Impact of a Mandatory Infection Control Education Program on Nosocomial Acquisition of Methicillin-ResistantStaphylococcus aureus

2009 ◽  
Vol 30 (3) ◽  
pp. 249-256 ◽  
Author(s):  
Todd C. Lee ◽  
Christine Moore ◽  
Janet M. Raboud ◽  
Matthew P. Muller ◽  
Karen Green ◽  
...  
Keyword(s):  
Infection Control ◽  
Education Program ◽  
Hospital Staff ◽  
Fiscal Year ◽  
Number Of Patients ◽  
Before And After ◽  
Previous Hospitalization ◽  
Control Education ◽  
The Impact ◽  
Mrsa Colonization

Objective.To assess the impact of an institution-wide infection control education program on the rate of transmission of methicillin-resistantStaphylococcus aureus(MRSA).Design.Before-and-after study.Setting.A 472-bed, urban, university-affiliated hospital.Intervention.During the period March-May 2004, all hospital staff completed a mandatory infection control education program, including the receipt of hospital-specific MRSA data and case-based practice with additional precautions.Outcome Measure.The rate of nosocomial MRSA acquisition was calculated as the number of cases of nosocomial MRSA acquisition per 100 days that a person with MRSA colonization or infection detected at admission is present in the hospital (“admission MRSA” exposure-days) for 3 time periods: June 2002-February 2003 (before the Toronto outbreak of severe acute respiratory syndrome [SARS]), June 2003-February 2004 (after the outbreak of SARS), and June 2004-February 2005 (after education). A case of nosocomial acquisition of MRSA colonization or infection represented a patient first identified as colonized or infected more than 72 hours after admission or at admission after a previous hospitalization.Results.The rate of nosocomial acquisition of MRSA colonization or infection was 8.8 cases per 100 admission MRSA exposure-days for the period before SARS, 3.8 cases per 100 admission MRSA exposure-days for the period after SARS (P< .001 for before SARS vs after SARS), and 1.9 cases per 100 admission MRSA exposure-days for the period after education (P= .02 for after education vs before education). The volume of alcohol-based handrub purchased was apparently stable, with 4,010 L during fiscal year 2003-2004 (April 2003-March 2004) compared with 3,780 L during fiscal year 2004—2005. The observed rate of compliance with hand washing did not change significantly (40.9% during education vs 44.2% after education;P= .23). The total number of patients screened for MRSA colonization was not different in the 3 periods.Conclusions.The rate of nosocomial acquisition of MRSA colonization or infection decreased after SARS and was further reduced in association with a hospital-wide education program.

Impact of Michigan’s new opioid prescribing laws on spine surgery patients: analysis of the Michigan Spine Surgery Improvement Collaborative

2020 ◽  
pp. 1-6
Author(s):  
Paul Park ◽  
Victor Chang ◽  
Hsueh-Han Yeh ◽  
Jason M. Schwalb ◽  
David R. Nerenz ◽  
...  
Keyword(s):  
Spine Surgery ◽  
Spinal Surgery ◽  
Readmission Rate ◽  
Rating Scale ◽  
Short Term ◽  
Readmission Rates ◽  
Opioid Prescribing ◽  
Number Of Patients ◽  
Before And After ◽  
The Impact

