scholarly journals The Way of Laryngoscope Disinfection: A Survey of Practice in Various Hospitals and Clinics

2021 ◽  
Vol 9 (1) ◽  
pp. 4-10
Author(s):  
Molla Md Rubaiat ◽  
Kazi Ashkar Lateef ◽  
Abdul Quader ◽  
Husain Md Khurshid
Keyword(s):  
Povidone Iodine ◽  
Soap Solution ◽  
Improve Patient Safety ◽  
Tap Water ◽  
National Level ◽  
Chemical Agent ◽  
Source Of Infection ◽  
Potential Source ◽  
Contact Data ◽  
Improve Patient

Background and Aims: During general anaesthesia, laryngoscope is a common equipment for intubation used by anaesthesiologists. Laryngoscope has been identified as a potential source of cross infection. Though guidelines exist for appropriate disinfection practices, recent reviews suggested that current methods of disinfection areless effective and compliance is poor with the established protocols. We conducted a questionnaire-based survey to study the current disinfection practices being followed by a cross section of anaesthesiologists. Methods: A simple questionnaire containing 14 questions was distributed amongst anaesthesiologists through online as well as direct contact. Data were analyzed with percentage analysis. Results: Out of 150 anaesthesiologists, 120 submitted the completed questionnaires. Residents constituted 41% and 46% were consultants. Eighteen (12%) used only tap water for cleaning and 132 (88%) used a chemical agent after rinsing with water. Out of 132, 76 (51%) used detergent/soap solution, 29 (19%) would wash and then soak in disinfectant or germicidal agents (glutaraldehyde, povidone iodine and chlorhexidine) and 18 (12%) would wipe the blade with an alcohol swab. With respect to disinfection of laryngoscope handles, 70% respondents said they used an alcohol swab, 18% did not use any method, 9% were not aware of the method being used, while 3% did not respond. Conclusion: Our results indicate wide variation in methods of decontamination of laryngoscopes. Awareness regarding laryngoscope as a potential source of infection was high. We need to standardize and implement guidelines on a national level and make available resources which will help to improve patient safety. CBMJ 2020 January: Vol. 09 No. 01 P: 04-10

Examination of Bottled Water for Nontuberculous Mycobacteria

1997 ◽  
Vol 60 (2) ◽  
pp. 185-187 ◽  
Author(s):  
ALAN E. HOLTZMAN ◽  
TIMOTHY W. ARONSON ◽  
NORMAN GLOVER ◽  
SEYMOUR FROMAN ◽  
GERARD N. STELMA ◽  
...  
Keyword(s):  
High Risk ◽  
Los Angeles ◽  
Oxalic Acid ◽  
Nontuberculous Mycobacteria ◽  
Tap Water ◽  
Cetylpyridinium Chloride ◽  
Bottled Water ◽  
Source Of Infection ◽  
Potential Source ◽  
Risk Patients

The objective of this study was to examine bottled water for the presence of nontuberculous mycobacteria as a potential source of infection in AIDS patients. Twenty brands of bottled water commonly used in the Los Angeles area were tested for the presence of nontuberculous mycobacteria. The three brands most commonly used in the Los Angeles area were tested most frequently. Sixty-nine samples were filtered and the filters were treated using cetylpyridinium chloride, sodium hydroxide, or oxalic acid (or a combination of these) as decontaminants to remove background flora. An aliquot of each sample was untreated. The filters were placed on selective Middlebrook 7H10 agar plates containing 500 μg of cycloheximide per ml. Plates were examined at 3 and 8 weeks. No acid-fast organisms were found. Although no nontuberculous mycobacteria were observed in any samples tested, before recommending the use of bottled water as an alternative to tap water by high-risk patients, the possible presence of other contaminants must be considered.

