A Five-Year Study of Needlestick Injuries: Significant Reduction Associated With Communication, Education, and Convenient Placement of Sharps Containers

1992 ◽  
Vol 13 (5) ◽  
pp. 265-271 ◽  
Author(s):  
Donna J. Haiduven ◽  
Tammy M. DeMaio ◽  
David A. Stevens
Keyword(s):  
Infection Control ◽  
Patient Care ◽  
Healthcare Workers ◽  
Medical Center ◽  
Educational Programs ◽  
Needlestick Injuries ◽  
San Jose ◽  
Communication Education ◽  
Santa Clara Valley ◽  
Control Department

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.

A Prolonged Outbreak of Methicillin-Resistant Staphylococcus aureus in the Burn Unit of a Tertiary Medical Center

1996 ◽  
Vol 17 (12) ◽  
pp. 798-802 ◽  
Author(s):  
Patricia A. Meier ◽  
Cheryl D. Carter ◽  
Sarah E. Wallace ◽  
Richard J. Hollis ◽  
Michael A. Pfaller ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Healthcare Workers ◽  
Medical Center ◽  
Tertiary Care ◽  
Chromosomal Dna ◽  
Methicillin Resistant ◽  
Persistent Problem ◽  
Tertiary Care Medical Center ◽  
Burn Unit

AbstractObjective:To report an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) in our burn unit and the steps we used to eradicate the organism.Design And Setting:Outbreak investigation in the burn unit of a 900-bed tertiary-care medical center.Outbreak:Between March and June 1993, MRSA was isolated from 10 patients in our burn unit. All isolates had identical antibiograms and chromosomal DNA patterns.Control Measures:Infection control personnel encouraged healthcare workers to wash their hands after each patient contact. The unit cohorted all infected or colonized patients, placed each affected patient in isolation, and, if possible, transferred the patient to another unit. Despite these measures, new cases occurred. Infection control personnel obtained nares cultures from 56 healthcare workers, 3 of whom carried the epidemic MRSA strain. One healthcare worker cared for six affected patients, and one cared for five patients. We treated the three healthcare workers with mupirocin. Subsequently, no additional patients became colonized or infected with the epidemic MRSA strain.Conclusions:The outbreak ended after we treated healthcare workers who carried the epidemic strain with mupirocin. This approach is not appropriate in all settings. However, we felt it was justified in this case because of a persistent problem after less intrusive measures.

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
Keyword(s):  
Blood Pressure ◽  
Clostridium Difficile ◽  
Patient Care ◽  
Healthcare Workers ◽  
Medical Center ◽  
Universal Precautions

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.

scholarly journals Knowledge and Attitude Regarding Infection Control and Standard Precautions among Healthcare Workers of Rural Nepal

2018 ◽  
Vol 3 (2) ◽  
pp. 453-457
Author(s):  
Ajay Kumar Rajbhandari ◽  
Reshu Agrawal Sagtani ◽  
Bijay Thapa ◽  
Puspanjali Adhikari
Keyword(s):  
Infection Control ◽  
Patient Care ◽  
Healthcare Workers ◽  
Healthcare Personnel ◽  
Healthcare Associated Infection ◽  
Standard Precautions ◽  
Cross Sectional ◽  
Before And After ◽  
Knowledge And Attitude ◽  
Micro Organisms

Introduction: A healthcare associated infection (HCAI) during patient care is an emerging challenge to healthcare service delivery. Transmission of most of these HCAIs can be prevented through application of standard precautions which are a set of infection control practices followed during patient care, whether or not they appear infectious or symptomatic.Objective: This study aims to assess the existing knowledge and attitude on infection control and standard precautions among healthcare personnel working in peripheral healthcare settings of Nepal.Methodology: It was a cross-sectional study and included nine different health facilities in Makwanpur district. Knowledge and attitude regarding infection control and standard precautions were assessed with the help of a self-administered questionnaire on a pre-determined scale. The results are presented as frequency distribution table and valid proportions.Results: In the study, 91.9% of the HCWs agreed that HCAI is caused by micro-organisms that can be transmitted between patients while 51.5% of them disagreed that HCAI can be caused by micro-organisms carried on the hands of healthcare workers. Majority (98.6%) of the HCWs believed that the use of gloves, mask and apron reduces the risk of HCAI whereas 13.5% of HCWs disagreed that gloves should be changed between the examination of different patients. Although 97% of the HCWs agreed that hand should be washed before and after examining the patient, 17.6% of them informed that they do not always wash their hands before and after examining a patient.Conclusion: Irrespective of limited availability of infection control guidelines, it was found that the knowledge on HCAI control was good and majority of the respondents showed favorable attitude towards infection control and standard precautions.  BJHS 2018;3(2)6: 453-457.

