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Chauvet P, Enguix A, Sautou V, Slim K. A systematic review comparing the safety, cost and carbon footprint of disposable and reusable laparoscopic devices. J Visc Surg 2024; 161:25-31. [PMID: 38272757 DOI: 10.1016/j.jviscsurg.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
INTRODUCTION The objective of this systematic review of the literature is to compare a selection of currently utilized disposable and reusable laparoscopic medical devices in terms of safety (1st criteria), cost and carbon footprint. MATERIAL AND METHODS A search was carried out on electronic databases for articles published up until 6 May 2022. The eligible works were prospective (randomized or not) or retrospective clinical or medical-economic comparative studies having compared disposable scissors, trocars, and mechanical endoscopic staplers to the same instruments in reusable. Two different independent examiners extracted the relevant data. RESULTS Among the 2882 articles found, 156 abstracts were retained for examination. After comprehensive analysis concerning the safety and effectiveness of the instruments, we included four articles. A study on trocars highlighted increased vascular complications with disposable instruments, and another study found more perioperative incidents with a hybrid stapler as opposed to a disposable stapler. As regards cost analysis, we included 11 studies, all of which showed significantly higher costs with disposable instruments. The results of the one study on carbon footprints showed that hybrid instruments leave four times less of a carbon footprint than disposable instruments. CONCLUSION The literature on the theme remains extremely limited. Our review demonstrated that from a medical and economic standpoint, reusable medical instruments, particularly trocars, presented appreciable advantages. While there exist few data on the ecological impact, those that do exist are unmistakably favorable to reusable instruments.
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Affiliation(s)
- Pauline Chauvet
- Gynecology and Obstetrics Department, CHU de Clermont-Ferrand, 63003 Clermont-Ferrand, France.
| | - Audrey Enguix
- Pharmacy Department, CHU de Clermont-Ferrand, Clermont-Ferrand, France
| | - Valérie Sautou
- Clermont Auvergne University, CHU de Clermont Ferrand, Clermont Auvergne INP, CNRS, ICCF, 63000 Clermont-Ferrand, France
| | - Karem Slim
- Digestive Surgery Department CHU de Clermont-Ferrand, Clermont-Ferrand, France; Collectif d'Eco-Responsabilité En Santé, Beaumont, France
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Maamri H, Ben Ayed H, Ben Hmida M, Trigui M, Baklouti M, Ben Jemaa M, Ketata N, Kassiss M, Yaich S, Damak J. Effectiveness of a training program on health-care professionals' knowledge and practices regarding thermo-sensitive reusable medical devices disinfection: A quasi-experimental study. Infect Dis Health 2024; 29:1-7. [PMID: 37574407 DOI: 10.1016/j.idh.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/26/2023] [Accepted: 07/23/2023] [Indexed: 08/15/2023]
Abstract
INTRODUCTION Appropriate knowledge of healthcare professionals (HCPs) on the various aspects of disinfection and reuse of medical devices is a basic requirement to ensure proper disinfection and to minimize the risk of healthcare associated infections. In this regard this study aimed to assess the effectiveness of a training intervention on knowledge and practices regarding thermosensitive reusable medical devices (TRMD) disinfection among HCPs. METHODS This was a quasi-experimental study including a pre-test, an intervention (workshops, demonstrations, posters), and a post-test evaluation of the HCPs' knowledge and practices regarding the disinfection of TRMD. It was conducted between February and July 2022 at Hedi Chaker University hospital, Sfax, Southern Tunisia. RESULTS Overall, 31 participants were females (54.4%). The global Knowledge Score (KS) had significantly risen from pre-to post-training test (61.0 ± 9 vs 74.0 ± 12.5; p < 0.001). According to the disinfection type, the KS of non-critical and critical TRMD disinfection had significantly increased between pre and post-intervention (60 (IQR = [40.0-80.0]) vs 80 (IQR = [40.0-80.0]), p < 0.001) and (66.6 (IQR = [50.0-66.6]) vs 83.3 (IQR = [66.6-100.0]); p < 0.001) respectively. The mean change in global KS of TRMD disinfection was statistically higher among females (17.5 ± 11.2 vs 8.5 ± 3.2; p = 0.006) and medical staff (18.9 ± 11.9 vs 7.1 ± 3.9; p = 0.019). Conformity scores did not significantly change after the training program (58.1 ± 22.7 vs 63.7 ± 19.6; p = 0.678). CONCLUSION This study highlighted the effectiveness of the training intervention on HCP knowledge. However, practices were not improved. Conducting ongoing audits with on-the-job training is extremely needed.
