Assessing the efficacy of photocatalytic oxidation on bacterial contamination in a clinical setting – a randomised controlled trial

2011 ◽  
Vol 12 (6) ◽  
pp. 251-253
Author(s):  
Anwar Abbas Jafri ◽  
Sanjay Gupta ◽  
Zaki Ibrahim ◽  
Paul Baker ◽  
Tamsin Oswald ◽  
...  
Keyword(s):  
Clinical Setting ◽  
Photocatalytic Oxidation ◽  
Controlled Trial ◽  
Colony Count ◽  
Clinical Environment ◽  
Randomised Study ◽  
Air Contamination ◽  
Air Sampler ◽  
Airborne Contamination ◽  
Air Purifier

Airborne contamination has been shown to be a significant source of wound contamination in orthopaedic surgery. This is the first reported study looking at the efficacy of ActivTek 300, a portable UV/TiO2-based air purifier unit to reduce airborne contamination in a clinical setting. In this randomised study the investigator was blinded as to whether the unit had been on or off for the previous seven days. Air contamination was measured weekly using a validated technique in ward treatment rooms using a Mini Air Sampler (MAS-100) and agar plates, over a period of 12 weeks. The agar plates were then incubated for 24 hours and the results were expressed as number of colony forming units per plate (cfu). The biomedical scientist who manually counted the number of cfus was blinded as to whether the unit was on or off. Measurements were duplicated to improve the accuracy of the study, and in addition to this an identical experiment was set up in a second treatment room on a separate randomisation schedule. Analysis of the data demonstrated median colony count was significantly lower with the unit on (Median = 43 interquartile range (IQR) 30 to 83) than when it was off (median = 95 IQR 44 to 143) ( p < 0.01). This represents a 55% mean reduction in the colony count. This study suggests that the portable UV/TiO2-based air purifier unit is efficacious in reducing airborne contamination in the clinical environment and may have a promising role in reducing overall infection rates in surgical patients.

scholarly journals Air contamination of households versus hospital inpatient rooms occupied by SARS-CoV-2 positive patients

2021 ◽  
pp. 1-14
Author(s):  
L. Silvia Munoz-Price ◽  
Frida Rivera ◽  
Nathan Ledeboer
Keyword(s):  
Hospital Inpatient ◽  
Air Samples ◽  
Air Contamination ◽  
Air Sampler

Abstract Households are settings with some of the highest COVID-19 secondary-attack-rates. We compared the air contamination in hospital rooms versus households of COVID-19 patients. Inpatient air-samples were only positive at 0.3 meters from patients. Household air samples were positive even without a COVID-19 patient in the proximity to the air sampler.

scholarly journals Development and Comparison of Complementary Methods to Study Potential Skin and Inhalational Exposure to Pathogens During Personal Protective Equipment Doffing

2019 ◽  
Vol 69 (Supplement_3) ◽  
pp. S231-S240 ◽  
Author(s):  
Jennifer Therkorn ◽  
David Drewry ◽  
Jennifer Andonian ◽  
Lauren Benishek ◽  
Carrie Billman ◽  
...  
Keyword(s):  
Pilot Study ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Recovery Efficiency ◽  
Breathing Zone ◽  
Tracer Method ◽  
Fluorescent Tracer ◽  
Air Sampler ◽  
Airborne Contamination ◽  
Skin Contamination

Abstract Background Fluorescent tracers are often used with ultraviolet lights to visibly identify healthcare worker self-contamination after doffing of personal protective equipment (PPE). This method has drawbacks, as it cannot detect pathogen-sized contaminants nor airborne contamination in subjects’ breathing zones. Methods A contamination detection/quantification method was developed using 2-µm polystyrene latex spheres (PSLs) to investigate skin contamination (via swabbing) and potential inhalational exposure (via breathing zone air sampler). Porcine skin coupons were used to estimate the PSL swabbing recovery efficiency and limit of detection (LOD). A pilot study with 5 participants compared skin contamination levels detected via the PSL vs fluorescent tracer methods, while the air sampler quantified potential inhalational exposure to PSLs during doffing. Results Average PSL skin swab recovery efficiency was 40% ± 29% (LOD = 1 PSL/4 cm2 of skin). In the pilot study, all subjects had PSL and fluorescent tracer skin contamination. Two subjects had simultaneously located contamination of both types on a wrist and hand. However, for all other subjects, the PSL method enabled detection of skin contamination that was not detectable by the fluorescent tracer method. Hands/wrists were more commonly contaminated than areas of the head/face (57% vs 23% of swabs with PSL detection, respectively). One subject had PSLs detected by the breathing zone air sampler. Conclusions This study provides a well-characterized method that can be used to quantitate levels of skin and inhalational contact with simulant pathogen particles. The PSL method serves as a complement to the fluorescent tracer method to study PPE doffing self-contamination.

