scholarly journals What’s on your keyboard? A systematic review of the contamination of peripheral computer devices in healthcare settings

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e026437 ◽  
Author(s):  
Nicole Ide ◽  
Bianca K Frogner ◽  
Cynthia M LeRouge ◽  
Patrick Vigil ◽  
Matthew Thompson
Keyword(s):  
Systematic Review ◽  
Healthcare Worker ◽  
Computer Hardware ◽  
Primary Data ◽  
Light Emitting Devices ◽  
Healthcare Settings ◽  
Skin Commensals ◽  
Cleaning Methods ◽  
Chlorine Bleach ◽  
Human Infections

ObjectiveTo determine the extent and type of microbial contamination of computer peripheral devices used in healthcare settings, evaluate the effectiveness of interventions to reduce contamination of these devices and establish the risk of patient and healthcare worker infection from contaminated devices.DesignSystematic reviewMethodsWe searched four online databases: MEDLINE, CINAHL, Embase and Scopus for articles reporting primary data collection on contamination of computer-related equipment (including keyboards, mice, laptops and tablets) and/or studies demonstrating the effectiveness of a disinfection technique. Pooling of contamination rates was conducted where possible, and narrative synthesis was used to describe the rates of device contamination, types of bacterial and viral contamination, effectiveness of interventions and any associations between device contamination and human infections.ResultsOf the 4432 records identified, a total of 75 studies involving 2804 computer devices were included. Of these, 50 studies reported contamination of computer-related hardware, and 25 also measured the effects of a decontamination intervention. The overall proportion of contamination ranged from 24% to 100%. The most common microbial contaminants were skin commensals, but also included potential pathogens including methicillin-resistantStaphylococcus aureus,Clostridiumdifficile, vancomycin-resistantenterococci andEscherichia coli. Interventions demonstrating effective decontamination included wipes/pads using isopropyl alcohol, quaternary ammonium, chlorhexidine or dipotassium peroxodisulfate, ultraviolet light emitting devices, enhanced cleaning protocols and chlorine/bleach products. However, results were inconsistent, and there was insufficient data to demonstrate comparative effectiveness. We found little evidence on the link between device contamination and patient/healthcare worker colonisation or infection.ConclusionsComputer keyboards and peripheral devices are frequently contaminated; however, our findings do not allow us to draw firm conclusions about their relative impact on the transmission of pathogens or nosocomial infection. Additional studies measuring the incidence of healthcare-acquired infections from computer hardware, the relative risk they pose to healthcare and evidence for effective and practical cleaning methods are needed.

scholarly journals Prevalence of retinopathy in prediabetes: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040997
Author(s):  
Varo Kirthi ◽  
Paul Nderitu ◽  
Uazman Alam ◽  
Jennifer Evans ◽  
Sarah Nevitt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diabetic Retinopathy ◽  
Data Extraction ◽  
Meta Analysis ◽  
International Diabetes Federation ◽  
Current Data ◽  
Risk Of Bias ◽  
Fundus Photography ◽  
Primary Data ◽  
Cochrane Library

IntroductionThere is growing evidence of a higher than expected prevalence of retinopathy in prediabetes. This paper presents the protocol of a systematic review and meta-analysis of retinopathy in prediabetes. The aim of the review is to estimate the prevalence of retinopathy in prediabetes and to summarise the current data.Methods and analysisThis protocol is developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. A comprehensive electronic bibliographic search will be conducted in MEDLINE, EMBASE, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar and the Cochrane Library. Eligible studies will report prevalence data for retinopathy on fundus photography in adults with prediabetes. No time restrictions will be placed on the date of publication. Screening for eligible studies and data extraction will be conducted by two reviewers independently, using predefined inclusion criteria and prepiloted data extraction forms. Disagreements between the reviewers will be resolved by discussion, and if required, a third (senior) reviewer will arbitrate.The primary outcome is the prevalence of any standard features of diabetic retinopathy (DR) on fundus photography, as per International Clinical Diabetic Retinopathy Severity Scale (ICDRSS) classification. Secondary outcomes are the prevalence of (1) any retinal microvascular abnormalities on fundus photography that are not standard features of DR as per ICDRSS classification and (2) any macular microvascular abnormalities on fundus photography, including but not limited to the presence of macular exudates, microaneurysms and haemorrhages. Risk of bias for included studies will be assessed using a validated risk of bias tool for prevalence studies. Pooled estimates for the prespecified outcomes of interest will be calculated using random effects meta-analytic techniques. Heterogeneity will be assessed using the I2 statistic.Ethics and disseminationEthical approval is not required as this is a protocol for a systematic review and no primary data are to be collected. Findings will be disseminated through peer-reviewed publications and presentations at national and international meetings including Diabetes UK, European Association for the Study of Diabetes, American Diabetes Association and International Diabetes Federation conferences.PROSPERO registration numberCRD42020184820.