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Affiliation(s)
- Hanen Maamri
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia.
| | - Houda Ben Ayed
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Mariam Ben Hmida
- Preventive Medicine and Hygiene Department, Habib Bourguiba University Hospital, University of Sfax, Tunisia
| | - Maroua Trigui
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Mouna Baklouti
- Preventive Medicine and Hygiene Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Maissa Ben Jemaa
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Nouha Ketata
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Mondher Kassiss
- Preventive Medicine and Hygiene Department, Habib Bourguiba University Hospital, University of Sfax, Tunisia
| | - Sourour Yaich
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
| | - Jamel Damak
- Community Health and Epidemiology Department, Hedi Chaker University Hospital, University of Sfax, Tunisia
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Wright KN, Melnyk AI, Emont J, Van Dis J. Sustainability in Obstetrics and Gynecology. Obstet Gynecol 2023; 142:1341-1346. [PMID: 37944151 DOI: 10.1097/aog.0000000000005435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/14/2023] [Indexed: 11/12/2023]
Abstract
Current practices in the U.S. health care industry drive climate change. This review summarizes the vast research on the negative health effects of the climate crisis on patients as relevant to obstetrics and gynecology. We further propose solutions to decarbonize operating rooms, labor and delivery units, and nurseries and neonatal intensive care units through evidence-based reduction in our single-use supply, energy, and water, as well as anesthetic gases and appropriate waste sorting.
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Affiliation(s)
- Kelly N Wright
- Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, California; the Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics, Gynecology, and Reproductive Sciences, Pittsburgh, Pennsylvania; and the Department of Obstetrics and Gynecology, Columbia University Medical Center, and NewYork-Presbyterian Hospital, New York, and the Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, New York
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Kheirabadi S, Sheikhi A. Recent advances and challenges in recycling and reusing biomedical materials. CURRENT OPINION IN GREEN AND SUSTAINABLE CHEMISTRY 2022; 38:100695. [PMID: 36277846 PMCID: PMC9568467 DOI: 10.1016/j.cogsc.2022.100695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 06/16/2023]
Abstract
Medical waste has increased in the past 3 years as a result of the coronavirus disease 2019 (COVID-19) pandemic. This condition is expected to exacerbate due to the growing healthcare markets and aging population, posing health threats to the public via environmental footprints. To alleviate these impacts, there is an urgent need for medical waste management. This article highlights the drawbacks of current disposal methods and the potential of medical waste reuse and recycling, emphasizing the processes, materials, and chemistry involved in each practice. Further discussion is provided on the chemical and mechanical recycling of plastics as the dominating material in biomedical applications, and possible strategies and challenges in recycling and reusing biomedical materials are explored in this review.
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Affiliation(s)
- Sina Kheirabadi
- Department of Chemical Engineering, The Pennsylvania State University, University Park, PA, 16802, USA
| | - Amir Sheikhi
- Department of Chemical Engineering, The Pennsylvania State University, University Park, PA, 16802, USA
- Department of Biomedical Engineering, The Pennsylvania State University, University Park, PA, 16802, USA
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Oturu K, Ijomah W, Orr A, Verpeaux L, Broadfoot B, Clark S, Devine R. Remanufacturing of single-use medical devices: a case study on cross-border collaboration between the UK and Nigeria. HEALTH AND TECHNOLOGY 2022; 12:273-283. [PMID: 35136709 PMCID: PMC8814787 DOI: 10.1007/s12553-022-00641-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 01/21/2022] [Indexed: 11/24/2022]
Abstract
This paper aims to evaluate the current state of the remanufacturing of medical devices, considering the differences between developed and developing countries. With reference to various socio-economic factors, the impact of remanufacturing to sustainability was evaluated and from this, single-use medical devices were deemed to be critical in minimising waste within the medical industry. This is even more critical with increasing use of single-use devices in the Coronavirus disease 2019 (COVID 19) pandemic. It was identified that cleaning is a key consideration for ensuring a safe remanufacturing process that would minimise the risk of infection to patients. Therefore, this process was evaluated and appropriate recommendations made. Although there may be some challenges, further research would be required for integration of the methodology and process outlined into the medical sector.
