scholarly journals Modern approaches to ensure hand hygiene of medical staff in a measure complex for prevention of nosocomial infections in health facilities

2021 ◽  
Vol 17 (4) ◽  
pp. 32-38
Author(s):  
E.V. Khandoga ◽  
I.V. Kochin ◽  
R.L. Terekhov ◽  
A.A. Ostapenko ◽  
V.V. Tsarjov

Hand hygiene of medical staff plays a significant role in the prevention of nosocomial infections in healthcare facilities. Therefore, there is a need to identify approaches to facilitate proper adherence to hand hygiene. The study aims to substantiate the need for hand hygiene of medical staff, to explore modern methods for evaluating the effectiveness of hand hygiene supplies and problems associated with the use of these supplies along with their solutions. The authors have carried out the general and targeted analysis and expert evaluation of research results regarding measures for the prevention of nosocomial infections in health facilities. Analytical study of a large number of sources (over 50) on modern approaches to ensure hand hygiene of medical staff has been conducted with Content analysis and Open Source Intelligence methods. As a result of the study, authors have identified the need for further development of strategies to facilitate hand hygiene in health facilities and for the improvement of existing educational and motivational programs dedicated to hand hygiene of medical staff. Factors that may affect the effectiveness of antiseptics usage have been highlighted. The authors emphasize adverse reactions associated with the use of hand hygiene supplies (contact dermatitis and contact allergy) and the need for the development of measures to reduce risks of these adverse reactions among medical staff.

2021 ◽  
Vol 25 (1) ◽  
pp. 118-125
Author(s):  
V. V. Chorna ◽  
V. M. Makhniuk ◽  
H. V. Chaika ◽  
S. T. Yurchenko ◽  
M. O. Kovaliv

Annotation. The aim of the work was to evaluate the design decisions of new psychiatric health care facilities in Ukraine and their comparative characteristics with EU institutions. An analysis of the requirements for the design of domestic new psychiatric wards, day hospitals in outpatient psychiatric wards in general hospitals according to paragraph 8.2.15 SBN B.2.2-10: 2019. State building codes of Ukraine “Buildings and structures. Healthcare facilities” (draft, final version) and European facilities of the same type based on the study of literature data. The method of theoretical analysis is used. It was found that conditions of the location of inpatient departments, their zoning, composition, and area of premises, requirements to ensure a safe stay of patients in wards, toilets, and bathrooms are regulating in the new SBN B.2.2-10: 2019. This essentially repeats the sanitary and hygienic requirements of the previous document SBN B .2.2-10: 2001 “Healthcare facilities”, ie no changes are aiming at creating an ecological environment and comfortable conditions for patients and medical staff of psychiatric healthcare facilities. In this normative document, there is no clear understanding of the location of medical facilities and the next post of a nurse in inpatient departments of psychiatric hospitals; there is no area for a private stay of patients with mental disorders in the middle of the department and outside it; the regulations of life support systems for nurses and patients in the inpatient department (lighting, noise, air exchange, etc.) of psychiatric hospitals are not standardized. In European psychiatric clinics, the “therapeutic environment” provides for the presence of single and double wards (coincides with domestic building codes); area of 37.7 m2 per patient under foreign law, while the project DBN B.2.2-10: 2019 – the zone per patient is 12 m2, which is three times less; separate bathrooms and toilets, common areas, individual access to the garden, where the conditions of privacy of patients are creating (not provided by Ukrainian regulations); location of most patient rooms around the central work area for medical staff (according to national legislation – a corridor-type system); creation of visual supervision over the doors of bedrooms, showers, toilets, kitchens, garden gazebos, as well as the selection of colours for painting the walls of wards and corridors of offices (not provided by Ukrainian regulations). To create a proper “therapeutic/healing environment” in new domestic mental health facilities (psychiatric wards, day hospitals in outpatient psychiatric wards in general hospitals, mental health centres), it is necessary to implement European requirements in the design of these facilities with the involvement of multidisciplinary groups: from architects to nurses, from construction contractors to patients and supplement SBN B.2.2-10: 2019 “Buildings and structures. Health Facilities” is a guide to designing psychiatric health facilities.


