scholarly journals PREVENTION & CONTROL STRATEGIES FOR NOSOCOMIAL INFECTION

2021 ◽  
Author(s):  
Suriya Narayanan Harikrishnan ◽  
Dattatreya Mukherjee ◽  
Sufia Imam ◽  
Aayushi Raj Sinha
Keyword(s):  
Health Care ◽  
Nosocomial Infection ◽  
Patient Care ◽  
Nosocomial Infections ◽  
Health Care Professionals ◽  
Invasive Procedure ◽  
Healthcare Facility ◽  
Direct Patient Care ◽  
Hospital Treatment ◽  
Carrier Status

Nosocomial infection is every infectious process appearing during hospital stays, despite itsclinical picture carrier status and time of manifestation – during hospital treatment orafter discharge.A nosocomial infection is contracted because of an infection or toxin that exists in a certainlocation, such as a hospital. People now use nosocomial infections interchangeably with theterms health-care associated infections (HAIs) and hospital-acquired infections. For a HAI,the infection must not be present before someone has been under medical care.The responsibility of HAI prevention is with the healthcare facility. Hospitals andhealthcare staff should follow the recommended guidelines for sterilization anddisinfection. However, due to the nature of healthcare facilities, it’s impossible to eliminate100 percent of nosocomial infections.Prevention of nosocomial infections requires an integrated, monitored, programme whichincludes the following key components:(1.) limiting transmission of organisms between patients in direct patient care throughadequate handwashing and glove use, and appropriate aseptic practice, isolationstrategies, sterilization and disinfection practices, and laundry(2.) controlling environmental risks for infection(3.) protecting patients with appropriate use of prophylactic antimicrobials, nutrition,and vaccinations(4.) limiting the risk of endogenous infections by minimizing invasive procedure, andpromoting optimal antimicrobial use(5.) surveillance of infections, identifying and controlling outbreaks(6.) prevention of infection in staff members(7.) enhancing staff patient care practices, and continuing staff education.Infection control is the responsibility of all health care professionals — doctors, nurses,therapists, pharmacists, engineers and others.

scholarly journals Building capacity for implementation—the KT Challenge

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Agnes T. Black ◽  
Marla Steinberg ◽  
Amanda E. Chisholm ◽  
Kristi Coldwell ◽  
Alison M. Hoens ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Qualitative Data ◽  
Practice Change ◽  
Evidence Based ◽  
Science Literature ◽  
Health Care Settings ◽  
Improvement Programs ◽  
The Impact

Abstract Background The KT Challenge program supports health care professionals to effectively implement evidence-based practices. Unlike other knowledge translation (KT) programs, this program is grounded in capacity building, focuses on health care professionals (HCPs), and uses a multi-component intervention. This study presents the evaluation of the KT Challenge program to assess the impact on uptake, KT capacity, and practice change. Methods The evaluation used a mixed-methods retrospective pre-post design involving surveys and review of documents such as teams’ final reports. Online surveys collecting both quantitative and qualitative data were deployed at four time points (after both workshops, 6 months into implementation, and at the end of the 2-year funded projects) to measure KT capacity (knowledge, skills, and confidence) and impact on practice change. Qualitative data was analyzed using a general inductive approach and quantitative data was analyzed using non-parametric statistics. Results Participants reported statistically significant increases in knowledge and confidence across both workshops, at the 6-month mark of their projects, and at the end of their projects. In addition, at the 6-month check-in, practitioners reported statistically significant improvements in their ability to implement practice changes. In the first cohort of the program, of the teams who were able to complete their projects, half were able to show demonstrable practice changes. Conclusions The KT Challenge was successful in improving the capacity of HCPs to implement evidence-based practice changes and has begun to show demonstrable improvements in a number of practice areas. The program is relevant to a variety of HCPs working in diverse practice settings and is relatively inexpensive to implement. Like all practice improvement programs in health care settings, a number of challenges emerged stemming from the high turnover of staff and the limited capacity of some practitioners to take on anything beyond direct patient care. Efforts to address these challenges have been added to subsequent cohorts of the program and ongoing evaluation will examine if they are successful. The KT Challenge program has continued to garner great interest among practitioners, even in the midst of dealing with the COVID-19 pandemic, and shows promise for organizations looking for better ways to mobilize knowledge to improve patient care and empower staff. This study contributes to the implementation science literature by providing a description and evaluation of a new model for embedding KT practice skills in health care settings.

