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Zhou W, Guo H. Curative effect of hydrogen peroxide combined with silver ion disinfection on pelvic floor dysfunction. World J Clin Cases 2024; 12:4508-4517. [PMID: 39070827 PMCID: PMC11235482 DOI: 10.12998/wjcc.v12.i21.4508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/06/2024] [Accepted: 06/06/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Pelvic floor dysfunction (PFD) is related to muscle fiber tearing during childbirth, negatively impacting postpartum quality of life of parturient. Appropriate and effective intervention is necessary to promote PFD recovery. AIM To analyze the use of hydrogen peroxide and silver ion disinfection for vaginal electrodes in conjunction with comprehensive rehabilitation therapy for postpartum women with PFD. METHODS A total of 59 women with PFD who were admitted to the hospital from May 2019 to July 2022 were divided into two groups: Control group (n = 27) received comprehensive rehabilitation therapy and observation group (n = 32) received intervention with pelvic floor biostimulation feedback instrument in addition to comprehensive rehabilitation therapy. The vaginal electrodes were disinfected with hydrogen peroxide and silver ion before treatment. Intervention for both groups was started 6 weeks postpartum, and rehabilitation lasted for 3 months. Pelvic floor muscle voltage, pelvic floor muscle strength, vaginal muscle voltage, vaginal muscle tone, pelvic floor function, quality of life, and incidence of postpartum PFD were compared between the two groups. RESULTS Before comprehensive rehabilitation treatment, basic data and pelvic floor function were not significantly different between the two groups. After treatment, the observation group showed significant improvements in the maximum voltage and average voltage of pelvic floor muscles, contraction time of type I and type II fibers, pelvic floor muscle strength, vaginal muscle tone, vaginal muscle voltage, and quality of life (GQOLI-74 reports), compared with the control group. The observation group had lower scores on the pelvic floor distress inventory (PFDI-20) and a lower incidence of postpartum PFD, indicating the effectiveness of the pelvic floor biostimulation feedback instrument in promoting the recovery of maternal pelvic floor function. CONCLUSION The combination of the pelvic floor biostimulation feedback instrument and comprehensive rehabilitation nursing can improve pelvic floor muscle strength, promote the recovery of vaginal muscle tone, and improve pelvic floor function and quality of life. The use of hydrogen peroxide and silver ion disinfectant demonstrated favorable antibacterial efficacy and is worthy of clinical application.
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Affiliation(s)
- Wei Zhou
- Department of Outpatient, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
- West China School of Nursing, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Hua Guo
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Ren H, Xiao Y, Tang B, Shi Y, Zeng Z, Qiu X, Ding Y, Xiao R. The Price of Beauty: A Literature Review on Non-Tuberculous Mycobacteria Infection After Cosmetic Procedures. Aesthet Surg J 2024; 44:NP574-NP584. [PMID: 38591553 DOI: 10.1093/asj/sjae076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 03/22/2024] [Accepted: 03/26/2024] [Indexed: 04/10/2024] Open
Abstract
Non-tuberculous mycobacteria (NTM) infection of the skin and soft tissues is a complication of cosmetic procedures. The incidence of cutaneous NTM infections has increased significantly as aesthetic operations have become more commonplace. With the rise of cosmetic tourism, the geographic expansion of NTM infections is a major concern. Due to the unique pathogenesis of NTM infections, diagnosis and treatment remain significant challenges for clinicians. Clinical management relies on a combination of antibiotic therapy with drug susceptibility testing and appropriate surgical debridement. Some new drugs, photodynamic therapy, and bacteriophage therapy have been developed in recent years, and may improve the aesthetic outcomes. This review summarizes the cosmetic procedures prone to NTM infections in recent years and their clinical features. We propose a 2-stage treatment procedure, including a hospitalization phase and a follow-up phase. We aim to increase the alertness of clinicians to NTM infections for timely detection and treatment. LEVEL OF EVIDENCE: 3
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Watanabe K, Totsu Y. Development of aids to relieve vulvodynia during the postpartum period. Glob Health Med 2024; 6:149-155. [PMID: 38690132 PMCID: PMC11043126 DOI: 10.35772/ghm.2023.01045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 12/08/2023] [Accepted: 12/24/2023] [Indexed: 05/02/2024]
Abstract
Postpartum women live with a low quality of life due to pain caused by episiotomy and perineal laceration. In particular, they endure pain when sitting for long periods of time to breastfeed. The purpose of this study is to develop a sitting aid to alleviate postpartum vulvodynia. This study was conducted in the following four phases from July 2017 to May 2019. They are: material selection and molding, cleaning and disinfection testing, pressure distribution measurement testing, and trial testing by postpartum women. The main material was a 100% polypropylene object with a three-dimensional reticular fiber spring structure and fiber density of 3.8 kg/m2. As a result, a sitting aid that withstands washing and disinfection well in the medical field and is breathable. It had moderate resilience and elasticity and reduced pressure on the seating surface for women weighing approximately 45 kg and 55 kg, but we were skeptical about its use for women weighing more than that. The completed sitting aid is noninvasively effective in improving the quality of life of many postpartum women, but the density and thickness of the main material should be reexamined to meet the needs of women in a wider weight range. In addition, a self-administered questionnaire survey of trial users revealed that some women did not experience relief from vulvodynia even after using the sitting aid. Such women also had physical problems such as discomfort in the lower back, difficulty breastfeeding, and difficulty standing up. For women with multiple physical problems, individual causes should be addressed.
