The use of pine in a healthcare environment

AbstractObjective:To determine the comparative virulence of methicillin-resistantStaphylococcus aureus(MRSA) and methicillin-sensitiveS aureus(MSSA) by consideration of predisposing factors and outcomes in patients infected with these organisms in the healthcare setting.Design:Analysis of an historical cohort of 504 bacteremic patients (316 MSSA and 188 MRSA), examining factors associated with mortality.Setting:A 916-bed, university-affiliated, tertiary referral hospital.Results:Risk factors for the development of MRSA include male gender, admission due to trauma, immunosuppression, presence of a central vascular line or an indwelling urinary catheter, and a past history of MRSA infection. Overall mortality was 22%. Death due to bacteremia was significantly greater in the MRSA group (risk ratio, 1.68;P<.05), although these patients were not found to be more likely to die due to underlying disease during treatment of bacteremia. In those patients who recovered from bacteremia, no significant differences for the outcome of death could be determined between the MRSA and MSSA groups.Conclusions:There is a general consensus in the published literature that MRSA bacteremia is more likely to be associated with death, and we confirm this conclusion. However, in contrast to other studies, our MRSA cohort does not appear to be more at risk of death due to underlying disease during treatment for bacteremia. Similarly, the general consensus that MRSA patients have an increased overall mortality was not confirmed in our study. Differences in comorbidities of patients may provide some explanation of these conflicting results, while an alternate explanation is that MRSA strains are more virulent than MSSA in some centers. Perhaps the most plausible explanation is that treatment is provided earlier and in a more aggressive fashion in some centers, leading to an overall lower mortality rate in all staphylococcal bacteremias in these institutions.

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Prosthetic valve endocarditis presenting as meningoencephalitis complicated by pseudo-aneurysms in a remote Aboriginal healthcare setting in Australia: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytab265 ◽

2021 ◽

Vol 5 (8) ◽

Author(s):

Anna Louise Watson ◽

Gregory Rice ◽

Tony Hieu Vo ◽

Nadarajah Kangaharan

Keyword(s):

Prosthetic Valve ◽

Prosthetic Valve Endocarditis ◽

Healthcare Setting ◽

Blood Cultures ◽

Fatal Complication ◽

Optimal Care ◽

Australian Aboriginal ◽

Valvular Surgery ◽

Case Summary ◽

History Of

Abstract Background The Australian Aboriginal population has a high burden of cardiac conditions predisposing patients to infective endocarditis. Pseudo-aneurysms are a rare and potentially fatal complication of both prior valvular surgery and endocarditis. Case summary A 31-year-old female with a history of bicuspid aortic valve requiring valve replacement presented with meningoencephalitis. Transoesophageal echo and positive blood cultures for Staphylococcus aureus confirmed prosthetic valve endocarditis (PVE). Aortic root mycotic pseudo-aneurysms developed during antimicrobial therapy and two large pseudo-aneurysms remain post-redo valve, root and arch replacement. Discussion Complications associated with PVE are common, especially due to S. aureus. Redo cardiac surgery is high risk, percutaneous treatments may be technically difficult due to altered post-operative anatomy, and medication adherence issues and lack of healthcare engagement further compromise optimal care in this patient population.

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Abstract 82: Patient and Hospital Characteristics of Pregnancy-Related Stroke from the Get With The Guidelines Stroke Registry

Stroke ◽

10.1161/str.46.suppl_1.82 ◽

2015 ◽

Vol 46 (suppl_1) ◽

Author(s):

Lisa Leffert ◽

Caitlin Clancy ◽

Brian Bateman ◽

Margueritte Cox ◽

Phillip Schulte ◽

...

