scholarly journals Educational Interventions on Pregnancy Vaccinations during Childbirth Classes Improves Vaccine Coverages among Pregnant Women in Palermo’s Province

Vaccines ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1455
Author(s):  
Claudio Costantino ◽  
Walter Mazzucco ◽  
Nicole Bonaccorso ◽  
Livia Cimino ◽  
Arianna Conforto ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Pregnant Women ◽  
Educational Intervention ◽  
Influenza Infection ◽  
Educational Interventions ◽  
Medical Doctor ◽  
Full Time ◽  
Pertussis Infection ◽  
Cross Sectional ◽  
Maternal Immunization

Maternal immunization is considered the best intervention in order to prevent influenza infection of pregnant women and influenza and pertussis infection of newborns. Despite the existing recommendations, vaccination coverage rates in Italy remain very low. Starting from August 2018, maternal immunization against influenza and diphtheria-tetanus-pertussis were strongly recommended by the Italian Ministry of Health. We conducted a cross sectional study to estimate the effectiveness of an educational intervention, conducted during childbirth classes in three general hospitals in the Palermo metropolitan area, Italy, on vaccination adherence during pregnancy. To this end, a questionnaire on knowledge, attitudes, and immunization practices was structured and self-administered to a sample of pregnant women attending childbirth classes. Then, an educational intervention on maternal immunization, followed by a counseling, was conducted by a Public Health medical doctor. After 30 days following the interventions, the adherence to the recommended vaccinations (influenza and pertussis) was evaluated. At the end of the study 326 women were enrolled and 201 responded to the follow-up survey. After the intervention, among the responding pregnant women 47.8% received influenza vaccination (+44.8%), 57.7% diphtheria-tetanus-pertussis vaccination (+50.7%) and 64.2% both the recommended vaccinations (+54.8%). A significant association was found between pregnant women that received at least one vaccination during pregnancy and higher educational level (graduation degree/master’s degree), employment status (employed part/full-time) and influenza vaccination adherence during past seasons (at least one during last five years). The implementation of vaccination educational interventions, including counseling by healthcare professionals (HCPs), on maternal immunization during childbirth courses improved considerably the vaccination adherence during pregnancy.

scholarly journals 31. Influenza Vaccination During Pregnancy: A Descriptive Cross-sectional Survey of the Knowledge, Beliefs, and Attitudes of Mexican Gynecologists and Family Physicians

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S39-S39
Author(s):  
Erika Z Lopatynsky-Reyes ◽  
Sue Ann Costa-Clemens ◽  
Enrique Chacon-Cruz ◽  
Michael Greenberg
Keyword(s):  
Influenza Vaccination ◽  
Pregnant Women ◽  
Latin American ◽  
Vaccine Coverage ◽  
Family Physicians ◽  
Morbidity And Mortality ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Beliefs And Attitudes ◽  
In Pregnancy

Abstract Background Influenza in pregnancy is associated with elevated morbidity and mortality. Influenza vaccines are both safe and effective in pregnancy, supporting routine use in this population. Even though influenza vaccination in Mexico is recommended for pregnant women, there are no publications of influenza vaccine coverage in pregnancy. This is the first Latin American survey done only in physicians aiming to assess the knowledge, beliefs, and attitudes that Mexican Obstetrics-Gynecologists (OBG) and Family Physicians (FP) have towards influenza and influenza immunization during pregnancy. Methods A cross-sectional survey was conducted, both paper-based and online. The questionnaire was composed of 35 questions, which addressed general knowledge of influenza, recommendations for vaccination during pregnancy, and beliefs and attitudes concerning the acceptability of the vaccine in pregnant women. Results A total of 206 completed surveys were available, 98 (47.6%) from OBG, 108 (52.4%) from FP. Regarding current practicing medical institutions, 76 (37%), 69 (34%), 31 (14.5%), 30 (14.5%) reported working for the Mexican Institute of Social Security, Private Sector, Secretariat of Health, or a combination of all respectively, representing an estimated 2,472 daily pregnancy consultations. About a quarter (26.2%) reported not having a notion that influenza is more severe among pregnant women. More than half (51.5%) ignored the potential side effects of influenza infection on the fetus. The majority (56.8%) did not know when vaccination during pregnancy should occur. Pregnancy as a risk factor for developing influenza complications was known only in 48.1%. Also, 46.1 % believed that vaccination only confers protection to the mother, but not to the fetus. Nevertheless, 96.1% considered that immunization against influenza during pregnancy is a safe and effective preventive intervention. A results’ summary is shown in Figure-1. Conclusion Based on this survey, current knowledge of OBG and FP for influenza morbidity and mortality during pregnancy, and the importance of influenza vaccination in pregnant women, is poor. Mandatory recommendations to educate medical providers regarding influenza vaccination during pregnancy in Mexico are necessary, even as imperative for CME credits. Disclosures All Authors: No reported disclosures

