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 600. Decreased Hospital Readmission After Programmatic Strengthening of an Outpatient Parenteral Antimicrobial Therapy (OPAT) Program

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S362-S363
Author(s):  
Gaurav Agnihotri ◽  
Alan E Gross ◽  
Minji Seok ◽  
Cheng Yu Yen ◽  
Farah Khan ◽  
...  
Keyword(s):  
Hospital Readmission ◽  
Multinomial Logistic Regression ◽  
Univariate Analysis ◽  
Tertiary Care ◽  
Intervention Group ◽  
Care Hospital ◽  
Full Time ◽  
Post Intervention ◽  
Before And After ◽  
The Impact

Abstract Background Although it is recommended that an OPAT program should be managed by a formal OPAT team that supports the treating physician, many OPAT programs face challenges in obtaining necessary program staff (i.e nurses or pharmacists) due to limited data examining the impact of a dedicated OPAT team on patient outcomes. Our objective was to compare OPAT-related readmission rates among patients receiving OPAT before and after the implementation of a strengthened OPAT program. Methods This retrospective quasi-experiment compared adult patients discharged on intravenous (IV) antibiotics from the University of Illinois Hospital before and after implementation of programmatic changes to strengthen the OPAT program. Data from our previous study were used as the pre-intervention group (1/1/2012 to 8/1/2013), where only individual infectious disease (ID) physicians coordinated OPAT. Post-intervention (10/1/2017 to 1/1/2019), a dedicated OPAT nurse provided full time support to the treating ID physicians through care coordination, utilization of protocols for lab monitoring and management, and enhanced documentation. Factors associated with readmission for OPAT-related problems at a significance level of p< 0.1 in univariate analysis were eligible for testing in a forward stepwise multinomial logistic regression to identify independent predictors of readmission. Results Demographics, antimicrobial indications, and OPAT administration location of the 428 patients pre- and post-intervention are listed in Table 1. After implementation of the strengthened OPAT program, the readmission rate due to OPAT-related complications decreased from 17.8% (13/73) to 6.5% (23/355) (p=0.001). OPAT-related readmission reasons included: infection recurrence/progression (56%), adverse drug reaction (28%), or line-associated issues (17%). Independent predictors of hospital readmission due to OPAT-related problems are listed in Table 2. Table 1. OPAT Patient Demographics and Factors Pre- and Post-intervention Table 2. Factors independently associated with hospital readmission in OPAT patients Conclusion An OPAT program with dedicated staff at a large academic tertiary care hospital was independently associated with decreased risk for readmission, which provides critical evidence to substantiate additional resources being dedicated to OPAT by health systems in the future. Disclosures All Authors: No reported disclosures

scholarly journals Daily Bathing with Chlorhexidine-Based Soap and the Prevention of Staphylococcus aureus Transmission and Infection

2014 ◽  
Vol 35 (3) ◽  
pp. 243-250 ◽  
Author(s):  
Melissa A. Viray ◽  
James C. Morley ◽  
Craig M. Coopersmith ◽  
Marin H. Kollef ◽  
Victoria J. Fraser ◽  
...  
Keyword(s):  
At Risk ◽  
Staphylococcus Aureus ◽  
Tertiary Care ◽  
Control Unit ◽  
Post Intervention ◽  
Icu Patients ◽  
Chlorhexidine Bathing ◽  
Before And After ◽  
Surgical Icu ◽  
Time Series Methodology