OBJECTIVEIn 2017, Michigan passed new legislation designed to reduce opioid abuse. This study evaluated the impact of these new restrictive laws on preoperative narcotic use, short-term outcomes, and readmission rates after spinal surgery.METHODSPatient data from 1 year before and 1 year after initiation of the new opioid laws (beginning July 1, 2018) were queried from the Michigan Spine Surgery Improvement Collaborative database. Before and after implementation of the major elements of the new laws, 12,325 and 11,988 patients, respectively, were treated.RESULTSPatients before and after passage of the opioid laws had generally similar demographic and surgical characteristics. Notably, after passage of the opioid laws, the number of patients taking daily narcotics preoperatively decreased from 3783 (48.7%) to 2698 (39.7%; p < 0.0001). Three months postoperatively, there were no differences in minimum clinically important difference (56.0% vs 58.0%, p = 0.1068), numeric rating scale (NRS) score of back pain (3.5 vs 3.4, p = 0.1156), NRS score of leg pain (2.7 vs 2.7, p = 0.3595), satisfaction (84.4% vs 84.7%, p = 0.6852), or 90-day readmission rate (5.8% vs 6.2%, p = 0.3202) between groups. Although there was no difference in readmission rates, pain as a reason for readmission was marginally more common (0.86% vs 1.22%, p = 0.0323).CONCLUSIONSThere was a meaningful decrease in preoperative narcotic use, but notably there was no apparent negative impact on postoperative recovery, patient satisfaction, or short-term outcomes after spinal surgery despite more restrictive opioid prescribing. Although the readmission rate did not significantly increase, pain as a reason for readmission was marginally more frequently observed.

The impact of a music education program on meta-musical awareness, logical-mathematical, and notational skills in preschoolers

2021 ◽  
pp. 025576142110272
Author(s):  
Oriana Incognito ◽  
Laura Scaccioni ◽  
Giuliana Pinto
Keyword(s):  
Music Education ◽  
Education Program ◽  
Cognitive Abilities ◽  
Musical Training ◽  
Control Group ◽  
Transfer Of Knowledge ◽  
General Domain ◽  
Music Program ◽  
Before And After ◽  
The Impact

A number of studies suggest a link between musical training and both specific and general cognitive abilities, but despite some positive results, there is disagreement about which abilities are improved. This study aims to investigate the effects of a music education program both on a domain-specific competence (meta-musical awareness), and on general domain competences, that is, cognitive abilities (logical-mathematical) and symbolic-linguistic abilities (notational). Twenty 4- to 6-year-old children participated in the research, divided into two groups (experimental and control) and the measures were administered at two different times, before and after a 6-month music program (for the experimental group) and after a sports training program (for the control group). Children performed meta-musical awareness tasks, logical-mathematical tasks, and emergent-alphabetization tasks. Non-parametric statistics show that a music program significantly improves the development of notational skills and meta-musical awareness while not the development of logical-mathematical skills. These results show that a musical program increases children’s meta-musical awareness, and their ability to acquire the notational ability involved in the invented writing of words and numbers. On the contrary, it does not affect the development of logical skills. The results are discussed in terms of transfer of knowledge processes and of specific versus general domain effects of a musical program.

Economic Impact of an Infection Control Education Program in a Specialized Preschool Setting

PEDIATRICS ◽  
2001 ◽  
Vol 108 (6) ◽  
pp. e102-e102 ◽  
Author(s):  
S. J. Ackerman ◽  
S. B. Duff ◽  
P. H. Dennehy ◽  
M. S. Mafilios ◽  
L. R. Krilov
Keyword(s):  
Infection Control ◽  
Economic Impact ◽  
Education Program ◽  
Control Education ◽  
Preschool Setting

scholarly journals CONQUERING MEDIA COVERAGE: The use of battle metaphors in hospital foundation communications and it's impact on news coverage

2021 ◽  
Author(s):  
Sara Hoffman
Keyword(s):  
Media Coverage ◽  
News Coverage ◽  
Hospital Staff ◽  
Fiscal Year ◽  
Public Action ◽  
Multimodal Discourse ◽  
Patient Families ◽  
The Media ◽  
Setting Theory ◽  
The Impact

Battle terminology such as “fight,” “conquer,” and “hero” and imagery that compares doctors and patients to superheroes, soldiers and athletes have become increasingly prevalent in hospital foundation communications. The use of these metaphors has been highly controversial. While some audiences have praised foundation campaigns that use this type of messaging for emphasizing the strength of patients and hospital staff, encouraging patient families, and motivating patients to be resilient, others argue that these campaigns marginalize those who are unable to overcome their health conditions, positioning them as failures or losers. While the use of battle metaphors in hospital communications has been a heated topic in online discussion, little is known about the impact of this language on the media coverage and financial support that they generate for hospitals. This paper presents a multimodal discourse analysis of the communications of six hospital foundations in Toronto, Canada followed by a quantitative and sentiment analysis of the media coverage each foundation has received within the last fiscal year. The aim of this paper is to determine if there is a relationship between the use of battle metaphors in hospital foundation communications and the amount and sentiment of media coverage. According to agenda setting theory, media coverage has a palpable impact on public action. Therefore, the findings of this research may assist hospital foundations in developing useful communications practices they can employ to increase media exposure and, consequently, attract more donations to support their institutions.