Influenza Vaccination Among Registered Nurses: Information Receipt, Knowledge, and Decision-Making at an Institution With a Multifaceted Educational Program

2008 ◽  
Vol 29 (2) ◽  
pp. 99-106 ◽  
Author(s):  
Cori L. Ofstead ◽  
Sharon J. Tucker ◽  
Timothy J. Beebe ◽  
Gregory A. Poland
Keyword(s):  
Influenza Vaccination ◽  
Registered Nurses ◽  
Educational Program ◽  
Medical Center ◽  
Vaccine Safety ◽  
Educational Interventions ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Vaccination Rates ◽  
To Receive

Objective.To evaluate the receipt of information and knowledge about influenza and vaccination, as well as influenza vaccination status and reasons for declining vaccination, among registered nurses.Design.Cross-sectional survey of registered nurses (RNs).Setting.A large tertiary medical center with a long-standing, multifaceted influenza vaccination program and relatively high vaccination rates among employees overall (76.5%).Participants.Randomly selected group of 990 RNs employed as inpatient staff nurses at the institution.Results.The survey was completed by 513 (51.8%) of 990 RNs. Most RNs (86.7%) had received an influenza vaccination in the past, and 331 (64.5%) intended to receive vaccination during the 2005-2006 influenza season. More than 90% of RNs acknowledged exposure to educational bulletins, and most had received information about influenza severity (383 [74.7%]), transmission (398 [77.6%]), vaccine safety (416 [81.1%]), and the time and location of free vaccination (460 [89.7%]). A majority (436 [85.0%]) felt they had received all the information they needed to make good decisions about vaccination. However, only 49 RNs (9.6%) gave correct answers to more than 85% of the knowledge questions on the survey. The reasons most frequently reported for declining vaccination were doubts about the risk of influenza and the need for vaccination, concerns about vaccine effectiveness and side effects, and dislike of injections.Conclusions.RNs exposed to a longstanding, multifaceted educational program had received information about influenza vaccination, but misconceptions were common and only 331 (64.5%) intended to receive vaccination. Strategies other than educational interventions are needed to increase influenza vaccination rates and thereby to ensure healthcare worker and patient safety.

scholarly journals Population-based survey of HIV sero-status and vertical transmission among naive pregnant women in Sokoto, Nigeria

2014 ◽  
Vol 6 (3) ◽  
pp. 49-57 ◽  
Author(s):  
Fiekumo Igbida Buseri ◽  
Charity Ngozi Okonkwo
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Statistical Significance ◽  
Demographic Data ◽  
Age Groups ◽  
P Value ◽  
Full Time ◽  
Cross Sectional ◽  
Significant Difference