scholarly journals Risk factors for antibiotic resistance development in healthcare settings in China: A systematic review

2021 ◽  
pp. 1-30
Author(s):  
Qi Chen ◽  
Duguang Li ◽  
Claudia Beiersmann ◽  
Florian Neuhann ◽  
Babak Moazen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Antibiotic Resistance ◽  
Resistance Development ◽  
Healthcare Settings

scholarly journals User involvement in adolescents’ mental healthcare: protocol for a systematic review

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018800
Author(s):  
Petter Viksveen ◽  
Stig Erlend Bjønness ◽  
Siv Hilde Berg ◽  
Nicole Elizabeth Cardenas ◽  
Julia Rose Game ◽  
...  
Keyword(s):  
Systematic Review ◽  
Critical Appraisal ◽  
Research Evidence ◽  
Data Extraction ◽  
Mental Healthcare ◽  
User Involvement ◽  
Cochrane Collaboration ◽  
Research Literature ◽  
Primary Data ◽  
Evaluation Approach

IntroductionUser involvement has become a growing importance in healthcare. The United Nations state that adolescents have a right to be heard, and user involvement in healthcare is a legal right in many countries. Some research provides an insight into the field of user involvement in somatic and mental healthcare for adults, but little is known about user involvement in adolescents’ mental healthcare, and no overview of the existing research evidence exists.Methods and analysisThe aim of this systematic review is to provide an overview of existing research reporting on experiences with and the effectiveness and safety issues associated with user involvement for adolescents’ mental healthcare at the individual and organisational level. A systematic literature search and assessment of published research in the field of user involvement in adolescents’ mental healthcare will be carried out. Established guidelines will be used for data extraction (Cochrane Collaboration guidelines, Strengthening the Reporting of Observational studies in Epidemiology and Critical Appraisal Skills Programme (CASP)), critical appraisal (Cochrane Collaboration guidelines and Pragmatic-Explanatory Continuum Indicator Summary) and reporting of results (Preferred Reporting Items for Systematic reviews and Meta-Analyses, Consolidated Standards of Reporting Trials and CASP). Confidence in the research evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Adolescents are included as coresearchers for the planning and carrying out of this systematic review. This systematic review will provide an overview of the existing research literature and thereby fill a knowledge gap. It may provide various stakeholders, including decision-makers, professionals, individuals and their families, with an overview of existing knowledge in an underexplored field of research.Ethics and disseminationEthics approval is not required for this systematic review as we are not collecting primary data. The results will be published in a peer-reviewed journal and at conference presentations and will be shared with stakeholder groups.

scholarly journals A Systematic Review of Librarian-Provided Services Delivered in Healthcare Settings Finds a Positive Effect on Clinician and Patient Relevant Outcomes and Identifies Gaps in the Evidence

2015 ◽  
Vol 10 (1) ◽  
pp. 95
Author(s):  
Elizabeth Margaret Stovold
Keyword(s):  
Systematic Review ◽  
Conference Proceedings ◽  
Data Collection ◽  
Literature Search ◽  
Healthcare Setting ◽  
Risk Of Bias ◽  
Randomised Trials ◽  
Inclusion Criteria ◽  
Healthcare Settings ◽  
Positive Effect