scholarly journals SP9.1.1 The Impact of Anaesthetic Use on Healing in Sub-cutaneous Abscess Management: A Retrospective Before and After Cohort Study

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Hannah Elkadi ◽  
Eleanor Dodd ◽  
Theodore Poulton ◽  
William Bolton ◽  
Joshua Burke ◽  
...  
Keyword(s):  
Wound Healing ◽  
Local Anaesthetic ◽  
Surrogate Endpoints ◽  
Incision And Drainage ◽  
Number Of Patients ◽  
Significant Difference ◽  
Patient Reported ◽  
Before And After ◽  
The Impact

Abstract Aims Despite being the most common surgical procedure, there is wide variation that exists in the management of simple subcutaneous abscesses with no national guideline describing best practice. During the COVID-19 Pandemic national guidelines promoted the use of regional or local anaesthetic (LA) instead of general anaesthesia (GA) to avoid aerosol generating intubation associated with GA. This study aimed to assess the impact of anaesthetic choice in outcomes following incision and drainage of subcutaneous abscesses. Methods Two cohorts of patients undergoing abscess incision and drainage at St. James’ University Hospital Leeds were retrospectively identified over a 14-week period before and after the introduction of the new COVID-19 anaesthetic guidelines. Wound healing surrogate endpoints were used: i) total number of follow up appointments and ii) attendance to healthcare services after 30 days from I&D. Result 133 patients were included. Significantly more procedures were performed under LA after the intervention (84.1% vs 5.7%; p &lt; 0.0001) with a significant reduction in wound packing (68.3% vs 87.1%. p=0.00473). Follow up data found no significant difference in the average number of follow-up appointments (7.46 vs 5.11; p = 0.0731) and the number of patients who required ongoing treatment after 30 days (n = 14 vs n = 14, p = 0.921). Conclusion Drainage of simple subcutaneous abscess under 5 cm is safe under local anaesthetic with no significant difference in surrogate endpoints of wound healing observed in this patient cohort. Recurrent packing may not be required. Future work should explore patient reported measures such as pain management and the health economics of this intervention.

The impact of an education intervention on the approach of hospital staff to patients with dementia in a Danish general hospital setting: An explanatory sequential mixed-methods study

2021 ◽  
pp. 205715852110229
Author(s):  
Annemarie Toubøl ◽  
Lene Moestrup ◽  
Katja Thomsen ◽  
Jesper Ryg ◽  
Dennis Lund Hansen ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Data Collection ◽  
General Hospital ◽  
Hospital Staff ◽  
Education Intervention ◽  
Post Intervention ◽  
Sequential Mixed Methods ◽  
Number Of Patients ◽  
The Impact ◽  
Dementia Education

The number of patients with dementia admitted to hospitals is increasing. However, the care and treatment of these patients tends to be suboptimal. A response to this is a widespread implementation of educational initiatives. Nevertheless, the effect of such initiatives is questioned. The aim of this study was to investigate the impact of a dementia education intervention by examining the self-reported outcomes of general hospital staff and exploring the staff’s experiences of these outcomes. An explanatory sequential mixed-methods design framed the study method. The quantitative data collection included repeated questionnaires: pre-intervention ( n = 849), one month post-intervention ( n = 618), and five months post-intervention ( n = 468) followed by a qualitative data collection using interviews ( n = 16). The GRAMMS guideline was followed. The integration of the quantitative and qualitative results suggests that the impact of the education intervention can be ascribed to the interdisciplinary focus, which facilitated a comprehensive commitment to creating careful solutions for patients with dementia. A prioritization of person over task seems to be assisted by an improved interdisciplinary cooperation initiated by the inclusion of all employed staff at the hospital in a dementia education intervention.