Background: This study aims at investigating the seroprevalence of HIV infection among status naive pregnant women and probable vertical transmission in Sokoto, Nigeria.Materials and Methods: This cross-sectional study examined 13,026 apparently healthy pregnant women aged between 14 and 45 years and 312 mother-baby pairs in 4 different hospital settings in Sokoto State, North West, Nigeria between March, 2011 and February, 2013. The babies were aged between 8 and 16 months. HIV screening was performed using qualitative rapid tests and ELISA and HIV-DNA polymerase chain reaction (PCR) techniques. Measurement of CD4+ T-lymphocytes was carried out by the BD FACScount System. All seropositive pregnant women were immediately placed on triple antiretroviral therapy (ART) throughout the duration of the pregnancy and beyond.Results: An overall 2.4% prevalence of HIV-1 infection among the pregnant women and 20.5% incident of mother-to-child transmission were found. Of the seropositive pregnant women, 75.0% were full-time house wives, 13.8% and 11.2% were traders and civil servants respectively; of which, 70.2% were within the ages of 14 and 27 years (youthful predominance). Pearson’s χ2analysis did not show any statistically significant difference in the Mean values in the 4 health facilities (χ2 =2.084, df=3, P-value=0.555). Similarly, no significant difference in HIV seropositivity in the demographic data of the pregnant women were observed (P>0.05). Infection was recorded in all age groups but there was no statistical significance between age groups and infection (P = 0.833). Of the 64 seropositive babies, 62 (92.5%) contracted HIV from antiretroviral therapy non-adherence mothers (χ2 =271.457, df=1, P<0.01), OR=1506.6 (95%CI=285.5-7950.4). Conclusion: This study found high prevalence of vertical transmission due to ART non-adherence. Intervention initiatives should, therefore, focus seriously on ART non-adherence. DOI: http://dx.doi.org/10.3126/ajms.v6i3.11530Asian Journal of Medical Sciences Vol.6(3) 2015 49-57  

Impact of Severe Acute Respiratory Syndrome and the Perceived Avian Influenza Epidemic on the Increased Rate of Influenza Vaccination Among Nurses in Hong Kong

2008 ◽  
Vol 29 (3) ◽  
pp. 256-261 ◽  
Author(s):  
Dennise K. P. Tam ◽  
Shui-Shan Lee ◽  
Sing Lee
Keyword(s):  
Hong Kong ◽  
Avian Influenza ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Influenza Infection ◽  
Vaccination Rate ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Major Barrier ◽  
Vaccination Rates

Objective.To determine the rate of influenza vaccination and the factors associated with the vaccination's acceptance among nurses in Hong Kong.Design.Cross-sectional survey.Participants.Nurses practicing between 2003 and 2007.Methods.A questionnaire was sent to all nurses registered with any of the 3 nursing associations that participated in this study.Results.A total of 941 completed questionnaires were available for analysis, though not all nurses responded to every question (response rate, 33.5%-36.3%). Vaccination rates in 2006 and 2007 were 57.2% and 46.2%, respectively. Nurses who were vaccinated in 2006 were more likely to get vaccinated in 2007 (P<.01); 56% of the nurses perceived influenza vaccine as being effective against influenza. The perceived effectiveness of influenza vaccine was a consistent predictor of rates of vaccination in 2006 (odds ratio [OR], 8.47 [95% confidence interval {CI}, 6.13-11.70];P<.01) and 2007 (OR, 6.05 [95% CI, 3.79-9.67];P<.01). Concern about contracting avian influenza was a predictor of the vaccination rate in 2006 but not in 2007 (OR, 1.47 [95% CI, 1.03-2.09];P<.05), as was the perceived lack of control over avian influenza infection (OR, 1.52 [95% CI, 1.06-2.18];P<.05).Conclusions.The overall influenza vaccination rate for nurses in Hong Kong was about 50%. It was affected by the perceived threat of an impending outbreak. The attitudes of nurses toward the effectiveness of and rationale for vaccination were a major barrier to increasing the rate of vaccination.

scholarly journals A COMPARATIVE SURVEY OF KNOWLEDGE OF ANTISEPTIC AND DISINFECTANT USE AND EFFECT OF INTERVENTION ON MEDICAL AND SURGICAL STAFF NURSES IN A TERTIARY CARE HOSPITAL

2018 ◽  
Vol 11 (1) ◽  
pp. 120
Author(s):  
Chattar Kanchan ◽  
Dabhade Sangeeta ◽  
Ghongane Balasaheb
Keyword(s):  
Educational Intervention ◽  
Positive Impact ◽  
Tertiary Care ◽  
Educational Interventions ◽  
Cross Sectional Study ◽  
Individual Response ◽  
Care Hospital ◽  
Cross Sectional ◽  
Post Test ◽  
Retention Of Knowledge