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Affiliation(s)
- Kingsley Oturu
- Department of Design Manufacturing & Engineering Management, University of Strathclyde, Strathclyde, Scotland
| | - Winifred Ijomah
- Department of Design Manufacturing & Engineering Management, University of Strathclyde, Strathclyde, Scotland
| | - Andrew Orr
- Department of Design Manufacturing & Engineering Management, University of Strathclyde, Strathclyde, Scotland
| | - Laura Verpeaux
- Department of Design Manufacturing & Engineering Management, University of Strathclyde, Strathclyde, Scotland
| | - Ben Broadfoot
- Department of Mechanical & Aerospace Engineering, University of Strathclyde, Strathclyde, Scotland
| | - Stuart Clark
- Department of Mechanical & Aerospace Engineering, University of Strathclyde, Strathclyde, Scotland
| | - Ryan Devine
- Department of Mechanical & Aerospace Engineering, University of Strathclyde, Strathclyde, Scotland
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Costa EA, Costa E. Dispositivos de uso único: políticas de regulação de reuso e implicações para a saúde coletiva. SAÚDE EM DEBATE 2021. [DOI: 10.1590/0103-1104202113025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO O reuso de dispositivos médicos de uso único implica segurança em saúde. Este estudo analisa sistemas regulatórios de reuso de produtos médicos de uso único em âmbito internacional. Trata-se de revisão integrativa, com descritores específicos, sem restrição de ano da publicação. A busca dos dados, entre outubro e dezembro de 2017, incluiu 23 estudos. As políticas de reuso desses produtos variam entre países, com normas legitimando essas práticas, como a norte-americana e a alemã, normas restritivas e regulações inexistentes em nível nacional, como no Canadá, no Japão e na Europa. Essas políticas centram-se na regulação pré-comercialização, estruturam-se na classificação dos produtos, com questões relacionadas ao rótulo dos produtos, se multiuso ou de uso único, ponto-chave do dilema desse reuso. Este estudo aponta a necessidade de reestruturação das políticas de reuso de produtos de uso único quanto à classificação desses dispositivos, bem como à adoção de mecanismos para clarificação do rótulo desses produtos. Ressalta os condicionantes internos e externos que envolvem o desenvolvimento das políticas de saúde e o papel do Estado na preservação dos direitos da saúde de seus cidadãos, em detrimento dos grupos de interesses privados e dotados de fortes recursos de poder, como a indústria de produtos médicos.
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Affiliation(s)
| | - Ediná Costa
- Universidade Federal da Bahia (UFBA), Brasil
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Duong TH, Park JW, Maeng SK. Assessment of organic carbon migration and biofilm formation potential on polymeric tubes in contact with water. JOURNAL OF HAZARDOUS MATERIALS 2021; 411:125095. [PMID: 33858087 DOI: 10.1016/j.jhazmat.2021.125095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 12/31/2020] [Accepted: 01/07/2021] [Indexed: 06/12/2023]
Abstract
Biofilm formation has been frequently identified as a pathway of nosocomial infection in polymeric tubes used for patients of all ages. Biofilm formation on tube surfaces can lead to hygienic failure and cause diarrhea, stomach pain, inflammation, and digestive system disease. This study investigated the influence of polymeric tube materials in contact with water on the biomass formation potential and migration potential of microbially available carbon from plasticizers using a BioMig test. The thermoplastic elastomer tube, which is reusable, leached a relatively low amount of assimilable organic carbon to water. In contrast, the assimilable organic carbon migration potential of polyurethane was the most significant, 6-fold greater than that of the thermoplastic elastomer. Moreover, the same materials (e.g., silicone) produced via different manufacturing processes showed significant differences in migration behaviors. The potential biomass formation observed in polyurethane was approximately 7 × 109 cells cm-2 for both Aeromonas hydrophila and Escherichia coli strains. This study highlights the importance of choosing the correct material characteristics of polymeric tubes in contact with water to protect them from bacterial contamination. Therefore, manufacturers can use the BioMig test to evaluate and produce more hygienic and biostable tubes.