scholarly journals Investigating SARS-CoV-2 surface and air contamination in an acute healthcare setting during the peak of the COVID-19 pandemic in London

2020 ◽  
Author(s):  
Jie Zhou ◽  
Jonathan A. Otter ◽  
James R. Price ◽  
Cristina Cimpeanu ◽  
Danel Meno Garcia ◽  
...  
Keyword(s):  
Limit Of Detection ◽  
Healthcare Setting ◽  
Viral Rna ◽  
Cross Sectional ◽  
Air Samples ◽  
Air Contamination ◽  
Viral Culture ◽  
Air Sampler ◽  
Surface Samples ◽  
Acute Healthcare

ABSTRACTBackgroundEvaluation of SARS-CoV-2 surface and air contamination during the COVID-19 pandemic in London.MethodsWe performed this prospective cross-sectional observational study in a multi-site London hospital. Air and surface samples were collected from seven clinical areas, occupied by patients with COVID-19, and a public area of the hospital. Three or four 1.0 m3 air samples were collected in each area using an active air sampler. Surface samples were collected by swabbing items in the immediate vicinity of each air sample. SARS-CoV-2 was detected by RT-qPCR and viral culture; the limit of detection for culturing SARS-CoV-2 from surfaces was determined.ResultsViral RNA was detected on 114/218 (52.3%) of surfaces and 14/31 (38.7%) air samples but no virus was cultured. The proportion of surface samples contaminated with viral RNA varied by item sampled and by clinical area. Viral RNA was detected on surfaces i and in air in public areas of the hospital but was more likely to be found in areas immediately occupied by COVID-19 patients than in other areas (67/105 (63.8%) vs. 29/64 (45.3%) (odds ratio 0.5, 95% confidence interval 0.2-0.9, p=0.025, Chi squared test)). The high PCR Ct value for all samples (>30) indicated that the virus would not be culturable.ConclusionsOur findings of extensive viral RNA contamination of surfaces and air across a range of acute healthcare settings in the absence of cultured virus underlines the potential risk from environmental contamination in managing COVID-19, and the need for effective use of PPE, physical distancing, and hand/surface hygiene.

scholarly journals HOMESIDE: home-based family caregiver-delivered music and reading interventions for people living with dementia: protocol of a randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031332 ◽  
Author(s):  
Felicity Anne Baker ◽  
Jodie Bloska ◽  
Sabine Braat ◽  
Anna Bukowska ◽  
Imogen Clark ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Psychological Symptoms ◽  
Controlled Trial ◽  
Well Being ◽  
Resource Utilisation ◽  
Home Setting ◽  
Randomised Study ◽  
People With Dementia ◽  
Home Based ◽  
Randomised Controlled

IntroductionPharmacological interventions to address behavioural and psychological symptoms of dementia (BPSD) can have undesirable side effects, therefore non-pharmacological approaches to managing symptoms may be preferable. Past studies show that music therapy can reduce BPSD, and other studies have explored how formal caregivers use music in their caring roles. However, no randomised study has examined the effects on BPSD of music interventions delivered by informal caregivers (CGs) in the home setting. Our project aims to address the need for improved informal care by training cohabiting family CGs to implement music interventions that target BPSD, and the quality of life (QoL) and well-being of people with dementia (PwD) and CGs.Methods and analysisA large international three-arm parallel-group randomised controlled trial will recruit a sample of 495 dyads from Australia, Germany, UK, Poland and Norway. Dyads will be randomised equally to standard care (SC), a home-based music programme plus SC, or a home-based reading programme plus SC for 12 weeks. The primary outcome is BPSD of PwD (measured using the Neuropsychiatric Inventory-Questionnaire). Secondary outcomes will examine relationship quality between CG and PwD, depression, resilience, competence, QoL for CG and QoL for PwD. Outcomes will be collected at baseline, at the end of the 12-week intervention and at 6 months post randomisation. Resource Utilisation in Dementia will be used to collect economic data across the life of the intervention and at 6-month follow-up. We hypothesise that the music programme plus SC will generate better results than SC alone (primary comparison) and the reading programme plus SC (secondary comparison).Ethics and disseminationEthical approval has been obtained for all countries. Results will be presented at national and international conferences and published in scientific journals and disseminated to consumer and caregiver representatives and the community.Trial registration numbersACTRN12618001799246p; NCT03907748