Experience of an Interdisciplinary Pediatric Pain Service

PEDIATRICS ◽  
1991 ◽  
Vol 88 (6) ◽  
pp. 1226-1232
Author(s):  
Barbara S. Shapiro ◽  
David E. Cohen ◽  
Kenneth W. Covelman ◽  
Carol J. Howe ◽  
Sam M. Scott
Keyword(s):  
Sickle Cell Disease ◽  
Patient Care ◽  
Sickle Cell ◽  
Health Care Professionals ◽  
Tertiary Care ◽  
Direct Patient Care ◽  
Team Approach ◽  
Cell Disease ◽  
Number Of Patients ◽  
Physician Time

This article is a report of our experience with an interdisciplinary pain service in a large tertiary care pediatric hospital. During the first 2 years of operation, we received 869 consultations and referrals from more than 19 hospital divisions. Postoperative pain was the most frequent reason for consultation (56% of patients). Patients with pain related to cancer and sickle cell disease comprised 25% of the consultations. The remaining patients had a wide variety of primary diagnoses and causes of pain. We calculated the time spent by pain service physicians in direct patient care. The majority (63%) of physician time was spent with a small number of patients (17%). Most of these patients had pain that was unrelated to surgery, cancer, or sickle cell disease, and many posed dilemmas in diagnosis and treatment. Physician time was correlated directly to the use of psychologic and physical therapies for the pain, involving multiple team members. This experience supports the demand for an interdisciplinary pain service in a tertiary care children's hospital. A significant amount of physician time is necessary to provide patient care and to maintain a team approach, however, and pediatricians and other health care professionals who aim to implement such services should be cognizant of the time required.

scholarly journals Safeguarding Abuse in Health Care

2018 ◽  
Vol 12 (2) ◽  
pp. 5-10
Author(s):  
Chanda Karki Bhandari ◽  
Gehanath Baral
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Care Facility ◽  
Health Care Facility ◽  
Healthcare Facility ◽  
Structural Level ◽  
Care Providers ◽  
Ethical Guidelines ◽  
Abuse In Health Care

Aims: The aim of the review is to understand the concept of abuse in health care in general and its various forms. It includes- review what is meant by healthcare and health care abuse; identify its various forms and to recognize who may be the most potential victims; find out the reasons of abuse by health care providers; and know the role of  ethical guidelines and institutional policy in confronting abuse in health care.Methods: Literatures and publications on the subject were searched in order to identify research studies investigating abuse in health care that were studied, analyzed and presented.  Results: Abuse in health care today is an emerging concept in need of a clear analysis and definition. At the same time, boundaries to the related concepts are not demarcated. Medical professionals and institutions are being targeted worldwide today for negligence and the medical litigation has become a huge challenge. Throughout history, health care professionals have been trusted because of their competency and caring abilities. However, the disturbing reality is that physical and psychological maltreatment of patients do occur in the health care settings throughout the world. The abuse can vary from treating someone with disrespect in a way which significantly affects the person's quality of life, to causing actual physical suffering. Differently able and dependent people are more susceptible to such abuse. Work overload, Staff burnout, lack of information and instructions were also indicated to underlie instances of abuse in health care.Conclusions: We in the healthcare facility should first accept that abuse in health care does occur and causes distress. This change needs to occur at individual, cultural and structural level. Next step will be for the staffs to be aware of abuse in health care when it happens and recognize it as such. It is always better to create a situation where we could prevent abuse from happening at health centers. Hospital personnel must implement a change in workplace culture to stop abusive behaviors wherever they occur. Each and every health care facility should be client friendly and respecting their rights. Effective ethical guidelines were needed to minimize abuse as existing ethical codes were found to be ineffective and above all there was a lack of awareness of the contents of the relevant ethical documents.