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Affiliation(s)
- Thi Huyen Duong
- Department of Civil and Environmental Engineering, Sejong University, 209 Neungdong-ro, Gwangjin-gu, Seoul 05006, Republic of Korea
| | - Ji Won Park
- Department of Civil and Environmental Engineering, Sejong University, 209 Neungdong-ro, Gwangjin-gu, Seoul 05006, Republic of Korea
| | - Sung Kyu Maeng
- Department of Civil and Environmental Engineering, Sejong University, 209 Neungdong-ro, Gwangjin-gu, Seoul 05006, Republic of Korea.
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Akweongo P, Chatio ST, Owusu R, Salari P, Tedisio F, Aikins M. How does it affect service delivery under the National Health Insurance Scheme in Ghana? Health providers and insurance managers perspective on submission and reimbursement of claims. PLoS One 2021; 16:e0247397. [PMID: 33651816 PMCID: PMC7924798 DOI: 10.1371/journal.pone.0247397] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 02/08/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION In 2003, the Government of Ghana launched the National Health Insurance Scheme (NHIS) to enable all Ghanaian residents to have access to health services at the point of care without financial difficulty. However, the system has faced a number of challenges relating to delays in submission and reimbursement of claims. This study assessed views of stakeholders on claims submission, processing and re-imbursement under the NHIS and how that affected health service delivery in Ghana. METHODS The study employed qualitative methods where in-depth interviews were conducted with stakeholders in three administrative regions in Ghana. Purposive sampling method was used to select health facilities and study participants for the interviews. QSR Nvivo 12 software was used to code the data into themes for thematic analysis. RESULTS The results point to key barriers such as lack of qualified staff to process claims, unclear vetting procedure and the failure of National Health Insurance Scheme officers to draw the attention of health facility staff to resolve discrepancies on time. Participants perceived that lack of clarity, inaccurate data and the use of non-professional staff for NHIS claims vetting prolonged reimbursement of claims. This affected operations of credentialed health facilities including the provision of health services. It is perceived that unavailability of funds led to re-use of disposable medical supplies in health service delivery in credentialed health facilities. Stakeholders suggested that submission of genuine claims by health providers and regular monitoring of health facilities reduces errors on claims reports and delays in reimbursement of claims. CONCLUSION Long delays in claims reimbursement, perceived vetting discrepancies affect health service delivery. Thus, effective collaboration of all stakeholders is necessary in order to develop a long-term strategy to address the issue under the NHIS to improve health service delivery.
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Affiliation(s)
| | - Samuel Tamti Chatio
- University of Ghana, School of Public Health, Accra, Ghana
- Navrongo Health Research Centre, Navrongo, Ghana
| | - Richmond Owusu
- University of Ghana, School of Public Health, Accra, Ghana
| | - Paola Salari
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), University of Basel, Basel, Switzerland
| | - Fabrizio Tedisio
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute (Swiss TPH), University of Basel, Basel, Switzerland
| | - Moses Aikins
- University of Ghana, School of Public Health, Accra, Ghana
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Guidelines for infection control and prevention in anaesthesia in South Africa. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2021. [DOI: 10.36303/sajaa.2021.27.4.s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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10
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Sun Y, Zhang D, Lueth TC. Bionic Design of a Disposable Compliant Surgical Forceps With Optimized Clamping Performance. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:4704-4707. [PMID: 33019042 DOI: 10.1109/embc44109.2020.9176027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Disposable forceps are frequently used in different surgical procedures to prevent infections caused by poorly sterilized reusable metal forceps. Compared to traditional rigid-joint mechanisms, compliant mechanisms are much easier to sterilize due to their monolithic structure, hence they are widely used for designing disposable surgical forceps. However, the clamping performance of plastic compliant forceps is generally less robust than metal forceps, which has greatly limited their use in medical applications. To cope with this problem, a novel 3D-printed plastic compliant forceps with optimized clamping performance was developed in this paper for open surgery and physical nursing applications. Bio-inspired topology optimization techniques were employed to synthesize the forceps. The clamping capability of the proposed forceps was evaluated by finite element analysis and loading tests. Results showed that the proposed forceps can generate greater and more stable clamping forces than the previous model of disposable compliant forceps. The proposed bionic optimization method also has potential for synthesizing compliant devices for robotic surgery.
