scholarly journals Effectiveness of an Antimicrobial Polymer to Decrease Contamination of Environmental Surfaces in the Clinical Setting

2014 ◽  
Vol 35 (8) ◽  
pp. 1060-1062 ◽  
Author(s):  
Kerri A. Thom ◽  
Harold C. Standiford ◽  
J. Kristie Johnson ◽  
Nader Hanna ◽  
Jon P. Furuno
Keyword(s):  
Real World ◽  
Environmental Contamination ◽  
Clinical Setting ◽  
Pathogenic Bacteria ◽  
Infect Control Hosp ◽  
Environmental Surfaces

We performed a real-world, controlled intervention to investigate use of an antimicrobial surface polymer, MSDS Poly, on environmental contamination. Pathogenic bacteria were identified in 18 (90%) of 20 observations in treated rooms and 19 (83%) of 23 observations in untreated rooms (P = .67). MSDS Poly had no significant effect on environmental contamination.Infect Control Hosp Epidemiol 2014;35(8):1060–1062

Amelioration of user experiences and glycaemic outcomes with an Advanced Hybrid Closed Loop System in a real-world clinical setting

2021 ◽  
pp. 108986
Author(s):  
Pilar Isabel Beato-Víbora ◽  
Fabiola Gallego-Gamero ◽  
Ana Ambrojo-López ◽  
Estela Gil-Poch ◽  
Irene Martín-Romo ◽  
...  
Keyword(s):  
Real World ◽  
Clinical Setting ◽  
Closed Loop ◽  
Loop System ◽  
Closed Loop System ◽  
User Experiences

Romidepsin Therapy Over 5 Years in a Clinical Setting—Real-world Experience

JAMA Oncology ◽  
2016 ◽  
Vol 2 (6) ◽  
pp. 794
Author(s):  
Susan E. Bates ◽  
Larisa J. Geskin
Keyword(s):  
Real World ◽  
Clinical Setting

scholarly journals Nursing-Home Patient Functional and Microbiota Status Drive Environmental Contamination with Vancomycin-Resistant Enterococci

2021 ◽  
Vol 1 (S1) ◽  
pp. s68-s68
Author(s):  
Joyce Wang ◽  
Betsy Foxman ◽  
A. Krishna Rao ◽  
Lona Mody ◽  
Evan Snitkin
Keyword(s):  
Nursing Homes ◽  
Gut Microbiota ◽  
Functional Status ◽  
Environmental Contamination ◽  
Functional Dependence ◽  
Patient Factors ◽  
High Functioning ◽  
Vancomycin Resistant Enterococci ◽  
Environmental Surfaces ◽  
Vancomycin Resistant

Background: Patient colonization and shedding of vancomycin-resistant enterococci (VRE) is a major source of environmental contamination leading to VRE transmission in nursing homes. We hypothesize that we can inform mitigation strategies by identifying patient clinical and microbiota features associated with environmental contamination with VRE. Methods: During a 6-month period of active surveillance in 6 Michigan nursing homes, 245 patients (with 806 follow-up visits) were enrolled. Patient clinical data and swabs for VRE were collected from multiple body sites and high-touch environmental surfaces. In total, 316 perirectal swabs were collected from 137 patients for gut microbiota analysis and community status type (CST) assignment based on taxonomic composition. The associations between VRE colonization pattern, gut microbial CST, and patient factors were examined using multivariable generalized estimating equations, adjusting for patient-and facility-level clustering. We used VRE colonization patterns to group study visits: “uncolonized” (patient−/environment−); “environment-only” (patient−/environment+); “patient-only” (patient+/environment−); “both” (patient+/environment+). Results: Across all study visits, VRE colonization on patient hand and groin/perirectal area was positively correlated with VRE contamination of high-touch environmental surfaces, suggesting direct transfer of VRE between patient and environment via patient hands (Figure 1A). We next set out to identify patient factors associated with patient colonization and environmental contamination. At baseline, while patients in the “both” group had anticipated risk factors such as longer prior hospitalization and more frequent broad-spectrum antibiotic use, they were unexpectedly younger than “uncolonized” patients and had similar functional status. This last feature contrasted with the “patient-only” group, characterized by higher urinary catheter use and higher functional dependence, suggestive of lower functional dependence facilitating patient contamination of their environment. No clinical features distinguished “uncolonized” and “environment-only” patients (Table 1). Lastly, in multivariable analyses, we determined the contribution of patient functional status and gut microbiota features to environmental contamination. Low-diversity CST, characterized by reduced anaerobic taxa, was weakly associated with “patient-only” and significantly associated with “both.” Notably, high functional dependence was significantly associated with “environment-only” and “patient-only” but not “both,” indicating high-functioning patients with disrupted gut microbiota as drivers of environmental contamination (Figure 1B). Conclusions: Our findings suggest that antimicrobial exposure disrupts patient gut microbiota, a significant mediator of colonization dynamics between patients and their environment, and that high-functioning patients may be more likely to spread VRE between their body sites and high-touch environmental surfaces (Figure 2). These findings highlight both antibiotic stewardship and patient hand hygiene as important targets for interrupting transmission mediated by environmental contamination.Funding: NoDisclosures: None

scholarly journals OR14-5 Challenges in implementing Hybrid Closed Loop Insulin Pump Therapy (medtronic 670g) In A 'Real World' Clinical Setting.