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Affiliation(s)
- Kaori Watanabe
- Department of Midwifery, National College of Nursing, Japan, Tokyo, Japan
| | - Yumiko Totsu
- Department of Midwifery, National College of Nursing, Japan, Tokyo, Japan
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Zou X, Ding H, Sun Q, Lu WL, Liu Y, Zhang S, Yin Z, Shi C, He G, Chien CW, Liu J, Liu J. Analysis of sterilizer allocation and related factors in dental health-care settings in Yunnan Province, China: a cross-sectional study. BMC Oral Health 2024; 24:416. [PMID: 38580975 PMCID: PMC10996231 DOI: 10.1186/s12903-024-04215-8] [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: 12/07/2023] [Accepted: 04/01/2024] [Indexed: 04/07/2024] Open
Abstract
OBJECTIVE To investigate the status and related factors of sterilizers in dental health-care settings in Yunnan Province, with the aim of providing a theoretical basis for the health administrative department to formulate regional quality control programs and systems, proposing reasonable suggestions for optimizing the allocation of sterilizer resources in Yunnan's dental health-care settings, thereby improving resource utilization efficiency. METHODS This cross-sectional survey was conducted in 2600 dental health-care settings in Yunnan Province in March 2020. Uni-variable linear regression, multi-variable linear regression, curve fitting and threshold effect analysis were used to understand the relationship between dental units and sterilizers. RESULTS A total of 2600 dental health-care settings were included. The disinfection and sterilization work were mainly completed by the dental department in 1510(58.1%) institutions. 44(1.7%) institutions were not allocated sterilization equipment, and 1632 (62.8%) had only one sterilizer. The median allocation of sterilizers was 1.0. Uni-variable linear regression showed significant differences in covariates such as dental unit, dental handpiece, disinfection equipment, dentist, and dental assistant, which were more sensitive (p < 0.001) and statistically significant. The adjusted model was more stable in the multi-variable linear regression, and the differences in covariates between different settings were statistically significant. Curve fitting revealed an S-shaped curvilinear relationship between the number of dental units and sterilizers in oral healthcare settings. CONCLUSION The disinfection and sterilization work was mainly completed by the dental department in dental health-care settings in Yunnan Province. Sterilizer allocation increases with the number of dental units, but some institutions have insufficient allocation of sterilizer and manpower resources, resulting in certain risks of infection control. Thus, it is necessary to strengthen supervision, inspection and regional quality control work in infection control of dentistry.
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Affiliation(s)
- Xinchun Zou
- Department of Infection Management, Kunming Medical University School and Hospital of Stomatology, Kunming, 650106, China
| | - Haiyan Ding
- Cancer Biotherapy Center, Key Laboratory of Melanoma Research, Peking University Cancer Hospital Yunnan (Yunnan Cancer Hospital,The Third Affiliated Hospital of Kunming Medical University), Kunming, 650031, China
| | - Qi Sun
- Department of Preventive Dentistry, Kunming Medical University School and Hospital of Stomatology, Kunming, 650106, China
| | - Wen Lin Lu
- Department of the Second Clinic, Kunming Medical University School and Hospital of Stomatology, Kunming, 650106, China
| | - Ying Liu
- Department of Infection Management, Kunming Medical University School and Hospital of Stomatology, Kunming, 650106, China
| | - Shinan Zhang
- Department of Preventive Dentistry, Kunming Medical University School and Hospital of Stomatology, Kunming, 650106, China
| | - Zhangcheng Yin
- Department of General Office, Kunming Medical University School and Hospital of Stomatology, Kunming, 650106, China
| | - Congchong Shi
- Department of Orthodontics, Kunming Medical University School and Hospital of Stomatology, Kunming, 650106, China
| | - Guozhong He
- School of Public Health, Kunming Medical University, Kunming, China
| | - Ching-Wen Chien
- Institute for Hospital Management, Tsing Hua University, Shenzhen Campus, 518055, China
| | - Jie Liu
- People's Liberation Army of China General Hospital, Beijing, 100039, China
| | - Juan Liu
- Department of General Office, Kunming Medical University School and Hospital of Stomatology, Kunming, 650106, China.