The Time Needed for Clinical Documentation versus Direct Patient Care

2009 ◽  
Vol 48 (01) ◽  
pp. 84-91 ◽  
Author(s):  
H.-P. Spötl ◽  
E. Ammenwerth
Keyword(s):  
Patient Care ◽  
Health Care Professionals ◽  
Time Pressure ◽  
Direct Patient Care ◽  
Steady Increase ◽  
Clinical Documentation ◽  
Computer Based ◽  
Internal Medicine Wards ◽  
Tion System ◽  
Physician Job Satisfaction

Summary Objectives: Health care professionals seem to be confronted with an increasing need for high-quality, timely, patient-oriented documentation. However, a steady increase in documentation tasks has been shown to be associated with increased time pressure and low physician job satisfaction. Our objective was to examine the time physicians spend on clinical and administrative documentation tasks. We analyzed the time needed for clinical and administrative documentation, and compared it to other tasks, such as direct patient care. Methods: During a 2-month period (December 2006 to January 2007) a trained investigator completed 40 hours of 2-minute work-sampling analysis from eight participating physicians on two internal medicine wards of a 200-bed hospital in Austria. A 37-item classifica tion system was applied to categorize tasks into five categories (direct patient care, communication, clinical documentation, administrative documentation, other). Results: From the 5555 observation points, physicians spent 26.6% of their daily working time for documentation tasks, 27.5% for direct patient care, 36.2% for communication tasks, and 9.7% for other tasks. The documentation that is typically seen as administrative takes only approx. 16% of the total documentation time. Conclusions: Nearly as much time is being spent for documentation as is spent on direct patient care. Computer-based tools and, in some areas, documentation assistants may help to reduce the clinical and administrative documentation efforts.

scholarly journals Internal Medicine Residents' Time Study: Paperwork Versus Patient Care

2011 ◽  
Vol 3 (4) ◽  
pp. 550-553 ◽  
Author(s):  
Dalal Alromaihi ◽  
Amanda Godfrey ◽  
Tina Dimoski ◽  
Paul Gunnels ◽  
Eric Scher ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Health Care ◽  
General Practice ◽  
Patient Care ◽  
Health Care Workers ◽  
Direct Patient Care ◽  
Time Study ◽  
Structured Education ◽  
Internal Medicine Residents ◽  
Care Workers

Abstract Background Multiple factors affect residency education, including duty-hour restrictions and documentation requirements for regulatory compliance. We designed a work sampling study to determine the proportion of time residents spend in structured education, direct patient care, indirect patient care that must be completed by a physician, indirect patient care that may be delegated to other health care workers, and personal activities while on an inpatient general practice unit. Methods The 3-month study in 2009 involved 14 categorical internal medicine residents who volunteered to use personal digital assistants to self-report their location and primary tasks while on an inpatient general practice unit. Results Residents reported spending most of their time at workstations (43%) and less time in patient rooms (20%). By task, residents spent 39% of time on indirect patient care that must be completed by a physician, 31% on structured education, 17% on direct patient care, 9% on indirect patient care that may be delegated to other health care workers, and 4% on personal activities. From these data we estimated that residents spend 34 minutes per patient per day completing indirect patient care tasks compared with 15 minutes per patient per day in direct patient care. Conclusions This single-institution time study objectively quantified a current state of how and where internal medicine residents spend their time while on a general practice unit, showing that residents overall spend less time on direct patient care compared with other activities.

scholarly journals Limiting transmission of COVID-19 in an inpatient psychiatric hospital using a special care unit as a behavioral health model - Michigan, March 1-August 31, 2020

2021 ◽  
Vol 10 (3) ◽  
pp. 25
Author(s):  
William Sanders ◽  
Kimberley Greenwald ◽  
Joshua Foster ◽  
David Meisinger ◽  
Richelle Payea ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Behavioral Health ◽  
Clinical Care ◽  
Psychiatric Hospitals ◽  
Behavioral Health Care ◽  
Special Care ◽  
Direct Patient Care ◽  
Special Care Unit ◽  
Psychiatric Facilities

