An Interdisciplinary Team Approach to Decrease Sacral Hospital-acquired Pressure Injuries: A Retrospective Cohort Study

2021 ◽  
Vol 67 (5) ◽  
pp. 26-32
Author(s):  
Shelby Isaacs ◽  
Tamir Pinhasov ◽  
Alisha Oropallo ◽  
Mary Brennan ◽  
Amit Rao ◽  
...  
Keyword(s):  
Interdisciplinary Team ◽  
University Hospital ◽  
Quality Data ◽  
Team Approach ◽  
Post Intervention ◽  
Sustained Reduction ◽  
Before And After ◽  
Intervention Patient ◽  
Hospital Acquired ◽  
Interdisciplinary Intervention

BACKGROUND: Hospital-acquired pressure injuries (HAPIs) of the sacrum are among the most common iatrogenic events in health care. Multi-intervention programs have been shown to decrease the prevalence of pressure injuries. PURPOSE: To assess changes in the yearly incidence of sacral HAPIs before and after implementation of a 3-pronged interdisciplinary intervention to reduce HAPI incidence. METHODS: A retrospective study of all patients admitted between 2010 and 2017 was conducted to evaluate the effect of a 2012 initiative on the incidence of sacral HAPIs. In 2012, an interdisciplinary team was created, and enhanced education programs for nursing staff and quality data reporting measures were implemented for all patients admitted to North Shore University Hospital, Manhasset, NY. Pre- and post-intervention patient variables and sacral HAPI outcomes were compared. RESULTS: Pre- intervention, the sacral HAPI incidence was 0.353% and 0.267% (mean 0.31%) in the years 2010 and 2011, respectively. Post-intervention the HAPI incidence was 0.033%, 0.043%, 0.008%, 0.007%, and 0.004% in the years 2013, 2014, 2015, 2016, and 2017, respectively (mean 0.019%) (2-sample unpaired t-statistic: 11.5937; P < .001). Significant variables and outcomes differences between pre-intervention (n = 245) and post-intervention (n = 49) patients with a sacral HAPI were seen for race (P < .0001), length of stay (P = .0096), and HAPI stage (P < .0001). CONCLUSION: A hospital-wide, multi-part, interdisciplinary intervention resulted in a significant and sustained reduction in the incidence of sacral HAPIs.

The effect of training and experience on mass casualty incident triage performance: Evidence from emergency personnel in a high complexity university hospital

2019 ◽  
Vol 14 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Juan P. Vargas, MD, MSc ◽  
Ives Hubloue, MD, PhD ◽  
Jazmín J. Pinzón, MD ◽  
Alejandra Caycedo Duque, MD
Keyword(s):  
Emergency Department ◽  
Mass Casualty Incident ◽  
Mass Casualty ◽  
University Hospital ◽  
Trauma Patients ◽  
Post Intervention ◽  
Cross Sectional ◽  
Emergency Department Staff ◽  
Department Staff ◽  
Before And After

Mass casualty incident (MCI) can occur at any time and place and health care institutions must be prepared to deal with these incidents. Emergency department staff rarely learn how to triage MCI patients during their medical or nurse degrees, or through on-the-job training. This study aims to evaluate the effect of training and experience on the MCI triage performance of emergency personnel.Methodology: This was a cross-sectional prospective study that analyzed the performance of 94 emergency department staff on the triage classifications of 50 trauma patients, before and after a short training in MCI triage, while taking into account their academic background and work experience.Results: The participants were assigned initially to one of two groups: low experience if they had less than 5 years of practice, and high experience if they had more than 5 years of practice. In the low experience group, the initial accuracy was 45.76 percent, over triage 45.84 percent, and subtriage 8.38 percent. In the high experience group, the initial accuracy was 53.80 percent, over triage 37.66 percent, and sub triage 8.57 percent.Postintervention Results: In the low experience group, the post intervention accuracy was 63.57 percent, over triage 21.15 percent, and subtriage 15.30 percentage. In the high experience group, the post-intervention accuracy was 67.66 percentage, over triage 15.19 percentage, and subtriage 17.14 percentage.  Conclusion: Upon completion of this study, it can be concluded that MCI triage training significantly improved the performance of all those involved in the workshop and that experience plays an important role in MCI triage performance.

scholarly journals Impact of Hospital Acquired Infection and Antibiotic Resistance Awareness Campaign on Knowledge Attitude and Practices of Medical Undergraduates in a Tertiary Care Teaching Hospital, India

2020 ◽  
Author(s):  
Ekadashi Rajni ◽  
Priyanka Rathi ◽  
Manisha Malik ◽  
Sonali Mittal ◽  
Ved Prakash Mamoria
Keyword(s):  
Antibiotic Resistance ◽  
Undergraduate Students ◽  
Tertiary Care ◽  
Post Intervention ◽  
Awareness Campaign ◽  
Poor Grade ◽  
Before And After ◽  
Grass Root Level ◽  
Study Participants ◽  
Hospital Acquired