Keyword(s):

Medical History ◽

Healthcare Setting ◽

Continuous Variables ◽

Principal Diagnosis ◽

Stroke Subtype ◽

Stroke Registry ◽

Clinical Detail ◽

History Of ◽

Get With The Guidelines ◽

Hospital Characteristics

Background: Stroke accounts for 14% of maternal deaths. Our knowledge of the risk factors and etiologies of pregnancy-related stroke (PRS) is limited, as most data are derived from small, single center series or large, administrative datasets lacking clinical detail. We sought to describe the patient and hospital characteristics of PRS by analyzing the Get with the Guidelines (GWTG) Stroke Registry. Methods: All female patients aged 18-44 entered into GWTG from 2008-2013 with PRS were ascertained by medical history of pregnancy (i.e. pregnant or <6 weeks postpartum) plus a principal diagnosis ICD-9 code (430, 431) (58%), PRS ICD-9 code (671.5x, 673.04, 674.0x) as the principal diagnosis alone (18%), or with a medical history of pregnancy (24%). Proportions for categorical and medians for continuous variables are reported. Results: We identified 46043 patients with stroke from 1554 sites, of whom 668 (1.5%) had PRS. Ischemic stroke (IS) occurred in 338 (51%), intracerebral hemorrhage (ICH) in 178 (27%) and subarachnoid hemorrhage (SAH) in 152 (23%). Many patient and hospital characteristics differed significantly by stroke subtype (Table). Hypertension, smoking and pre-stroke therapy with antithrombotics or antihypertensives were common; 7.4% of IS were recurrent. About 86% of all strokes did not occur in a healthcare setting and only 27% of patients arrived by EMS. Median initial blood pressure (BP) was higher in HS (ICH and SAH) than in IS, and half of all patients had initial BP below the threshold for pre-eclampsia (140/90 mmHg). HS patients were more often treated at larger, academic hospitals. Conclusions: PRS constituted 1.5% of all strokes aged 18-44 in a large contemporary stroke registry and 50% were HS. Most PRS occurred out of hospital, and half of all cases presented with normal BP levels. Further research is needed to better define PRS etiology.

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A Framework for Optimizing Technology-Enabled Diabetes and Cardiometabolic Care and Education: The Role of the Diabetes Care and Education Specialist

The Diabetes Educator ◽

10.1177/0145721720935125 ◽

2020 ◽

Vol 46 (4) ◽

pp. 315-322 ◽

Cited By ~ 2

Author(s):

Deborah A. Greenwood ◽

Fran Howell ◽

LaurieAnn Scher ◽

Gretchen Yousef ◽

Joanne Rinker ◽

...

Keyword(s):

Diabetes Care ◽

Technology Use ◽

Cardiometabolic Health ◽

Full Potential ◽

Care Experience ◽

Healthcare Environment ◽

Health Care Experience ◽

History Of ◽

Improve Health

Purpose The purpose of this article is to present a framework for optimizing technology-enabled diabetes and cardiometabolic care and education using a standardized approach. This approach leverages the expertise of the diabetes care and education specialist, the multiplicity of technologies, and integration with the care team. Technology can offer increased opportunity to improve health outcomes while also offering conveniences for people with diabetes and cardiometabolic conditions. The adoption and acceptance of technology is crucial to recognize the full potential for improving care. Understanding and incorporating the perceptions and behaviors associated with technology use can prevent a fragmented health care experience. Conclusion Diabetes care and education specialists (DCES) have a history of utilizing technology and data to deliver care and education when managing chronic conditions. With this unique skill set, DCES are strategically positioned to provide leadership to develop and deliver technology-enabled diabetes and cardiometabolic health services in the rapidly changing healthcare environment.

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Birth as Restorative

Journal of the American Psychiatric Nurses Association ◽

10.1177/1078390317734632 ◽

2017 ◽

Vol 24 (2) ◽

pp. 153-154

Author(s):

Jenna A. LoGiudice

Keyword(s):

Sexual Trauma ◽

Past History ◽

Healthcare Setting ◽

Birth Experience ◽

Trauma Informed Care ◽

Nurse Midwife ◽

History Of ◽

Trauma Informed ◽

Pregnancy And Birth

A woman’s past history of sexual trauma is inextricably woven into her pregnancy and birth experience. Two cases are presented by a practicing certified nurse midwife to demonstrate trauma-informed care in the childbearing setting. Providing trauma-informed care universally in the women’s healthcare setting is imperative given not all women disclose their history. Empowering survivors may allow for a restorative birth, in which trust of one’s own body can be regained.

