COVID-19 Pandemic Prevention Protocol: Perspectives and Approaches

Using observational data and variation in hospital admissions across days of the week, we examined the association between ED boarding time and development of delirium within 72 hours of admission among patients aged 65+ years admitted to an inpatient neurology ward. We exploited a natural experiment created by potentially exogenous variation in boarding time across days of the week because of competition for the neurology floor beds. Using proportional hazard models adjusting for socio-demographic and clinical characteristics in a propensity score, we examined the time to delirium onset among 858 patients: 2/3 were admitted for stroke, with the remaining admitted for another acute neurologic event. Among all patients, 81.2% had at least one delirium risk factor in addition to age. All eligible patients received delirium prevention protocols upon admission to the floor and received at least one delirium screening event. While the clinical and social-demographic characteristics of admitted patients were comparable across days of the week, patients with ED arrival on Sunday or Tuesday were more likely to have had delayed floor admission (waiting time greater than 13 hours) and delirium (adjusted HR = 1.54, 95%CI:1.37–1.75). Delayed initiation of delirium prevention protocol appeared to be associated with greater risk of delirium within the initial 72 hours of a hospital admission.

Download Full-text

An HIV Prevention Protocol Reviewed at 15 National Sites: How do Ethics Committees Protect Communities?

Journal of Empirical Research on Human Research Ethics ◽

10.1525/jer.2008.3.2.77 ◽

2008 ◽

Vol 3 (2) ◽

pp. 77-86 ◽

Cited By ~ 12

Author(s):

Bethany Griffin Deeds ◽

Marné Castillo ◽

Zephyr Beason ◽

Shayna D. Cunningham ◽

Jonathan M. Ellen ◽

...

Keyword(s):

Hiv Prevention ◽

Ethics Committees ◽

Prevention Protocol

Download Full-text

How do we change practice?

Archives of Pediatric Neurosurgery ◽

10.46900/apn.v3i2(may-august).93 ◽

2021 ◽

Vol 3 (2(May-August)) ◽

pp. e932021

Author(s):

John Kestle

Keyword(s):

Infection Rate ◽

Infection Prevention ◽

Shunt Infection ◽

Current Data ◽

Research Network ◽

Csf Shunt ◽

Prevention Measures ◽

Skin Preparation ◽

Prevention Protocol ◽

Csf Shunt Infection

OBJECT: The goal of this video lecture was to show the importance to research group organizing protocols to reduce cerebrospinal fluid (CSF) shunt infection at Hydrocephalus Clinical Research Network (HCRN) centers (from 8.7% to 5.7%). Antibiotic-impregnated catheters (AICs) were not part of the protocol but were used off protocol by some surgeons. The authors therefore began using a new protocol that included AICs in an effort to reduce the infection rate further. The improvement of quality was related to reduce variation and improve outcome. METHODS The previous protocol was implemented at HCRN centers on January 1, 2012, for all shunt procedures (excluding external ventricular drains [EVDs], ventricular reservoirs, and subgaleal shunts). Compliance with the protocol and outcome events up to March 30, 2014, were recorded. The actual protocol is based on 7 points (HCRNq centers): intravenous antibiotics, skin preparation, hand scrub, double gloves, iodophoretic surgical field, catheter and antibiotics, and vancomycin irrigation RESULTS. Before protocol implementation in 30 participating centers, and 1318 subjects (1571 surgical cases) enrolled the overall infection rate was 6.0% (95% CI 5.1%-7.2%). The actual infection rate when using this new protocol has been analyzed. CONCLUSIONS CSF shunt procedures performed in compliance with a new infection prevention protocol at HCRNq centers had a lower infection rate than noncompliant procedures. Based on the current data, HCRNq centers the role of AICs compared with other infection prevention measures is still under analysis.

Download Full-text

Comparative analgesic efficacy of pregabalin administered according to either a prevention protocol or an intervention protocol in rats with cisplatin-induced peripheral neuropathy

Clinical and Experimental Pharmacology and Physiology ◽

10.1111/1440-1681.12971 ◽

2018 ◽

Vol 45 (10) ◽

pp. 1067-1075 ◽

Cited By ~ 5

Author(s):

Felicity Y Han ◽

Andy Kuo ◽

Janet R Nicholson ◽

Laura Corradinni ◽

Maree T Smith

Keyword(s):

Peripheral Neuropathy ◽

Analgesic Efficacy ◽

Intervention Protocol ◽

Prevention Protocol

Download Full-text

Standardizing preoperative preparation to reduce surgical site infections among pediatric neurosurgical patients

Journal of Neurosurgery Pediatrics ◽

10.3171/2016.10.peds16287 ◽

2017 ◽

Vol 19 (4) ◽

pp. 399-406 ◽

Cited By ~ 7

Author(s):

Joshua K. Schaffzin ◽

Katherine Simon ◽

Beverly L. Connelly ◽

Francesco T. Mangano

Keyword(s):