Objective.Determine whether daily bathing with chlorhexidine-based soap decreased methicillin-resistant Staphylococcus aureus (MRSA) transmission and intensive care unit (ICU)-acquired S. aureus infection among ICU patients.Design.Prospective pre-post-intervention study with control unit.Setting.A 1,250-bed tertiary care teaching hospital.Patients.Medical and surgical ICU patients.Methods.Active surveillance for MRSA colonization was performed in both ICUs. In June 2005, a chlorhexidine bathing protocol was implemented in the surgical ICU. Changes in S. aureus transmission and infection rate before and after implementation were analyzed using time-series methodology.Results.The intervention unit had a 20.68% decrease in MRSA acquisition after institution of the bathing protocol (12.64 cases per 1,000 patient-days at risk before the intervention vs 10.03 cases per 1,000 patient-days at risk after the intervention; β, −2.62 [95% confidence interval (CI), −5.19 to −0.04]; P = .046). There was no significant change in MRSA acquisition in the control ICU during the study period (10.97 cases per 1,000 patient-days at risk before June 2005 vs 11.33 cases per 1,000 patient-days at risk after June 2005; β, −11.10 [95% CI, −37.40 to 15.19]; P = .40). There was a 20.77% decrease in all S. aureus (including MRSA) acquisition in the intervention ICU from 2002 through 2007 (19.73 cases per 1,000 patient-days at risk before the intervention to 15.63 cases per 1,000 patient-days at risk after the intervention [95% CI, −7.25 to −0.95]; P = .012)]. The incidence of ICU-acquired MRSA infections decreased by 41.37% in the intervention ICU (1.96 infections per 1,000 patient-days at risk before the intervention vs 1.15 infections per 1,000 patient-days at risk after the intervention; P = .001).Conclusions.Institution of daily chlorhexidine bathing in an ICU resulted in a decrease in the transmission of S. aureus, including MRSA. These data support the use of routine daily chlorhexidine baths to decrease rates of S. aureus transmission and infection.

scholarly journals 819. Antibiotic Resistance in Pathogens Causing Hospital Acquired Infections in Brazil: A Multicenter Study

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S502-S503
Author(s):  
Carlos Starling ◽  
Bráulio R G M Couto ◽  
Estevão Urbano Silva ◽  
Virginia Andrade ◽  
Edna M M Leite ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Tertiary Care ◽  
Healthcare Associated Infections ◽  
Gram Positive ◽  
Resistance Profile ◽  
Hospital Acquired Infections ◽  
Microbiological Methods ◽  
Belo Horizonte ◽  
Healthcare Associated ◽  
Hospital Acquired

Abstract Background In the present study we determined the prevalence of antibiotic resistance in the most common organisms causing healthcare-associated infections in tertiary-care hospitals in Belo Horizonte, a 3,000,000 inhabitants city from Brazil. Methods Microbiology data of hospital acquired infections (HAI) defined by the National Healthcare Safety Network (NHSN)/CDC protocols of seven general hospitals were analyzed: three public institutions, two philanthropic, and two private hospitals. Samples from different topographies were plate in an ideal culture medium and after growth, the microorganisms were identified by standard biochemical and microbiological methods, using the VITEK 2 compact system (Biomerieux), which allows the simultaneous identification of Gram-positive and Gram bacteria -negative and combine the identification and TSA results in a single report. Six hospitals used automated methods and one institution used manual method for antimicrobial susceptibility testing. Results Samples of seven Gram-negative and two Gram-positive bacteria collected between Dec/2019-Nov/2020 from HAI isolates were analyzed: 565 Klebsiella, 293 Escherichia coli, 153 Proteus, 403 Pseudomonas, 275 Acinetobacter, 174 Serratia, 153, 361 Staphylococcus aureus, and 176 Enterococcus. Antibiotic resistance profile of each strain is summarized in Figures 1, 2, and 3. Resistance profile: Klebsiella, E. coli, Proteus. ATB profile: Pseudomonas, Acinetobacter, Serratia. ATB profile: Enterobacter, S. aureus, Enterococcus . Conclusion Benchmarks for antibiotic resistance in the most common organisms causing healthcare-associated infections were defined, and can be used as indicators for healthcare assessment, specially in developing countries institutions. Disclosures All Authors: No reported disclosures

scholarly journals EFFECT OF LOCKDOWN ON EDUCATION OF RURAL UNDERGRADUATE STUDENTS DURINGCOVID-19 PANDEMIC IN UMARBAN (DHAR), M.P., INDIA

2021 ◽  
pp. 14-18
Author(s):  
Jyoti Agrawal
Keyword(s):  
Online Education ◽  
Undergraduate Students ◽  
Rural Areas ◽  
Online Classes ◽  
Virtual Classrooms ◽  
Before And After ◽  
E Learning ◽  
Study Participants ◽  
The Impact ◽  
Support Students

