scholarly journals Molecular Survey of the Dissemination of TwoblaKPC-Harboring IncFIA Plasmids in New Jersey and New York Hospitals

2014 ◽  
Vol 58 (4) ◽  
pp. 2289-2294 ◽  
Author(s):  
Liang Chen ◽  
Kalyan D. Chavda ◽  
Roberto G. Melano ◽  
Tao Hong ◽  
Albert D. Rojtman ◽  
...  
Keyword(s):  
Health Care ◽  
New York ◽  
New Jersey ◽  
Plasmid Transfer ◽  
Health Care Facilities ◽  
Conjugative Plasmid ◽  
Content Type ◽  
Care Facilities ◽  
Clonal Spread ◽  
Sequence Types

ABSTRACTKlebsiella pneumoniaecarbapenemase (KPC)-producingK. pneumoniaestrains have spread worldwide and become a major threat in health care facilities. Transmission ofblaKPC, the plasmid-borne KPC gene, can be mediated by clonal spread and horizontal transfer. Here, we report the complete nucleotide sequences of two novelblaKPC-3-harboring IncFIA plasmids, pBK30661 and pBK30683. pBK30661 is 74 kb in length, with a mosaic plasmid structure; it exhibits homologies to several other plasmids but lacks the plasmid transfer operon (tra) and the origin of transfer (oriT) that are required for plasmid transfer. pBK30683 is a conjugative plasmid with a cointegrated plasmid structure, comprising a 72-kb element that highly resembles pBK30661 (>99.9% nucleotide identities) and an extra 68-kb element that harborstraandoriT. A PCR scheme was designed to detect the distribution ofblaKPC-harboring IncFIA (pBK30661-like and pBK30683-like) plasmids in a collection of clinicalEnterobacteriaceaeisolates from 10 hospitals in New Jersey and New York. KPC-harboring IncFIA plasmids were found in 20% of 491K. pneumoniaeisolates, and all carriedblaKPC-3. pBK30661-like plasmids were identified mainly in the epidemic sequence type 258 (ST258)K. pneumoniaeclone, while pBK30683-like plasmids were widely distributed in ST258 and otherK. pneumoniaesequence types and among non-K. pneumoniae Enterobacteriaceaespecies. This suggests that both clonal spread and horizontal plasmid transfer contributed to the dissemination ofblaKPC-harboring IncFIA plasmids in our area. Further studies are needed to understand the distribution of this plasmid group in other health care regions and to decipher the origins of pBK30661-like and pBK30683-like plasmids.

scholarly journals Laboratory Analysis of an Outbreak of Candida auris in New York from 2016 to 2018: Impact and Lessons Learned

2019 ◽  
Vol 58 (4) ◽  
Author(s):  
YanChun Zhu ◽  
Brittany O’Brien ◽  
Lynn Leach ◽  
Alexandra Clarke ◽  
Marian Bates ◽  
...  
Keyword(s):  
Health Care ◽  
New York ◽  
Real Time ◽  
Real Time Pcr ◽  
Health Care Facilities ◽  
Clinical Isolates ◽  
Environmental Surveillance ◽  
Candida Auris ◽  
Content Type ◽  
Care Facilities

ABSTRACT Candida auris is a multidrug-resistant yeast which has emerged in health care facilities worldwide; however, little is known about identification methods, patient colonization, environmental survival, spread, and drug resistance. Colonization on both biotic (patients) and abiotic (health care objects) surfaces, along with travel, appear to be the major factors for the spread of this pathogen across the globe. In this investigation, we present laboratory findings from an ongoing C. auris outbreak in New York (NY) from August 2016 through 2018. A total of 540 clinical isolates, 11,035 patient surveillance specimens, and 3,672 environmental surveillance samples were analyzed. Laboratory methods included matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS) for yeast isolate identification, real-time PCR for rapid surveillance sample screening, culture on selective/nonselective media for recovery of C. auris and other yeasts from surveillance samples, antifungal susceptibility testing to determine the C. auris resistance profile, and Sanger sequencing of the internal transcribed spacer (ITS) and D1/D2 regions of the ribosomal gene for C. auris genotyping. Results included (a) identification and confirmation of C. auris in 413 clinical isolates and 931 patient surveillance isolates as well as identification of 277 clinical cases and 350 colonized cases from 151 health care facilities, including 59 hospitals, 92 nursing homes, 1 long-term acute care hospital (LTACH), and 2 hospices, (b) successful utilization of an in-house developed C. auris real-time PCR assay for the rapid screening of patient and environmental surveillance samples, (c) demonstration of relatively heavier colonization of C. auris in nares than in the axilla/groin, and (d) predominance of the South Asia clade I with intrinsic resistance to fluconazole and elevated MIC to voriconazole (81%), amphotericin B (61%), flucytosine (5FC) (3%), and echinocandins (1%). These findings reflect greater regional prevalence and incidence of C. auris and the deployment of better detection tools in an unprecedented outbreak.