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Sahiledengle B. Decontamination of patient equipment: nurses' self-reported decontamination practice in hospitals of southeast Ethiopia. BMC Res Notes 2019; 12:392. [PMID: 31300038 PMCID: PMC6624938 DOI: 10.1186/s13104-019-4427-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 07/05/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Failure to adequately decontaminate patient equipment will increase the risk of transmission of infection between patients and may contribute to the development of hospital-acquired infections. In effect, full obedience towards the acceptable decontamination process by healthcare workers is required. The aim of this study was to assess decontamination practice and associated factors among nurses in hospitals of the southeast, Ethiopia. RESULTS A total of 273 nurses participated in the study with a response rate of 98.9%. Of these respondents, the acceptable decontamination practice was found to be 49.1% [95% CI 43.2-54.9%]. Nurses who have reported good infection prevention practice were 7.313 times more likely to had acceptable decontamination practice than there counterpart [AOR = 7.313; 95% CI: 4.030, 13.272, p value = 0.000]. Nurses who were working in the department having instructive posters or guideline target on instrument processing were 2.675 times more likely to had acceptable decontamination practice [AOR = 2.675; 95% CI: 1.376, 5.200, p-value = 0.004]. This low decontamination practice among nurses is a concern and might make hospitalized patients prone to different pathogenic microorganisms, which in turn can increase the risk of healthcare-associated infections. Therefore, enhancing the current nurses' decontamination practice through considering those identified factors is crucial.
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Affiliation(s)
- Biniyam Sahiledengle
- Department of Public Health, Madda Walabu University Goba Referral Hospital, Bale-Goba, Ethiopia.
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Eze S, Ijomah W, Wong TC. Accessing medical equipment in developing countries through remanufacturing. ACTA ACUST UNITED AC 2019. [DOI: 10.1007/s13243-018-0065-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Joshi SC, Diwan V, Joshi R, Sharma M, Pathak A, Shah H, Tamhankar AJ, Stålsby Lundborg C. "How Can the Patients Remain Safe, If We Are Not Safe and Protected from the Infections"? A Qualitative Exploration among Health-Care Workers about Challenges of Maintaining Hospital Cleanliness in a Resource Limited Tertiary Setting in Rural India. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091942. [PMID: 30200603 PMCID: PMC6163563 DOI: 10.3390/ijerph15091942] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/01/2018] [Accepted: 09/03/2018] [Indexed: 02/06/2023]
Abstract
Background: Health care-associated infections (HAIs) result in treatment delays as well as failures and financial losses not only to patients but also to the treating hospital and overall health-care delivery system. Due to hospital-acquired infections, there are problems of increase in morbidity and mortality, additional diagnostic and therapeutic interventions and ultimately antimicrobial resistance. Proper understanding among health-care workers about the ill effects of HAIs is very important to address this issue. The present study is a qualitative exploration aimed at understanding various aspects of hospital environmental hygiene and Infection prevention control program, by exploring the staff perception regarding the challenges, facilitators and barriers as well as feasible measures towards improvement in a rural tertiary teaching hospital in central India. Method: A qualitative study was conducted using 10 focus group discussions (FGDs) among five different professional groups, which included hospital administrators, doctors, nurses, environmental cleaning staff, and undergraduate medical students. The FGD guide included the following topics: (1) opinion about the status of cleanliness, (2) concepts and actual practices prevailing of hospital environmental hygiene, (3) Barriers, constraints, and problems in maintaining hospital environmental hygiene, (4) Suggestions for improvements. The data were analyzed manually using the content (thematic) analysis method. Results: Two themes were identified: Theme 1: “Prevailing practices and problems related to hospital surface/object contamination and hospital infection control”. Theme 2: “Measures suggested for improving hospital cleanliness within the existing constraints”. The participants emphasized the influence of resource constraints and needed inputs. They brought up the consequent prevailing practices and problems related, on one hand, to various stakeholders (service consumers, hospital personnel including the management), on the other, to specific infection prevention and control processes. They also suggested various measures for improvement. Conclusions: The study has revealed prevailing practices, problems, and suggested measures related to hospital environmental hygiene, particularly hospital cleanliness and HAI prevention and control processes. These insights and assertions are important for developing future behavioral and structural interventions in resource-limited settings. This study recommends a nationwide reliable HAI surveillance system and a robust infection prevention and control program in each health-care institution.