Microbial Air Contamination in an Intensive Care Unit

2015 ◽  
Vol 4 (3) ◽  
pp. 145
Author(s):  
Chih-Yi Chang ◽  
Liang Tseng ◽  
Lung-Shih Yang
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Center ◽  
Statistical Significance ◽  
Incidence Density ◽  
Air Contamination ◽  
Care Services ◽  
Air Sampler ◽  
Significant Difference ◽  
Central Taiwan

Unit layout affects every aspect of intensive care services, including patient safety. A previous study has shown that patients admitted to beds adjacent to the sink and to the door of a large bayroom had the highest number of positive blood cultures and the highest blood culture incidence density, respectively. The present study measures microbial air contamination in a medical intensive care unit of a medical center in central Taiwan. Of the 17 rooms, 8 rooms with distinct physical environmental characteristics were selected. Sampling tests were conducted between December 2013 and February 2014 with a microbial air sampler (MAS-100NT). TSA was used for bacteria collection and DG18 for fungi collection. The overall average bacterial and fungal concentrations were 83CFU/m<sup>3</sup> and 69CFU/m<sup>3</sup>, respectively. The ranges were between 8-354 CFU/m<sup>3</sup> and 0-1468 CFU/m<sup>3</sup>, respectively. A significant difference was found in the bacterial concentration (p=.005) between different room locations. The highest concentration was found in the rooms located at the front end of the circulation (99 CFU/m<sup>3</sup>), while the lowest was found in the rooms located at the rear end of the circulation (55CFU/m<sup>3</sup>). Differences in fungal concentrations for different room locations did not reach statistical significance. In addition, differences in bacterial and fungal concentrations for rooms with different sink locations did not reach statistical significance. Even though the microbial concentrations generally complied with standards, the results may help designers and hospital administrators develop a healthier environment for patients.

scholarly journals Describing the perceptions of student nurses regarding barriers and benefits of a peer-mentorship programme in a clinical setting in KwaZulu-Natal

2019 ◽  
Vol 24 ◽  
Author(s):  
Zanele P. Mlaba ◽  
Waheedha Emmamally
Keyword(s):  
Clinical Setting ◽  
Peer Mentoring ◽  
Resource Constraints ◽  
Student Nurses ◽  
Clinical Settings ◽  
Clinical Environment ◽  
Staff Shortage ◽  
Peer Mentorship ◽  
Negative Perceptions ◽  
Quantitative Descriptive

Background: Novice student nurses encounter challenges when making the transition to clinical learning because of the complex and unpredictable nature of clinical settings. A selected campus initiated a peer-mentoring programme based on research findings, which revealed that student nurses were inadequately mentored in clinical settings because of mentors experiencing work overload, time and resource constraints, staff shortage and patient-care demands.Aim: The aim of this study was to describe the perceptions of student nurses regarding barriers and benefits of a peer-mentorship programme in a clinical setting.Setting: The study was conducted in a clinical setting in KwaZulu-Natal.Methods: A quantitative, descriptive design was used, whereby data were collected through questionnaires. A total of 56 mentors (third- and fourth-year nursing diploma student nurses) and 94 mentees (first- and second-year nursing diploma students) participated in the study.Results: The mentors highlighted insufficient practice opportunities because of the short duration of the placement, time and resource constraints, and the simultaneous mentoring of too many students as barriers, while the mentees highlighted the reluctance of mentors to fulfil their roles and lack of dedication and unfriendliness as barriers to effective mentorship. The benefits of being a mentor were self-achievement, enhancement of skills and acquiring of positive work ethics, while the major mentee benefits included experiencing less anxiety, adapting to the clinical environment easily and being less intimidated in the clinical setting.Conclusions: This study revealed that both mentors and mentees perceived peer-mentoring programmes as important to their clinical growth. However, these programmes require formative evaluations to address negative perceptions of student mentees and mentors and to identify challenges faced by them.

scholarly journals Using natural experimental studies to guide public health action: turning the evidence-based medicine paradigm on its head

2019 ◽  
Vol 74 (2) ◽  
pp. 203-208 ◽  
Author(s):  
David Ogilvie ◽  
Jean Adams ◽  
Adrian Bauman ◽  
Edward W. Gregg ◽  
Jenna Panter ◽  
...  
Keyword(s):  
Public Health ◽  
Population Health ◽  
Controlled Trial ◽  
Experimental Studies ◽  
Health Interventions ◽  
Evidence Based ◽  
Natural Experiments ◽  
Public Health Action ◽  
Randomised Study ◽  
Health Action

