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Bacterial growth and recovery on hospital biometric devices: effect of two types of disinfectants. Porto Biomed J 2021; 6:e088. [PMID: 33884315 PMCID: PMC8055484 DOI: 10.1097/j.pbj.0000000000000088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 08/05/2020] [Indexed: 11/26/2022] Open
Abstract
Objectives: The aim of the study was to evaluate the presence of bacterial contamination on biometric identification devices in a public hospital; identify the species of bacteria implicated in the contamination and assess bacterial recovery after the use of 2 types of disinfectants: alcohol 70% and isopropyl alcohol chlorhexidine. Design: Before and after trial. Setting: Public hospital, tertiary referral center. Participants: All existing biometric identification devices in the hospital (n = 20). Methods: Collection of 2 microbiological samples from the fingerprint reading surface of biometric devices immediately before and after applying the solution with alcohol 70% and in separate time periods with isopropyl alcohol chlorhexidine. Results: It have been identified 21 different bacterial species in a total of 78 samples, mostly Staphylococcus epidermidis (32 samples) and S aureus (7 samples). S epidermidis was eliminated in 61.5% of the samples after disinfecting with alcohol 70% and in 92.3% of the samples disinfected with isopropyl alcohol chlorhexidine. S aureus was eliminated in 33.3% and 100% of the samples, respectively. We found no bacterial growth in 10% of the devices after disinfection with 70% alcohol and in 78.9% of devices after disinfection with isopropyl alcohol chlorhexidine. We also found that there was a decrease in the frequency of species isolated after using both disinfection solutions, although isopropyl alcohol chlorhexidine appeared to be more effective. Conclusions: The biometric identification devices used in this hospital seem to be safe regardless of the products used for its cleaning. The majority of the bacteria found are commensal skin microorganisms. We did not find pathogenic bacteria for immunocompetent individuals, in particular methicillin-resistant S aureus.
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The impact of universal face masking and enhanced hand hygiene for COVID-19 disease prevention on the incidence of hospital-acquired infections in a Taiwanese hospital. Int J Infect Dis 2020; 104:15-18. [PMID: 33383221 PMCID: PMC7832929 DOI: 10.1016/j.ijid.2020.12.072] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/27/2020] [Accepted: 12/23/2020] [Indexed: 01/22/2023] Open
Abstract
Objectives During the coronavirus disease 2019 (COVID-19) pandemic, strict infection control measures have been implemented in healthcare settings and hospitals, including respiratory and hand hygiene. This study investigated the impact of these control measures on the incidence rates of hospital-acquired infections (HAI) and multidrug-resistant organisms (MDRO) in a Taiwan medical center. Methods This study compared the consumption of personal prevention resources and the incidence density of HAI and MDRO in a medical center in Taiwan from January to May 2020, encapsulating the COVID-19 outbreak period in the study, to baseline data from the same timeframe in 2018 and 2019. Results There was no significant difference between the number of inpatient days in 2020, 2018 and 2019. The consumption of either alcohol for hand hygiene or surgical masks significantly increased in 2020. However, the overall HAI incidence density did not significantly differ from the rate at the baseline period. It was found that the incidence density of MDRO was significantly lower in 2020, especially in carbapenem-resistant Acinetobacter baumannii and vancomycin-resistant Enterococcus. Conclusions A collateral benefit of the COVID-19 prevention measures on the incidence density of MDRO was observed in a hospital in Taiwan where the incidence of COVID-19 was low.
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Adler A, Friedman ND, Marchaim D. Multidrug-Resistant Gram-Negative Bacilli: Infection Control Implications. Infect Dis Clin North Am 2016; 30:967-997. [PMID: 27660090 DOI: 10.1016/j.idc.2016.08.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Antimicrobial resistance is a common iatrogenic complication of both modern life and medical care. Certain multidrug resistant and extensively drug resistant Gram-negative organisms pose the biggest challenges to health care today, predominantly owing to a lack of therapeutic options. Containing the spread of these organisms is challenging, and in reality, the application of multiple control measures during an evolving outbreak makes it difficult to measure the relative impact of each measure. This article reviews the usefulness of various infection control measures in containing the spread of multidrug-resistant Gram-negative bacilli.
