Positive Impact of Nurses on Infection Control and Practices Prevention Regarding Affect the Clinical Environment

117 Background: The province of Ontario is committed to improving palliative care services. This commitment to change is outlined in The Declaration of Partnership, the provincial roadmap for improving palliative care. To help drive this change in the clinical environment, a Clinical Council for Palliative Care was established to be responsible for providing direction on clinical implications of policy, and advancing clinical improvement in palliative care in Ontario. To this end, Clinical Council has articulated a set of 12 interrelated provincial clinical standards which outline priority areas for clinical change and improvement in the province. Methods: Key stakeholder engagement was undertaken to identify evidence-based, best practices for delivery of palliative services. A consensus process was used to identify the priority set of essential clinical standards for high quality care that is both practical and scalable. Expert working groups were established to refine the standards based on evidence and leading or best practice to the Ontario context. Response was solicited from stakeholders, and qualitative analysis was conducted; standards will be refined based on feedback. Results: Based on the results of the stakeholder engagement, a “Clinical Change Strategy” was identified and a set 12 “clinical imperatives” were identified. Through the consensus process 12 Provincial Clinical Standards were endorsed. Conclusions: Engaging in an evidence informed process with key stakeholders has enabled the creation of a set of 12 interconnected Provincial Clinical Standards for palliative care in Ontario. These standards will help to advance high quality palliative care in the province. The standards represent a population health based strategy for change, which can have a positive impact at the systems level. Stakeholder feedback will result in further refinement of the standards, which will ultimately provide the foundation for standardized approaches for palliative services across Ontario.

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Canadian Internal Medicine Ultrasound (CIMUS) Recommendations Regarding Internal Medicine Point-of-Care Ultrasound (POCUS) use during Coronavirus (COVID-19) Pandemic

Canadian Journal of General Internal Medicine ◽

10.22374/cjgim.v15i2.438 ◽

2020 ◽

Vol 15 (2) ◽

pp. 8-11 ◽

Cited By ~ 3

Author(s):

Irene WY Ma ◽

Ranjani Somayaji ◽

Elissa Rennert-May ◽

Joseph Minardi ◽

Michael H Walsh ◽

...

Keyword(s):

Internal Medicine ◽

Infection Control ◽

Point Of Care ◽

Contextual Factors ◽

Point Of Care Ultrasound ◽

Clinical Environment ◽

High Level ◽

Infection Control Guidelines ◽

Cleaning And Disinfection ◽

Do So

With the COVID-19 pandemic, we are in unprecedented times - our clinical environment is changing rapidly and may continue to do so in the future. Over the last decade there has been an increased support for the use of internal medicine point-of-care ultrasound (POCUS) across the country and worldwide. While standard infection control guidelines are available on device and tranducer cleaning and disinfection, these recommendations may not apply during the COVID-19 pandemic. While we anticipate that the experience and need for POCUS deployment will differ across the country depending on several contextual factors, similar principles will likely emerge across multiple settings. To that end, to enable POCUS readiness, we recommend that each program/ practice site consider undertaking the following steps and recommendations on a semi-urgent basis if POCUS use is anticipated. The objective of this article to provide internists who currently use POCUS with the interim recommendations on processes that need to be in place prior to its use. This document refers primarily to the non-critical use of ultrasound devices based on the Spaulding classification6 (see Appendix for definitions) and does not apply to the setting of critical use where sterilization is required, nor semi-critical use, where high-level disinfection is required. Each institution must have its own policy in place on the cleaning and disinfection procedures for POCUS. This doucument is meant to serve as an adjunct to existing protocols.