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Affiliation(s)
- Sudhir Chandra Joshi
- Department of Community Medicine, R.D. Gardi Medical College, Ujjain 456006, India.
| | - Vishal Diwan
- Department of Public Health and Environment, R.D. Gardi Medical College, Ujjain 456006, India.
- International Centre for Health Research, Ujjain Charitable Trust Hospital and Research Centre, Ujjain 456001, India.
- Department of Public Health Sciences, Global Health, Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 17177 Stockholm, Sweden.
| | - Rita Joshi
- Department of Microbiology, R.D. Gardi Medical College, Ujjain 456006, India.
| | - Megha Sharma
- Department of Public Health Sciences, Global Health, Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 17177 Stockholm, Sweden.
- Department of Pharmacology, R.D. Gardi Medical College, Ujjain 456006, India.
| | - Ashish Pathak
- Department of Public Health Sciences, Global Health, Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 17177 Stockholm, Sweden.
- Department of Pediatrics, R.D. Gardi Medical College, Ujjain 456006, India.
- Department of Women and Children's Health, International Maternal and Child Health Unit, Uppsala University, 75185 Uppsala, Sweden.
| | - Harshada Shah
- Department of Microbiology, R.D. Gardi Medical College, Ujjain 456006, India.
| | - Ashok J Tamhankar
- Department of Public Health Sciences, Global Health, Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 17177 Stockholm, Sweden.
- Indian Initiative for Management of Antibiotic Resistance, Department of Environmental Medicine, R.D. Gardi Medical College, Ujjain 456006, India.
| | - Cecilia Stålsby Lundborg
- Department of Public Health Sciences, Global Health, Health Systems and Policy (HSP): Medicines Focusing Antibiotics, Karolinska Institutet, 17177 Stockholm, Sweden.
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Low-energy electron-beam treatment as alternative for on-site sterilization of highly functionalized medical products – A feasibility study. Radiat Phys Chem Oxf Engl 1993 2018. [DOI: 10.1016/j.radphyschem.2018.04.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Dussán KB, Leidal A, Corriveau N, Montgomery D, Eagle KA, LaHood BJ. Increasing Medical Trainees' Empathy Through Volunteerism and Mentorship. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2017; 4:2382120517737995. [PMID: 29349343 PMCID: PMC5757631 DOI: 10.1177/2382120517737995] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 09/11/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Within medical education, there have been recent calls for increased understanding and exposure to poverty to increase trainees' empathy toward the underserved. Students participating in Michigan Cardiovascular Outcomes Research and Reporting Program research program volunteered at World Medical Relief (WMR) in Detroit, Michigan, a nonprofit organization which recycles medical equipment for developing countries and within greater Detroit. Participants' perceptions of the underserved were measured before and after the experience. METHODS Preliminary questionnaires were given to participants prior to and after exposures at WMR. Questionnaires examined participants' attitudes toward the underserved, knowledge of medical supply reuse, and their perceived ability to impact change. P values of <.025 were considered significant. RESULTS A total of 39 participants completed the survey, 77% previously volunteered, 33% had volunteered internationally. Participants were >4× more likely than previously to have knowledge of the variety of recycled medical supplies at WMR. Prior to volunteering, 48.7% of participants gave little thought to how excess medical supplies could be collected versus 0% after exposure. Participants were 1.5× more likely to agree that the experience was enhanced working with their peers and 2.7× more likely to consider starting their own organization/intervention for medical supply donations. Those participants that never previously volunteered were 1.3× more likely to do so with encouragement from a mentor. CONCLUSIONS Encouraging exposure to such service programs resulted in enhanced knowledge of community resources and increased motivation to participate in outreach and belief of individual responsibility to care for the underserved. Incorporating volunteerism into traditional education programs offers the opportunity to build awareness and interest in students reaching out to the underserved.