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Affiliation(s)
- Amos Adler
- Clinical Microbiology Laboratory, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Department of Medicine, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Dror Marchaim
- Department of Medicine, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Division of Infectious Diseases, Assaf Harofeh Medical Center, Zerifin 70300, Israel.
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Abstract
A study was undertaken to determine the theoretical principles of infection control and the related practices that were taught to qualified nurses, students, both RGN and Project 2000, and health care assistants. The aim was to understand how they applied this knowledge to practice. It was found that what they were taught was different for each of the four groups and that in the case of the nurse education programmes the teaching lacked application to practice. The study revealed that an understanding of how infection spread was frequently inaccurate. The ward sister and charge nurse were shown to have a powerful influence on the infection control practices of ward staff. Key issues involve the structure and organisation of nurse education programmes and management practices at ward level.
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Abstract
This paper discusses the term ‘cleanliness’ and applies it to healthcare. Ways of achieving cleanliness in premises where healthcare is delivered are explored. It is concluded that although once a world-leader in infection control practice and research, the United Kingdom is now lagging behind other countries. Traditionally hands have been regarded as the main vectors of healthcare-associated infection. However, hands can never be rendered entirely free of micro-organisms, so it is inevitable that healthcare-associated infection will always be a challenge. Decontamination of the healthcare environment, its fixtures, fittings and clinical equipment are also of pivotal importance in maintaining cleanliness, controlling infection and regaining consumer confidence in healthcare. Nurses play a major role in ensuring that appropriate decontamination processes and procedures are in place to meet required standards. To do so they must receive the appropriate education and training.
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Affiliation(s)
- Dinah Gould
- St Bartholomew's School of Nursing and Midwifery, City University, London
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Gould D, Gammon J, Salem RB, Chudleigh J, Fontenla M. Flowers in the clinical setting: Infection risk or workload issue? J Res Nurs 2016. [DOI: 10.1177/136140960400900507] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Healthcare-associated infection has become a topic of interest to the general public in the United Kingdom, kindled by media accounts of poor hygiene and the risks of cross-infection. In the spring of 2003, one of the broadsheet newspapers published an article debating the hygiene and infection risks associated with cut flowers brought into clinical areas. There were reports that in many wards this practice is no longer allowed because flowers are considered dirty, trigger allergies and the water is regarded as harbouring bacteria, leading to infection. Discussion with infection control experts revealed that questions concerning the risks associated with flowers are among those most frequently asked. A literature search was undertaken to establish the evidence base, and a questionnaire study was performed with a purposive sample of 39 nurses to document how they manage flowers in the clinical setting. Empirical research studies were difficult to obtain. Early work had been undertaken to explore the added workload associated with maintaining fresh flowers and ways of reducing it. Later studies revealed that the water in flower vases and cut plants both harbour large numbers of Gram-negative pathogens. Cross-infection and cases of clinical infection have never been documented, thus flowers have not been considered a risk, except to severely immunocompromised patients. However, scrutiny of the more general literature relating to Gram-negative sepsis indicated that cross-infection has been documented from a wide range of environmental sources and it is possible that it may take place from flowers via the hands of staff if they are not properly decontaminated. Nevertheless, these risks can be reduced by scrupulous attention to hand hygiene and commonsense measures. Over half the nurses (n = 26, 66.6%) thought that flowers constituted an infection risk and a number of other disadvantages were cited. Most nurses (n = 31, 80%) were not in favour of flowers in the clinical setting and there was some evidence that this attitude was related to the amount of work generated, with infection and other risks used to justify it. Interest in the topic was considerable and the results can be used to stimulate discussion and emphasise the importance of controlling health-related infection.