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“Just Throw It Behind You and Just Keep Going”: Emotional Labor when Ethnic Minority Healthcare Staff Encounter Racism in Healthcare

Frontiers in Sociology ◽

10.3389/fsoc.2021.741202 ◽

2022 ◽

Vol 6 ◽

Author(s):

Beth Maina Ahlberg ◽

Sarah Hamed ◽

Hannah Bradby ◽

Cecilia Moberg ◽

Suruchi Thapar-Björkert

Keyword(s):

Ethnic Minority ◽

Thematic Analysis ◽

Emotional Labor ◽

Ethical Dilemmas ◽

Healthcare Setting ◽

Healthcare Staff ◽

Negative Effects ◽

Staff Members ◽

Healthcare Environment ◽

Taking Care

Encountering racism is burdensome and meeting it in a healthcare setting is no exception. This paper is part of a larger study that focused on understanding and addressing racism in healthcare in Sweden. In the paper, we draw on interviews with 12 ethnic minority healthcare staff who described how they managed emotional labor in their encounters with racism at their workplace. Data were analyzed using thematic analysis. The analysis revealed that experienced emotional labor arises from two main reasons. The first is the concern and fear that ethnic minority healthcare staff have of adverse consequences for their employment should they be seen engaged in discussing racism. The second concerns the ethical dilemmas when taking care of racist patients since healthcare staff are bound by a duty of providing equal care for all patients as expressed in healthcare institutional regulations. Strategies to manage emotional labor described by the staff include working harder to prove their competence and faking, blocking or hiding their emotions when they encounter racism. The emotional labor implied by these strategies could be intense or traumatizing as indicated by some staff members, and can therefore have negative effects on health. Given that discussions around racism are silenced, it is paramount to create space where racism can be safely discussed and to develop a safe healthcare environment for the benefit of staff and patients.

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Comparing nonpharmaceutical interventions for containing emerging epidemics

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.1616438114 ◽

2017 ◽

Vol 114 (15) ◽

pp. 4023-4028 ◽

Cited By ~ 87

Author(s):

Corey M. Peak ◽

Lauren M. Childs ◽

Yonatan H. Grad ◽

Caroline O. Buckee

Keyword(s):

Infectious Disease ◽

Natural History ◽

Influenza A ◽

Healthcare Setting ◽

Contact Tracing ◽

Symptom Monitoring ◽

History Of ◽

Nonpharmaceutical Interventions ◽

Epidemiological Characteristics ◽

The Relationship

Strategies for containing an emerging infectious disease outbreak must be nonpharmaceutical when drugs or vaccines for the pathogen do not yet exist or are unavailable. The success of these nonpharmaceutical strategies will depend on not only the effectiveness of isolation measures but also the epidemiological characteristics of the infection. However, there is currently no systematic framework to assess the relationship between different containment strategies and the natural history and epidemiological dynamics of the pathogen. Here, we compare the effectiveness of quarantine and symptom monitoring, implemented via contact tracing, in controlling epidemics using an agent-based branching model. We examine the relationship between epidemic containment and the disease dynamics of symptoms and infectiousness for seven case-study diseases with diverse natural histories, including Ebola, influenza A, and severe acute respiratory syndrome (SARS). We show that the comparative effectiveness of symptom monitoring and quarantine depends critically on the natural history of the infectious disease, its inherent transmissibility, and the intervention feasibility in the particular healthcare setting. The benefit of quarantine over symptom monitoring is generally maximized for fast-course diseases, but we show the conditions under which symptom monitoring alone can control certain outbreaks. This quantitative framework can guide policymakers on how best to use nonpharmaceutical interventions and prioritize research during an outbreak of an emerging pathogen.

