Assessment health status of ICU medical equipment levels at Neyshabur hospitals using ICNA and ACC indices

The efficiency of cleaning in intensive care units: A systematic review

OBJECTIVES

This review aims to analyze the studies on cleaning practices and the efficiency of the cleaning carried out in environments that have a great risk of resistant microorganism infection, such as intensive care units.

METHODS

In this study, a retrospective literature review was undertaken of the relevant publications between the years 2005 and 2020, using the keywords "Cross Infection, Infection Control, Multidrug-Resistant Bacteria, Intensive Care, Room Cleaning, Environmental Cleaning, Hospital-Associated Infection"; using the international databases Pubmed, CINAHL and EBSCO and domestic database ULAKBIM on search engines. Titles and abstracts of all relevant articles found on electronic searches were reviewed by the researchers independently. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guideline and Patient, Intervention, Comparison, Outcomes, Study design model were used in analysing the studies.

RESULTS

The selected studies were reviewed in four main categories: Materials used in cleaning, the period between taking environmental samples, cleaning methods, and the efficiency of cleaning. Among the studies included herein, eight were randomized controlled trials, three were retrospective intervention studies, two were case-control studies and one was a retrospective cohort study.

CONCLUSIONS

Today, the assessment of cleaning in environments can be evaluated by different methods, but there are advantages and disadvantages of these methods. Therefore, in the relevant literature, it is suggested that cleaning must be evaluated by several methods, not only one. Also, training the staff that carries out the cleaning and rewarding correct behavior by giving feedback are important approaches to increase the efficiency of cleaning. It is suggested that cleaning must be carried out every day, regularly with effective methods and equipment; frequency of cleaning during epidemics must be increased, institutions must prepare cleaning manuals according to evidence-based guidelines that are recognized at an international level.

Farmers' health risk and the use of personal protective equipment (PPE) during pesticide application

Personal protective equipment (PPE) is always considered the last and sometimes the most important safety shield against pesticides' hazards health risks. The spread of pests and low-quality pesticides, especially in developing countries, has increased health hazard potential among farmers. The present study aimed to assess farmers' health risks when using PPE (composite index) by exploring its most important predictive factors. A sample of 370 farmers in Ardabil province, Iran, was selected based on the multistage sampling method. The results reveal that most farmers use three types of PPE when applying pesticides. Based on their perception of pesticides' health risk, the number of PPE used differs. The highest health hazard in using PPE and the minimum perception of health risks caused by pesticides among farmers are related to the pesticides Paraquat and Chlorpyrifos. Also, the most important predictive factors of the composite index were found to be farm size, pesticides' health risk perception, previous experiences with harmful effects of chemical pesticides on health (especially among large-scale farmers), training courses, and ability to afford PPE-related costs, respectively. Accordingly, farmers' safety and health programs in the region should focus on reducing or replacing the mentioned high-risk pesticides. Reducing government subsidies for high-risk pesticides, establishing government subsidies for farmers' PPE, providing extension training (especially for small-scale farmers), and receiving ongoing training feedback to improve farmers' health risk perception of pesticides and the need to use PPE will effectively reduce farmers' health risks.

The efficiency of cleaning in intensive care units: A systematic review

OBJECTIVES

This review aims to analyze the studies on cleaning practices and the efficiency of the cleaning carried out in environments that have a great risk of resistant microorganism infection, such as intensive care units.

METHODS

In this study, a retrospective literature review was undertaken of the relevant publications between the years 2005 and 2020, using the keywords "Cross Infection, Infection Control, Multidrug-Resistant Bacteria, Intensive Care, Room Cleaning, Environmental Cleaning, Hospital-Associated Infection"; using the international databases Pubmed, CINAHL and EBSCO and domestic database ULAKBIM on search engines. Titles and abstracts of all relevant articles found on electronic searches were reviewed by the researchers independently. The Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guideline and Patient, Intervention, Comparison, Outcomes, Study design model were used in analysing the studies.

RESULTS

The selected studies were reviewed in four main categories: Materials used in cleaning, the period between taking environmental samples, cleaning methods, and the efficiency of cleaning. Among the studies included herein, eight were randomized controlled trials, three were retrospective intervention studies, two were case-control studies and one was a retrospective cohort study.

CONCLUSIONS

Today, the assessment of cleaning in environments can be evaluated by different methods, but there are advantages and disadvantages of these methods. Therefore, in the relevant literature, it is suggested that cleaning must be evaluated by several methods, not only one. Also, training the staff that carries out the cleaning and rewarding correct behavior by giving feedback are important approaches to increase the efficiency of cleaning. It is suggested that cleaning must be carried out every day, regularly with effective methods and equipment; frequency of cleaning during epidemics must be increased, institutions must prepare cleaning manuals according to evidence-based guidelines that are recognized at an international level.