Introduction: Healthcare professionals have an important role in tackling the growing menace of Hospital Acquired Infections (HAI) and Antibiotic Resistance (ABR). Regular trainings imparted early in career can result in better understanding of these crucial issues. Aim: To identify the baseline Knowledge Attitude and Practices (KAP) of 5th semester MBBS undergraduate students of a University Medical College in Rajasthan, India, and to determine the changes in these parameters after the implementation of a vigorous “HAI and ABR Awareness campaign”. Materials and Methods: This prospective interventional study involved 86, 5th semester MBBS undergraduate students. The study instrument was a preformed pretested 30 item self-administered questionnaire. The study intervention included a series of lectures, role plays, poster competition; and an audio-visual quiz. The performance of individual participants before and after the intervention was then statistically analysed with Microsoft Excel and software Statistical Package for the Social Sciences (SPSS) version 20. Results: The pre-intervention overall KAP score of each student was found to be poor in 17.4%, average in 61.6%, and excellent in 20.9% in study participants. Post-intervention grades were found to be poor, average, and excellent in 1.1%, 8.14%, and 90.7% study participants, respectively. A statistically significant decrease in the percentage of students with poor grade and a significant increase in those with excellent grade were observed. Conclusion: There is a need for suitable amendments in current MBBS curriculum to include modules which comprehensively address the core issues of ABR, HAIs and Antimicrobial Stewardship (AMS). This would help to bring out attitude and behavioural changes in students at the very grass-root level.

scholarly journals Effectiveness Hand Washing and Hand Rub Method in Reducing Total Bacteria Colony from Nurses in Medan

2019 ◽  
Vol 7 (20) ◽  
pp. 3380-3383
Author(s):  
Tetty Aman Nasution ◽  
Rina Yunita ◽  
Ayodhia Pitaloka Pasaribu ◽  
Fikri M. Ardinata
Keyword(s):  
Hand Hygiene ◽  
Simple Procedure ◽  
Sampling Technique ◽  
Hand Washing ◽  
University Hospital ◽  
Duration Of Treatment ◽  
Bacterial Colony ◽  
Hospital Acquired Infection ◽  
Before And After ◽  
Hospital Acquired

BACKGROUND: Hospital-acquired infection (HAI) is a major problem for the patient's health care and may impact the duration of treatment. Hand hygiene is a simple procedure but giving good prevention usually done among nurses at the hospital. AIM: Objective of the study is to determine the effectivity of handwashing method compared to hand rub to eliminate microorganisms on nurse’s hands at Sumatera Utara University Hospital. This is an experimental analytic study using random sampling technique. METHODS: There were 16 nurses enrolled in this study. There were 2 groups involved; the first group using handwashing with soap and the other one using hand rub. The swabs were taken from each hand from both groups before and after washing their hands. Moreover, the swabs directly sent to Microbiology Laboratory of Sumatera Utara University to identify bacteria which colonise the hand. RESULTS: There were no significant differences between using handwashing method compared to hand rub in reducing total bacterial colony on hands (p = 0.088). The average of total colony decreased by using handwashing method is 59.5%, and by using a hand, rub is 47.2%. CONCLUSION: Hand hygiene method using alcohol-based hand rub liquid has been recommended by WHO and can replace hand washing method in a particular situation.

scholarly journals Postgraduate Interprofessional Case-Based Learning in Childhood Cancer: A Feasibility Study

Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4314
Author(s):  
Martha Krogh Topperzer ◽  
Marianne Hoffmann ◽  
Hanne Bækgaard Larsen ◽  
Susanne Rosthøj ◽  
Martin Kaj Fridh ◽  
...  
Keyword(s):  
Childhood Cancer ◽  
Feasibility Study ◽  
University Hospital ◽  
Learning Session ◽  
Post Intervention ◽  
Team Collaboration ◽  
Safety Attitudes ◽  
Before And After ◽  
Case Based Learning ◽  
Case Based

This paper presents a feasibility study assessing the acceptability, demand, implementation, and practicality of postgraduate interprofessional case-based learning in childhood cancer at Copenhagen University Hospital—Rigshospitalet. Healthcare professionals included nurses, doctors, social workers, physiotherapists, occupational therapists, pharmacists, pharmacologists, dieticians, nursing assistants, and professionals with a supportive function (teachers, secretaries, priests, and daycare workers). All participated in a postgraduate interprofessional case-based learning session. Feasibility was assessed using Bowen’s focus areas of acceptability, demand, implementation, and practicality. Before and after the intervention session, three measurement tools were used 2–3 weeks before participation and 3–4 weeks after participation to collect data: Assessment of Interprofessional Team Collaboration Scale, Readiness for Interprofessional Learning Scale, and Safety Attitudes Questionnaire. Representing 13 occupational groups, 49 participants completed the case-based learning sessions, indicating acceptability and practicality. The pre- and post-intervention questionnaires were completed by 79% of the participants, 88% of whom rated the professional content as good or very good. A change over time was detected on all three scales measuring mean difference post-intervention scores. The outcome measures can be used to assess the effect of the intervention. Postgraduate interprofessional case-based learning in childhood cancer is feasible in terms of acceptability, demand, implementation, and practicality. Implementation requires leadership commitment at all levels.

