scholarly journals Rapid phase I evaluation of a novel automated hand hygiene monitoring system in response to COVID-19

2022 ◽  
pp. bmjinnov-2021-000859
Author(s):  
Katie-Rose Cawthorne ◽  
Darren Powell ◽  
Richard PD Cooke
Author(s):  
Swetha Tatineni ◽  
Nicola M Orlov ◽  
Joseph M Riehm ◽  
Amarachi Erondu ◽  
Christine L Mozer ◽  
...  

During the COVID-19 pandemic, hospitals published physical-distancing guidance and created dedicated respiratory isolation units (RIUs) for patients with COVID-19. The degree to which such distancing occurred between clinicians and patients is unknown. In this study, heat sensors from an existing hospital hand-hygiene monitoring system objectively tracked room entries as a proxy for physical distancing in both RIUs and general medicine units before and during the pandemic. The RIUs saw a 60.6% reduction in entries per room per day (from 85.7 to 33.8). General medicine units that cared for patients under investigation for COVID-19 and other patients experienced a 14.7% reduction in entries per room per day (from 76.9 to 65.1). While gradual extinction was observed in both units as COVID-19 cases declined, the RIUs had a higher degree of physical distancing. Although the optimal level of physical distancing is unknown, sustaining physical distancing in the hospital may require re-education and real-time monitoring.


2011 ◽  
Vol 80 (8) ◽  
pp. 596-603 ◽  
Author(s):  
Alexander I. Levchenko ◽  
Veronique M. Boscart ◽  
Geoffrey R. Fernie

2019 ◽  
Vol 47 (12) ◽  
pp. 1443-1448 ◽  
Author(s):  
John M. Boyce ◽  
Timothea Cooper ◽  
Jun Yin ◽  
Fang-Yong Li ◽  
James W. Arbogast

2014 ◽  
Vol 88 (2) ◽  
pp. 84-88 ◽  
Author(s):  
S.J. Storey ◽  
G. FitzGerald ◽  
G. Moore ◽  
E. Knights ◽  
S. Atkinson ◽  
...  

2008 ◽  
Vol 295 (2) ◽  
pp. R624-R632 ◽  
Author(s):  
Frédéric Lador ◽  
Enrico Tam ◽  
Marcel Azabji Kenfack ◽  
Michela Cautero ◽  
Christian Moia ◽  
...  

We tested the hypothesis that vagal withdrawal plays a role in the rapid (phase I) cardiopulmonary response to exercise. To this aim, in five men (24.6 ± 3.4 yr, 82.1 ± 13.7 kg, maximal aerobic power 330 ± 67 W), we determined beat-by-beat cardiac output (Q̇), oxygen delivery (Q̇aO2), and breath-by-breath lung oxygen uptake (V̇o2) at light exercise (50 and 100 W) in normoxia and acute hypoxia (fraction of inspired O2 = 0.11), because the latter reduces resting vagal activity. We computed Q̇ from stroke volume (Qst, by model flow) and heart rate ( fH, electrocardiography), and Q̇aO2 from Q̇ and arterial O2 concentration. Double exponentials were fitted to the data. In hypoxia compared with normoxia, steady-state fH and Q̇ were higher, and Qst and V̇o2 were unchanged. Q̇aO2 was unchanged at rest and lower at exercise. During transients, amplitude of phase I (A1) for V̇o2 was unchanged. For fH, Q̇ and Q̇aO2, A1 was lower. Phase I time constant (τ1) for Q̇aO2 and V̇o2 was unchanged. The same was the case for Q̇ at 100 W and for fH at 50 W. Qst kinetics were unaffected. In conclusion, the results do not fully support the hypothesis that vagal withdrawal determines phase I, because it was not completely suppressed. Although we can attribute the decrease in A1 of fH to a diminished degree of vagal withdrawal in hypoxia, this is not so for Qst. Thus the dual origin of the phase I of Q̇ and Q̇aO2, neural (vagal) and mechanical (venous return increase by muscle pump action), would rather be confirmed.


2009 ◽  
Vol 24 (3) ◽  
pp. e13
Author(s):  
Jane E. Holsinger ◽  
Jane E. Holsinger ◽  
Melissa Wagoner ◽  
Jessica Close ◽  
Sandy Trumpower ◽  
...  

Author(s):  
Zaid Ali Shhedi ◽  
Alin Moldoveanu ◽  
Florica Moldoveanu ◽  
Cristian Taslitchi

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S425-S425
Author(s):  
Maureen Banks ◽  
Andrew Phillips ◽  
Keith Chin ◽  
Lou Ann Bruno-Murtha

