Overview of common infection prevention and control infractions and complaints in personal service settings in Ontario in 2018: a descriptive analysis

Objectives Aesthetic services can pose a potential risk of infection to clients if instruments are not discarded or reprocessed after each use. Public health inspectors (PHIs) inspect personal service settings (PSS) to monitor compliance with infection prevention and control (IPAC) requirements. This study aimed to assess the prevalence of various IPAC infractions in Ontario PSS that were identified during routine compliance inspections and whether these were similar to those identified during investigations in these settings in which an IPAC lapse was deemed to exist. Methods PSS inspection results were analyzed from three public health units (PHUs) in Ontario in 2018. Premises were grouped into three premises types (hairdressing/barbering, aesthetics, and body modification) and infractions from 16 IPAC compliance categories were compared. Results of IPAC lapse investigations for all of Ontario were also compared across premises types. Results There were 5,386 inspections conducted in 4,483 PSS by three PHUs in 2018. PSS offering aesthetics were most likely to have infractions identified. Common infractions were related to inappropriate reuse of single-use and reusable instruments. Of the 121 IPAC lapses reported by PHUs in 2018, 52 (43.0%) were in PSS, and 73.1% of these were associated with nail salons/spas. Conclusions Operators could benefit from increased awareness of infection control best practices and the potential for infections to occur if these are not followed. PHIs could consider an alternate frequency of PSS inspection to increase operator education and compliance with minimum IPAC requirements.

Сryoablation technology for bone metastases

Puncture cryoablation of tumor lesions was performed as a part of complex palliative treatment of 32 patients with the fourth stage of the disease with bone metastases. Each patient, depending on the extent of the lesion, underwent from one to eight procedures. New domestic nitrogen equipment with reusable instruments was used. Cryoablation procedures were performed in the room for Computed Tomography (CT) using robotic navigation, as well as in the operating room under ultrasound monitoring. The indications for the procedure were severe pain syndrome, disease progression, prevention of pathological fractures, and the impossibility of performing the surgical treatment in patients with comorbidities. When performing cryoablation, the number and diameter of cryoprobes, the length of the needle and cryoprobe tip, the direction of insertion, and their mutual positioning were determined depending on the size and shape of the tumor lesion. The technique of puncture approaches and monitoring rules are described in detail. It is recommended to avoid the destruction of the pelvic ring, hip joint, to be careful in cases of tumor localization in the body and arches of the vertebrae, in the lateral parts of the sacrum, in the places where the nerve trunks adhere to the bone. The cryoablation procedure cannot be planned if the skin, the wall of a hollow organ, and the spinal cord are involved in the tumor process. There is a high risk of fracture after performing total cryoablation of metastasis if it covers more than a third of the diameter of the tubular bone.

STERILIZATION & CROSS INFECTION IN DENTISTRY

Objectives: This study aims to assess the knowledge, perception and attitudeof patients towards sterilization and cross Infection and to assess the effects of education onperception and behavior towards sterilization and cross infection. Cross infection control ismost important in dentistry as it is considered one of the main reasons of rapid spread ofinfectious diseases now a days. Setting: Major public sector hospital of Punjab Pakistan, PunjabDental Hospital Lahore. Material & Method: We surveyed patients in OPDs of Punjab DentalHospital Lahore. Survey questions covered demographics as well as 15 questions related tosterilization and cross infection in dentistry. Questionnaires were given to educated peopleand interviews were taken from uneducated or less educated people. Data was collected andanalyzed. Results: patients have some knowledge about sterilization and cross infection buttheir concepts need a lot of improvement. Patients know that microbial contamination occursbut they are unaware of the diseases that are transmitted. Similarly on other perspective thereis discrepancy in knowledge and practice, as they do not take it seriously or they are unawareof the consequences of cross infection or long term effects of HIV, Hepatitis B & C. Disposableinstruments are very important for controlling cross infection. Only 60% people said they wouldprefer disposable instruments over reusable instruments when option is given to them. Mostpeople are reluctant to be treated with disposable instruments due to extra cost on treatment.92% were well aware of significance of hand washing of dentist before and after dental checkup,but when they go through dental examination they are either careless or hesitant to ask dentistto wash hands. Conclusion: Besides the knowledge there are other factors like patientsattitude and concerns also play vital role in preventing infection transmission in them. We haveto educate them about infectious diseases and their root of transmission and their long termeffects on health.

Sensor Integrated Instruments for Surgical Quality Assurance and Process Monitoring

Demographic changes will increase the number of surgical procedures in the next years. Therefore, quality assurance of clinical processes, such as the reprocessing of surgical instruments as well as intraoperative workflows will be of increasing importance to ensure patient safety. Surgical procedures are often complex and may involve risks for the patient. For fixation of screws, e.g. in case of pedicle screws, osteosynthesis plates or revision joint replacement surgery implants, the application of defined torques may be crucial in order to achieve optimal therapeutic results and minimal complication rates. In many cases a subjective rating of the surgeon is necessary as no adequate instrumentation is available. With the same subjective feeling, hammering or screwing in are performed to implant e.g. the acetabular component in THA.Our actual work is dedicated to the implementation of a functional prototypes of sensor-integrated instruments for specific types of intervention (especially in traumatology) and the evaluation of the sensor integrated surgical instruments in combination with RFID technology for smart process optimization in the operating room as well as for reprocessing of surgical instruments and surgical management in combination with a knowledge-based planning, control and documentation system. Complementary (preferably wireless) sensors such for instrument identification, tracking or more complex measurements such as forces, torques, temperature or impacts during surgery as well as during reprocessing of reusable instruments could enable computer network based quality assurance in a much broader and comprehensive manner.Within the framework of the OR.NET initiative we follow the approach to integrate wireless sensors for measurement of temperature, force-torque as well as inertial sensors for orientation and impact control, depending on the specific type of application for monitoring of workflows during surgery as well as during reprocessing of reusable instruments and devices. The integration of smart surgical instruments into an open networked operating room based on the open communication standard IEEE 11073 knowledge-based workflow system, can help to improve the process and quality management.

The Sterility of Reusable Surgical Instruments with Pouches Packaging on One of the Private Hospital in Bandung

Healthcare associated infection is one of the common infection that happens in Indonesia. One form control to prevent healthcare associated infection is the sterilization process of the materials and medical instruments that used for taking care of patients. At the private hospital whereas a place of research, there’s never been done the study of sterility test for reusable instrument with pouches, based on previous studies showed that 8 sets from 40 sets of reusable instrument with linen were not sterile moreover there were positively influence from the amount of time to the sterility of reusable instrument. The purpose of these studies was to determining the relationship between a long storage time and the sterility of reusable instruments with pouches. The method that used in this study was the sterility testing of reusable instrument with pouches which were stored in a central operations room storage with a long storage time of 1 and 2 months. From 30 reusable instruments with pouches which were stored for nine months there were 5 instruments were not sterile. The results of statistic analysis showed that the amount of storage time not significantly associated to the sterility of reusable instrument with pouches in the operating room central storage space.