2014 ◽  
Vol 95 (3) ◽  
pp. 415-421
Author(s):  
A V Evstropov ◽  
L U Kuznetsova

Aim. To study the changes of the of non-state day patient healthcare facilities performance indicators on providing ambulatory surgical care. Methods. Data of joint statistical reports of railway transport health facilities issued at 2002-2011, as well as documents that regulates providing surgical care to the population of the Russian Federation, Rosstat and Russian Health Ministry statistical data for the same period, were used for the analysis. Results. Surgical aid provided in day patient healthcare facilities of different types was changing differently. In out-patient clinics, the number of operations increased twicefold during 10 years, surgical aid provision per 10 000 population increased almost by 3 times (287%) over the 10-year period. The opposite trends were observed in day care facilities of the hospitals - the number of operations decreased, as well as surgical aid provision per 10 000 population and surgical procedures rate on 100 discharged patients from 6.5 to 3. In 2002, the structure of outpatient surgeries in day patient healthcare facilities was the following: skin and subcutaneous tissue surgeries - 41.8%, female reproductive organs - 51.4%, ears, nose and throat - 2.7%. By 2011, the structure has changed: with 70.3% surgeries performed on female reproductive organs, and 18.3% - on skin and subcutaneous tissue. Comparative assessment of the development of surgical care in day patient healthcare facilities based in out-patient clinics of JSC «Russian Railways» revealed that in this matter railway medical complex was more dynamic and developing rapidly. Conclusion. Non-state health facilities of the transport industry (for example, medical complex of JSC «Russian Railways») have all the managerial and legislative backgroung for further development of out-patient surgery within the framework of 24-hour hospital substituting technologies in in day patient healthcare facilities based in out-patient clinics.


2020 ◽  
Vol 41 (S1) ◽  
pp. s8-s10
Author(s):  
Julia Johnson ◽  
Asad Latif ◽  
Bharat Randive ◽  
Abhay Kadam ◽  
Uday Rajput ◽  
...  

Background: In low- and middle-income country (LMIC) healthcare facilities, gaps in infection prevention and control (IPC) practices increase risk of healthcare-associated infections (HAIs) and mortality among hospitalized neonates. Method: In this quasi-experimental study, we implemented the Comprehensive Unit-based Safety Program (CUSP) to improve adherence to evidence-based IPC practices in neonatal intensive care units (NICUs) in 4 tertiary-care facilities in Pune, India. CUSP is a validated strategy to empower staff to improve unit-level patient safety. Baseline safety culture was measured using the Hospital Survey on Patient Safety Culture (HSOPS). Baseline IPC assessments using the Infection Control Assessment Tool (ICAT) were completed to describe existing IPC practices to identify focus areas, the first of which was hand hygiene (HH). Sites received training in CUSP methodology and formed multidisciplinary CUSP teams, which met monthly and were supported by monthly coaching calls. Staff safety assessments (SSAs) guided selection of multimodal interventions. HH compliance was measured by direct observation using trained external observers. The primary outcome was HH compliance, evaluated monthly during the implementation and maintenance phases. Secondary outcomes included CUSP meeting frequency and HH compliance by healthcare worker (HCW) role. Result: In March 2018, 144 HCWs and administrators participated in CUSP training. Site meetings occurred monthly. During the implementation phase (June 2018–January 2019), HH monitoring commenced, sites formed their teams, completed the SSA, and selected interventions to improve HH based on the WHO’s IPC multimodal improvement strategy: (1) system change; (2) training and education; (3) monitoring and feedback; (4) reminders and communication; and (5) a culture of safety (Fig. 1). During the maintenance phase (February–September 2019), HH was monitored monthly and sites adapted interventions as needed. HH compliance improved from 58% to 70% at participant sites from implementation to maintenance phases (Fig. 2), with an odds ratio (OR) of 1.66 (95% CI, 1.50–1.84; P < .001). HH compliance improved across all HCW roles: (1) physician compliance improved from 55% to 67% (OR, 1.69; 95% CI, 1.42–2.01; P < .001); (2) nurse compliance from 61% to 73% (OR, 1.68; 95% CI, 1.46–1.93; P < .001); and (3) other HCW compliance from 52% to 62% (OR, 1.48; 95% CI, 1.10–1.99; P = .010). Conclusion: CUSP was successfully adapted by 4 diverse tertiary-care NICUs in Pune, India, and it resulted in increased HH compliance at all sites. This multimodal strategy is a promising framework for LMIC healthcare facilities to sustainably address IPC gaps and reduce HAI and mortality in neonates.Funding: NoneDisclosures: Aaron Milstone, Johns Hopkins University, BD (consulting)