Approximately 53,000 patients/year are admitted to psychiatric hospitals in Michigan and treatment typically involves social gatherings and group therapies (SAMHSA 2017; Michigan DHS 2019). Often psychiatric inpatients are in close proximity placing them at high risk of infection and have comorbid medical conditions that predispose them to severe COVID-19 consequences. In March 2020, Pine Rest Christian Mental Health Services, Grand Rapids, MI initiated protocols and precautions to mitigate the spread of COVID-19 between patients and health care personnel (HCP) based on emerging CDC guidelines. Multiple strategies [COVID-19 testing, masking of patients and HCP, restricting visitors, and creation of Special Care Unit (SCU) with negative pressure] were effectively implemented and limited transmission of COVID-19 within Pine Rest. Admission to the SCU totaled 25 adults (three Pine Rest patients who tested positive during or after admission, and 22 COVID-19 positive patients who were transferred from other facilities). Average age of SCU inpatients was 38.5 ± 16.6 years with the majority being male. Average hospitalization was 9 ± 4 days. Among the 21 COVID-19 positive HCP, 15 [71%] provided direct clinical care on various units, zero provided care on the SCU, and six had roles with no direct patient care. Average age among COVID-19 positive HCP providing direct patient care[n = 15] was 29.5 ± 13.5 years, majority were female, and 3 [20%] were admitted to local medical hospital for treatment. This report demonstrates that quality behavioral health care can be safely provided at inpatient psychiatric facilities and serve as a guideline that other psychiatric facilities can follow to decrease transmission in future epidemics.

scholarly journals Awareness among health care professionals regarding nosocomial pathogens and role of fomites in their transmission.

2020 ◽  
Vol 27 (05) ◽  
pp. 1032-1037
Author(s):  
Khadija Mumtaz ◽  
Nadia Aslam ◽  
Naima Mehdi ◽  
Nazma Kiran ◽  
Sadaf Farzand ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Nosocomial Infections ◽  
Health Care Professionals ◽  
Basic Knowledge ◽  
Care Hospital ◽  
Nosocomial Pathogens ◽  
Care Workers ◽  
Health Care Associated Infections ◽  
Tract Infections

Objectives: This study was performed to access the knowledge of health care professionals regarding health care associated infections, nosocomial pathogens, fomites and their role in transmission of nosocomial pathogens. Study Design: Descriptive, questionnaire based, cross-sectional study. Setting: Tertiary care hospital of Lahore, Punjab. Period: From October 2017 to January 2018. Material & Methods: Questionnaires were carefully formulated to access basic knowledge of physicians, surgeons and nurses. Responses given were analyzed and recorded as frequency and percentage. Results: Regarding health care associated infections, respiratory tract infections were identified by 72% surgeons, 65% physicians and 59% nurses. Surgical wound infections were identified by 76% of surgeons and 81% nurses. 45.7% physician identified bacteraemia as nosocomial infection. Rate of identification for rest of nosocomial infections was sub optimum (<50%) by health care workers. Regarding identification of nosocomial pathogens, Methicillin Resistant Staphylococcus aureus was marked by 65% of physicians, 83.8% of nurses, 76% of surgeons. Pseudomonas nosocomial pathogen was identified by 40%, 46% and 64% of physicians, nurses and surgeons respectively. The rate of identification for rest of the nosocomial organisms was again sub optimum (<40%) by health care workers. Regarding fomites, mattresses and pillows, thermometer, stethoscopes were identified by 75.7%, 59.2 and 50% of Health care professionals respectively. Conclusion: This survey identified positive attitude among Health care workers towards infection control but low level of knowledge regarding health care associated infections and nosocomial pathogens. Therefore, to prevent nosocomial infections, there is strong need to develop strategies for improving knowledge of Health care professionals.

scholarly journals Examining the role of MEDLINE as a patient care information resource: an analysis of data from the Value of Libraries study