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The Natural History of Outpatient Alcohol and Drug Abuse Treatment in a Private Healthcare Setting

Alcoholism Clinical and Experimental Research ◽

10.1111/j.1530-0277.1996.tb05262.x ◽

1996 ◽

Vol 20 (5) ◽

pp. 847-852 ◽

Cited By ~ 19

Author(s):

Helen M. Pettinati ◽

Portia Payne Belden ◽

Bradley D. Evans ◽

Charles R. Ruetsch ◽

Kathleen Meyers ◽

...

Keyword(s):

Drug Abuse ◽

Natural History ◽

Healthcare Setting ◽

Drug Abuse Treatment ◽

Private Healthcare ◽

History Of ◽

Alcohol And Drug Abuse ◽

Abuse Treatment

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The Impact of Environmental Design on Doffing Personal Protective Equipment in a Healthcare Environment: A Formative Human Factors Trial

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2017.68 ◽

2017 ◽

Vol 38 (06) ◽

pp. 712-717 ◽

Cited By ~ 10

Author(s):

Tracey A. Herlihey ◽

Stefano Gelmi ◽

Joseph A. Cafazzo ◽

Trevor N. T. Hall

Keyword(s):

Human Factors ◽

Personal Protective Equipment ◽

Environmental Design ◽

Healthcare Setting ◽

Worker Safety ◽

Protective Equipment ◽

Safety Communication ◽

Healthcare Environment ◽

Design Changes ◽

The Impact

OBJECTIVE To explore the impact of environmental design on doffing personal protective equipment in a simulated healthcare environment. METHODS A mixed-methods approach was used that included human-factors usability testing and qualitative questionnaire responses. A patient room and connecting anteroom were constructed for testing purposes. This experimental doffing area was designed to overcome the environmental failures identified in a previous study and was not constructed based on any generalizable hospital standard. RESULTS In total, 72 healthcare workers from Ontario, Canada, took part in the study and tested the simulated doffing area. The following environmental design changes were tested and were deemed effective: increasing prominence of color-coded zones; securing disinfectant wipes and hand sanitizer; outlining disposal bins locations; providing mirrors to detect possible contamination; providing hand rails to assist with doffing; and restricting the space to doff. Further experimentation and iterative design are required with regard to several important features: positioning the disposal bins for safety, decreasing the risk of contamination and user accessibility; optimal positioning of mirrors for safety; communication within the team; and positioning the secondary team member for optimal awareness. Additional design suggestions also emerged during this study, and they require future investigation. CONCLUSIONS This study highlights the importance of the environment on doffing personal protective equipment in a healthcare setting. Iterative testing and modification of the design of the environment (doffing area) are important to enhancing healthcare worker safety. Infect Control Hosp Epidemiol 2017;38:712–717

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Organizational Factors and Technological Barriers are Determinants for the Intention to Use Wireless Handheld Technology in Healthcare Environment

Health Information Systems ◽

10.4018/978-1-60566-988-5.ch074 ◽

2011 ◽

pp. 1197-1211

Author(s):

Raj Gururajan

Keyword(s):

Technology Adoption ◽

New Technology ◽

Organizational Factors ◽

Healthcare Setting ◽

Ease Of Use ◽

Handheld Devices ◽

Handheld Technology ◽

Healthcare Environment ◽

Two Factors ◽

Technological Barriers

Traditional technology adoption models identified ‘ease of use’ and ‘usefulness’ as the dominating factors for technology adoption. However, recent studies in healthcare have established that these two factors are not always reliable on their own and other factors may influence technology adoption. To establish the identity of these factors, a mixed method approach was used and data were collected through interviews and a survey. The survey instrument was specifically developed for this study so that it is relevant to the Indian healthcare setting. Authors identified clinical management and technological barriers as the dominant factors influencing the wireless handheld technology adoption in the Indian healthcare environment. The results of this study showed that new technology models will benefit by considering the clinical influences of wireless handheld technology, in addition to known factors. The scope of this study is restricted to wireless handheld devices such as PDAs, smart telephones, and handheld PCs.

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