A Review of: Perrier, L., Farrell, A., Ayala, A. P., Lightfoot, D., Kenny, T., Aaronson, E., . . . Weiss, A. ( 2014). Effects of librarian-provided services in healthcare settings: A systematic review. Journal of the American Medical Informatics Association, 21(6), 1118-1124. http://dx.doi.org/10.1136/amiajnl-2014-002825 Abstract Objective – To assess the effects of librarian-provided services, in any healthcare setting, on outcomes important to patients, healthcare providers, and researchers. Design – Systematic review and narrative synthesis. Setting – MEDLINE, CINAHL, ERIC, LISA, and CENTRAL databases; library-related websites, conference proceedings, and reference lists of included studies. Subjects – Twenty-five studies identified through a systematic literature search. Methods – In consultation with the review team, a librarian designed a search to be run in MEDLINE that was peer-reviewed against a published checklist. The team then conducted searches in the five identified databases, adapting the search as appropriate for each database. Authors also checked the websites of library and evidence based healthcare organisations, along with abstracts of relevant conference proceedings, to supplement the electronic search. Two authors screened the literature search results for eligible studies, and reached agreement by consensus. Studies of any librarian-delivered service in a healthcare setting, directed at either patients, clinicians of any type, researchers, or students, along with studies reporting outcomes relevant to clinicians, patients, or researchers, were eligible for inclusion. The authors assessed results initially on the titles and abstracts, and then on the full-text of potentially relevant reports. The data from included studies were then extracted into a piloted data extraction form, and each study was assessed for quality using the Cochrane EPOC risk of bias tool or the Newcastle-Ottawa scale. The results were synthesised narratively. Main Results – The searches retrieved a total of 25 studies that met the inclusion criteria, comprised of 22 primary papers and 3 companion reports. Authors identified 12 randomised trials, 4 controlled before-and-after studies, 3 cohorts, 2 non-randomised trials, and 1 case-control study. They identified three main categories of intervention: librarians teaching search skills; providing literature searching as a service; and a combination of the teaching and provision of search services. The interventions were delivered to a mix of trainees, clinicians, and students. None of the studies examined services delivered directly to patients or to researchers. The quality assessment found most of the studies had a mid- to high-risk of bias due to factors such as lack of random sequence generation, a lack of validated tools for data collection, or a lack of statistical analysis included in the study. Two studies measured patient relevant outcomes and reported that searches provided by librarians to clinicians had a positive impact on the patient’s length of stay in hospital. Five studies examined the effect of librarian provided services on outcomes important to clinicians, such as whether a literature search influenced a clinical decision. There was a trend towards a positive effect, although two studies found no significant difference. The majority of studies investigated the impact of training delivered to trainees and students on their literature search skills. Twelve of these studies found a positive effect of training on the recipients’ search skills, while three found no difference. The secondary outcomes considered by this review were satisfaction with the service (8 studies), relevance of the answers provided by librarians (2), and cost (3). The majority reported good satisfaction, and relevance. A cost benefit was found in 2 of 3 studies that reported this outcome. Conclusion – Authors report a positive effect of training on the literature search skills of trainees and students, and identified a benefit in the small number of studies that examined librarian services to clinicians. Future studies should use validated data collection tools, and further research should be conducted in the area of services provided to clinicians. Research is needed on the effect of librarian-provided services to patients and researchers as no studies meeting the inclusion criteria examining these two groups were identified by the literature search.

scholarly journals Comparing pharmacological venous thromboembolism prophylaxis to intermittent pneumatic compression in acute intracerebral haemorrhage: protocol for a systematic review and network meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e024405 ◽  
Author(s):  
Vignan Yogendrakumar ◽  
Ronda Lun ◽  
Brian Hutton ◽  
Dean A Fergusson ◽  
Dar Dowlatshahi
Keyword(s):  
Systematic Review ◽  
Venous Thromboembolism ◽  
Intracerebral Haemorrhage ◽  
Meta Analysis ◽  
Indirect Evidence ◽  
Intermittent Pneumatic Compression ◽  
Qualitative Assessment ◽  
Primary Data ◽  
Thromboembolism Prophylaxis ◽  
Increased Risk

IntroductionPatients with an intracerebral haemorrhage are at increased risk of venous thromboembolism. Pharmacotherapy and pneumatic compression devices are capable of preventing venous thromboembolism, however both interventions have limitations. There are no head-to-head comparisons between these two interventions. To address this knowledge gap, we plan to perform a systematic review and network meta-analysis to examine the comparative effectiveness of pharmacological prophylaxis and mechanical compression devices in the context of intracerebral haemorrhage.Methods and analysisMEDLINE, PUBMED, EMBASE, CENTRAL, ClinicalTrials.gov and the Internet Stroke Trials Registry will be searched with assistance from an experienced information specialist. Eligible studies will include those that have enrolled adults presenting with spontaneous intracerebral haemorrhage and compared one or more of the respective interventions against each other and/or a control. Primary outcomes to be assessed are occurrence of new venous thromboembolism (deep vein thrombosis and/or pulmonary embolism) and haematoma expansion, defined as a significant enlargement of baseline haemorrhage or new haemorrhage occurrence. Both randomised and non-randomised comparative studies will be included. Data on participant characteristics, study design, intervention details and outcomes will be extracted. Study quality will be assessed using the Cochrane Risk of Bias Tool and the Robins-I tool. Bayesian network meta-analyses will be performed to compare interventions based on all available direct and indirect evidence. If the transitivity assumption for network meta-analysis cannot be met, we will perform a qualitative assessment.Ethics and disseminationFormal ethics is not required as primary data will not be collected. The findings of this study will be disseminated through conference presentations, and peer-reviewed publications. In an area of clinical practice where equipoise exists, the findings of this study may assist in determining which treatment intervention is most effective in venous thromboembolism prevention.PROSPERO registration numberCRD42018090960.