‘Do not Do’ Recommendations in Hemophilia

2020 ◽  
Vol 20 (3) ◽  
pp. 168-174
Author(s):  
Hortensia De la Corte-Rodriguez ◽  
E. Carlos Rodriguez-Merchan ◽  
M. Teresa Alvarez-Roman ◽  
Monica Martin-Salces ◽  
Victor Jimenez-Yuste
Keyword(s):  
Improve Patient Safety ◽  
Health Resources ◽  
Fresh Frozen Plasma ◽  
Factor Ix ◽  
Levels Of Care ◽  
Fresh Frozen ◽  
History Of ◽  
Improve Patient ◽  
Different Levels ◽  
Frozen Plasma

Background: It is important to discard those practices that do not add value. As a result, several initiatives have emerged. All of them try to improve patient safety and the use of health resources. Purpose: To present a compendium of "do not do recommendations" in the context of hemophilia. Methods: A review of the literature and current clinical guidelines has been made, based on the best evidence available to date. Results: The following 13 recommendations stand out: 1) Do not delay the administration of factor after trauma; 2) do not use fresh frozen plasma or cryoprecipitate; 3) do not use desmopressin in case of hematuria; 4) do not change the product in the first 50 prophylaxis exposures; 5) do not interrupt immunotolerance; 6) do not administer aspirin or NSAIDs; 7) do not administer intramuscular injections; 8) do not do routine radiographs of the joint in case of acute hemarthrosis; 9) Do not apply closed casts for fractures; 10) do not discourage the performance of physical activities; 11) do not deny surgery to a patient with an inhibitor; 12) do not perform instrumental deliveries in fetuses with hemophilia; 13) do not use factor IX (FIX) in patients with hemophilia B with inhibitor and a history of anaphylaxis after administration of FIX. Conclusions: The information mentioned previously can be useful in the management of hemophilia, from different levels of care. As far as we know, this is the first initiative of this type regarding hemophilia.

scholarly journals Writing’s on the wall: improving the WHO Surgical Safety Checklist

2021 ◽  
Vol 10 (1) ◽  
pp. e001086
Author(s):  
Claire Cushley ◽  
Tom Knight ◽  
Helen Murray ◽  
Lawrence Kidd
Keyword(s):  
Patient Safety ◽  
Online Survey ◽  
Improve Patient Safety ◽  
Surgical Safety Checklist ◽  
Surgical Safety ◽  
Time Out ◽  
Mandatory Requirement ◽  
Who Checklist ◽  
Improve Patient ◽  
Theatre Team

Background and problemThe WHO Surgical Safety Checklist has been shown to improve patient safety as well as improving teamwork and communication in theatres. In 2009, it was made a mandatory requirement for all NHS hospitals in England and Wales. The WHO checklist is intended to be adapted to suit local settings and was modified for use in Gloucestershire Hospitals NHS Foundation Trust. In 2018, it was decided to review the use of the adapted WHO checklist and determine whether improvements in compliance and engagement could be achieved.AimThe aim was to achieve 90% compliance and engagement with the WHO Surgical Safety Checklist by April 2019.MethodsIn April 2018, a prospective observational audit and online survey took place. The results showed compliance for the ‘Sign In’ section of the checklist was 55% and for the ‘Time Out’ section was 91%. Engagement by the entire theatre team was measured at 58%. It was proposed to move from a paper checklist to a wall-mounted checklist, to review and refine the items in the checklist and to change the timing of ‘Time Out’ to ensure it was done immediately prior to knife-to-skin.ResultsFollowing its introduction in September 2018, the new wall-mounted checklist was reaudited. Compliance improved to 91% for ‘Sign In’ and to 94% for ‘Time Out’. Engagement by the entire theatre team was achieved 100% of the time. Feedback was collected, adjustments made and the new checklist was rolled out in stages across all theatres. A reaudit in December 2018 showed compliance improved further, to 99% with ‘Sign In’ and to 100% with ‘Time Out’. Engagement was maintained at 100%.ConclusionsThe aim of the project was met and exceeded. Since April 2019, the new checklist is being used across all theatres in the Trust.

scholarly journals Understanding safety in healthcare: the system evolution, erosion and enhancement model