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Gregory Goodwin ◽  
Gretchen Waldman ◽  
Justine Lyons ◽  
Adeolu Oladunjoye ◽  
Garry Steil
Keyword(s):  
Real World ◽  
Clinical Setting ◽  
Closed Loop ◽  
Insulin Pump ◽  
Insulin Pump Therapy ◽  
Pump Therapy

A Systematic Review of Coding Systems Used in Pharmacoepidemiology and Database Research

2018 ◽  
Vol 57 (01/02) ◽  
pp. 01-42 ◽  
Author(s):  
Yong Chen ◽  
Marko Zivkovic ◽  
Su Su ◽  
Jianyi Lee ◽  
Edward Bortnichak ◽  
...  
Keyword(s):  
Real World ◽  
Clinical Setting ◽  
English Language ◽  
Data Extraction ◽  
Therapeutic Area ◽  
Coding System ◽  
Clinical Coding ◽  
Real World Data ◽  
Coding Systems ◽  
Database Research

Summary Background: Clinical coding systems have been developed to translate real-world healthcare information such as prescriptions, diagnoses and procedures into standardized codes appropriate for use in large healthcare datasets. Due to the lack of information on coding system characteristics and insufficient uniformity in coding practices, there is a growing need for better understanding of coding systems and their use in pharmacoepidemiology and observational real world data research. Objectives: To determine: 1) the number of available coding systems and their characteristics, 2) which pharmacoepidemiology databases are they adopted in, 3) what outcomes and exposures can be identified from each coding system, and 4) how robust they are with respect to consistency and validity in pharmacoepidemiology and observational database studies. Methods: Electronic literature database and unpublished literature searches, as well as hand searching of relevant journals were conducted to identify eligible articles discussing characteristics and applications of coding systems in use and published in the English language between 1986 and 2016. Characteristics considered included type of information captured by codes, clinical setting(s) of use, adoption by a pharmacoepidemiology database, region, and available mappings. Applications articles describing the use and validity of specific codes, code lists, or algorithms were also included. Data extraction was performed independently by two reviewers and a narrative synthesis was performed. Results: A total of 897 unique articles and 57 coding systems were identified, 17% of which included country-specific modifications or multiple versions. Procedures (55%), diagnoses (36%), drugs (38%), and site of disease (39%) were most commonly and directly captured by these coding systems. The systems were used to capture information from the following clinical settings: inpatient (63%), ambulatory (55%), emergency department (ED, 34%), and pharmacy (13%). More than half of all coding systems were used in Europe (59%) and North America (57%). 34% of the reviewed coding systems were utilized in at least 1 of the 16 pharmacoepidemiology databases of interest evaluated. 21% of coding systems had studies evaluating the validity and consistency of their use in research within pharmacoepidemiology databases of interest. The most prevalent validation method was comparison with a review of patient charts, case notes or medical records (64% of reviewed validation studies). The reported performance measures in the reviewed studies varied across a large range of values (PPV 0-100%, NPV 6-100%, sensitivity 0-100%, specificity 23-100% and accuracy 16-100%) and were dependent on many factors including coding system(s), therapeutic area, pharmacoepidemiology database, and outcome. Conclusions: Coding systems vary by type of information captured, clinical setting, and pharmacoepidemiology database and region of use. Of the 57 reviewed coding systems, few are routinely and widely applied in pharmacoepidemiology database research. Indication and outcome dependent heterogeneity in coding system performance suggest that accurate definitions and algorithms for capturing specific exposures and outcomes within large healthcare datasets should be developed on a case-by-case basis and in consultation with clinical experts.

Using Simulation in Radiographic Science Education

2020 ◽  
pp. 37-67
Author(s):  
Christopher Ira Wertz ◽  
Jessyca Wagner ◽  
Trevor Mark Ward ◽  
Wendy Mickelsen
Keyword(s):  
Medical Education ◽  
Science Education ◽  
Adverse Effects ◽  
Real World ◽  
Clinical Setting ◽  
Virtual Simulation ◽  
Common Method ◽  
Psychomotor Skills ◽  
Science Students ◽  
Education Programs

Students in radiographic science education programs must master both the didactic education and psychomotor skills necessary to perform radiographic examinations on patients in a clinical setting. Simulation is the most common method of helping radiographic science students prepare to perform such examinations. Simulation can be performed either in live or virtual environments. Recently there has been a trend to adopt virtual simulation in medical education because of the reduced adverse effects virtual simulation provides as opposed to live simulation and real-world practice. Though there is a paucity of literature available discussing virtual simulation's use in radiographic science education, recent studies in this field and related medical imaging modalities have shown the benefits of using virtual simulation. The purpose of this chapter is to discuss the current use of virtual simulation in radiographic science education and characteristics to consider when implementing a simulation program.

scholarly journals Preventing Viral Contamination: Effects of Wipe and Spray-based Decontamination of Gloves and Gowns

2019 ◽  
Vol 69 (Supplement_3) ◽  
pp. S228-S230 ◽  
Author(s):  
Gwen L Robinson ◽  
Stephanie Hitchcock ◽  
Zegbeh Kpadeh-Rogers ◽  
Nicole Karikari ◽  
J Kristie Johnson ◽  
...  
Keyword(s):  
Environmental Contamination ◽  
Personal Protective Equipment ◽  
Laboratory Simulation ◽  
Protective Equipment ◽  
Viral Contamination ◽  
Environmental Surfaces ◽  
Contamination Effects

Abstract We conducted a laboratory simulation to evaluate the contamination of environmental surfaces when using wipe vs spray methods of personal protective equipment (PPE) decontamination. We did not observe any environmental contamination with the bacteriophage MS-2 when bleach solution spray or wipes were used for PPE disinfection.

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