scholarly journals Impact of Multidisciplinary Collaborative Intervention on Isolation Implementation in the Prevention and Control of Multidrug Resistance Infection—A Retrospective Study

2020 ◽  
Author(s):  
Ying Wang ◽  
Xinping Zhang ◽  
Xiaoquan Lai

Abstract Background: Isolation is important in the prevention and control of infection with multidrug-resistant organisms(MDROs) but implementation is weak. We aim to analyze the impact of multidisciplinary collaborative intervention on isolation in multidrug-resistant organism(MDRO) infection and determine the factors affecting the implementation of isolation measures.Methods: A retrospective analysis of the issuance of isolation orders for 1338 patients with MDRO infection and colonization in 10 months before and after multidisciplinary collaborative interventions carried out on November 1, 2018 at a teaching tertiary hospital in central China. Univariate analysis and multivariate logistic regression analysis were used to analyze factors affecting isolation implementation. Results: The overall issuance rate of isolation orders was 66.12%, which increased from 33.12% before the intervention to 75.88% after the intervention (P <0.000). The multidisciplinary collaborative intervention (OR = 0.154) is a promoting factor for the issuance of isolation orders, in addition to Length of stay(LOS)> 15d (OR = 0.459) and department (P <0.05). Conclusions: Multidisciplinary collaborative interventions related to isolation can promote doctors to issue isolation orders in accordance with regulations.

Author(s):  
Gavin H. West ◽  
Laura S. Welch

This chapter describes the hazards for construction workers, with a particular focus on injuries as well as exposures to hazardous chemicals and dusts. A section describes hazardous exposures to lead and other heavy metals. Another section describes noise exposure. The impact of musculoskeletal disorders among construction workers is then discussed. A section on respiratory diseases focuses on asbestosis, silicosis, chronic obstructive pulmonary disease, and asthma. Exposures known to cause dermatitis and cancer are reviewed. There is a discussion of engineered nanomaterials as a potential emerging hazard. Various approaches to prevention and control, including regulations and health services, are described.


2021 ◽  
Vol 10 (7) ◽  
pp. 479
Author(s):  
Yihang Li ◽  
Liyan Xu

The COVID-19 pandemic is a major challenge for society as a whole, and analyzing the impact of the spread of the epidemic and government control measures on the travel patterns of urban residents can provide powerful help for city managers to designate top-level epidemic prevention policies and specific epidemic prevention measures. This study investigates whether it is more appropriate to use groups of POIs with similar pedestrian flow patterns as the unit of study rather than functional categories of POIs. In this study, we analyzed the hour-by-hour pedestrian flow data of key locations in Beijing before, during, and after the strict epidemic prevention and control period, and we found that the pedestrian flow patterns differed greatly in different periods by using a composite clustering index; we interpreted the clustering results from two perspectives: groups of pedestrian flow patterns and functional categories. The results show that depending on the specific stage of epidemic prevention and control, the number of unique pedestrian flow patterns decreased from four before the epidemic to two during the strict control stage and then increased to six during the initial resumption of work. The restrictions on movement are correlated with most of the visitations, and the release of restrictions led to an increase in the variety of unique pedestrian flow patterns compared to that in the pre-restriction period, even though the overall number of visitations decreased, indicating that social restrictions led to differences in the flow patterns of POIs and increased social distance.


2014 ◽  
Vol 23 (2) ◽  
pp. 278-285 ◽  
Author(s):  
Denise Maia Alves da Silva ◽  
Maria Alix Leite Araújo ◽  
Raimunda Magalhães da Silva ◽  
Roumayne Fernandes Vieira Andrade ◽  
Heber José de Moura ◽  
...  

The aim of this study was to investigate the knowledge of family health strategy professionals regarding the prevention and control of the vertical transmission of syphilis. This cross-sectional study was carried out in Fortaleza, Ceará, Brazil, from August to October 2009. A questionnaire was used, with its correct answers being in line with the recommendations of the Ministry of Health. Univariate analysis was carried out, with frequency distribution, mean and standard deviation. A total of 269 professionals participated, 44.7% had 6 to 10 years of experience in the FHS, and 60% of the questions regarding their knowledge were answered correctly: 75.8% were aware of the request period of the Venereal Disease Research Laboratory (VDRL) test; 78.1% of the alternative drug for the treatment for pregnant women allergic to penicillin, 55.1% of the request period for VDRL for cure and control, and 50.2% of the conduct with a sexual partner. It was concluded that healthcare professionals are unaware of the appropriate actions for the prevention and control of congenital syphilis.


