scholarly journals Prehospital infection control and prevention in Denmark: a cross-sectional study on guideline adherence and microbial contamination of surfaces

Author(s):  
Heidi Storm Vikke ◽  
Matthias Giebner ◽  
Hans Jørn Kolmos
2019 ◽  
Vol 2 (3) ◽  
pp. 54
Author(s):  
Heidi Storm Vikke

Background: Prehospital acute care and treatment have become more complex, and while invasive procedures are standard procedures, focus on infection control and prevention is scarce. We aimed to evaluate guideline adherence, microbial contamination, and associated risk factors. Methods: In a nationwide cross-sectional study, we evaluated guideline adherence to thorough cleaning (TC) once a day, and moderate cleaning (MC) in-between patient courses. Microbial contamination on hand-touch sites (HTS) and provider-related sites (PRS) was assessed by total aerobic colony forming units (CFU) and presence of selected pathogens, using swab and agar imprints. Also, microbial contamination was assessed in relation to potential risk factors. Results: 80 ambulances and coherent EMS providers were enrolled. Adherence to guidelines regarding TC was 35%, but regarding MC it was 100%. In total, 129 (27%) of 480 HTS presented a total CFU > 2.5/cm2 and/or pathogenic growth, indicating hygiene failures. The prevalence of selected pathogens on HTS was: S. aureus 7%; Enterococcus 3% and Enterobacteriaceae 1%. Total CFU on the PRS ranged from 0-250/cm2, and the prevalence of pathogens was 18% (S. aureus 15%, Enterococcus 3% and Enterobacteriaceae 0.3%). Methicillin-resistant S. aureus was found in one sample, and Vancomycin-resistant Enterococcus in two. No Enterobacteriaceae with extended-spectrum beta-lactamases were recorded. Conclusion: Guideline adherence was suboptimal, and many HTS did not comply fully with proposed standards for cleanliness. Pathogens were demonstrated on both HTS and PRS, indicating that the EMS may be a source of infection in hospitalized patients. Moreover, cleaning effort and time appears associated with microbial contamination, but a comprehensive investigation of risk factors is needed.


Author(s):  
Martin Mumuni Danaah Malick ◽  
Edem Yao Akpa ◽  
Peter Paul Bamaalabong

Background: Hospital Acquired Infections (HAIs) place a significant economic burden on the healthcare system. Infection control practices are important in minimizing healthcare associated infections. However, low compliance with Universal and Standard Precautions has been reported in a number of studies. The Centre for Disease Control and Prevention (CDC) developed baseline definitions for HAIs that were republished in 2004 and has defined HAIs as those that develop during hospitalization but are neither present nor incubating upon the patient’s admission to the hospital; generally, these infections occur between 48 to 72 hours after admission and within 10 days after hospital discharge. this study aimed at unveiling the level of knowledge, attitude and practices on infection prevention control in the operating theatres by anaesthesia practitioners at TTH. Materials and Methods: A cross-sectional study design was employed. A mixed-method approach was used for data collection which includes a structured questionnaire carried out via face to face interview and observation. Results: The study showed that 100% of the respondents have knowledge on hospital acquired infection control in the theatre in one way or the other whereas attitude and practices toward hospital infection control in the operating theatres are undesirable in some specific areas of infection control such as wearing of sterile gowns and goggle. As high as 80.6% and 69.4% do not wear goggle and gowns respectively whilst performing regional anaesthesia.  Conclusions:  This study demonstrated that anaesthetists at TTH have reported sub-optimal levels of compliance i.e. attitude and practices with selective infection control. The study further demonstrated that discrepancies exist between anaesthetists’ attitudes towards a guideline as well as their actual practice.