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Affiliation(s)
- Dinah Gould
- St Bartholomew School of Nursing and Midwifery, City University, London
| | - John Gammon
- Swansea Institute of Higher Education, Townhill, Swansea
| | | | | | - Marina Fontenla
- St Bartholomew School of Nursing and Midwifery, City University, London
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Sodhi K, Shrivastava A, Arya M, Kumar M. Knowledge of infection control practices among intensive care nurses in a tertiary care hospital. J Infect Public Health 2013; 6:269-75. [PMID: 23806701 DOI: 10.1016/j.jiph.2013.02.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 01/09/2013] [Accepted: 02/11/2013] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The threat of hospital-acquired infections persists despite advances in the health care system. A lack of knowledge regarding infection control practices among health care workers decreases compliance with these practices. We conducted a study to assess the knowledge of infection control practices among nursing professionals at our hospital. METHODS In total, 100 nurses in the intensive care units at our hospital were given a questionnaire with 40 multiple choice questions, including 10 questions each regarding hand hygiene, standard and transmission-based precautions, care bundles and general infection control practices. The responses were scored as percentages. RESULTS The overall knowledge and awareness regarding different infection control practices were excellent (>90% positive responses) in 5% of the nursing professionals, good (80-90% positive responses) in 37%, average (70-80% positive responses) in 40% and below average (<70% positive responses) in 18%. CONCLUSION The infection control knowledge among the nurses was fairly good; however, there is still a wide scope of improvement with regular educational programs and in-house training.
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Kelsall NKR, Griggs RKL, Bowker KE, Bannister GC. Should finger rings be removed prior to scrubbing for theatre? J Hosp Infect 2006; 62:450-2. [PMID: 16487627 DOI: 10.1016/j.jhin.2005.09.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2003] [Accepted: 09/01/2005] [Indexed: 11/29/2022]
Abstract
Finger rings increase surface bacterial counts. Although scrubbing reduces these (P=0.05), there are more bacteria under rings than on adjacent skin or the opposite hand. If rings are removed before scrubbing, bacterial counts are reduced but remain higher than on adjacent skin or the opposite hand. Ideally, finger rings should not be worn by theatre staff. However, if they are, they should be removed prior to scrubbing for surgical operations.
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Affiliation(s)
- N K R Kelsall
- Avon Orthopaedic Centre, Southmead Hospital, North Bristol NHS Trust, Westbury-On-Trym, Bristol, UK
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Nigam Y, Cutter J. A preliminary investigation into bacterial contamination of Welsh emergency ambulances. Emerg Med J 2003; 20:479-82. [PMID: 12954699 PMCID: PMC1726203 DOI: 10.1136/emj.20.5.479] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The objective of this regional study across Wales was to perform a preliminary examination of Welsh emergency vehicles to determine levels of bacterial contamination. METHODS Specific sites within emergency vehicles were swabbed, before and after vehicle cleaning, over a 12 month period, on a monthly basis. All swabs were sent to pathology laboratories for culturing and analysis. RESULTS Results showed that most sites within emergency vehicles across Wales were contaminated with a range of bacterial species before vehicle cleaning. After vehicle cleaning, many sites in vehicles were still contaminated, and some sites that were previously uncontaminated, became freshly contaminated as a result of cleaning methods used. CONCLUSIONS The authors conclude that the Welsh emergency vehicles examined exhibited an unacceptable level of bacterial contamination. This finding should be carefully considered and all attempts must be made to tackle the problem of vehicle cleanliness and infection control.
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Affiliation(s)
- Y Nigam
- School of Health Science, University of Wales Swansea, Swansea, UK.