Surgical Site Infections ◽

Pediatric Neurosurgery ◽

Postoperative Management ◽

Neurosurgical Procedure ◽

Protocol Adherence ◽

Protocol Development ◽

Published Evidence ◽

Neurosurgical Patients ◽

Before And After ◽

Prevention Protocol

OBJECTIVE Surgical site infections (SSIs) are costly to patients and the health care system. Pediatric neurosurgery SSI risk factors are not well defined. Intraoperative protocols have reduced, but have not eliminated, SSIs. The effect of preoperative intervention is unknown. Using quality improvement methods, a preoperative SSI prevention protocol for pediatric neurosurgical patients was implemented to assess its effect on SSI rate. METHODS Patients who underwent a scheduled neurosurgical procedure between January 2014 and December 2015 were included. Published evidence and provider consensus were used to guide preoperative protocol development. The Model for Improvement was used to test interventions. Intraoperative and postoperative management was not standardized or modified systematically. Staff, family, and overall adherence was measured as all-or-nothing. In addition, SSI rates among eligible procedures were measured before and after protocol implementation. RESULTS Within 4 months, overall protocol adherence increased from 51.3% to a sustained 85.7%. SSI rates decreased from 2.9 per 100 procedures preintervention to 0.62 infections postintervention (p = 0.003). An approximate 79% reduction in SSI risk was identified (risk ratio 0.21, 95% CI 0.08–0.56; p = 0.001). CONCLUSIONS Clinical staff and families successfully collaborated on a standardized preoperative protocol for pediatric neurosurgical patients. Standardization of the preoperative phase of care alone reduced SSI rates. Attention to the preoperative in addition to the intraoperative and postoperative phases of care may lead to further reduction in SSI rates.

Download Full-text

5210 Pediatric Obesity Clinical Decision Support Chart

10.1542/9781581108941 ◽

2014 ◽

Author(s):

Keyword(s):

Health Care Professionals ◽

Obese Child ◽

Clinical Decision ◽

Child Health Care ◽

Treatment Interventions ◽

Management Guidelines ◽

Practical Support ◽

Flip Chart ◽

Assessment And Treatment ◽

Prevention Protocol

This convenient flip chart provides child health care professionals practical support and guidance to help improve care and outcomes for overweight youth. Bring your practice the latest ready-to-use tools including *Step-by-step prevention, assessment, and treatment interventions for the overweight and obese child developed by the CDC *15-minute obesity prevention protocol *Hypertension evaluation and management guidelines *Growth charts spanning birth to 20 years of age, including body mass index-for-age percentiles *Blood pressure levels for boys and girls *Coding information for obesity-related health services

Download Full-text

15-Minute Obesity Prevention Protocol

10.1542/9781581104219-obesity-prevention ◽

2008 ◽

pp. 11-12

Keyword(s):

Obesity Prevention ◽

Prevention Protocol

Download Full-text

Impact of Pressure Injury Prevention Protocol in Home Care Services on the Prevalence of Pressure Injuries in the Dubai Community

Dubai Medical Journal ◽

10.1159/000511226 ◽

2020 ◽

Vol 3 (3) ◽

pp. 99-104

Author(s):

Sajitha Prasad ◽

Nazneen Hussain ◽

Sangeeta Sharma ◽

Somy Chandy ◽

Jessy Kurien

Keyword(s):

Health Care ◽

Home Care ◽

Care Delivery ◽

Assessment Tools ◽

Care Plan ◽

Significant Drop ◽

Braden Scale ◽

Increased Risk ◽

Prevention Protocol ◽

The Impact

Background: Pressure injuries (PIs) in the community have emerged as a health care burden in the past few years, leading to high rates of morbidity and mortality among the elderly population. There is evidence that simple risk assessment tools and protocols have reduced the prevalence of PIs considerably by shifting the focus to timely prevention and adequate management. The prevalence of PIs is high in home care setting and utilizes a major share of the organizational resources for its treatment and prevention. Aim: This study aims to assess the impact of the newly developed PI prevention protocol for home care patients in Dubai. The objectives are to evaluate effective implementation of the proposed protocol and its impact on the prevalence of PIs in the community to identify the gaps for improvement in the future. Methods: This retrospective observational was conducted in 13 primary health care centers in Dubai, UAE. Data were collected from 249 patients’ records at an average age of 75.5 ± 14.5 years old with compromised mobility (bedbound/chairbound) from January to July 2019. The PI prevalence was assessed before and after 6 months of implementing the PI prevention protocol and comparison was done using a standardized skin assessment scale (Braden Scale). Internationally validated tools from the Agency for Healthcare Research and Quality and National Institute for Health and Care Excellence were used to ensure the reliable use of the Braden Scale and PI protocol compliance. The prevalence was calculated from the existing key performance indicators in the home care office and considering the significant improvement at p value of <0.05. Results: The findings in the first quarter revealed a significant drop in both prevalence (9.0%) and incidence rate (6.0%) to approximately 2.0%. Overall PIs prevalence declined significantly after implementing the protocol (p < 0.0001) among both genders. Also, a significant improvement was detected in the use of Braden Scale and multidisciplinary care plan (p < 0.0001). Conclusion: This study indicates that standardization of care delivery reduces the increased risk and incidence of PIs with a potentially positive outcome on PI prevalence.

Download Full-text