scholarly journals Why does healthcare utilisation differ between socioeconomic groups in OECD countries with universal healthcare coverage? A protocol for a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e054806
Author(s):  
Iris Meulman ◽  
Ellen Uiters ◽  
Johan Polder ◽  
Niek Stadhouders
Keyword(s):  
Systematic Review ◽  
Healthcare Access ◽  
Healthcare Utilisation ◽  
Oecd Countries ◽  
Primary Data ◽  
Scientific Article ◽  
Socioeconomic Groups ◽  
Universal Healthcare ◽  
Healthcare Coverage ◽  
Universal Healthcare Coverage

IntroductionEven in advanced economies with universal healthcare coverage (UHC), a social gradient in healthcare utilisation has been reported. Many individual, community and healthcare system factors have been considered that may be associated with the variation in healthcare utilisation between socioeconomic groups. Nevertheless, relatively little is known about the complex interaction and relative contribution of these factors to socioeconomic differences in healthcare utilisation. In order to improve understanding of why utilisation patterns differ by socioeconomic status (SES), the proposed systematic review will explore the main mechanisms that have been examined in quantitative research.Methods and analysisThe systematic review will follow the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and will be conducted in Embase, PubMed, Scopus, Web of Science, Econlit and PsycInfo. Articles examining factors associated with the differences in primary and specialised healthcare utilisation between socioeconomic groups in Organisation for Economic Co-operation and Development (OECD) countries with UHC will be included. Further restrictions concern specifications of outcome measures, factors of interest, study design, population, language and type of publication. Data will be numerically summarised, narratively synthesised and thematically discussed. The factors will be categorised according to existing frameworks for barriers to healthcare access.Ethics and disseminationNo primary data will be collected. No ethics approval is required. We intend to publish a scientific article in an international peer-reviewed journal.

scholarly journals SARS-CoV-2 and the role of fomite transmission: a systematic review

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 233
Author(s):  
Igho J. Onakpoya ◽  
Carl J. Heneghan ◽  
Elizabeth A. Spencer ◽  
Jon Brassey ◽  
Annette Plüddemann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sample Collection ◽  
Quality Of Reporting ◽  
Cycle Threshold ◽  
Healthcare Settings ◽  
Viral Culture ◽  
Mechanistic Pathway ◽  
General Wards ◽  
Study Designs

Background: SARS-CoV-2 RNA has been detected in fomites which suggests the virus could be transmitted via inanimate objects. However, there is uncertainty about the mechanistic pathway for such transmissions. Our objective was to identify, appraise and summarise the evidence from primary studies and systematic reviews assessing the role of fomites in transmission.  Methods: This review is part of an Open Evidence Review on Transmission Dynamics of SARS-CoV-2. We conduct ongoing searches using WHO Covid-19 Database, LitCovid, medRxiv, and Google Scholar; assess study quality based on five criteria and report important findings on an ongoing basis. Results: We found 64 studies: 63 primary studies and one systematic review (n=35). The settings for primary studies were predominantly in hospitals (69.8%) including general wards, ICU and SARS-CoV-2 isolation wards. There were variations in the study designs including timing of sample collection, hygiene procedures, ventilation settings and cycle threshold. The overall quality of reporting was low to moderate. The frequency of positive SARS-CoV-2 tests across 51 studies (using RT-PCR) ranged from 0.5% to 75%. Cycle threshold values ranged from 20.8 to 44.1. Viral concentrations were reported in 17 studies; however, discrepancies in the methods for estimation prevented comparison. Eleven studies (17.5%) attempted viral culture, but none found a cytopathic effect. Results of the systematic review showed that healthcare settings were most frequently tested (25/35, 71.4%), but laboratories reported the highest frequency of contaminated surfaces (20.5%, 17/83).  Conclusions: The majority of studies report identification of SARS-CoV-2 RNA on inanimate surfaces; however, there is a lack of evidence demonstrating the recovery of viable virus. Lack of positive viral cultures suggests that the risk of transmission of SARS-CoV-2 through fomites is low. Heterogeneity in study designs and methodology prevents comparisons of findings across studies. Standardized guidelines for conducting and reporting research on fomite transmission is warranted.

scholarly journals A systematic review of the effects of nicotine replacement therapy on agitation among nicotine-dependent psychiatric inpatients

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S296-S296
Author(s):  
Joseph Toms ◽  
Jacob King
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Controlled Trial ◽  
Psychiatric Inpatients ◽  
Cochrane Collaboration ◽  
Search Strategies ◽  
Primary Data ◽  
Psychiatric Admission ◽  
Cross Sectional ◽  
Nicotine Replacement