scholarly journals Assessment of Reflex Urine Culture Criteria Changes and its Impact on Treatment of Asymptomatic Bacteriuria

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S346-S346 ◽  
Author(s):  
Kirre Wold ◽  
Jeff Brock ◽  
Kelly Percival ◽  
Lindsey Rearigh ◽  
Lucas Vocelka ◽  
...  
Keyword(s):  
Asymptomatic Bacteriuria ◽  
Signs And Symptoms ◽  
Hospital Data ◽  
Post Intervention ◽  
Number Of Patients ◽  
Positive Urine ◽  
Before And After ◽  
Implementation Period ◽  
Inappropriate Antibiotics ◽  
The Impact

Abstract Background Asymptomatic bacteriuria (ASB) is a common clinical condition identified by the presence of bacteria in the urine of a patient without signs and symptoms of a urinary tract infection (UTI). Treatment of ASB leads to unnecessary antimicrobial use and can cause more harm than benefit in many patients. This study is to determine the impact of more stringent criteria for urinalysis with culture if indicated (UAC), implemented in September 2016, on the treatment of asymptomatic bacteriuria. Methods A pre-post descriptive study of patients was conducted with an order placed for UAC in the Emergency Department (ED) or hospital. Data was collected retrospectively via chart reviews. The data on ASB patients from November 2015 to April 2016 was compared with the post-implementation period October 2016 to January 2017. The number of UAC orders and cultures were averaged for 6 months pre and post implementation of the criteria change. Results A total of 580 patient charts were assessed post-implementation of the UAC criteria change. A majority of the orders originated from the ED, (N = 430, 72.8%). ASB was treated inappropriately at a rate of 60.4% (N = 64/106) pre-implementation and a rate of 65% (N = 41/63) post implementation, P = 0.542. The total number of UAC ordered before and after implementation did not change, (N = 2852 pre-intervention vs N = 2825 post-intervention, P = 0.744), as seen in Figure 1. However, the number of reflexed urine cultures did significantly decrease post criteria change,&#x2028; (N = 1056 pre-intervention vs. N = 603 post-intervention, P &lt; 0.0001). In addition, the number of positive urine cultures also significantly decreased, (N = 378 pre-intervention vs. N = 289 post-intervention, P = 0.0447). The impact the criteria change had on patient care is the number of potential antibiotic courses saved by reflexing fewer urine cultures off the UAC. Based on the decrease in positive urine cultures, it is estimated 702 courses of inappropriate antibiotics for ASB could be saved per year (59/month). Conclusion More stringent criteria for reflex urine cultures significantly decreases the number of urine cultures performed, therefore decreasing the number of patients treated with ASB. Additional stewardship measures are necessary to reduce the treatment of ASB for patients who have cultures performed. Disclosures All authors: No reported disclosures.

Impact of a Large-Scale Coach Education Program from a Lifelong-Learning Perspective

2013 ◽  
Vol 6 (1) ◽  
pp. 23-42 ◽  
Author(s):  
Diana Deek ◽  
Penny Werthner ◽  
Kyle J. Paquette ◽  
Diane Culver
Keyword(s):  
Lifelong Learning ◽  
Education Program ◽  
Large Scale ◽  
Learning Experience ◽  
Coach Education ◽  
Coach Learning ◽  
Before And After ◽  
Coaching Certification ◽  
The Impact ◽  
Depth Interviews

This study examines the impact of a coach education program on coach learning and perceived changes to coaching practices, while situating this episodic learning experience within a lifelong-learning perspective. Three sets of in-depth interviews were conducted with 10 coaches taking part in one of three competition-development modules within Canada’s National Coaching Certification Program (Coaching and Leading Effectively, Managing Conflict, and Psychology of Performance). It was found that (a) the coaches’ biographies varied widely, (b) all of the coaches reported learning from the modules, (c) eight of ten coaches reported a change in their coaching practices as a result of participation in one of the modules, and (d) the coaches credited a combination of mediated, unmediated, and internal learning situations for their learning before and after the modules. These findings suggest that a large-scale coach education program can have an impact on coaches when the program takes a lifelong-learning perspective and integrates constructivist principles into its design and delivery.