Patient satisfaction with the quality of care in Ghana’s health-care institutions

2019 ◽  
Vol 13 (2) ◽  
pp. 160-170 ◽  
Author(s):  
Aaron Asibi Abuosi ◽  
Mahama Braimah
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Service Delivery ◽  
National Survey ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Content Type ◽  
Care Facilities

Purpose The purpose of this study was to examine patient satisfaction with the quality of care in Ghana’s health-care facilities using a disaggregated approach. Design/methodology/approach The study was a cross-sectional national survey. A sample of 4,079 males and females in the age group of 15-49 years were interviewed. Descriptive statistics, principal component analysis and t-tests were used in statistical analysis. Findings About 70 per cent of patients were satisfied with the quality of care provided in health-care facilities in Ghana, whereas about 30 per cent of patients were fairly satisfied. Females and insured patients were more likely to be satisfied with the quality of care, compared with males and uninsured patients. Research limitations/implications Because data were obtained from a national survey, the questionnaire did not include the type of facility patients attended to find out whether satisfaction with the quality of care varied by the type of health facility. Future studies may, therefore, include this. Practical implications The study contributes to the literature on patient satisfaction with the quality of care. It highlights that long waiting time remains an intractable problem at various service delivery units of health facilities and constitutes a major source of patient dissatisfaction with the quality of care. Innovative measures must, therefore, be adopted to address the problem. Originality/value There is a paucity of research that uses a disaggregated approach to examine patient satisfaction with the quality of care at various service delivery units of health facilities. This study is a modest contribution to this research gap.

Indoor air in healing environments

Facilities ◽  
2019 ◽  
Vol 37 (9/10) ◽  
pp. 600-623 ◽  
Author(s):  
Marco Gola ◽  
Gaetano Settimo ◽  
Stefano Capolongo
Keyword(s):  
Health Care ◽  
Air Quality ◽  
Indoor Air ◽  
Management Strategies ◽  
Health Care Facilities ◽  
Chemical Pollution ◽  
Content Type ◽  
Starting Point ◽  
Care Facilities ◽  
Maintenance Activities

Purpose Several countries have carried out air quality monitoring in professional workplaces where chemicals are used. Health-care spaces have been less investigated. This paper aims to define a protocol, as developed by a research group, for inpatient rooms to understand the state of the art and to suggest design and management strategies for improving process quality. Design/methodology/approach Starting from the ISO-16000 standard and guidelines for monitoring activities, a protocol is defined for a one year investigation, with passive samplers. Through data analysis of the investigations and analysis of the cleaning and finishing products, heating, ventilation and air conditioning and maintenance activities, etc., it is possible to highlight the potential influences of chemical pollution. Findings A methodology is defined for understanding the chemical pollution and the possible factors related to construction materials, cleaning products and maintenance activities. Research limitations/implications The paper analyzes only a limited number of case studies because the monitoring activity is still in progress. Practical implications The investigation offers a starting point for a wide tool for the definition of design, maintenance and management strategies in health-care facilities. Social implications The research project, aimed at improving the knowledge of indoor air quality (IAQ) in inpatient rooms, is a starting point for a supporting tool for future regulations concerning health-care facilities. Originality/value IAQ is an issue on which many governments are focusing. Several health-care researchers have reported studies that aim at improving users’ health. Most investigations are about biological and physical risks, but chemical risks have been less studied. The paper suggests some design and management strategies for inpatient room.