Abstract Background Hand hygiene (HH) is the cornerstone of infection prevention and improved compliance has been associated with reduced healthcare-associated infections (HAIs). However, traditional methods for HH data collection have limitations and may not accurately reflect true compliance. We sought to evaluate whether an electronic hand hygiene monitoring system (HHMS) can improve data collection, compliance, and reduce HAIs. Methods A HHMS was implemented as part of a pilot at a single facility in June 2018 for all healthcare workers (HCWs) who entered patient rooms. The system prompted HCWs to perform HH with an audible and visual reminder emitted from a badge if a HH event had not been registered within specific timeframes of entering or exiting a patient room. The system captured compliance with preferential handwashing (soap and water) for at least 15 seconds upon exit of Clostridioides difficile (C. difficile) designated rooms. All HH data were collected by the HHMS. Hand hygiene compliance and HAI data were compared for the pre-intervention (June 2017-May 2018) and intervention periods (July 2018-March 2019). No changes were made to environmental cleaning protocols or compliance monitoring, nor in antibiotic stewardship practices. Results HH compliance by direct observation in the pre-intervention period was 91% (1,612 observations). HH compliance with the HHMS during the intervention period was 97% (2,778,402 observations). The mean monthly HH opportunities recorded during the pre-intervention period was 134, while the HHMS captured 308,711, a greater than 2,300-fold increase. The incidence of healthcare facility-onset C. difficile infections (HO-CDI) pre-intervention was 9.60 per 10,000 patient-days (41 GDH+/Toxin+ laboratory-identified [labID] events/42,726 patient-days). With the HHMS, HO-CDI decreased 70% (P = 0.0003) to 2.89 per 10,000 patient-days (9 labID events/31,169 patient-days). No policy changes in environmental cleaning of high-touch surfaces were made or observed during the pilot. Conclusion The use of an HHMS facilitated more comprehensive HH data and improved compliance. The preliminary findings also support an association between more robust HH compliance data and a significant decrease in toxin-producing CDI. Disclosures All authors: No reported disclosures.


Holzforschung ◽  
2010 ◽  
Vol 64 (1) ◽  
Author(s):  
Lili Yu ◽  
Jinzhen Cao ◽  
Guangjie Zhao

Abstract The reactions between constituents of alkaline copper quat (ACQ) and of wood were investigated by a tensile stress relaxation approach. Small samples were stressed and impregnated with various ACQ solutions, in which the ratios of monoethanolamine (MEA), ACQ, and didecyl dimethyl ammonium chloride (DDAC) were varied. The other parameters included temperature and concentration of the treating solutions. The stress relaxation curves of wood were recorded during the impregnation period and the effects of impregnation parameters were investigated by an orthogonal experimental design (OED). The effects of water, MEA, and DDAC on stress relaxation of the samples were also observed. The bulking effect of water was tested separately in samples treated with distilled water without stretching. The results showed that the stress relaxes dramatically in the initial period and then changes slightly over a long period, which is readily visible in double logarithmic plots of f (t)/f (0) versus time (t). There are complex interactions between the components of ACQ solutions and wood matrix: (1) in rapid phase I, the splitting of the easily accessible hydrogen bonds (mainly in the amorphous hemicelluloses) are prevalent by interaction with components of ACQ solution; (2) in slow phase II, Cu penetrates deeper in less accessible regions (e.g., in paracrystalline regions of cellulose) and renders possible further relaxation. The results of range and variance analysis reveal that the molar ratio of Cu to MEA and temperature of ACQ solution have significant effects on the rate of reaction during phase I, whereas in phase II only the temperature of ACQ solution has a significant effect. The stress relaxation curves of samples impregnated in water, MEA, and DDAC all showed a quasi one phase stress relaxation rate, which suggests that phase II is mostly related to Cu in ACQ formulations. It is concluded that the formation of complexes with Cu is still the major reaction in wood although there is competition among ACQ constituents for reaction sites.


2006 ◽  
Vol 290 (4) ◽  
pp. R1071-R1079 ◽  
Author(s):  
Frédéric Lador ◽  
Marcel Azabji Kenfack ◽  
Christian Moia ◽  
Michela Cautero ◽  
Denis R. Morel ◽  
...  

We tested whether the kinetics of systemic O2 delivery (Q̇aO2) at exercise start was faster than that of lung O2 uptake (V̇o2), being dictated by that of cardiac output (Q̇), and whether changes in Q̇ would explain the postulated rapid phase of the V̇o2 increase. Simultaneous determinations of beat-by-beat (BBB) Q̇ and Q̇aO2, and breath-by-breath V̇o2 at the onset of constant load exercises at 50 and 100 W were obtained on six men (age 24.2 ± 3.2 years, maximal aerobic power 333 ± 61 W). V̇o2 was determined using Grønlund's algorithm. Q̇ was computed from BBB stroke volume (Qst, from arterial pulse pressure profiles) and heart rate ( fh, electrocardiograpy) and calibrated against a steady-state method. This, along with the time course of hemoglobin concentration and arterial O2 saturation (infrared oximetry) allowed computation of BBB Q̇aO2. The Q̇, Q̇aO2 and V̇o2 kinetics were analyzed with single and double exponential models. fh, Qst, Q̇, and V̇o2 increased upon exercise onset to reach a new steady state. The kinetics of Q̇aO2 had the same time constants as that of Q̇. The latter was twofold faster than that of V̇o2. The V̇o2 kinetics were faster than previously reported for muscle phosphocreatine decrease. Within a two-phase model, because of the Fick equation, the amplitude of phase I Q̇ changes fully explained the phase I of V̇o2 increase. We suggest that in unsteady states, lung V̇o2 is dissociated from muscle O2 consumption. The two components of Q̇ and Q̇aO2 kinetics may reflect vagal withdrawal and sympathetic activation.


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