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Affiliation(s)
- Kathleen Bronson Dussán
- Department of Internal Medicine, VA Ann Arbor Healthcare System and University of Michigan, Ann Arbor, MI, USA
| | - Adam Leidal
- Department of Internal Medicine-Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Nicole Corriveau
- Department of Internal Medicine-Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Daniel Montgomery
- Department of Internal Medicine-Cardiology, University of Michigan, Ann Arbor, MI, USA
| | - Kim A Eagle
- Department of Internal Medicine-Cardiology, University of Michigan, Ann Arbor, MI, USA
- Medical School, University of Michigan, Ann Arbor, MI, USA
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Barbara J LaHood
- Department of Internal Medicine-Cardiology, University of Michigan, Ann Arbor, MI, USA
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Lamin E, Newman DK. Clean intermittent catheterization revisited. Int Urol Nephrol 2016; 48:931-9. [DOI: 10.1007/s11255-016-1236-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 01/29/2016] [Indexed: 12/27/2022]
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Roseira CE, Silva DMD, Passos IPBD, Orlandi FS, Padoveze MC, Figueiredo RMD. Diagnosis of compliance of health care product processing in Primary Health Care. Rev Lat Am Enfermagem 2016; 24:e2820. [PMID: 27878220 PMCID: PMC5173301 DOI: 10.1590/1518-8345.1439.2820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 07/21/2016] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: identify the compliance of health care product processing in Primary Health Care and assess possible differences in the compliance among the services characterized as Primary Health Care Service and Family Health Service. Method: quantitative, observational, descriptive and inferential study with the application of structure, process and outcome indicators of the health care product processing at ten services in an interior city of the State of São Paulo - Brazil. Results: for all indicators, the compliance indices were inferior to the ideal levels. No statistically significant difference was found in the indicators between the two types of services investigated. The health care product cleaning indicators obtained the lowest compliance index, while the indicator technical-operational resources for the preparation, conditioning, disinfection/sterilization, storage and distribution of health care products obtained the best index. Conclusion: the diagnosis of compliance of health care product processing at the services assessed indicates that the quality of the process is jeopardized, as no results close to ideal levels were obtained at any service. In addition, no statistically significant difference in these indicators was found between the two types of services studied.
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18
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Reuse of single-use critical medical devices. Gastroenterol Nurs 2015; 38:135-6. [PMID: 25831253 DOI: 10.1097/sga.0000000000000098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Passos IPBD, Padoveze MC, Roseira CE, de Figueiredo RM. Adaptation and validation of indicators concerning the sterilization process of supplies in Primary Health Care services. Rev Lat Am Enfermagem 2015; 23:148-54. [PMID: 25806643 PMCID: PMC4376043 DOI: 10.1590/0104-1169.3518.2536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 09/04/2014] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES: to adapt and validate, by expert consensus, a set of indicators used to assess
the sterilization process of dental, medical and hospital supplies to be used in
PHC services. METHOD: qualitative methodological study performed in two stages. The first stage
included a focal group composed of experts to adapt the indicators to be used in
PHC. In the second stage, the indicators were validated using a 4-point Likert
scale, which was completed by judges. A Content Validity Index of ≥ 0.75 was
considered to show approval of the indicators. RESULTS: the adaptations implemented by the focal group mainly referred to the physical
structure, inclusion of dental care professionals, inclusion of chemical
disinfection, and replacement of the hot air and moist heat sterilization methods.