Confidentiality and security of information in the public health-care facilities to curb HIV/AIDS trauma among patients in Africa

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ngoako Solomon Marutha ◽  
Olefhile Mosweu
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Facilities ◽  
Public Health Care ◽  
Chronic Patients ◽  
Aids Patients ◽  
Content Type ◽  
The Public ◽  
Care Facilities ◽  
Hiv Aids

Purpose This study sought to investigate a framework for ensuring the confidentiality and security of information at the public health-care facilities to curb HIV/AIDS trauma among patients in Africa. In most instances, trauma to HIV/AIDS patients accelerate because of their personal information relating to the state of illness leaks to public people. Design/methodology/approach This qualitative study used literature to study confidentiality and security of information at the public health-care facilities to curb HIV/AIDS trauma among patients in Africa. Findings The study revealed that confidentiality and security of information has been neglected, in most instances, at the health-care facilities, and this has, to some extent, affected HIV/AIDS patients negatively, leading to trauma, stigma and skipping of treatment by patients resulting in accelerated mortality among chronic patients. The study recommends that patients’ information be always strictly controlled and kept confidential and secured at all the times, especially that of HIV/AIDS patients. Practical implications The proposed framework can be used by health-care facilities to guide the management and promotion of the confidentiality and security of information in the public health-care facilities to curb additional trauma to HIV/AIDS patients in the context of Africa, and even beyond. Originality/value The study provides a framework to ensure the confidentiality and security of information at the public health-care facilities to curb additional trauma to HIV/AIDS patients.

Renovation in hospitals: a case study on the use of control cubes for local repairs in health-care facilities

2020 ◽  
Vol 18 (3) ◽  
pp. 247-257
Author(s):  
Ehsan Mousavi ◽  
Vivek Sharma ◽  
Dhaval Gajjar ◽  
Shervin Shoai Naini
Keyword(s):  
Health Care ◽  
Air Quality ◽  
Indoor Air Quality ◽  
Indoor Air ◽  
Health Care Facilities ◽  
Repair Work ◽  
Content Type ◽  
Care Facilities ◽  
Pathogenic Agents ◽  
The Impact

Purpose The purpose of this study is to evaluate the effectiveness of the control cubes for dust control in health-care facilities. Research shows that more than 80% of pathogenic agents in hospitals are spread into the air, where they either remain airborne or deposit on the surface. At the same time, renovation and repair activities, including regular maintenance, are a necessity in active health-care facilities and a multitude of studies have documented their impact on indoor air quality. The dust that is generated by construction activities may potentially carry pathogenic agents, varying from coarse particles (≤10 µm, PM10) to fine particles (≤2.5 µm, PM2.5), including airborne bacteria, and fungal spores linked to high patient mortality in immune-compromised patients. Design/methodology/approach This study measures the impact and effectiveness of one such preventative measure, namely, the control cube (CC), on air quality during renovation and repair. CC is a temporary structure, typically made from stainless steel, around the local repair zone to minimize the spread of dust and potential microorganisms. The current paper presents a comparative analysis to identify the effectiveness of a CC equipped with the high-efficiency particulate filtration (HEPA) filter in a hospital setting by simulating construction renovation and repair work. Findings A baseline was established to measure the effectiveness of CCs and the impact of negative pressure on the indoor air quality in a hospital during simulated renovation work. Results showed that CCs are very effective in minimizing the spread of dust due to construction activities in the hospital. However, it is imperative to ensure that the air inside the CC is cleaned via filtration. Originality/value CCs are very effective, and this paper investigates the best approach for facility managers to implement this strategy.

Incorporating sustainability in small health-care facilities: an integrated model

2018 ◽  
Vol 31 (4) ◽  
pp. 441-451 ◽  
Author(s):  
Kevin Wing Ki Chu ◽  
Lenis Lai Wan Cheung
Keyword(s):  
Health Care ◽  
Integrated Model ◽  
Health Care Facilities ◽  
Content Type ◽  
Execution Plan ◽  
Potential Barriers ◽  
Care Facilities ◽  
Day To Day Operations ◽  
Leadership And Change ◽  
Practical Implications

