
Author(s):  
Dana Lustbader ◽  
Renee Pekmezaris ◽  
Michael Frankenthaler ◽  
Rajni Walia ◽  
Frederick Smith ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Palliative Medicine ◽  
Intervention Group ◽  
Hospital Length Of Stay ◽  
Rank Test ◽  
Control Group ◽  
Do Not Resuscitate ◽  
Log Rank Test ◽  
The Impact ◽  
Reduced Time

AbstractObjective:The purpose of this study was to assess the impact of a palliative medicine consultation on medical intensive care unit (MICU) and hospital length of stay, Do Not Resuscitate (DNR) designation, and location of death for MICU patients who died during hospitalization.Method:A comparison of two retrospective cohorts in a 17-bed MICU in a tertiary care university-affiliated hospital was conducted. Patients admitted to the MICU between January 1, 2003 and June 30, 2004 (N = 515) were compared to MICU patients who had had a palliative medicine consultation between January 1, 2005 and June 1, 2009 (N = 693). To control for disease severity, only patients in both cohorts who died during their hospitalization were considered for this study.Results:Palliative medicine consultation reduced time until death during the entire hospitalization (log-rank test,p < 0.01). Time from MICU admission until death was also reduced (log-rank test,p < 0.01), further demonstrating the impact of the palliative care consultation on the duration of dying for hospitalized patients. The intervention group contained a significantly higher percentage of patients with a DNR designation at death than did the control group (86% vs. 68%, χ2test,p < 0.0001).Significance of results:Palliative medicine consultation is associated with an increased rate of DNR designation and reduced time until death. Patients in the intervention group were also more likely to die outside the MICU as compared to controls in the usual care group.

scholarly journals The Effect of Music Therapy on Problem-Solving Skills

2016 ◽  
Vol 6 (2) ◽  
pp. 169
Author(s):  
Zeinab Sirous Jahedi ◽  
Nasser Amini Khoi
Keyword(s):  
Problem Solving ◽  
Music Therapy ◽  
Sampling Method ◽  
Average Score ◽  
Control Group ◽  
Problem Solving Skills ◽  
Statistical Population ◽  
Quasi Experimental ◽  
And Control ◽  
The Impact

<p>The aim of the present research was study of the impact of music therapy on problem-solving skills of 4 to 6 years old children in Tehran. This research was a quasi-experimental study with pretest-posttest control group. The statistical population was all 4 to 6 years old children in region 2 of Tehran. Using the random sampling method, the study sample was chosen in two experiment (15 individuals) and control (15 individuals) groups.   The experiment group received 12 sessions of music therapy and the control group was waiting for treatment meanwhile. To evaluate the problem-solving skill in children, the three subscales of Wechsler’s Preschool and Primary Scale of Intelligence (WPPSI) were used, including: mazes, cubes and arithmetic.  Analysis of data obtained from the questionnaires was conducted in two parts of descriptive and inferential. The data analysis indicated the significant increase of problem-solving average score of the experiment group compared to the control group.</p>

The effect of body-movement teaching, learning motivation and performance

2016 ◽  
Vol 24 (3) ◽  
pp. 414-437 ◽  
Author(s):  
Satoshi Sugahara ◽  
Hisayo Sugao ◽  
Steven Dellaportas ◽  
Takahiro Masaoka
Keyword(s):  
Body Movement ◽  
Learning Motivation ◽  
Control Group ◽  
Content Type ◽  
Entry Level ◽  
Quasi Experimental ◽  
And Performance ◽  
Teaching Learning ◽  
The Impact ◽  
Experimental Group

Purpose This research applies a quasi-experimental research method to investigate the impact of an innovative resource titled “Accounting Exercise” (teaching intervention using physical movement and lyrics) on learning motivation and performance on a group of students enrolled in a first-year undergraduate accounting course in Japan. Design/methodology/approach Five classes were randomly assigned to either an experimental group (two classes) or a control group (three classes). In the experimental group, 90 students participated in a 15-min “Accounting Exercise” at the commencement of lectures over three consecutive weeks. The remaining 133 students assigned to the control group did not participate in the Accounting Exercise. Findings The findings indicate that the Accounting Exercise provided stimuli in maintaining students’ learning motivation. This finding is important for entry-level students where learning motivation has the potential to influence students’ future decisions on major areas of study and career choices. Originality/value This finding is important for entry-level students where future career options are decided. This effect is also believed to contribute to reducing the declining numbers of students in accounting majors.

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