Mathematical Modeling of Pathogen Trajectory in a Patient Care Environment

2013 ◽  
Vol 34 (11) ◽  
pp. 1181-1188 ◽  
Author(s):  
Angela L. Hewlett ◽  
Scott E. Whitney ◽  
Shawn G. Gibbs ◽  
Philip W. Smith ◽  
Hendrik J. Viljoen
Keyword(s):  
Mathematical Modeling ◽  
Infection Control ◽  
Patient Care ◽  
Medical Center ◽  
Tertiary Care ◽  
Healthcare Delivery ◽  
Time Lapse ◽  
Infection Control Practice ◽  
Control Practice ◽  
Tertiary Care Medical Center

Objective.Minimizing healthcare worker exposure to airborne infectious pathogens is an important infection control practice. This study utilized mathematical modeling to evaluate the trajectories and subsequent concentrations of particles following a simulated release in a patient care room.Design.Observational study.Setting. Biocontainment unit patient care room at a university-affiliated tertiary care medical center.Methods. Quantitative mathematical modeling of airflow in a patient care room was achieved using a computational fluid dynamics software package. Models were created on the basis of a release of particles from various locations in the room. Computerized particle trajectories were presented in time-lapse fashion over a blueprint of the room. A series of smoke tests were conducted to visually validate the model.Results.Most particles released from the head of the bed initially rose to the ceiling and then spread across the ceiling and throughout the room. The highest particle concentrations were observed at the head of the bed nearest to the air return vent, and the lowest concentrations were observed at the foot of the bed.Conclusions.Mathematical modeling provides clinically relevant data on the potential exposure risk in patient care rooms and is applicable in multiple healthcare delivery settings. The information obtained through mathematical modeling could potentially serve as an infection control modality to enhance the protection of healthcare workers.

Methicillin-ResistantStaphylococcus aureusOutbreak at a Veterans' Affairs Medical Center: Importance of Carriage of the Organism by Hospital Personnel

1990 ◽  
Vol 11 (6) ◽  
pp. 291-296 ◽  
Author(s):  
Annette C. Reboli ◽  
Joseph F. John ◽  
Christel G. Platt ◽  
J. Robert Cantey
Keyword(s):  
Infection Control ◽  
Healthcare Workers ◽  
Medical Center ◽  
Veterans Affairs ◽  
Control Measures ◽  
University Hospital ◽  
Contact Tracing ◽  
Hospital Personnel ◽  
Surgical Resident ◽  
Number Of Patients

AbstractThe reported prevalence of nasal carriage of methicillin-resistantStaphylococcus aureus (MRSA) by hospital personnel averages 2.5%. From August 1985 to September 1987, 155 patients at our Veterans' Affairs Medical Center (VAMC) were colonized or infected with MRSA. In December 1986, only two (2.1%) of 94 healthcare workers were identified as nasal carriers. Prompted by a sharp increase in the number of patients with MRSA in early 1987, contact tracing identified 450 employees, of whom 36 (8%) were nasal carriers. Thirty-five percent of surgical residents (7 of 20) were nasal carriers. Prior to being identified as a nasal carrier, one surgical resident was associated with the inter-hospital spread of the VAMC MRSA strain to the burn unit of the affiliated university hospital. Three family members of two employee carriers were also found to harbor the epidemic strain. All 36 carriers were decolonized with various antimicrobial combinations. Vigorous infection control measures were effective in controlling the epidemic. The frequency of MRSA carriage by hospital personnel at our medical center during the epidemic proved higher than previously appreciated. Thus, healthcare workers may comprise a sizable MRSA reservoir. During an MRSA epidemic, infection control should attempt to identify and decolonize this hospital reservoir, as these individuals can disseminate MRSA both within the hospital as well as into the community.

Effect of Educational Programs, Rigid Sharps Containers, and Universal Precautions on Reported Needlestick Injuries in Healthcare Workers

1991 ◽  
Vol 12 (4) ◽  
pp. 214-219 ◽  
Author(s):  
Calvin C. Linnemann ◽  
Constance Cannon ◽  
Martha DeRonde ◽  
Bruce Lanphear
Keyword(s):  
Infection Control ◽  
General Hospital ◽  
Educational Program ◽  
Healthcare Workers ◽  
University Hospital ◽  
Needlestick Injuries ◽  
Universal Precautions ◽  
Control Programs ◽  
University Of Cincinnati ◽  
The University