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Cannabis as a Possible Treatment for Spasticity in Multiple Sclerosis / Kanabis Kao Moguci Tretman U Lecenju Spasticnosti Kod Multiple Skleroze

Serbian Journal of Experimental and Clinical Research ◽

10.1515/sjecr-2015-0047 ◽

2016 ◽

Vol 17 (1) ◽

pp. 61-66

Author(s):

Katarina Vesic ◽

Slavica Djukic Dejanovic ◽

Milica Borovcanin ◽

Janko Samardzic ◽

Gordana Toncev

Keyword(s):

Multiple Sclerosis ◽

Cannabinoid Receptor ◽

Therapeutic Potential ◽

Positive Impact ◽

Moderate Intensity ◽

Symptom Improvement ◽

Clinical Environment ◽

Cannabinoid Receptor 2 ◽

Multiple Sclerosis Patients ◽

Based Medicine

Abstract The therapeutic potential of cannabis has been known for centuries. Cannabinoids express their effects through two types of receptors, cannabinoid receptor 1 (CB1) and cannabinoid receptor 2 (CB2). Present studies indicate that cannabis-based drugs can make a positive impact in the treatment of different diseases. For many years, multiple sclerosis patients have self-medicated with illegal street cannabis to alleviate spasticity, a common and debilitating symptom that impairs quality of life. Nabiximols is the cannabis-based medicine approved in many countries as an add-on therapy for symptom improvement in patients with spasticity who have not responded adequately to other medications. Adverse events such as dizziness, diarrhoea, fatigue, nausea, headache and somnolence occur quite frequently with nabiximols, but they are generally of mild-to-moderate intensity and their incidence can be markedly reduced by gradual uptitration. The prerequisite for the therapeutic use of cannabis in Serbia arerequires legal clarification for the use of the drug in a clinical environment

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The role of textiles as fomites in the healthcare environment: a review of the infection control risk

PeerJ ◽

10.7717/peerj.9790 ◽

2020 ◽

Vol 8 ◽

pp. e9790

Author(s):

Lucy Owen ◽

Katie Laird

Keyword(s):

Infectious Diseases ◽

Infection Control ◽

Case Studies ◽

Healthcare Worker ◽

Large Scale ◽

Epidemiological Studies ◽

Risk Of Infection ◽

Clinical Environment ◽

Healthcare Environment

Background Infectious diseases are a significant threat in both healthcare and community settings. Healthcare associated infections (HCAIs) in particular are a leading cause of complications during hospitalisation. Contamination of the healthcare environment is recognised as a source of infectious disease yet the significance of porous surfaces including healthcare textiles as fomites is not well understood. It is currently assumed there is little infection risk from textiles due to a lack of direct epidemiological evidence. Decontamination of healthcare textiles is achieved with heat and/or detergents by commercial or in-house laundering with the exception of healthcare worker uniforms which are laundered domestically in some countries. The emergence of the COVID-19 pandemic has increased the need for rigorous infection control including effective decontamination of potential fomites in the healthcare environment. This article aims to review the evidence for the role of textiles in the transmission of infection, outline current procedures for laundering healthcare textiles and review studies evaluating the decontamination efficacy of domestic and industrial laundering. Methodology Pubmed, Google Scholar and Web of Science were searched for publications pertaining to the survival and transmission of microorganisms on textiles with a particular focus on the healthcare environment. Results A number of studies indicate that microorganisms survive on textiles for extended periods of time and can transfer on to skin and other surfaces suggesting it is biologically plausible that HCAIs and other infectious diseases can be transmitted directly through contact with contaminated textiles. Accordingly, there are a number of case studies that link small outbreaks with inadequate laundering or infection control processes surrounding healthcare laundry. Studies have also demonstrated the survival of potential pathogens during laundering of healthcare textiles, which may increase the risk of infection supporting the data published on specific outbreak case studies. Conclusions There are no large-scale epidemiological studies demonstrating a direct link between HCAIs and contaminated textiles yet evidence of outbreaks from published case studies should not be disregarded. Adequate microbial decontamination of linen and infection control procedures during laundering are required to minimise the risk of infection from healthcare textiles. Domestic laundering of healthcare worker uniforms is a particular concern due to the lack of control and monitoring of decontamination, offering a route for potential pathogens to enter the clinical environment. Industrial laundering of healthcare worker uniforms provides greater assurances of adequate decontamination compared to domestic laundering, due to the ability to monitor laundering parameters; this is of particular importance during the COVID-19 pandemic to minimise any risk of SARS-CoV-2 transmission.

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