Author(s):  
Syed Sharaf Ali Shah ◽  
Safdar Pasha ◽  
Nikhat Iftikar ◽  
Altaf Ahmed Soomro ◽  
Nazia Farrukh ◽  
...  

Objective: To assess the magnitude of the problem of injection safety in public and private health facilities in two districts of Sindh and Punjab provinces of Pakistan. Methods: A cross-sectional observational study was conducted between October and December 2020 among public and private health facilities of two districts of Pakistan: Gujarat in Punjab and Larkana in Sindh provinces. A convenient sample size of 60 healthcare facilities (30 from each district) was taken due to time and resource constraint. Six data collection tools were used which included structured observations and interviews with injection prescribers and providers based on WHO Revised Tool C, which were finalised after piloting. Results: Reuse of injection equipment was not observed in any of the 60 health facilities. In exit interviews of 120 patients, it was found that 27 (22.5%) patients reported receiving an injection, while 11 (9.2%) were prescribed intravenous (IV) drips. More injections and drips were prescribed in the private sector (n=15; 25.0%) in comparison with the public sector (n=12; 20.0%). Slightly higher proportion of IV drips were prescribed by the private providers when compared to public sector healthcare providers: 6 (10.0%) vs 5 (8.3%) respectively. Most of the prescribers (n=58; 96.7%) reported that patients who attended public and private health facilities demanded injectable medicines. Used syringes and drips were noted to be visible in open containers and buckets for final disposal in 20 (33.3%) assessed health facilities. Continuou...


2015 ◽  
Vol 14 (1) ◽  
pp. 52-67 ◽  
Author(s):  
Raquel Vannucci Capelletti ◽  
Ângela Maria Moraes

Water is the main stimulus for the development of microorganisms, and its flow has an important role in the spreading of contaminants. In hospitals, the water distribution system requires special attention since it can be a source of pathogens, including those in the form of biofilms often correlated with resistance of microorganisms to various treatments. In this paper, information relevant to cases of nosocomial infections involving water circuits as a source of contaminants is compiled, with emphasis on the importance of microbiological control strategies to prevent the installation, spreading and growth of microorganisms in hospitals. An overview of the worldwide situation is provided, with emphasis on Brazilian hospitals. Different approaches normally used to control the occurrence of nosocomial infections due to waterborne contaminants are analyzed, and the use of the polysaccharide chitosan for this specific application is briefly discussed.


Author(s):  
Hario Megatsari ◽  
Ilham Akhsanu Ridlo ◽  
Dian Kusuma

BACKGROUND Indonesian tobacco control initiatives are minimal despite having the second-highest adult male smoking prevalence in the world, with less than 10% of districts/cities banning outdoor tobacco advertisements. This research aimed to provide evidence on the presence of outdoor tobacco advertisements near health facilities in Surabaya where there is no outdoor advertising ban. METHODS Data collection was carried out in Surabaya from October to November 2018. Data of government (public) and private health facilities were obtained from the city health office. Two spatial data analyses were carried out: a buffer analysis near the healthcare facilities and an advertisement hotspot analysis using ArcMap 10.6. RESULTS From 308 tobacco advertisements that were identified, there were billboards (63%), banners (31%), and videoboards (7%). Of 142 public and 1,242 private health facilities in Surabaya, 26% and 31% had advertisements within 300 m and 63% and 70% were within advertisement hotspots, respectively. Furthermore, 5% of advertisements were within 300 m from public health facilities and 21% of them were within 300 m from private health facilities. CONCLUSIONS Outdoor tobacco advertisements were widespread throughout the city, prominently around public and private health facilities.