AbstractObjective:To evaluate the effect of infection control programs on reported needlestick injuries in a general hospital.Design:Surveillance of all reported needlestick injuries at the University of Cincinnati Hospital was maintained by the infection control department for five years, from 1985 through 1989. Data on individual workers were collected, tabulated on a monthly basis, and reviewed continually to monitor trends in injuries. During this time, the effects of each of three new infection control programs on reported injuries were evaluated sequentially.Setting:A 700-bed general hospital that serves as the main teaching hospital of the University of cincinnati.Participants:All employees of University Hospital who reported to personnel health for management of needlestick injuries.Interventions:In 1986, an educational program to prevent injuries was initiated and continued throughout the surveillance period. In 1987, rigid sharps disposal containers were placed in all hospital rooms. In 1988, universal precautions were introduced with an intensive inservice.Results:Surveillance identified 1,602 needlestick injuries (320/year) or 104/1 ,000/ year. After the educational program began, reported injuries increased rather than decreased, and this was attributed to increased reporting. Subsequently, after installation of the new disposal containers, reported injuries returned to the levels seen prior to the educational program, but recapping injuries showed a significant decrease from 63/year to 30, or 20/1,000/year to 10. This decrease was observed in nurses but not in other healthcare workers. After universal precautions were instituted, total injuries increased slightly, but recapping injuries remained at 50% of the levels reported prior to the use of rigid sharps disposal containers.Conclusions: The three infection control programs failed to produce a major reduction in reported needlestick injuries, except for a decrease in recapping injuries associated with the placement of rigid sharps disposal containers in all patient rooms. These observations indicate that new approaches are needed to reduce needlestick injuries.

A Clinical Path for Adult Diabetes

1997 ◽  
Vol 23 (6) ◽  
pp. 664-671 ◽  
Author(s):  
Lisa Courtney ◽  
Malcolm Gordon ◽  
Louise Romer
Keyword(s):  
Patient Care ◽  
Medical Center ◽  
Quality Care ◽  
High Volume ◽  
Health Educators ◽  
San Jose ◽  
Diagnostic Categories ◽  
Outpatient Departments ◽  
Adult Diabetes ◽  
Care Path

The use of clinical paths for patient care management was explored by this development team as a mechanism to provide consistent, high-quality care to hospitalized patients in high-volume, high-risk diagnostic categories. Reviewing the historical aspects and importance of clinical paths helped expand the team's perspective to incorporate pre-and posthospitalization phases of patient care into the clinical path being developed. A multidisciplinary team of physicians, nurses, health educators, and dietitians from both inpatient and outpatient departments of Kaiser-Santa Teresa Medical Center in San Jose, California, devised and implemented an Adult Diabetes Mellitus care path. Staff education preceded the implementation of the care paths. Measurements of quality indicators showed improvements in patient satisfaction, patient education, patient knowledge, and nutrition assessments.

scholarly journals Successful Control of a Norovirus Outbreak in a Chilean Pediatric Intensive Care Unit

2020 ◽  
Vol 41 (S1) ◽  
pp. s393-s394
Author(s):  
Dona Benadof ◽  
Vanessa Garcia ◽  
Paulina Cifuentes ◽  
Aldo Gaggero
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Patient Care ◽  
Attack Rate ◽  
Healthcare Workers ◽  
Control Measures ◽  
Sodium Hypochlorite Solution ◽  
Strict Adherence ◽  
Viral Shedding

Background: Noroviruses are nonenveloped, single-stranded RNA viruses belonging to the Caliciviridae family; they cause high-profile outbreaks in healthcare settings, due to their contagiousness, prolonged viral shedding, and ability to survive in the environment. Methods: Description of a norovirus outbreak in a pediatric ICU with multibed rooms. We report the epidemiology, molecular diagnosis, and control. Results: In August and September 2019, an outbreak of acute gastroenteritis affected 13 patients and 26 healthcare workers at an intensive care unit of Roberto Del Río Children’s Hospital, which consists of 22 beds in a multibed-room format. Patients manifested self-limited nondysenteric diarrhea; other symptoms were vomiting (54%) and fever (23%). Healthcare workers reported diarrhea, nausea, vomiting, fever, malaise, and abdominal cramps. The mean age of the patients was 1 year old, all diaper users. The average days of diarrhea in patients was 4 days (2–6 days). There were 87 exposed patients, with an attack rate of 14.9% and 107 exposed staff, with an attack rate of 24.3%. Rotavirus and bacterial etiology were ruled out, and norovirus was subsequently diagnosed in 10 of 13 patients using qRT-PCR; 80% (8 of 10) corresponded with GII norovirus and 20% with a GI (2 of 10). Control measures included enforcement of standard precautions, strict adherence to contact precautions (use of gloves and gowns), hand hygiene before and after patients contact, and mask use if exposure to vomitus. Healthy staff were assigned for patients care. Environmental disinfection twice daily with 1.000 ppm sodium hypochlorite solution was encouraged and supervised with focus on cleaning high-touch surfaces, such as bathrooms, sinks, tables, floors and patient-care items. Active and prospective surveillance were conducted to search for new cases. Infection control practices were coupled with education to staff, patients, and visitors. The outbreak was controlled on September 18, 2019, after 23 days and several interventions, with complete recovery in all cases. Conclusions: We concluded that timely detection of a norovirus outbreak in a healthcare facility is imperative for effective infection control, especially in a multibed-room setting, because of the extended viral shedding in children and the transmission route that included aerosolized viral particles in vomitus. Molecular methods offer a rapid and definitive way to establish etiology, but these tests may not be accessible. Direct contact with infected children and contaminated surfaces and patient-care items were relevant risk factors in this outbreak (which involved both patients and healthcare workers) and contributed with its length.Funding: NoneDisclosures: None

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