Objective: The study was carried out to find the knowledge and awareness of medical and surgical section nurses about the use of antiseptic and disinfectants and the immediate and late impact of an educational intervention like seminar and workshop in the knowledge of nurses.Method: This is a questionnaire-based pre- and post-test cross-sectional study.  200 nurses [100 working in medical wards and 100 working in surgical wards and Operation theatre (O.T.)] were selected using random number sampling method.  First a pre-test was given. Then an educational intervention in the form of power point presentation was carried out and post-test was given. One more test was carried out 1 month after post-test to check retention of knowledge by nurses.Result: In both medical and surgical pre-test, most of the questions answered correctly were in below 25% response. While in post-test number of the questions answered correctly was increased and maximum number of number of the questions solved correctly were between 50-75% and 75-100 percent. Individual response in the pre-test both medical and surgical nurses showed that maximum number of nurses have responses between 25-50% and 50-75% while response rate has increased in post-test where maximum number of responses were between 75-100%.Conclusion: Our study suggests that educational intervention has positive impact on the knowledge of nurses. There is a need to carry out such educational interventions periodically which will be helpful for better retention of knowledge by nurses. 

scholarly journals Prevalence of and factors associated with receipt of provider recommendation for influenza vaccination and uptake of influenza vaccination during pregnancy: cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alexandra Brixner ◽  
Susanne Brandstetter ◽  
Merle M. Böhmer ◽  
Birgit Seelbach-Göbel ◽  
Michael Melter ◽  
...  
Keyword(s):  
Influenza Vaccination ◽  
Pregnant Women ◽  
Cross Sectional Study ◽  
Vaccine Uptake ◽  
Health Study ◽  
Health Services Use ◽  
Cross Sectional ◽  
Vaccination Uptake ◽  
Risk Pregnancy ◽  
Vaccination Recommendation

Abstract Background Seasonal influenza vaccination has been recommended for pregnant women in Germany since 2010. The aim of this study was to examine prevalence and determinants of receipt of provider recommendation for influenza vaccination as well as influenza vaccination uptake during pregnancy. Methods We analysed data from the “KUNO Kids Health Study”, a prospective birth cohort. During the study period (5th July 2015 to 27th June 2018) data were collected from participating mothers by interview and questionnaire. According to Andersen’s behavioural model of health services use potential influencing factors describing the circumstances and characteristics of the mothers and their pregnancies which are potentially affecting whether women receive a recommendation for a vaccination or whether they utilize influenza vaccination were classified into three domains: ‘predisposing characteristics’, ‘enabling resources’ and ‘need’. Using multivariable logistic regression models odds ratios (OR) and corresponding 95% confidence intervals (95% CI) were calculated. Results As a combined result across three flu seasons, 368 of 1814 (20.3%) women received an influenza vaccination recommendation during pregnancy. Having had a high-risk pregnancy increased the odds of receiving a vaccination recommendation (OR = 1.3; 95% CI = 1.0–1.6; p = 0.045). In contrast, pregnancy onset in summer (OR = 0.7; 95% CI = 0.5–1.0; p = 0.027), autumn (OR = 0.4; 95% CI = 0.3–0.5; p < =0.001) or winter (OR = 0.5; 95% CI = 0.3–0.6; p < =0.001) (compared to spring) as well as mother’s birthplace outside Germany (OR = 0.6; 95% CI = 0.4–0.9; p = 0.023) reduced the chance of getting a vaccination recommendation. Two hundred forty-two of one thousand eight hundred sixty-five (13%) women were vaccinated against influenza during pregnancy. Having received a vaccination recommendation was strongly associated with vaccination uptake (OR = 37.8; 95% CI = 25.5–55.9; p < =0.001). Higher health literacy status was also associated with a higher chance of vaccination uptake (OR = 1.7; 95% CI = 1.2–2.6; p = 0.008), whereas pregnancy onset in autumn (compared to spring) reduced the chance (OR = 0.5; 95% CI = 0.3–0.8; p = 0.008). Conclusions At 13% the uptake rate of influenza vaccination is low. Having received a recommendation to vaccinate was strongly associated with uptake but only one fifth of all mothers report such a recommendation. Raising awareness in physicians regarding vaccinating during pregnancy seems to be of essential importance to increase vaccine uptake and to prevent influenza-related complications in pregnant women.