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Aiello AE, Cimiotti J, Della-Latta P, Larson EL. A comparison of the bacteria found on the hands of 'homemakers' and neonatal intensive care unit nurses. J Hosp Infect 2003; 54:310-5. [PMID: 12919763 PMCID: PMC2062569 DOI: 10.1016/s0195-6701(03)00146-4] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
This prevalence study was conducted to compare the counts, types and antimicrobial resistance profiles of bacterial flora on the hands of individuals in the community to that of nurses at a nearby university teaching hospital, with an intense hand hygiene regimen. Hand cultures were obtained from 204 individuals during a home visit and 119 nurses in two neonatal intensive care units (NICUs). The mean total log counts of organisms were 5.73 and 5.24 for the homemakers [defined as the person (usually the mother) who is the primary person responsible for arranging childcare, cooking, cleaning etc] and nurse hands, respectively (P<0.0001). Significantly more homemakers had Acinetobacter lwoffii, Enterobacter cloacae, Klebsiella pneumoniae, Pseudomonas aeruginosa, P. fluorescens/putida, and Staphylococcus aureus on their hands compared with the nurses (all P<0.05). However, significantly more nurses had Enterococcus faecalis, S. epidermidis, and S. warneri on their hands (P<0.05). Of note, the hands of nurses harboured significantly more S. epidermidis strains resistant to amoxicillin/clavulanate, cefazolin, clindamycin, erythromycin, and oxacillin and S. warneri resistant to amoxicillin/clavulanate, cefazolin, clindamycin, and oxacillin (P<0.05). Surprisingly, significantly more trimethoprim/sulfamethoxazole-resistant S. epidermidis and ciprofloxacin-resistant S. warneri was recovered from the hands of homemakers (P<0.05). This study demonstrates differences in prevalence, bacterial composition and antimicrobial resistance of hand flora of hospital personnel compared with homemakers. Moreover, the hands of homemakers may serve as community reservoirs for antimicrobial resistant strains of clinical importance.
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Affiliation(s)
- A E Aiello
- The Joseph L. Mailman School of Public Health, Columbia University, New York, NY, USA
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Educational theory into practice: development of an infection control link nurse programme. Nurse Educ Pract 2001; 1:35-41. [DOI: 10.1054/nepr.2001.0007] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/19/2001] [Indexed: 11/18/2022]
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Santos BM. [Monitoring of Staphylococcus aureus colonization in students of a course for nurses aides during their professional education]. Rev Lat Am Enfermagem 2000; 8:67-73. [PMID: 10909380 DOI: 10.1590/s0104-11692000000100010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Considering our goal of understanding the colonization by Staphylococcus aureus in students from a nursing auxiliary program, during their professional formation, we collected material from the nasal cavity (N), right (Md) and left (Me) hands from 42 students on different moments of their formation relating the levels of colonization to the activities developed during the program. Results showed an oscillation in the colonization rate in different moments and the possibility of agent reciprocal transmission between the students and the taken care receptors, considering the type of contact.
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Affiliation(s)
- B M Santos
- Departamento de Enfermagem Geral, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo
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Abstract
As part of a study of community nurses' perceptions of quality in nursing care, the author conducted in-depth qualitative interviews with seven community-based nurses. As part of the study, nurses were asked to describe episodes of wound care and to discuss the factors which could affect the quality of such care. One of the most interesting themes to emerge from the data was the apparent ambivalence of the nurses' attitudes towards infection control in wound care. Nurses discussed the concept of 'aseptic technique' in fatalistic terms and seemed uncertain about what could be achieved in terms of infection control. Although their policy guidelines referred to 'aseptic technique', their educational experience appeared to have made them feel uncertain about the implementation of the measures involved. With the proviso that this was a small scale qualitative study, the author concludes by suggesting that there is a need for greater clarity, both in what is taught and in what is included in practice policy with regard to infection control in wound care.
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Affiliation(s)
- C E Hallett
- School of Nursing, University of Manchester, UK
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Santos BM. [A longitudinal study of healthy Staphylococcus aureus carriers among the students of a nursing aide course]. Rev Soc Bras Med Trop 1999; 32:395-400. [PMID: 10495669 DOI: 10.1590/s0037-86821999000400010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The objective of the present study was to determine the extent of colonization by Staphylococcus aureus and the evolution of carrier status among students of a technical nursing course during their professional training. Forty students participated in the study, samples were collected from their nasal cavity and right and left hands at six different times during the technical nursing course. Nineteen students (45.2%) were found to be occasional carriers, 12 (28.6%) were intermittent carriers, 6 (14.3%) were persistent carriers, and 5 (11.9%) were non-carriers, showing that colonization did not increase during the course. Twenty-four of them (57.1%) did not perform activities related to nursing before or during the course, whereas 18 (42.9%) performed them.