Evaluating the sustained effectiveness of a multimodal intervention aimed at influencing PIVC insertion practices in the emergency department

2020 ◽  
Vol 37 (7) ◽  
pp. 444-449
Author(s):  
Zheng Jie Lim ◽  
Daniel Nagle ◽  
Fern McAllan ◽  
Radha Ramanan ◽  
Claire Dendle ◽  
...  
Keyword(s):  
Improve Patient Safety ◽  
Healthcare Personnel ◽  
Post Intervention ◽  
Healthcare Settings ◽  
Sustained Effect ◽  
Sustained Reduction ◽  
Before And After ◽  
Long Term Follow Up

IntroductionMultimodal interventions (MMI) are frequently used in various healthcare settings to encourage change in healthcare personnel practices and improve patient safety. In 2013, an MMI conducted in an Australian metropolitan ED used clinician champions, guidelines, education sessions and promotional materials to encourage a reduction in unused and inappropriate peripheral intravenous cannulas (PIVC). A 60-day postintervention demonstrated a successful reduction in the number of unused PIVCs without changes in appropriate insertions. We aimed to investigate if this MMI produced a sustained effect in reducing the frequency of unused PIVCs inserted in this ED.MethodsA single-centre retrospective cohort study of adult patients presenting to the above ED in Victoria, Australia, was conducted in April 2018. A random sample of 380 patients with a PIVC inserted in ED was assessed to determine if the PIVC was used (termed ‘Long-term follow-up’). The appropriateness of unused PIVCs was assessed. Our findings were compared with previously collected data in 2013 (‘Pre-Intervention’ and ‘Immediately Post-Intervention’) to determine a sustained reduction in the frequency of unused PIVC insertions was achieved. Long-term analysis of the MMI, including the overall frequency of PIVC insertions in ED before and after the MMI, was also collected.ResultsIn our Long-term follow-up cohort, 101 of 373 (27.1%, 95% CI 22.6% to 31.9%) PIVCs were unused (seven cases excluded). This was significantly lower than the Pre-Intervention cohort (139/376, 37.0%, 95% CI 32.1% to 42.1%). While not significant, the frequency of unused PIVCs in the Post-Intervention cohort was lower in comparison (73/378, 19.3%, 95% CI 15.4% to 23.7%). No significant change in the appropriateness of unused PIVCs was observed between the Post-Intervention and Long-term follow-up. The overall proportion of patients receiving a PIVC has remained low since the MMI.ConclusionAn MMI aimed at reducing unused PIVC insertions in ED has been effective in eliciting sustained change. Unused but appropriately inserted PIVCs seem unaffected by the intervention.

scholarly journals Hospital-acquired infections before and after healthcare reorganization in a tertiary university hospital in Norway

2008 ◽  
Vol 31 (1) ◽  
pp. 98-104 ◽  
Author(s):  
B. M. Andersen ◽  
M. Rasch ◽  
K. Hochlin ◽  
T. Tollefsen ◽  
L. Sandvik
Keyword(s):  
University Hospital ◽  
Hospital Acquired Infections ◽  
Before And After ◽  
Hospital Acquired

scholarly journals Intervention on knowledge and perception of hand hygiene among healthcare workers

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Ben Cheikh ◽  
S Ben Fredj ◽  
S Bhiri ◽  
H Ghali ◽  
S Khefacha ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Healthcare Workers ◽  
Intervention Program ◽  
Developed Countries ◽  
Effective Procedure ◽  
University Hospital ◽  
Effective Intervention ◽  
Post Intervention ◽  
Before And After ◽  
Hygiene Compliance

Abstract Background Many studies conducted in healthcare settings with limited resources reported healthcare associated infections (HAIs) rates higher than in developed countries. Hand hygiene is considered as the most effective procedure for reducing infection in a wide variety of settings. The aim of this study was to assess the effectiveness of an intervention program to improve knowledge and perception of hand hygiene among healthcare workers (HCWs). Methods We conducted a prospective before-and-after study design in university hospital Sahloul, Sousse, Tunisia, from January 2015 to December 2016. The same questionnaire, constructed by the WHO was distributed and collected at HCWs’ workplace. Results A total of 149 and 146 HCWs were enrolled, respectively at pre and post intervention. The majority was nursed women aged between 20 and 35 in pre intervention, whereas in post intervention the majority where physicians. Globally, our results showed tendencies toward improvement, but only two items were significant: the HW is the appropriate technique after injury (73.5% vs 86.8%; p = 0.006) and the hands of HCWs are the lead vehicle of HAIs (65.1% vs 83.6%; p = 0.01). On the other hand, judging by the HCWs’ responses, the probably most effective intervention to enhance hand hygiene compliance was that an alcohol-based hand-rub is available at each point of patient care. In contrast, empowering patients to remind HCWs to perform hand hygiene was mostly rated to be the least effective intervention both in pre and post intervention. Conclusions Our intervention to positively influence hand hygiene knowledge was unfortunately less effective than we had hoped it would be, which suggests a HCWs’ reluctance to attend the training program. Key messages Hand hygiene is considered as the most effective procedure for reducing nosocomial infection. the intervention to positively influence hand hygiene knowledge was effective.

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