2020 ◽  
Author(s):  
Denise van Hout ◽  
Paul Hutchinson ◽  
Marta Wanat ◽  
Caitlin Pilbeam ◽  
Herman Goossens ◽  
...  

ABSTRACTBackgroundWorking under pandemic conditions exposes health care workers (HCWs) to infection risk and psychological strain. Protecting the physical and psychological health of HCWs is a key priority. This study assessed the perceptions of European hospital HCWs of local infection prevention and control (IPC) procedures during the COVID-19 pandemic and the impact on their emotional wellbeing.MethodsWe performed two rounds of an international cross-sectional survey, between 31 March and 17 April 2020 via existing research networks (round 1), and between 14 May and 31 August 2020 via online convenience sampling (round 2). Main outcome measures were (1) behavioural determinants of HCW adherence with IPC procedures, (2) WHO-5 Well-Being Index, a validated scale of 0-100 reflecting emotional wellbeing. The WHO-5 was interpreted as a score below or above 50 points, a cut-off score used in previous literature to screen for depression.Results2,289 HCWs (round 1: n=190, round 2: n=2,099) from 40 countries in Europe participated. Mean age of respondents was 42 (±11) years, 66% were female, 47% and 39% were medical doctors and nurses, respectively. 74% (n=1699) of HCWs were directly treating patients with COVID-19, of which 32% (n=527) reported they were fearful of caring for these patients. HCWs reported high levels of concern about COVID-19 infection risk to themselves (71%) and their family (82%) as a result of their job. 40% of HCWs considered that getting infected with COVID-19 was not within their control. This was more common among junior than senior HCWs (46% versus 38%, P value <.01). Sufficient COVID-19-specific IPC training, confidence in PPE use and institutional trust were positively associated with the feeling that becoming infected with COVID-19 was within their control. Female HCWs were more likely than males to report a WHO-5 score below 50 points (aOR 1.5 (95% confidence interval (CI) 1.2-1.8).ConclusionsIn Europe, the COVID-19 pandemic has had a differential impact on those providing direct COVID-19 patient care, junior staff and women. Health facilities must be aware of these differential impacts, build trust and provide tailored support for this vital workforce during the current COVID-19 pandemic.


2018 ◽  
Vol 28 (suppl_4) ◽  
Author(s):  
M Fattorini ◽  
D Rosadini ◽  
S Cresti ◽  
A De Luca ◽  
L Cubattoli ◽  
...  

2020 ◽  
Vol 8 ◽  
Author(s):  
Zhong Sun ◽  
Guozhong He ◽  
Ninghao Huang ◽  
Hongyu Chen ◽  
Shuwei Zhang ◽  
...  

Background: COVID-19 developed into a global pandemic in 2020 and poses challenges regarding the prevention and control capabilities of countries. A large number of inbound travelers from other regions could lead to a renewed outbreak of COVID-19 in the local regions. Globally, as a result of the imbalance in the control of the epidemic, all countries are facing the risk of a renewed COVID-19 outbreak brought about by travelers from epidemic areas. Therefore, studies on a proper management of the inbound travelers are urgent.Methods: We collected a total of 4,733,414 inbound travelers and 174 COVID-19 diagnosed patients in Yunnan province from 21 January 2020 to 20 February 2020. Data on place of origin, travel history, age, and gender, as well as whether they had suspected clinical manifestations for inbound travelers in Yunnan were collected. The impact of inbound travelers on the local epidemic was analyzed with a collinear statistical analysis and the effect of the control measures on the epidemic was evaluated with a sophisticated modeling approach.Results: Of the 174 COVID-19 patients, 60.9% were not from Yunnan, and 76.4% had a history of travel in Hubei. The amount of new daily cases in Yunnan was significant correlated with the number of inbound travelers from Hubei and suspected cases among them. Using Susceptible–Exposed–Infectious–Recovered (SEIR) model analysis, we found that the prevention and control measures dropped the local R0 down to 1.07 in Yunnan province.Conclusions: Our preliminary analysis showed that the proper management of inbound travelers from outbreak areas has a significantly positive effect on the prevention and control of the virus. In the process of resettlement, some effective measures taken by Yunnan province may provide an important reference for preventing the renewed COVID-19 outbreak in other regions.