The validation stage resulted in an index of 0.96, which ranged from 0.90 to 1.00,
for the components of the indicators. CONCLUSION: the judges considered the indicators after adaptation to be validated. Even
though there may be differences among items processed around the world, there
certainly are common characteristics, especially in countries with economic and
cultural environments similar to Brazil. The inclusion of these indicators to
assess the safety of healthcare supplies used in PHC services should be
considered.
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Håkansson MÅ. Reuse versus single-use catheters for intermittent catheterization: what is safe and preferred? Review of current status. Spinal Cord 2014; 52:511-6. [DOI: 10.1038/sc.2014.79] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 03/31/2014] [Accepted: 04/13/2014] [Indexed: 01/21/2023]
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Russell D, Deakin A, Fogg QA, Picard F. Non-invasive quantification of lower limb mechanical alignment in flexion. ACTA ACUST UNITED AC 2014; 19:64-70. [PMID: 24856249 PMCID: PMC4266097 DOI: 10.3109/10929088.2014.885566] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Non-invasive navigation techniques have recently been developed to determine mechanical femorotibial alignment (MFTA) in extension. The primary aim of this study was to evaluate the precision and accuracy of an image-free navigation system with new software designed to provide multiple kinematic measurements of the knee. The secondary aim was to test two types of strap material used to attach optical trackers to the lower limb. METHODS Seventy-two registrations were carried out on 6 intact embalmed cadaveric specimens (mean age: 77.8 ± 12 years). A validated fabric strap, bone screws and novel rubber strap were used to secure the passive tracker baseplate for four full experiments with each knee. The MFTA angle was measured under the conditions of no applied stress, valgus stress, and varus stress. These measurements were carried out at full extension and at 30°, 40°, 50° and 60° of flexion. Intraclass correlation coefficients, repeatability coefficients, and limits of agreement (LOA) were used to convey precision and agreement in measuring MFTA with respect to each of the independent variables, i.e., degree of flexion, applied coronal stress, and method of tracker fixation. Based on the current literature, a repeatability coefficient and LOA of ≤ 3° were deemed acceptable. RESULTS The mean fixed flexion for the 6 specimens was 12.8° (range: 6-20°). The mean repeatability coefficient measuring MFTA in extension with screws or fabric strapping of the baseplate was ≤ 2°, compared to 2.3° using rubber strapping. When flexing the knee, MFTA measurements taken using screws or fabric straps remained precise (repeatability coefficient ≤ 3°) throughout the tested range of flexion (12.8-60°); however, using rubber straps, the repeatability coefficient was >3° beyond 50° flexion. In general, applying a varus/valgus stress while measuring MFTA decreased precision beyond 40° flexion. Using fabric strapping, excellent repeatability (coefficient ≤ 2°) was observed until 40° flexion; however, beyond 50° flexion, the repeatability coefficient was >3°. As was the case with precision, agreement between the invasive and non-invasive systems was satisfactory in extension and worsened with flexion. Mean limits of agreement between the invasive and non-invasive system using fabric strapping to assess MFTA were 3° (range: 2.3-3.8°) with no stress applied and 3.9° (range: 2.8-5.2°) with varus and valgus stress. Using rubber strapping, the corresponding values were 4.4° (range: 2.8-8.5°) with no stress applied, 5.5° (range: 3.3-9.0°) with varus stress, and 5.6° (range: 3.3-11.9°) with valgus stress. DISCUSSION Acceptable precision and accuracy may be possible when measuring knee kinematics in early flexion using a non-invasive system; however, we do not believe passive trackers should be mounted with rubber strapping such as was used in this study. Flexing the knee appears to decrease the precision and accuracy of the system. The functions of this new software using image-free navigation technology have many potential clinical applications, including assessment of bony and soft tissue deformity, pre-operative planning, and post-operative evaluation, as well as in further pure research comparing kinematics of the normal and pathological knee.
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Affiliation(s)
- David Russell
- Faculty of Biomedical and Life Sciences, University of Glasgow , Glasgow , and
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