A survey was conducted to assess the impact of lockdown due to COVID-19 on online education of undergraduate learners of government colleges Umarban, district Dhar (454449) Madhya Pradesh, India. An online as well as offline survey was conducted from 10 October 2020 to 15 March 2021 to collect the information. To analyze the possibility and attention of students for online education, various online quizzes were conducted in which a structural questionnaire link using ‘Google form’ was sent to students through WhatsApp. A total of 265 students were taken for the survey. The simple percentage distribution was used to assess the learning status of the study participants. During the lockdown period, around 15.47% of learners were involved in e-learning. Most of the learners were used android mobile for attending e-learning. The present study revealed that around 60% of students were seen to involve in farming during lockdown instead of online classes. In addition to this, 45% of students never joined an online class during the entire session. Further analysis demonstrated that 13% of students do not have their own mobile phone, nearly 18% could not join due to poor internet connectivity, 21% of students faced unfavorable study environment at home and 3% of students have other reasons. This study also showed a comparative analysis of the presence of students before and after the COVID 19 pandemic. As the ratio of presence of students in physical and virtual classrooms was 2.32. The overall results from this study revealed that especially in rural areas COVID – 19 pandemic had affected more adversely on classroom attendance, where people already do not want to give importance to education. Higher education institutions may benefit from these findings while formulating strategies to support students during this pandemic. Moreover, to promote education in COVID 19 era strong strategies are urgently needed.

scholarly journals 772. Effect of Selective Digestive Decontamination Using Oral Colistin on HAI Rates and All-Cause Mortality Among Cardiovascular Surgery Patients - A Single Centre Experience from India

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S483-S483
Author(s):  
Sneha R ◽  
Arun Wilson ◽  
Anup R Warrier ◽  
Shilpa Prakash ◽  
Reima Elizabeth ◽  
...  
Keyword(s):  
Blood Stream Infection ◽  
Tertiary Care ◽  
Blood Stream ◽  
Selective Digestive Decontamination ◽  
Care Hospital ◽  
Intervention Period ◽  
All Cause Mortality ◽  
Study Participants ◽  
Hospital Acquired ◽  
Interventional Group

Abstract Background Hospital acquired infections affect the morbidity and mortality of ICU patients considerably. Selective digestive decontamination (SDD) is defined as the prophylactic application of topical, non-absorbable antimicrobials in the oropharynx and stomach, with the goal of eradicating potentially pathogenic microorganisms but preserving the protective anaerobic microbiota. SDD has been applied in trials among critically ill patients and found to be effective in reducing HAI. Methods This cohort study was conducted in our cardiothoracic vascular surgery ICU of a tertiary care hospital, where patients were given oral colistin syrup (100mg 6th hourly for 5 days) in the immediate post op during the intervention period. We compared the clinical and microbiological outcomes of patients before (5 months, pre-intervention arm) and after (5 months, intervention arm) the implementation of SDD (Oral colistin syrup). Results A total of 78 patients were included in the interventional arm with a mean age of 58.7 years whereas the pre-interventional group consisted of 94 study participants with a median age of 57.5 years. 11 out of 94 had positive respiratory sample culture (11.7%) in the preintervention group which mandated antibiotic therapy for HAP compared to one culture positive in the interventional period (OR 0.0980, 95% CI: 0.0124 to 0.777 and P=0.0279). One patient had blood stream infection in the pre-intervention period compared to none in the intervention phase. All-cause mortality in the pre-interventional group was 7.44% (7 in 94) vs 1.28% (1 in 78) in the interventional group (OR 0.1614, 95% CI: 0.0194 to 1.3416, P= 0.0914). Adverse events (nausea, vomiting & loose stools) were observed in a total of 24 study patients, but necessitated withdrawal of regimen only in nine patients. Conclusion An SDD regimen of Colistin alone in Cardiac Surgery patients resulted in statistically significant reduction in incidence of Hospital Acquired Pneumonia, along with a reduction in all-cause mortality (though not statistically significant). Disclosures All Authors: No reported disclosures

The impact of incorporating early rapid influenza diagnosis on hospital occupancy and hospital acquired influenza

