603 VTE Prophylaxis Compliance on The Burns Unit

Aim To assess if VTE risk assessments are correctly completed and implemented on the Burns Unit. Method 2-week prospective analysis of all inpatients admitted to the adult Burns Unit. Data was collected from patient files and drug Kardexs. Variables including TBSA, date of injury, date of admission, date of VTE risk assessment score, correct prescription according to score and implementation were compiled in an excel spread sheet. Audited against Trust and NICE Guideline 89. Results The first cycle identified errors in risk assessment completion related to inaccurate BMI assessment and failure to identify the burn as a risk factor. The risk assessment was only re-assessed 71% of the time post operatively or following change in condition. An action plan included re-education of medical staff, reminder posters in theatre and re-designing the burns operation note to include a VTE re-assessment tick box. A re-audit showed an improvement in correct VTE scoring from 65% to 100% and VTE reassessment from 71% to 100%. Conclusions Following the first cycle, Wythenshawe Hospital Burns Unit has improved in compliance with the NICE and Trust Guidelines. The two most frequent errors identified on completion of the risk assessment form have not been seen in the second cycle following education of medical staff. All patients should continue to be prescribed the prophylaxis indicated, unless contraindicated. For those patients who cannot wear AES due to a burn to their lower legs, flowtrons and/or enoxaparin should be considered instead. For those patients who refuse treatment an incident form must be completed.

Perceptions of Mothers and Community Members Regarding Breastfeeding in Public Spaces in Alexandra, Gauteng Province, South Africa

Background: Mothers experience significant barriers to breastfeed in public spaces, which could result in a detrimental impact on the World Health Organization’s recommendation of exclusive breastfeeding. Failure to support and accept breastfeeding in public spaces could lead to mixed feeding or even abandonment of breastfeeding. Objective: The current study aimed to identify the knowledge of breastfeeding benefits and perceptions about it among mothers and community members in Alexandra, Gauteng Province, South Africa. Methods: A quantitative, non-experimental descriptive study was deployed using two structured questionnaires, which were distributed among mothers (n=96) and community members (n=96). All 192 questionnaires were completed and returned, although two questionnaires of mothers could not be used due to incompleteness. An excel spread sheet and Statistical Package for Social Sciences version 25 was used to analyze the data. Results: The findings of the current study revealed a positive correlation between the knowledge level about breastfeeding benefits [infants (r=0.45, p≤0.000) and mothers (r=0.29, p≤0.000)] and perceptions in public spaces. Community members and mothers who were knowledgeable regarding breastfeeding benefits exhibited supportive attitudes towards breastfeeding in public spaces. Conclusion: Altogether, the majority of mothers (69%) were comfortable to breastfeed in public spaces, and community members (84%) were supportive. Limited knowledge of breastfeeding benefits was associated with unsupportive attitudes towards breastfeeding in public spaces. Health messages that target these factors are essential to encourage support and acceptance of breastfeeding in public spaces. This could be executed through public education via posters in public spaces and during community health outreaches.

Klebsiella pneumoniae: an increasing threat to public health

Objectives This review fills the paucity of information on K. pneumoniae as a nosocomial pathogen by providing pooled data on epidemiological risk factors, resistant trends and profiles and resistant and virulent genes of this organism in Asia. Methods Exhaustive search was conducted using PubMed, Web of Science, and Google scholar for most studies addressing the prevalence, risk factors, drug resistant-mediated genes and/or virulent factors of K. pneumoniae in Asia. Data extracted for meta-analysis were analyzed using comprehensive meta-analysis version 3. Trends data for the isolation rate and resistance rates were entered into Excel spread sheet and the results were presented in graphs. Results The prevalence rate of drug resistance in K. pneumoniae were; amikacin (40.8%) [95% CI 31.9–50.4], aztreonam (73.3%) [95% CI 59.9–83.4], ceftazidime (75.7%) [95% CI 65.4–83.6], ciprofloxacin (59.8%) [95% CI 48.6–70.1], colistin (2.9%) [95% CI 1.8–4.4], cefotaxime (79.2%) [95% CI 68.0–87.2], cefepime (72.6) [95% CI 57.7–83.8] and imipenem (65.6%) [95% CI 30.8–89.0]. TEM (39.5%) [95% CI 15.4–70.1], SHV-11 (41.8%) [95% CI 16.2–72.6] and KPC-2 (14.6%) [95% CI 6.0–31.4] were some of the resistance mediated genes observed in this study. The most virulent factors utilized by K. pneumoniae are; hypermucoviscous phenotype and mucoviscosity-related genes, genes for biosynthesis of lipopolysaccharide, iron uptake and transport genes and finally, adhesive genes. Conclusion It can be concluded that, antimicrobial resistant in K. pneumoniae is a clear and present danger in Asia which needs strong surveillance to curb this menace. It is very important for public healthcare departments to monitor and report changes in antimicrobial-resistant isolates.

It's about Time! Introducing Students to the Concept of Billable Hours and Improving Their Excel Skills By Creating a Spreadsheet to Track Their Time

ABSTRACT The concepts of billable hours and tracking time are a reality in public accounting. The purpose of this case is to educate students on the concept of billable hours and to improve the student's Excel skills through the development of a spreadsheet to track their time. Students were required to create the time-tracking Excel spread-sheet and to track all (personal and school-related) of their time for two weeks. Students were given pre/post tests and surveys and the results reflect that students significantly increased their performance in intermediate and advanced Excel skills, billable hours concepts and realize the difficulty in tracking time. Even though the students acknowledged the difficulty in tracking time, they did enjoy learning more about billable hours that they may encounter in their future professions.

Opening cultural heritage in the age of OAI-PMH: finding Armenia in the OATD discovery service

Purpose – Open Access Theses and Dissertations (OATD) distinguishes itself from other ETD databases by providing immediate access to theses that are freely available online. The Republic of Armenia is a small geographical area in Central Asia with a population of only three million, yet an estimated total of five to seven million people of Armenian ancestry live outside of Armenia. What knowledge of Armenian cultural heritage can be discovered by searching OATD for open access theses that relate to Armenian history and culture?. The paper aims to discuss these issues. Design/methodology/approach – The OATD database was searched for the terms Armenia or Armenian. Discovered thesis records were exported into citation management tools and analysed for subject content, year of publication, institutional repository source, and a determination of whether Armenia was a primary or secondary topic. Access to theses was also tested to verify their open access. The remaining thesis records (n=152) were exported into an Excel spread sheet for numerical analysis and graphic production. Findings – From the records getting enhanced metadata (n=152), slightly more (52 per cent) were master's theses. Nearly two-thirds (63 per cent) used the Republic and culture of Armenia as a primary theme. English was the predominant author language (85 per cent) with Portuguese and French represented less than 5 per cent. World history and social sciences research were the most represented subjects. Most open access theses on Armenia or Armenian culture date from after 2000. All enhanced records, along with their abstracts and direct links, are available in a searchable RefWorks shared folder. Originality/value – The OATD database was evaluated for scholarly representation of a particular country and culture.