AimsThis systematic review aims to evaluate the effect of nicotine replacement therapies (NRTs) on measures of agitation amongst nicotine-dependent adult psychiatric inpatients.BackgroundSince the introduction of the smoke-free policy for all psychiatric facilities, a psychiatric admission is likely to upset a nicotine-dependent individual's normal routine of nicotine consumption. In addition to the physiological effects of nicotine withdrawal (NW), the interpersonal dynamic which nurse-led guardianship of nicotine products constructs presents stressors to the nicotine dependent patient.Several systematic reviews evaluating changes in objective measures of agitation amongst smoking patients in medical critical care units have found varied results, with some demonstrating worsening agitation with NRT use. We therefore believe that there is sufficient equipoise in the use of NRT to prompt a review of studies amongst psychiatric inpatients.MethodThis review identified English language studies through developed search strategies in PubMed/MEDLINE, EMBASE, PyschINFO, PSYCHLit, Cochrane databases, and Google scholar. The bibliographies of notable papers were explored. Hand searches of five major psychiatric journals were conducted. Peer reviewed studies of any study design were included if they reported primary data of adult psychiatric inpatients. Studies were extracted from 1990 – present, this was felt appropriate as nicotine replacement patches became available in 1992.Search strategies were informed by MeSH search terms and included multiple conceptions of “agitation”, including variations on; agitation, irritability, and arousal to capture the concept from broad academic constructions. The quality of studies was assessed with the Newcastle-Ottawa and Cochrane Collaboration tools.This review follows PRISMA guidelines, and an application for PROSPERO registration has been submitted pending acceptance.ResultTwo studies were identified which matched inclusion criteria. A double-blinded randomised placebo-controlled trial of 40 nicotine-dependent inpatients from Allen et al. reported a significant 23% reduction in Agitated Behaviour Scores at 24 hours following NRT administration on admission compared to their matched placebo controls. Yet a retrospective cross-sectional analysis from Okoli using scores for NW identified more severe withdrawal symptoms including “restlessness” and “anger/irritability” than nicotine-dependent patients not provided with NRT.ConclusionDespite considerable commentary within literature there is presently only one study providing moderate evidence of a positive benefit to measures of agitated behaviour from the use of NRT amongst nicotine-dependent psychiatric inpatients. There is currently very low evidence whether NRT improves or exacerbates the agitation associated with NW amongst nicotine-dependent psychiatric inpatients.

scholarly journals Fluid resuscitation in paediatric burns: how do we get it right? A systematic review of the evidence

2018 ◽  
Vol 104 (3) ◽  
pp. 280-285 ◽  
Author(s):  
Christopher Stutchfield ◽  
Anna Davies ◽  
Amber Young
Keyword(s):  
Systematic Review ◽  
Fluid Resuscitation ◽  
Primary Data ◽  
Controlled Trials ◽  
Burn Shock ◽  
Cochrane Central Register ◽  
Study Protocols ◽  
Central Register ◽  
Affect Patient Outcome ◽  
Randomised Controlled

BackgroundOptimal fluid resuscitation in children with major burns is crucial to prevent or minimise burn shock and prevent complications of over-resuscitation.ObjectivesTo identify studies using endpoints to guide fluid resuscitation in children with burns, review the range of reported endpoint targets and assess whether there is evidence that targeted endpoints impact on outcome.DesignSystematic review.MethodsMedline, Embase, Cinahl and the Cochrane Central Register of Controlled Trials databases were searched with no restrictions on study design or date. Search terms combined burns, fluid resuscitation, endpoints, goal-directed therapy and related synonyms. Studies reporting primary data regarding children with burns (<16 years) and targeting fluid resuscitation endpoints were included. Data were extracted using a proforma and the results were narratively reviewed.ResultsFollowing screening of 777 unique references, 7 studies fulfilled the inclusion criteria. Four studies were exclusively paediatric. Six studies used urine output (UO) as the primary endpoint. Of these, one set a minimum UO threshold, while the remainder targeted a range from 0.5–1.0 mL/kg/hour to 2–3 mL/kg/hour. No studies compared different UO targets. Heterogeneous study protocols and outcomes precluded comparison between the UO targets. One study targeted invasive haemodynamic variables, but this did not significantly affect patient outcome.ConclusionsFew studies have researched resuscitation endpoints for children with burns. Those that have done so have investigated heterogeneous endpoints and endpoint targets. There is a need for future randomised controlled trials to identify optimal endpoints with which to target fluid resuscitation in children with burns.

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