2019 ◽  
Vol 40 (8) ◽  
pp. 897-903 ◽  
Author(s):  
Lior Nesher ◽  
Gal Tsaban ◽  
Jacob Dreiher ◽  
Kenneth V.I. Rolston ◽  
Gal Ifergane ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Early Discharge ◽  
Antibiotic Administration ◽  
Care Hospital ◽  
Before And After ◽  
Medical Wards ◽  
Hospital Acquired ◽  
Occupancy Rates ◽  
The Impact ◽  
Hospital Occupancy

AbstractObjective:To assess the impact of incorporating early rapid influenza diagnosis on antimicrobial usage, nosocomial influenza transmission, length of stay, and occupancy rates among hospitalized patients.Setting:A 1,100 bed tertiary-care hospital in southern Israel.Methods:We implemented early rapid detection of influenza with immediate communication of results. Using Orion methods, we compared the 2017–2018 influenza season to the prior season in our hospital and to the 2017–2018 occupancy rates at other Israeli hospitals.Results:During the intervention season, 5,006 patients were admitted; 1,824 were tested for influenza, of whom 437 (23.9%) were positive. In the previous season, 4,825 patients were admitted; 1,225 were tested and 288 (23.5%) were positive. Time from admission to test report decreased from 35.5 to 18.4 hours (P < .001). Early discharge rates significantly increased, from 21.5% to 41.6% at 36 hours, from 37.2% to 54.5% at 48 hours, and from 66% to 73.2% at 72 hours. No increase in repeat ER visits, readmission, or mortality rates was observed. Hospital occupancy decreased by 10% compared to the previous year and was 26% lower than the national rate. Hospital-acquired influenza cases were reduced from 37 (11.4%) to 12 (2.7%) (P < .001). Antibiotic usage was reduced both before and after notification of test results by 16% and 12%, respectively.Conclusions:Implementing this intervention led to earlier discharge of patients, lower occupancy in medical wards, reduced antibiotic administration, and fewer hospital-acquired influenza events. This strategy is useful for optimizing hospital resources, and its implementation should be considered for upcoming influenza seasons.

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.

scholarly journals A cross-sectional questionnaire-based study of knowledge, attitude and practice of antibiotic usage among the undergraduate students of a tertiary care teaching rural hospital: with an emphasis of WHO fact-sheets

2019 ◽  
Vol 8 (9) ◽  
pp. 2113
Author(s):  
Ervilla Dass ◽  
Aneri Patel ◽  
Huzaifa Patel ◽  
Dhruvesh Patel ◽  
Himanshi Patel ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Undergraduate Students ◽  
Tertiary Care ◽  
Antibiotic Usage ◽  
Distributed Data ◽  
Cross Sectional ◽  
Attitude And Practice ◽  
Improper Use ◽  
Health Related ◽  
Knowledge Attitude And Practice

Background: Awareness regarding the antibiotic usage forms vital way to overcome the quickly deepening problem of antibiotic resistance. Hence, all the medical students should be made aware of the current emerging health related issues as future clinicians. It is in this regards that this study was undertaken among undergraduate (UG) students, in order to assess their knowledge, attitude & practice concerning antibiotic use.Methods: The present observational study was conducted over a period of four months starting from May 2018 till August 2018 among undergraduates. A total of 250 structured questionnaires were distributed. Data collected was further entered in Microsoft excel sheet and further analysed.Results: Total 250 students participated in this present study. Out of them, nearly 75.6% had heard about antibiotic resistance while 24.4% denied. Regarding the improper use of antibiotics that can cause antibiotic resistance 70% was aware. Moreover, nearly 40.4% attended a CME about rational use of antibiotics. The belief that the antibiotics are safe drugs hence they can be commonly used was reported by 48%. The results were grouped into knowledge, attitude and practice regarding the antibiotic use.Conclusions: Thus, the result gives us useful insight regarding KAP of the undergraduate students who will be future prescribers of antibiotics. This can be further applied to plan desirable educational informative interventions that focus on improving the knowledge for prescribing antibiotics in future clinicians, which can further help in reducing the development of antibiotic resistance.