The Performance Evaluation Mechanism Based on Information Construction for Large Stand-Alone Medical Equipment and Its Support for Decision-Making of Purchasing

BACKGROUND

Continuously deeper reform of public hospitals has put forward the need to innovate the philosophy and system of large medical equipment operation and management, and the phenomenon featuring "more attention to purchasing and less attention to management" need to be turned around.

METHODS

This research took use of information management to set up ID fields (unique number) for target stand-alone equipment; integrated statistics functions of HIS, PACS, LIS, RIS and equipment management system to get the basic operation data; informationized the work flow and reform technology to set up a post evaluation indictor system for the performance of stand-alone equipment; compared the service condition of newly purchased equipment with the feasibility application of relative department from various dimensions; designed objective post-evaluation indicators from various angles to scientifically manage existing medical equipment and support decision-making of new application for purchasing medical equipment.

RESULTS

Application performance of stand-alone equipment and clinical departments were ranked in a standardized manner. Decision-making mode based on data case of stand-alone equipment was set up. Net present value was evaluated. However, re-purchasing the instrument did not continuously increase the contribution of each instrument. The laboratory can purchase new instruments again, while the imaging department is not recommended to purchase.

CONCLUSION

The performance evaluation mechanism based on information construction for large stand-alone medical equipment and its support for decision-making of purchasing is of great significance to improve the service life of equipment, exert the maximum effect and reduce economic waste.

Microbial contamination of keyboards and electronic equipment of ICU (Intensive Care Units) in Kashan University of medical sciences and health service hospitals

Microbial contamination of computer keyboards and inanimate surfaces of electronic equipment in ICU (Intensive Care Units) can have a significant role for ICU-acquired colonization and a spectrum of nosocomial infections. The aim of this study was to survey the incidence of bacterial contamination and the distribution of species of computer keyboards and inanimate surfaces of bed side equipment in ICUs in Kashan University of medical sciences and health service hospitals. This descriptive, cross-sectional study was done on 75 computer keyboards and inanimate surfaces electronic equipment in 5 ICUs during 2016-2017. Samples were collected from computer keyboards and electronic equipment with normal saline rinsed swabs. Samples were Cultivated on Blood Agar (BA), and MacConkey Agar (MAC) and growing bacteria were identified based on their morphology and biochemical properties. Seventy six (76%) out of 75 computer Keyboards and electronic equipment were contaminated with bacteria and fungi. The most contamination pertained to gram positive bacteria (70.7%) and the most isolated bacteria were coagulase-negative staphylococci. The highest contamination rates were found on computer keyboards and electronic equipment of which were nurses. •This study demonstrates that monitoring inanimate surfaces and considering these surfaces as source of nosocomial infections is necessary.•In total, Seventy six (76%) out of 75 computer keyboards and electronic equipment in ICUs had positive culture.•It can be concluded that it is necessary for ICUs of Kashan university of medical sciences and Health service hospitals to have practical and regular program to reduce nosocomial infections.

Evaluation of safety standards accomplishment in educational hospitals of Neyshabur University of Medical Sciences-Iran

Patient's safety and staff in hospital is one issue that has always been considered as an important principle by experts in health systems. Therefore, for increase safety, standards and safety regulations must be considered. This study aims to evaluation of safety standards accomplishment in educational hospitals of Neyshabur University of medical Sciences. This cross-sectional descriptive study, safety standard status of all wards including 17 various wards from 22 Bahman hospital and 14 various wards from hakim Hospital in Neyshabur city (2016) was investigated. Data were collected using a questionnaire safety standard status hospitals (264 questions). Also data analyzed by SPSS16 software, using descriptive (Mean ± SD) and inferential statistics (T-Test). The results revealed that Safety standard status in 22bahman and hakim hospital were weak (2.42 ± 0.14) and moderate (3.04 ± 0.18) respectively. Also result showed in Hakim hospital, the highest and lowest safety standard status in Internal and Administrative-financial unit was (3.42 ± 0.19) (1.36 ± 0.58) respectively. In addition in hakim hospital, the highest and lowest safety standard status in operation room and administrative-financial unit (3.53 ± 0.28), 1.36 ± 0.58) respectively. According to the result, the safety condition in hospitals of Neyshabur city is moderate and poor status. However, imperfect implementation of safety protocols can endanger safety conditions in hospital. Therefore, it is necessary to take the required correcting measures to ensure full safety in hospitals. •Safety is defined by development of systems for preventing incidents, injuries, and other unpleasant events in organizations.•This article showed the safety status is not appropriate in most units of hospitals, which can lead to dangers for patients and personnel.•It is suggested for future studies to compare the safety status of different provinces.