2017 ◽  
Vol 105 (4) ◽  
Author(s):  
Kathel Dunn ◽  
Joanne Gard Marshall ◽  
Amber L. Wells ◽  
Joyce E. B. Backus
Keyword(s):  
Health Care ◽  
Adverse Events ◽  
Patient Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Information Resources ◽  
Information Resource ◽  
Care Providers ◽  
Other Information

Objective: This study analyzed data from a study on the value of libraries to understand the specific role that the MEDLINE database plays in relation to other information resources that are available to health care providers and its role in positively impacting patient care.Methods: A previous study on the use of health information resources for patient care obtained 16,122 responses from health care providers in 56 hospitals about how providers make decisions affecting patient care and the role of information resources in that process. Respondents indicated resources used in answering a specific clinical question from a list of 19 possible resources, including MEDLINE. Study data were examined using descriptive statistics and regression analysis to determine the number of information resources used and how they were used in combination with one another.Results: Health care professionals used 3.5 resources, on average, to aid in patient care. The 2 most frequently used resources were journals (print and online) and the MEDLINE database. Using a higher number of information resources was significantly associated with a higher probability of making changes to patient care and avoiding adverse events. MEDLINE was the most likely to be among consulted resources compared to any other information resource other than journals.Conclusions: MEDLINE is a critical clinical care tool that health care professionals use to avoid adverse events, make changes to patient care, and answer clinical questions.

scholarly journals Perceptions of Interprofessional and Collaborative Practice in Collegiate Athletic Trainers

2018 ◽  
Vol 53 (7) ◽  
pp. 703-708 ◽  
Author(s):  
Dorice Hankemeier ◽  
Sarah A. Manspeaker
Keyword(s):  
Health Care ◽  
Patient Care ◽  
Health Care Professionals ◽  
Current Practice ◽  
Practice Patterns ◽  
Core Competencies ◽  
Athletic Trainers ◽  
Medical Model ◽  
Collaborative Practice ◽  
Cross Sectional

Context:  The ability to engage in interprofessional and collaborative practice (IPCP) has been identified as one of the Institute of Medicine's core competencies required of all health care professionals. Objective:  To determine the perceptions of athletic trainers (ATs) in the collegiate setting regarding IPCP and current practice patterns. Design:  Cross-sectional study. Patients or Other Participants:  Of 6313 ATs in the collegiate setting, 739 (340 men, 397 women, 2 preferred not to answer; clinical experience = 10.97 ± 9.62 years) responded (11.7%). Main Outcome Measure(s):  The Online Clinician Perspectives of Interprofessional Collaborative Practice survey section 1 assessed ATs' perceptions of working with other professionals (construct 1), ATs engaged in collaborative practice (construct 2), influences of collaborative practice (construct 3), and influences on roles, responsibilities, and autonomy in collaborative practice (construct 4). Section 2 assessed current practice patterns of ATs providing patient care and included the effect of communication on collaborative practice (construct 5) and patient involvement in collaborative practice (construct 6). Between-groups differences were assessed using a Kruskal-Wallis H test and Mann-Whitney U tests (P &lt; .05). Results:  Athletic trainers in the collegiate setting agreed with IPCP constructs 1 through 4 (construct 1 = 3.56 ± 0.30, construct 2 = 3.36 ± 0.467, construct 3 = 3.48 ± 0.39, construct 4 = 3.20 ± 0.35) and indicated that the concepts of constructs 5 and 6 (1.99 ± 0.46, 1.80 ± 0.50, respectively) were sometimes true in their setting. Athletic trainers functioning in a medical model reported lower scores for construct 5 (1.88 ± 0.44) than did those in an athletic model (2.03 ± 0.45, U = 19 522.0, P = .001). A total of 42.09% of the ATs' patient care was performed in collaborative practice. Conclusions:  Athletic trainers in the collegiate setting agreed that IPCP concepts were beneficial to patient care but were not consistently practicing in this manner. Consideration of a medical model structure, wherein more regular interaction with other health care professionals occurs, may be beneficial to increase the frequency of IPCP.

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