scholarly journals Estimation of lacrimal dysfunction indices in patients with recurrent pterygium

2020 ◽  
Vol 13 (1) ◽  
pp. 11-16
Author(s):  
Erkin N. Bilalov ◽  
Azamat F. Yusupov ◽  
Ahmadjon E. Nozimov ◽  
Okilkhon I. Oripov
Keyword(s):  
Tear Film ◽  
Tear Fluid ◽  
Fluid Composition ◽  
Optimal Correction ◽  
Number Of Patients ◽  
Before And After ◽  
Pathogenetic Therapy ◽  
Recurrent Pterygium ◽  
The Impact ◽  
Tear Dysfunction

The rationale of the research is driven by the severity of dry eye syndrome (DES) in the pterygium recurrencies development as well as by the necessity to investigate tear dysfunction and methods for its optimal correction in this patient population. Purpose of the study. To assess the impact of tear dysfunction indices on the development of recurrent pterygium. Materials and methods. We observed 60 patients (67 eyes) with recurrent pterygium. Patients were divided into four observation groups depending on the number of recurrencies. In order to study the dynamics of the DES manifestations during the postoperative period, pathogenetic therapy was used, which included a tear fluid substitute. All patients underwent a comprehensive assessment of subjective and objective DES indices before and after surgery. Results. A positive dynamics of subjective manifestations and objective indices of DES under the action of a tear substitute after surgery was reliably confirmed. A decrease in the number of patients with type III and IV crystallization after surgery was confirmed. Conclusion. The obtained data indicate an increase in the mucin content in the tear fluid composition, which leads to a stabilization of the tear film and to a decrease in the DES intensity.

scholarly journals Biomarkers-based Personalized Follow-up in Chronic Heart Failure Improves Patient’s Outcomes and Reduces Care Associate Cost

2020 ◽  
Author(s):  
Antonio Leon Justel ◽  
Jose Ignacio Morgado Garcia-Polavieja ◽  
Ana Isabel Alvarez Rios ◽  
Francisco Jose Caro Fernandez ◽  
Pedro Agustin Pajaro Merino ◽  
...  
Keyword(s):  
Incidence Rates ◽  
Primary Objective ◽  
Economic Problem ◽  
Functional Class ◽  
Post Intervention ◽  
Number Of Patients ◽  
Before And After ◽  
Ed Visits ◽  
The Impact

Abstract BACKGROUNDHeart failure (HF) is a major and growing medical and economic problem, with high prevalence and incidence rates worldwide. Cardiac Biomarker is emerging as a novel tool for improving management of patients with HF.METHODSThis is a real-world, before-and after-intervention trial, that assesses the impact of a personalized follow-up procedure for HF on patient’s outcomes and care associated cost, based on a clinical model of risk stratification and personalized management according to that risk. A total of 192 patients were enrolled and studied before and after an intervention. The primary objective was the rate of readmissions, due to a HF event, post-intervention compared to pre-intervention. Secondary outcomes compared the rate of ED visits and the number of patients who had reduced NYHA score pre and post-intervention. A cost- analysis was also performed on these data.RESULTSAdmission rates significantly decreased by 41% after the intervention (total length of stay was reduced by 55%). The rate of ED visits was reduced by 55%. Thirty-one percent of patients had an improved functional class score after the intervention, whereas only 7.8% got worse. The overall cost saving associated with the intervention was €139,717.65 for the whole group over 1 year.CONCLUSIONSA personalized follow-up of HF patients led to important outcome benefits and resulted in cost savings, mainly due to the reduction of patient hospitalization readmissions and a significant reduction of care- associated costs, suggesting that greater attention should be given to this high-risk cohort to minimize the risk of hospitalization readmissions.

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