Author(s):  
Jessica Gloria Mogi ◽  
Gustaaf A. E. Ratag

Background: The Indonesian government recognizes the importance of mental health issues as indicated by the inclusion of such issues as indicators in the national program, the Healthy Indonesian Program with Family Approach (PIS-PK). This program is enforced in community health centers (puskesmas) in every regency in the country. However, the continually increasing number of mental disorder cases and the intense stigmatization of people with these disorders indicate the need to re-evaluate the capacity and delivery of designated centers’ mental health programs.Methods: This community survey involved interviewing the program directors of four community health centers in north Minahasa using the WHO-AIMS 2.2 questionnaire.Results: Very little effort has been made to improve mental health facilities and programs. Examples of aspects of health facilities that are lacking include training for health workers, the provision of psychotropic drugs, and supported employment or occupational rehabilitation.Conclusions: Community health centers are primary healthcare facilities for society. Therefore, mental health services should be implemented as one of their main programs.


2019 ◽  
Vol 3 (2) ◽  
pp. 77
Author(s):  
Fakaruddin Wahyu ◽  
Linda Kumala Sari ◽  
Muhammad Zid

Kampung Naga is one of indigeneous villages in Indonesia.  Community of Kampung Naga are known for their strongness in preserving the traditions of their ancestral heritage. As a indigeneous village, the lives of its people are inseparable from traditional rules, including in terms of health. Eventhough, Kampung Naga is not a community who's banned Modernism. They think modernism are not prohibited, as long as it does not violate customary provisions. Sanitation issue and also health facilities is one of the issues that are often encountered in the case of indigeneous villages, including Kampung Naga. With the reality of Kampung Naga's life is still traditionally and in influence of custom, then in terms of sanitation management it also does not escape the prevailing traditional provisions. As time goes by, the more visitors come, the mindset of the people of Kampung Naga gradually changes, especially in terms of health. Today, the majority of the residents of Kampung Naga have used modern medicine through Puskesmas and also village polyclinics and are handled by medical staff such as doctors and midwives.


2016 ◽  
Vol 54 (1) ◽  
pp. 19-22
Author(s):  
Kinga Grobelska ◽  
Monika Betyna ◽  
Ewa Zieliński

Abstract Hyperbaric oxygen therapy (HBOT) is a safe treatment, provided fulfilling certain rules of patient qualifications to treatment, as well as supervision over the course of therapy by qualified medical staff. Side effects reported in the literature are rare, and are usually mild and transient. Professional medical staff allows minimising the adverse events occurrence. The scale of complications is unknown, especially in Polish hyperbaric center. Careful analysis could be used to develop prevention procedures for patients of hyperbaric oxygen therapy. Hyperbaric Oxygen Centre and Wound Treatment in Bydgoszcz during 28 months performed hyperbaric oxygen therapy (HBOT) in case of 423 patients. During this period, adverse events occurred occasionally. 17 cases have been reported. Authors described study case 77 year-old patient who was admitted due to non-healing wound-left lower abdomen (state after radiotherapy). During the fourth session, on decompression phase patient have had a generalized seizure (tonic-clonic). The decompression was stopped, the oxygen supply was disconnected but only after the drug administration seizures terminated. The most likely causative agent of the adverse reactions of the patient treated with HBOT was the oxygen toxic effect on the brain tissue. However, analyzing the circumstances of the seizure termination: phase of decompression at the pressure 2ATA and lack of oxygen disconnection response, it cannot be excluded other causes of this complication.


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