2017 ◽  
Vol 08 (02) ◽  
pp. 209-215 ◽  
Author(s):  
Akhoury Gourang Sinha ◽  
Raju Sharma

ABSTRACTBackground: Physiotherapy plays a central role in the management of children with cerebral palsy (CP); however, literature describing the use of physiotherapy service and the factors affecting utilization of physiotherapy service for this group of children in the Indian context remain unexplored. Aims and Objectives: To describe the utilization of physiotherapy services and explore the factors affecting utilization of physiotherapy services among children with CP of Jalandhar district of Punjab. Methodology: During June 2009 to March 2012 interview of family members of 248 children with CP (male = 159; female = 89) was conducted using a schedule focusing on demography, constraints of resources, expectations, beliefs, awareness, and service utilization. Cross tabulation with Chi-square, univariate, and multivariate logistic regression analysis were the tools of statistical analysis. Results: 44.4% children had not received any physiotherapy in their life time. In univariate analysis exposure to physiotherapy was found significantly associated with age of diagnosis (odds ratio [OR] = 2.47), finance constraint (OR = 2.27), personal constraint (OR = 2.54), transportation constraint (OR = 3.01), lack of advice for rehabilitation (OR = 2.36), ignorance about condition (OR = 11.94), and rehabilitation services (OR = 2.88). Multivariate model (χ2 = 57.16, df = 15, P < 0.001, pseudo R2 Cox and Snell = 0.22, Nagelkerke = 0.27) identified two main predictor variables of nonexposure to physiotherapy-ignorance about condition (OR = 7.3) and expectation of normalcy (OR = 0.43). Conclusion: The main drivers for the use of physiotherapy among children with CP in Jalandhar district of Punjab were awareness about the condition of CP and expectation of normalcy which demonstrated a complex relationship with sociodemographic factors.


mSphere ◽  
2019 ◽  
Vol 4 (2) ◽  
Author(s):  
Sabrina Sabino ◽  
Silvia Soares ◽  
Fabiano Ramos ◽  
Miriane Moretti ◽  
Alexandre P. Zavascki ◽  
...  

ABSTRACT The objective of this study is to evaluate the impact of carbapenem-resistant Enterobacteriaceae (CRE) infection on sepsis 30-day mortality. A retrospective cohort of patients >18 years old with sepsis and organ dysfunction or septic shock was conducted. Univariate analysis was done for variables potentially related to 30-day mortality, and the ones with P values of <0.05 were included in a backward stepwise hierarchic Cox regression model. Variables that remained with P values of <0.05 were retained in the model. A total of 1,190 sepsis episodes were analyzed. Gram-negative bacterial infections occurred in 391 (68.5%) of 571 patients with positive cultures, of which 69 (17.7%) were caused by a CRE organism. Patients with CRE infections had significantly higher 30-day mortality: 63.8% versus 33.4% (P < 0.01). CRE infection was also associated with a lower rate of appropriate empirical therapy (P < 0.01) and with the presence of septic shock (P < 0.01). In the hierarchic multivariate model, CRE remained significant when controlling for demographic variables, comorbidities, and infection site but lost significance when controlling for septic shock and appropriate empirical therapy. Older age (P < 0.01), HIV-positive status (P < 0.01), cirrhosis (P < 0.01), septic shock (P < 0.01), higher quick sepsis-related organ failure assessment (quick-SOFA) (P < 0.01), and appropriate empirical therapy (P = 0.01) remained in the final model. CRE infections were associated with higher crude mortality rates. A lower rate of appropriate empirical therapy and late diagnosis were more frequent in this group, and improvement of stewardship programs is needed. IMPORTANCE The importance of this work relies on exploring the impact of multidrug-resistant bacterial infections such as those with carbapenem-resistant Enterobacteriaceae (CRE) on sepsis mortality. These infections are growing at alarming rates worldwide and are now among the most frequent and difficult-to-treat bacteria due to the very few options for susceptible antimicrobials available. This study examined 1,190 sepsis episodes, and the main findings were as follows: (i) the prevalence of CRE infections significantly increased over time, (ii) CRE infection was associated with higher 30-day mortality than that of patients with other infections (63.8% versus 33.4%), and (iii) the effect of CRE on mortality was probably influenced by the fact that those patients received lower rates of empirical therapy with active antibiotics and were also diagnosed in more advanced stages of sepsis (septic shock). Those findings point to the need for rapid diagnostic methods to identify these bacteria and the need to adjust therapeutic guidelines to this worrisome epidemiological scenario.


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