Despite smaller effect sizes, interventions delivered at population level to prevent non-communicable diseases generally have greater reach, impact and equity than those delivered to high-risk groups. Nevertheless, how to shift population behaviour patterns in this way remains one of the greatest uncertainties for research and policy. Evidence about behaviour change interventions that are easier to evaluate tends to overshadow that for population-wide and system-wide approaches that generate and sustain healthier behaviours. Population health interventions are often implemented as natural experiments, which makes their evaluation more complex and unpredictable than a typical randomised controlled trial (RCT). We discuss the growing importance of evaluating natural experiments and their distinctive contribution to the evidence for public health policy. We contrast the established evidence-based practice pathway, in which RCTs generate ‘definitive’ evidence for particular interventions, with a practice-based evidence pathway in which evaluation can help adjust the compass bearing of existing policy. We propose that intervention studies should focus on reducing critical uncertainties, that non-randomised study designs should be embraced rather than tolerated and that a more nuanced approach to appraising the utility of diverse types of evidence is required. The complex evidence needed to guide public health action is not necessarily the same as that which is needed to provide an unbiased effect size estimate. The practice-based evidence pathway is neither inferior nor merely the best available when all else fails. It is often the only way to generate meaningful evidence to address critical questions about investing in population health interventions.

scholarly journals Impact of pre-enrolment medication use on clinical outcomes in SUMMIT

2019 ◽  
Vol 5 (1) ◽  
pp. 00203-2018 ◽  
Author(s):  
Jørgen Vestbo ◽  
Mark Dransfield ◽  
Julie A. Anderson ◽  
Robert D. Brook ◽  
Peter M.A. Calverley ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Inhaled Corticosteroids ◽  
Controlled Trial ◽  
Prior Treatment ◽  
Study Entry ◽  
Chronic Obstructive ◽  
Severe Exacerbation ◽  
Mortality And Morbidity ◽  
Randomised Study ◽  
The Impact

The impact of prior treatment on results of clinical trials in chronic obstructive pulmonary disease (COPD) has been debated. We used data from the Study to Understand Mortality and Morbidity in COPD Trial to examine the impact of prior treatment on the effects of randomised study drugs on mortality and exacerbations.We used data on 16 417 patients with moderate COPD and heightened cardiovascular risk and information on prior medications to examine the effects of fluticasone furoate (FF), vilanterol (VI) and combined FF/VI compared to placebo on moderate and severe exacerbation as well as mortality. The study was event-driven with a median study exposure of 1.8 years. This study was registered with ClinicalTrials.gov, number NCT01313676.There were no consistent associations between treatment prior to study entry and the effects of FF, VI or FF/VI on exacerbations during the study. However, patients taking inhaled corticosteroids and one or more bronchodilators prior to study entry seemed to have a better effect of active treatments than of placebo on mortality (hazard ratio for FF/VI 0.65, 95% CI 0.48–0.89). Survival in those randomised to placebo was independent of treatment prior to study enrolment.Prior treatment appears to affect treatment effects on mortality but not exacerbations in a randomised controlled trial of patients with COPD and heightened cardiovascular risk.

scholarly journals Airborne Bacteria and Carcass Contamination in Slaughterhouses

1997 ◽  
Vol 60 (1) ◽  
pp. 38-42 ◽  
Author(s):  
T. MARJATTA RAHKIO ◽  
HANNU J. KORKEALA
Keyword(s):  
Air Flow ◽  
The Other ◽  
Contamination Level ◽  
Airborne Bacteria ◽  
Microbiological Contamination ◽  
Air Contamination ◽  
Airborne Contamination ◽  
Carcass Contamination ◽  
Flow Detector

Microbiological contamination of air and carcasses .was studied in four slaughterhouses by using impactor samples taken at the back-splitting and weighing areas and by sampling carcasses with the swabbing method. Air flow was determined by an air-flow detector, and the movement of workers was observed. The air contamination level in the back-splitting areas (2.25 log CFU/100 liters of air) was generally higher than that in the weighing areas (2.03 log CFU/100 liters of air). Associations between the microbiological contamination of air and carcasses with the movements of workers were found. Layout of the slaughtering line was shown to be important in decreasing airborne contamination. Separation of the clean and unclean parts of the line as well as separation of the weighing area from the other clean parts of the line decreased the contamination level. It appears that airborne bacteria have an important role in carcass contamination.

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