High-Level Disinfection in Ambulatory Care: Overcoming the Barriers of a Decentralized System through Auditing and Education

Background: High-level disinfection (HLD) of semicritical instruments in a multispecialty ambulatory care network has the potential for increased risk due to the decentralized instrument reprocessing and lack of a sterile processing department. Attention to HLD practices is an important part of device-borne outbreak prevention. Method: An HLD database was developed to identify specific departments and locations where HLD occurred across a 30-medical practice ambulatory care network in eastern Massachusetts, which included otolaryngology, urology, endoscopy, and obstetrics/gynecology departments. Based on qualitative feedback from managers and reprocessing staff, this database centralized information that included the supply inventory including manufacturer and model information, HLD methodology, standard work, and listing of competency evaluations. The infection control team then led audits to directly observe compliance with instrument reprocessing and a monthly-driven HLD calendar was developed to enforce annual competencies. Result: The results of the audits demonstrated variability across departments with gaps in precleaning, transportation of used instruments, the dilution of enzymatic cleaner, and maintenance of quality control logs. Given the uniqueness of shape and size of various ambulatory locations, proper storage and separation between clean and dirty spaces were common pitfalls. Auditing also revealed different levels of staff understanding of standard work and variable inventory management. Centralized education sessions held jointly by the infection control team and various manufacturers for the reprocessing staff helped to create and reinforce best practices. Conclusion: Decentralized HLD that occurs across multiple ambulatory care sites led to gaps in instrument reprocessing and unique challenges due to variable geography of sites, physical space constraints, and an independent approach to procuring medical supplies. Through the auditing and feedback of all areas that perform HLD, an effective and sustainable strategy was created to ensure practice improvement. Streamlining standard work, seeking direct input from frontline staff, and collective educational events were critical to our success in the ambulatory setting.Funding: NoDisclosures: None

Analisis Penyebab Kegagalan Mesin Wrapping Menggunakan Failure Mode And Effect Analysis di PT. X

PT. X is an industry that produces green tea and black tea. In this study, there are often problems with the wrapping machine due to the age of use and the tight schedule of usage in the wrapping machine. If the machine operates in an unstable condition, it will greatly affect the results of the production. Damaged components such as cutting blades, heating heaters, thermo control and bearings. By using the Failure Mode and Effect Analysis (FMEA) method and also calculating the Risk Priority Number (RPN) value, the highest RPN value to the lowest is obtained, namely Cutting Knife (RPN = 100), Heater (RPN = 90), Thermo Control (RPN = 72) and Bearings (RPN = 36). It can be seen that the cause of damage to the wrapping machine and also the highest RPN calculation is found in the damage to the cutting knife whose RPN value is 100. From the analysis of the damage to the cutting knife, the author provides a suggested repair plan for the company so that it can be implemented in the company which can later improve the quality of the machine to be operated. for the future which cannot be separated from the supervisory role of the operators in charge of their cooperation to improve quality and the quality control team that always monitors quality.

Evaluasi Pengendalian Inflasi di Kota Bandar Lampung Tahun 2018

Inflation is one of the economic problems of a country including Indonesia. One of the efforts of the Indonesian government to control inflation is by coordinating with Bank Indonesia to establish an Inflation Control Team at the central and regional levels, through which the program is implemented to control inflation. The purpose of this research is to evaluate inflation control conducted by the Bandar Lampung City Government through the Bandar Lampung Regional Inflation Control Team in the foodstuffs group which is one of the contributing factors to high inflation in 2018. This research uses descriptive research method with qualitative approach, and uses data collection technique by interview, observation and documentation. Data analysis techniques used in this research are data reduction, data presentation, and conclusion drawing, while for data validity techniques using observation and triangulation extension techniques. This research uses Karl Ludwig Bartelenfy's evaluation model of input, process, output, results, and impact evaluation. The results of this study concluded that in controlling the inflation of foodstuff groups the Regional Inflation Control Team through the food task force carried out various programs of activities, among others, monitoring, coaching, market inspection and monitoring market prices, as well as market operation or cheap markets. From the activities program can be seen how the development of market prices, minimizing the circulation og products that do not meet the standards, and the availability of foodstuff. Program of activities have iven quite good results, this can be seen from the trendline chart taht shows a decrease in the foodstuff. Although it has not been significantly due to constraints on the budget, it also has a good impact in addition to the decrease in the inflation index but also on increasing cooperation with new partners that is expected to help and facilitate efforts to control inflation in the future.

Demonstrating the sustainability of capacity strengthening amidst COVID-19

The global disruptions caused by the coronavirus disease 2019 crisis posed a threat to the momentum the vector control team at the Liverpool School of Tropical Medicine (LSTM) and the Programme National de Lutte contre la Tryaponosomiase Humaine Africaine (PNLTHA) had built in their efforts to control tsetse fly populations in the Democratic Republic of Congo. But despite the pandemic and global lockdown, field activities did continue and the same impressive results in tsetse fly reduction were observed and the team followed this by completing a round of ‘tiny target’ deployment without any external presence. Such a success was possible due to the investment in vector control capacity strengthening undertaken by the LSTM and PNLTHA.

Perspective of healthcare workers regarding self-protection during COVID-19 pandemic: A cross-sectional study from Saudi Arabia

The aim of this study was to assess the perception of healthcare workers regarding self-protection during the COVID-19 pandemic in Saudi Arabia. The novel COVID-19 pandemic has completely changed the dynamic of governments, social lives, global economy, and health care systems priorities. Healthcare workers (HCWs) are one of the most group of people at risk of acquiring the infection, especially those who are taking care of COVID-19 patients. This cross-sectional survey-based study was conducted among HCWs during the period between May to July 2020 in Saudi Arabia. More than 70% of participating HCWs were able to access the personal safety policies and procedures in the workplace and COVID-19 treatment algorithm. In addition, the presence of an infection control team was also present in most of the institutes. The most common accessible personal protective equipment was hand gel sanitizer (89.9%), followed by disposable gloves (82.5%) and disposable masks (78.9%). More than 75% of participants reported that their institute has a special infection control team during the COVID-19 pandemic. Most of the respondents (~75%) believe that their institute would take all necessary measurements to protect their personal integrity at work. Several precautionary measures were undertaken appropriately by the Saudi Government to overcome the COVID-19 immediate and futuristic consequences. Personal protective equipment and protective measures would be crucial for public health if implemented appropriately during highly spreading infections (e.g., COVID-19) to minimize the transmission and preserve health