2013 ◽  
Vol 2 (3) ◽  
pp. 25 ◽  
Author(s):  
Jane Carthey
Keyword(s):  
Patient Safety ◽  
Complex Systems ◽  
Human Error ◽  
Improve Patient Safety ◽  
New Model ◽  
System Evolution ◽  
Accident Causation ◽  
System Migration ◽  
Improve Patient

The paper summarises previous theories of accident causation, human error, foresight, resilience and system migration. Five lessons from these theories are used as the foundation for a new model which describes how patient safety emerges in complex systems like healthcare: the System Evolution Erosion and Enhancement model. It is concluded that to improve patient safety, healthcare organisations need to understand how system evolution both enhances and erodes patient safety.

scholarly journals A data-driven metapopulation model for the Belgian COVID-19 epidemic: assessing the impact of lockdown and exit strategies

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pietro Coletti ◽  
Pieter Libin ◽  
Oana Petrof ◽  
Lander Willem ◽  
Steven Abrams ◽  
...  
Keyword(s):  
Phase 1 ◽  
Leisure Activities ◽  
National Level ◽  
Social Contact ◽  
Exit Strategy ◽  
Initial Wave ◽  
Contact Data ◽  
Stochastic Data ◽  
The Impact ◽  
Second Wave

Abstract Background In response to the ongoing COVID-19 pandemic, several countries adopted measures of social distancing to a different degree. For many countries, after successfully curbing the initial wave, lockdown measures were gradually lifted. In Belgium, such relief started on May 4th with phase 1, followed by several subsequent phases over the next few weeks. Methods We analysed the expected impact of relaxing stringent lockdown measures taken according to the phased Belgian exit strategy. We developed a stochastic, data-informed, meta-population model that accounts for mixing and mobility of the age-structured population of Belgium. The model is calibrated to daily hospitalization data and is able to reproduce the outbreak at the national level. We consider different scenarios for relieving the lockdown, quantified in terms of relative reductions in pre-pandemic social mixing and mobility. We validate our assumptions by making comparisons with social contact data collected during and after the lockdown. Results Our model is able to successfully describe the initial wave of COVID-19 in Belgium and identifies interactions during leisure/other activities as pivotal in the exit strategy. Indeed, we find a smaller impact of school re-openings as compared to restarting leisure activities and re-openings of work places. We also assess the impact of case isolation of new (suspected) infections, and find that it allows re-establishing relatively more social interactions while still ensuring epidemic control. Scenarios predicting a second wave of hospitalizations were not observed, suggesting that the per-contact probability of infection has changed with respect to the pre-lockdown period. Conclusions Contacts during leisure activities are found to be most influential, followed by professional contacts and school contacts, respectively, for an impending second wave of COVID-19. Regular re-assessment of social contacts in the population is therefore crucial to adjust to evolving behavioral changes that can affect epidemic diffusion.

Atmung – Standardisierte Checkliste macht Intubation von Neugeborenen sicherer

2017 ◽  
Vol 22 (03) ◽  
pp. 124-125
Author(s):  
Maria Weiß
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Improve Patient Safety ◽  
Improve Patient

Hatch LD. et al. Intervention To Improve Patient Safety During Intubation in the Neonatal Intensive Care Unit. Pediatrics 2016; 138: e20160069 Kinder auf der Neugeborenen-Intensivstation sind besonders durch Komplikationen während des Krankenhausaufenthaltes gefährdet. Dies gilt auch für die Intubation, die relativ häufig mit unerwünschten Ereignissen einhergeht. US-amerikanische Neonatologen haben jetzt untersucht, durch welche Maßnahmen sich die Komplikationsrate bei Intubationen in ihrem Perinatal- Zentrum senken lässt.

Allogeneic blood transfusion and AIS surgery: how the NSQIP database can improve patient safety

2021 ◽  
Author(s):  
Hady Eltayeby ◽  
Catherine Brown ◽  
Brendan T. Campbell ◽  
Craig Bonanni ◽  
Mark Indelicato ◽  
...  
Keyword(s):  
Patient Safety ◽  
Blood Transfusion ◽  
Improve Patient Safety ◽  
Allogeneic Blood Transfusion ◽  
Allogeneic Blood ◽  
Improve Patient
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