PurposeIt is challenging for small health-care facilities to implement changes when human and financial resources are limited for day-to-day operations. This paper aims to propose an integrated model for small- and medium-sized health-care facilities to integrate sustainability in their day-to-day operations, which have been derived from the leadership and change theories.Design/methodology/approachDrawing on previous research on leadership and change theories, the paper first critically reviewed the approaches to implementing changes and how applicable they are in the context of small- and medium-sized health-care facilities. Next, it proposes an integrated model with an execution plan.FindingsThe first part of the paper discusses how either the planned approach or emergent approach for change may fail in facilitating the implementation of sustainable initiatives, as incorporating sustainability into operations require both leadership of change and open learning systems. The second part outlines the four-phase combined approach, which includes phases of “exploration”, “planning”, “action” and “integration”, and discusses how change readiness is ensured through such approach.Practical implicationsThe authors propose an integrated model as a framework for integrating sustainability into the operations of small health-care facilities. The clearest possible steps at various phases are proposed. Potential barriers and risks are highlighted and the coping strategies proposed to maximise the chance of successfully transforming organisations.Originality/valueApplying the “how to” ideas based on the integrated model for change management will help leaders of health-care facilities gradually integrate sustainability into their day-to-day operations.

scholarly journals A New OXA-66-harboring Acinetobacter Baumannii Sub-Clonal Complex 195 is Spreading Widely in Guangzhou, China, A Multicenter Study

2020 ◽  
Author(s):  
Yujun Li ◽  
Xiaomei Huang ◽  
Yuyao Wang ◽  
Chuzhi Pan ◽  
Zexun Mo ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Antimicrobial Agents ◽  
Clonal Complex ◽  
Genetic Relationships ◽  
Health Care Facilities ◽  
Hospital Environment ◽  
Teaching Hospitals ◽  
Care Facilities ◽  
Clonal Spread ◽  
Sequence Types

Abstract Objectives The clonal spread of Acinetobacter baumannii (A. baumannii) is an emerging problem. We analyzed the molecular epidemiology of A. baumannii isolated from 5 teaching hospitals in Guangzhou, China. Methods 138 A. baumannii isolates were collected. Multilocus sequence typing (MLST) was used to assess the genetic relationships among the isolates. The blaOXA-51-like gene was amplified and then sequenced. Results Most of the isolates (55.8%, 77/138) were obtained from intensive care units (ICUs). The respiratory system was the most common site where A. baumannii was found (72.5%, 100/138). A. baumannii remained susceptible to polymyxin and tigecycline, but the susceptibility to other antimicrobial agents was below 30%. We used MLST to group the A. baumannii isolates into 8 existing sequence types (STs) and 17 new STs. With the predicted founder ST195 (accounted for 35.5% of all isolates, 49/138), Clonal complex (CC) 195 was the most prevalent and widely spread STs in the hospital environment. All ST195 isolates harbored OXA-66 according to the blaOXA-51-like gene sequencing. But each hospital had its unique epidemiological feature. Conclusions OXA-66 gene harboring CC195 was the most epidemic STs in Guangzhou, China. Health care facilities should develop their own management strategy.

Facilitators and Barriers to Implementing the International Dysphagia Diet Standardisation Initiative in Care Facilities in Upstate New York

2021 ◽  
pp. 1-9
Author(s):  
Caileen Harvey ◽  
Rachel Flemming ◽  
Julia Davis ◽  
Victoria Reynolds
Keyword(s):  
Health Care ◽  
New York ◽  
Health Care Professionals ◽  
Geographical Area ◽  
The United States ◽  
Health Care Facilities ◽  
Successful Implementation ◽  
Upstate New York ◽  
Texture Modification ◽  
Care Facilities

Introduction: Dysphagia is a swallowing disorder that can result in aspiration, asphyxiation, or other complications. One method of facilitating safer swallowing is modification of the diet and fluids of individuals living with dysphagia. The International Dysphagia Diet Standardisation Initiative (IDDSI) is a globally standardized framework for texture modification. Its implementation has been recommended in the United States, but adoption is not yet universal. This study investigated implementation issues by surveying health care professionals in health care facilities in rural, Upstate New York. Method: A questionnaire created through the SurveyMonkey platform was distributed to health care facilities within a predetermined geographical area in Upstate New York. The survey consisted of 22 questions and utilized a mixed-methods design. Results: Forty-six participants from 10 individual professions and nine types of facilities completed the study. Twenty texture modification labels and 10 fluid modification labels were described. Analysis of qualitative data yielded three main barriers to implementation: funding, education, and communication. Within each barrier, awareness and resources were recurrent themes. Discussion: The variety of modification labels in comparison with the sample size demonstrates a lack of standardization of texture modification processes across facilities. While nearly half the respondents had not heard of IDDSI prior to the survey, 89% agreed that a standardized dysphagia diet would improve patient health and safety. This demonstrated a willingness to adopt IDDSI and indicated that staff attitudes may not be a barrier to its implementation. Participants felt that training was needed for successful implementation and expressed concern about the lack of availability of financial resources. Supplemental Material: https://doi.org/10.23641/asha.17270861