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Affiliation(s)
- B M Santos
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil
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Bimar MC, Hajjar J, Pottecher B. [Risk of nosocomial infection in anesthesia. General recommendations]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 1998; 17:392-402. [PMID: 9750770 DOI: 10.1016/s0750-7658(98)80088-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hattula JL, Stevens PE. A descriptive study of the handwashing environment in a long-term care facility. Clin Nurs Res 1997; 6:363-74. [PMID: 9384056 DOI: 10.1177/105477389700600406] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The authors present a clinical research project accomplished by a nurse during her first year of practice after graduating from a B.S.N. program. In her caregiving at a long-term care facility subacute unit, she was unable to do proper handwashing. The poorly placed pump-style paper towel dispensers were inadequate for the task. She knew that handwashing before and after resident contact is the single most effective infection control measure to prevent nosocomial infections. In consultation with her university professor, she designed and implemented a descriptive study of the facility's handwashing environment. She mapped and measured handwashing areas, explained constrictions the environment placed on handwashing technique, collected random cultures from the sinks and dispenser levers, and illustrated for administrative and auxiliary personnel the basic principles of microbiology. Implications for infection prevention and control in long-term care facilities are discussed in light of increased "high-end skilled nursing" being offered in subacute units.
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Affiliation(s)
- J L Hattula
- School of Nursing, University of Wisconsin-Milwaukee, USA
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Gould D, Chamberlain A. The use of a ward-based educational teaching package to enhance nurses' compliance with infection control procedures. J Clin Nurs 1997; 6:55-67. [PMID: 9052110 DOI: 10.1111/j.1365-2702.1997.tb00284.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Obtaining study leave is becoming difficult for clinical nurses in the current economic climate, but the need to develop new clinical skills and to maintain existing good practice remains of prime importance to patient care and will become mandatory with the advent of post-registration education and practice (PREP) in the UK. The ward is widely acknowledged as the best venue for learning clinical skills by nurse educationalists and for many nurses is the preferred learning environment. The feasibility of using a ward-based teaching package to enhance nurses' compliance with key infection control precautions (hand decontamination, the use of gloves and the safe handling and disposal of sharp instruments) was tested in a quasi-experimental research study conducted on matched surgical wards in a teaching hospital, controlling for variables likely to influence performance (knowledge, availability of resources to perform infection control, previous opportunity to develop infection control expertise and nursing workload). Nurses on two wards received the intervention (experimental group). The remaining wards, which received no intervention, operated as controls. The ward-based sessions consisted of a carefully planned sequence of theory and practical demonstration delivered to qualified nurses in the clinical environment at convenient times selected by the ward managers. Performance of infection control precautions was audited before the intervention and 3 months afterwards. The sessions were well evaluated and the clinical environment was considered suitable for teaching by the nurses, but heavy and unpredictable workload prevented the teaching programme from being implemented as planned. The analysis of covariance failed to detect any changes in performance between nurses in the control and experimental groups. The implications of the study findings are discussed to help develop creative new ways of strengthening ward-based educational programmes.
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Affiliation(s)
- D Gould
- Department of Nursing Studies, King's College, London, UK
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Abstract
Infectious complications of central venous catheterization are an important clinical problem. Although systemic infection complicates only a small fraction of cases, the prevalence of catheter-related sepsis remains high because of the widespread use of these catheters in acutely ill hospitalized patients. The major route of infection is probably by migration of microorganisms from the skin along the outer surface of the catheter and through the subcutaneous catheter tract to the bloodstream. Semi-quantitative catheter tip cultures have become a standard clinical tool for the evaluation for catheter-related infection. Despite the use of this technique and a variety of other proposed methods for evaluating catheter colonization and infection, discriminating catheter-related sepsis from sepsis originating at another site is often difficult. Prevention of these infections is important. There have been many investigations of the factors that contribute to catheter infections. These studies have shown that meticulous attention to sterile technique during catheter insertion and during routine maintenance is critical.
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