2016 ◽  
Vol 32 (6) ◽  
pp. 189
Author(s):  
Mayumi Nitami ◽  
Sri Tjahyani Budiutami

Determinants of dengue mosquito eradication (PSN) in the households in Bogor in 2016PurposeThis study aimed to determine the factors that affect of PSN on housewives in Cibinong and the factors found that influence were: job, knowledge, attitude, behavior of housewife, counselling, active jumantik, giving abatement and the number of container.MethodsA cross-sectional study was conducted using 125 housewifes in Cibinong sub-district. The statistical analysis used chi-square and multiple logistic regression tests.ResultsThis study showed that counseling and the existence of jumantik cadre were the determinants of the application of mosquito nest eradication. Counseling was the most influential factor on the application of mosquito nest eradication.Conclusion Dengue control and prevention counseling should be given to all age groups in the community regularly and it is recommended to reactivate jumantik cadres.


2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S828-32
Author(s):  
Sajid Khan ◽  
Abdul Hameed Siddiqui ◽  
Ariz Samin ◽  
Syed Hassan Mustafa ◽  
Akhtar Gul ◽  
...  

Objective: To determine the frequency of acute kidney injury among patients undergoing coronary angiography. Study Design: Descriptive cross-sectional study. Place and Duration of Study: Department of Cardiology, Hayatabad Medical Complex, Peshawar, from Jan 2018 to Jul 2018. Methodology: This study was conducted in the in the Department of Cardiology, Hayatabad Medical Complex, Peshawar from 22nd Jan 2018 to 22nd Jul 2018. Through a descriptive cross-sectional study design, a total of 116 patients scheduled for coronary angiography were included in the study in a consecutive manner and baseline / follow up serum creatinine was recorded to detect acute kidney injury. Results: In this study 116 patients were included, 61.2% males and 38.8% females. Mean age of the patients was 55.6 years with a standard deviation of 6.6 years. Mean baseline serum creatinine level was 0.9 ± 0.11mg/dl which was 1.5 ± 0.11 48 hours after coronary angiography (p 0.000). AKI was recorded in 19.8% of patients. Conclusion: Acute kidney injury after coronary angiography is not uncommon in our population. More studies are recommended on its risk factors and complications to draw future directions for its control and prevention.


2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18132-e18132
Author(s):  
Elna Kuehnle ◽  
Wulf Siggelkow ◽  
Iris Schrader ◽  
Kristina Luebbe ◽  
Stefanie Noeding ◽  
...  

e18132 Background: In 2003 the German Cancer Society and the German Society for Breast Disease introduced a number of Quality Indicators (QIs) to improve standards of breast cancer care. Although QIs should be based on clinical evidence, evidence for important subpopulations (i.e. vulnerable patients) is often limited. In this prospective cross-sectional study we assessed conformity and non-conformity of guidelines and their impact on clinical outcome in a real-world setting. Methods: This prospective analysis included patients with primary breast cancer. Patients with stage IV and recurrent breast cancer were excluded. Data was collected from 2012-2016 in six certified breast care centers using a personal questionnaire and data from the patients' medical records. Guideline adherence to a set of 11 QIs was explored. Overall survival (OS) and disease free survival (DFS) were correlated with fulfillment of QIs and tumor characteristics. Results: Survival analysis was conducted in 2390 patients with a median follow-up of 16 months. 88 (4%) patients had a recurrent disease. 31 (1.3%) patients died of breast cancer. Tumor stage, grading, Her2- and hormone receptor status and Ki-67 correlated with DFS and OS. 1725/1907 patients (90.5%) received a guideline adherent treatment. The most prevalent reasons for non-conformity were old age (24.7%) and/or comorbidity (20.9%). Breast cancer specific DFS and OS were not significantly different between patients treated adherent or not adherent to the guidelines. In contrast, survival analysis of death other than breast cancer showed a significantly worse OS (p = 0.006) for patients not treated according to guideline recommendation. Conclusions: Conformity of clinical guidelines was observed in the majority of patients including healthy and vulnerable patients. These patients tended to have a longer breast cancer specific survival. Patients who were not considered suitable for guideline-adherent therapy died more often from other medical reasons rather than from breast cancer. In our study 10% of the patients had a limited life expectancy due to old age and co-morbidities with no assumed benefit from guideline adherence.


2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Peter Wasswa ◽  
Christine K. Nalwadda ◽  
Esther Buregyeya ◽  
Sheba N. Gitta ◽  
Patrick Anguzu ◽  
...  

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