scholarly journals The correlation between midwives’ support and accessed to Voluntary Counseling and Testing (VCT) on pregnant women

2018 ◽  
Vol 1 (2) ◽  
pp. 81-86
Author(s):  
Elfa Rahmawati Fitri ◽  
Herlin Fitriana Kurniawati
Keyword(s):  
Pregnant Women ◽  
Health Center ◽  
Sampling Technique ◽  
Full Time ◽  
Primary Health Center ◽  
Cross Sectional ◽  
Voluntary Counseling ◽  
Voluntary Counseling And Testing ◽  
Primary Health ◽  
Counseling And Testing

HIV/AIDS cases in Indonesia are still high including the infection from mothers to the babies. Infection cases from mothers to babies in Yogyakarta Special Province is also found on babies. The preliminary study also obtained the result that in 2015 not all of the pregnant women who were willing to have VCT (Voluntary Counseling and Testing) in Sleman Regency working area. The data of VCT  in Prambanan Primary Health Center also shows that the prevalence rate of VCT check as a preventive effort was still low. The research is aimed at investigating the correlation between midwife’s support and VCT on pregnant women in Prambanan Primary Health Center in 2016. The study employed observational analytic with a cross-sectional approach. The population of the study was all mothers who did pregnancy examination and got counseling VCT service. The samples used accidental sampling technique. Data analysis used chi-square with the trustworthy rate 95%. The result of the study showed that there was no correlation between midwife and VCT on pregnant women. It can happen because of the midwife as a professional attendant could not attend the pregnant women full time. It can be concluded that there was no correlation between midwife’s support and VCT on pregnant women in Prambanan Primary Health Center in 2016. It is expected that midwives can identify the problem in VCT on pregnant women by giving emotional and respect support to the patients as well as the families.

scholarly journals Do Turkish Gynecologists and Obstetricians recommend pregnant women the influenza vaccine?

2020 ◽  
Vol 2 (1) ◽  
pp. 16-23
Author(s):  
Irem Akdemir Kalkan ◽  
Ayşe Nur Usturalı Mut ◽  
Gule Cinar ◽  
Fatih Keskin ◽  
Kemal Osman Memikoglu ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Pregnant Women ◽  
Social Insurance ◽  
Viral Infections ◽  
Multivariate Logistic Regression Analysis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Vaccination Rates ◽  
Immunization Rates

Objective: Influenza is a systemic infectious disease. It is recommended that all pregnant women receive the influenza vaccine because the mortality of the disease is high during pregnancy. However, the rates of influenza vaccination in pregnant women are low. This study aims to estimate the rate at which Turkish gynecologists and obstetricians (GOs) recommend the influenza vaccine to their pregnant patients.. Materials and Methods: This study was designed as a cross-sectional survey. The sample size was calculated to be 364 based on 95% confidence interval and 5% margin of error. The data were collected through a questionnaire consisting of 17 questions, which was distributed through social media. The final study group included in the research consisted of 384 GOs. Results:The mean age of the GOs that participated in the study was 39.7 years (SD = 10.2). 43.5% of the GOs reported that they recommended the influenza vaccine to pregnant women who had consulted with them, while 62.8% reported that at least 50% of the pregnant women they had recommended the vaccine rejected it. According to multivariate logistic regression analysis, three factors increased the rate of GOs’ not to recommend influenza vaccination: the GOs’ age, not receiving influenza vaccination themselves, and not knowing the social insurance reimbursement for the vaccine. Conclusion: Vaccination of pregnant women is necessary because of the increased mortality risk of influenza during pregnancy. Even though GOs are not in charge of vaccinating their patients during their routine pregnancy follow-up, they can contribute to vaccination rates by recommending the vaccine. Physicians’ application of scientific knowledge and transferring it to their patients can contribute to increased adult immunization rates. Conclusion: Influenza, Influenza Vaccine, Pregnancy, Vaccination, Viral Infections

scholarly journals A COMPARATIVE SURVEY OF KNOWLEDGE OF ANTISEPTIC AND DISINFECTANT USE AND EFFECT OF INTERVENTION ON MEDICAL AND SURGICAL STAFF NURSES IN A TERTIARY CARE HOSPITAL