scholarly journals Evolving students' conceptions about responsible entrepreneurship: a classroom experiment

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Matthias Pepin ◽  
Luc K. Audebrand ◽  
Maripier Tremblay ◽  
Ndèye Binta Keita
Keyword(s):  
Undergraduate Students ◽  
Entrepreneurship Education ◽  
Learning Activities ◽  
Post Intervention ◽  
Content Type ◽  
Education Literature ◽  
Classroom Experiment ◽  
Before And After ◽  
Innovative Learning ◽  
Definition Of

PurposeEntrepreneurship education scholarship has been recently challenged to look at what goes on inside the entrepreneurship classroom to assess what students are really learning. Relying on the construction and analysis of a 3-h long set of learning activities on responsible entrepreneurship, this paper focuses on the activities conducted and what students have learned, based on Bloom's revised taxonomy of educational objectives.Design/methodology/approachThis paper builds on a pre-/post-intervention assessment around a set of learning activities with 151 undergraduate students. Before and after the class, students were asked to produce a definition of responsible entrepreneurship. They were also asked to reflect on what had changed from the beginning.FindingsAnalysis of students' pre/post definitions shows a standardization of their conceptions of responsible entrepreneurship. This result confirms that the learning objective of this class was met. Nevertheless, applying Bloom's revised taxonomy to students' reflections allows for more nuanced interpretation. The analysis indeed revealed that some students manifest relatively superficial learning while other shows a deeper ability to reflect on the concept.Originality/valueFirst, this paper contributes to the entrepreneurship education literature by showing the relevance of using Bloom's revised taxonomy for both teaching and research purposes. Second, it presents a set of innovative learning activities on responsible entrepreneurship that could be easily reproduced in other educational contexts. Third, it shows the importance of asking students what they learned and what has changed for them through class activities.

Save the Quinolones! Impact of a Non-Restrictive Fluoroquinolone Reduction Initiative on Antibiotic Use and Resistance at an Urban Teaching Hospital

2021 ◽  
pp. 089719002110034
Author(s):  
Steven M. Smoke ◽  
Slava Plotkin ◽  
Neeki Patel ◽  
Patrick Hilden
Keyword(s):  
Antibiotic Resistance ◽  
Ecological Study ◽  
Antibiotic Use ◽  
Negative Consequences ◽  
Intervention Period ◽  
Post Intervention ◽  
E Coli ◽  
Before And After ◽  
Improving Patient Care ◽  
The Impact

Background: Many antibiotic stewardship programs have sought to reduce fluoroquinolone use due to their association with a myriad of negative consequences. In hospital settings with fewer resources, initiatives that are less labor intensive may offer a more feasible approach to addressing fluoroquinolone use and improving patient care. Objective: This study assessed the impact of a non-restrictive fluoroquinolone reduction initiative on antibiotic use and resistance. Methods: This was a retrospective pre- and post-interventional ecological study conducted from 2016 to 2017. The fluoroquinolone reduction initiative consisted of education on risks and alternatives. Buttons promoting “Save the Quinolones” were also worn to increase visibility. Outcome measures were the rate of fluoroquinolone use and antibiotic resistance in Staphylococcus aureus, Escherichia coli, Proteus mirabilis, Klebsiella pneumoniae, and Pseudomonas aeruginosa before and after the intervention. Results: Overall, fluoroquinolone use decreased throughout the study, but there was a significantly greater rate of decrease in the post-intervention period (monthly decrease of 3.3% (1.3, 5.1) v. 7.4% (5, 9.8) p = 0.043). S. aureus susceptibility to oxacillin increased from 47.2% to 55.2% (difference 8.0, 95%CI 1.2 to 14.7). P. aeruginosa susceptibility to levofloxacin increased from 60% to 70.7% (difference 10.7, 95%CI 0.8 to 20.6). No differences in susceptibility rates of E. coli, P. mirabilis or K. pneumoniae were detected. Conclusion: This non-restrictive fluoroquinolone reduction initiative led to a significant decrease in fluoroquinolone use that was associated with decreased antibiotic resistance in S. aureus and P. aeruginosa.

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