Information management practices in public tertiary health-care facilities: an empirical investigation from the state of Kuwait

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Dari Alhuwail
Keyword(s):  
Health Care ◽  
Information Management ◽  
Management Practices ◽  
Health Care Organizations ◽  
Health Care Facilities ◽  
Care Organization ◽  
Data Set ◽  
Content Type ◽  
Management Standard ◽  
Care Facilities

Purpose This paper aims to gain insights about information management practices in public health-care organizations in Kuwait and offer recommendations to improve these practices. Design/methodology/approach This study involves secondary analysis of quantitative and qualitative accreditation-related data pertaining to the compliance with the Information Management standard at seven public tertiary health-care facilities over two accreditation cycles. Findings Overall, organizations improved their compliance with the Information Management standard. However, issues exist with effectively and efficiently transmitting data, aggregating clinical and administrative data and using the information for both strategic planning and quality improvement initiatives. Research limitations/implications The analysed data set does not provide information about the improvements done between the accreditation cycles. Caution should be applied before assuming generalizability of the results, considering the context and social constructs around the health-care system is essential. Practical implications Compliance with predetermined criteria through accreditation can improve information management practices. Without proper management of information at health-care facilities, achieving safe and effective patient care is futile. The role of health information technology (IT) should not be sidelined; robust health IT solutions can help support good information management practices thereby improving care quality and aiding health-care reform. Originality/value Concerning information management, health-care organizations providing focused services have clear advantages over organizations providing general care services. Considering the type of care organization (general vs specialized) can provide insights into how information management practices can affect the operations of the organization.

Towards quality primary health care: the dilemma of Community-Based Health Planning and Services (CHPS) in health service provision in Ghana

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Barnabas Addi ◽  
Benjamin Doe ◽  
Eric Oduro-Ofori
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Planning ◽  
Health Care Facilities ◽  
Health Needs ◽  
Community Based ◽  
Content Type ◽  
Primary Health ◽  
Care Facilities ◽  
Primary Health Care Facilities

PurposeOver the past two decades, Community-Based Health Planning and Services (CHPS) has been a pragmatic strategy towards universal Primary Health Care (PHC) in Ghana. However, the ability and capacity of these facilities to deliver quality primary health care remain an illusion as they are still crumbling in myriad challenges. These challenges are translated to the poor-quality services provision and low community utilization of CHPS facilities. The study presents a comparative analysis of three communities in the Kassena-Nankana East Municipality, Ghana.Design/methodology/approachUsing a mixed-method research design, the study gathered and analysed data from 110 households, three community health officers (CHOs) and three community leaders using semi-structured questionnaires and interview guides.FindingsThe findings indicated that the facilities do not have the requisite inputs such as drugs and supplies, logistics, appropriate health personnel, good infrastructure, funding support necessary to deliver quality and appropriate healthcare services that meet the health needs of the communities. For the CHPS to realize their full potentials as PHC facilities, it is required that the needed inputs such as logistics, drugs and appropriate staff are in place to facilitate the activities of CHOs.Research limitations/implicationsDue to the limited number of participants and selection of the study communities, the results may generalization. Also, the researchers acknowledged the inability to interview the district level health officials and the Kassena-Nankana Municipal Assembly during the field visits. This could have provided in-depth knowledge on the findings of this research as well as the validation of the results from the communities' perspective. Several attempts were made to contact and interview district-level authorities which proven futile due to the unavailability of targeted respondents. This resulted in limiting the studies at the community level. However, this limitation does not disprove the findings of this study.Practical implicationsThe article implications for planning primary health care strategies include a keen assessment of community health needs and institutional management of primary health care facilities, equip PHC facilities with adequate resources such as drugs and appropriate staffing to provide the health needs of the communities.Originality/valueThe paper fulfils the gap in the literature by providing empirical data on how the challenges of primary health care facilities affected the provision of high quality service and how this can affect community’s use of the facilities.

Sign in / Sign up

Export Citation Format

Share Document