2018 ◽  
Vol 11 (1) ◽  
pp. 120
Author(s):  
Chattar Kanchan ◽  
Dabhade Sangeeta ◽  
Ghongane Balasaheb
Keyword(s):  
Educational Intervention ◽  
Positive Impact ◽  
Tertiary Care ◽  
Educational Interventions ◽  
Cross Sectional Study ◽  
Individual Response ◽  
Care Hospital ◽  
Cross Sectional ◽  
Post Test ◽  
Retention Of Knowledge

Objective: The study was carried out to find the knowledge and awareness of medical and surgical section nurses about the use of antiseptic and disinfectants and the immediate and late impact of an educational intervention like seminar and workshop in the knowledge of nurses.Method: This is a questionnaire-based pre- and post-test cross-sectional study.  200 nurses [100 working in medical wards and 100 working in surgical wards and Operation theatre (O.T.)] were selected using random number sampling method.  First a pre-test was given. Then an educational intervention in the form of power point presentation was carried out and post-test was given. One more test was carried out 1 month after post-test to check retention of knowledge by nurses.Result: In both medical and surgical pre-test, most of the questions answered correctly were in below 25% response. While in post-test number of the questions answered correctly was increased and maximum number of number of the questions solved correctly were between 50-75% and 75-100 percent. Individual response in the pre-test both medical and surgical nurses showed that maximum number of nurses have responses between 25-50% and 50-75% while response rate has increased in post-test where maximum number of responses were between 75-100%.Conclusion: Our study suggests that educational intervention has positive impact on the knowledge of nurses. There is a need to carry out such educational interventions periodically which will be helpful for better retention of knowledge by nurses. 

Prescribers’ experience and opinions on antimicrobial stewardship programmes in hospitals: a French nationwide survey

2019 ◽  
Vol 74 (8) ◽  
pp. 2451-2458 ◽  
Author(s):  
A Perozziello ◽  
F X Lescure ◽  
A Truel ◽  
C Routelous ◽  
L Vaillant ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Improve Patient Care ◽  
Nationwide Survey ◽  
Educational Interventions ◽  
Antibiotic Consumption ◽  
Full Time ◽  
Core Element ◽  
Cross Sectional ◽  
Attending Physicians ◽  
Improve Patient

Abstract Objectives To assess prescribers’ experiences and opinions regarding antimicrobial stewardship programme (ASP) activities. Methods A cross-sectional paper-based survey was conducted among prescribers in 27 out of 35 randomly selected large hospitals in France. Results All 27 investigated hospitals (20 non-university public, 4 university-affiliated and 3 private hospitals) had an ASP and an appointed antibiotic advisor (AA), with a median of 0.9 full-time equivalents per 1000 acute-care beds (IQR 0–1.4). Of the 1963 distributed questionnaires, 920 were completed (46.9%). Respondents were mainly attending physicians (658/918, 71.7%) and medical specialists (532/868, 61.3%). Prescribers identified two main ASP objectives: to limit the spread of resistance (710/913, 77.8%) and to improve patient care and prognosis (695/913, 76.1%). The presence of an AA constituted a core element of ASP (96.2% agreement between answers of ASP leader and respondents). Respondents acknowledged an AA’s usefulness especially on therapeutic issues, i.e. choosing appropriate antibiotic (agreement 84.7%) or adapting treatment (89.6%), but less so on diagnostic issues (31.4%). Very few respondents reported unsolicited counselling and post-prescription controls. Three-quarters of prescribers identified local guidelines (692/918, 75.4%). Prescribers did not approve of measures counteracting their autonomy, i.e. automatic stop orders (agreement 23.4%) or pre-approval by AAs (28.8%). They agreed more with educational interventions (73.0%) and clinical staff meetings (70.0%). Conclusions Prescribers perceived ASP mainly through its ‘on-demand’ counselling activities. They preferred measures that did not challenge their clinical autonomy. High levels of antibiotic consumption in French hospitals bring into question the effectiveness of such an approach. However, limited ASP staffing and resources may preclude extended activities.

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