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5
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Chen H, Liu J, Zeng A, Qin N. Analysis of sterilization efficiency and application cost of three low temperature sterilization methods. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2024; 95:045112. [PMID: 38597749 DOI: 10.1063/5.0175121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 03/24/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE This paper discusses the sterilization efficiency of three low temperature sterilization methods used in thermosensitive medical devices and makes a preliminary analysis of sterilization costs so as to provide the basis for reasonable selection of low temperature sterilizer in Central Sterile Supply Department. METHODS Medical devices compatible with the three sterilization methods were selected for sterilization, and two packaging materials were selected for the three low-temperature sterilization equipment according to the compatibility of the packaging materials. The equipment packed with the same packaging materials were sterilized for five times, and each low-temperature sterilizer was sterilized for a total of ten times. The sterilization effect, sterilization cycle time, energy consumption, and cost of the three sterilizers were compared. RESULTS The cycle time of ethylene oxide sterilizer was 393.6 min, and the cycle time of hydrogen peroxide low temperature plasma sterilizer was 56.1 min. The cycle time of low temperature steam and formaldehyde sterilizer was 105.7 min. The hydrogen peroxide low temperature plasma sterilizes single cycle power consumption at a maximum of 5 kWh. The single cycle energy consumption of compressed air ethylene oxide sterilizer is up to 12 l. In terms of sterilization application cost, hydrogen peroxide low temperature plasma sterilization has the highest cost, followed by ethylene oxide sterilization, and low temperature steam and formaldehyde sterilization is the lowest. CONCLUSION The sterilization efficiency of hydrogen peroxide low temperature plasma sterilization is the highest, followed by low temperature steam and formaldehyde sterilization, and the lowest is ethylene oxide sterilization. The three low temperature sterilization methods can achieve effective sterilization of devices. Each hospital can choose an appropriate low temperature sterilization method according to the characteristics of thermosensitive instruments, turnover efficiency requirements, and financial status.
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Affiliation(s)
- Hui Chen
- West China Hospital/West China School of Nursing, Sichuan University, Guoxuexiang No. 37, Chengdu, Sichuan, China
| | - Jiawei Liu
- West China Hospital/West China School of Nursing, Sichuan University, Guoxuexiang No. 37, Chengdu, Sichuan, China
| | - Aiying Zeng
- West China Hospital/West China School of Nursing, Sichuan University, Guoxuexiang No. 37, Chengdu, Sichuan, China
| | - Nian Qin
- West China Hospital/West China School of Nursing, Sichuan University, Guoxuexiang No. 37, Chengdu, Sichuan, China
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Browne K, Mitchell BG. Multimodal environmental cleaning strategies to prevent healthcare-associated infections. Antimicrob Resist Infect Control 2023; 12:83. [PMID: 37612780 PMCID: PMC10463433 DOI: 10.1186/s13756-023-01274-4] [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: 05/09/2023] [Accepted: 07/10/2023] [Indexed: 08/25/2023] Open
Abstract
Infection transmission in healthcare is multifaceted and by in large involves the complex interplay between a pathogen, a host and their environment. To prevent transmission, infection prevention strategies must also consider these complexities and incorporate targeted interventions aimed at all possible transmission pathways. One strategy to prevent and control infection is environmental cleaning. There are many aspects to an environmental cleaning strategy. We believe the key to successfully reducing the risk of healthcare-associated infections through the environment, is to design and implement a multimodal intervention. This paper aims to provide an overview of important considerations for designing a meaningful and sustainable environmental program for healthcare facilities.
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Affiliation(s)
- Katrina Browne
- School of Nursing and Health, Avondale University, Cooranbong, NSW, Australia
- Central Coast Local Health District, Gosford Hospital, Gosford, NSW, Australia
| | - Brett G Mitchell
- School of Nursing and Health, Avondale University, Cooranbong, NSW, Australia.
- Central Coast Local Health District, Gosford Hospital, Gosford, NSW, Australia.
- School of Nursing and Midwifery, Monash University, Melbourne, VIC, Australia.
- Hunter Medical Research Institute, Newcastle, NSW, Australia.
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Pradere B, Mallet R, de La Taille A, Bladou F, Prunet D, Beurrier S, Bardet F, Game X, Fournier G, Lechevallier E, Meria P, Matillon X, Polguer T, Abid N, De Graeve B, Kassab D, Mejean A, Misrai V, Pinar U. Climate-smart Actions in the Operating Theatre for Improving Sustainability Practices: A Systematic Review. Eur Urol 2023; 83:331-342. [PMID: 35151515 DOI: 10.1016/j.eururo.2022.01.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 01/02/2022] [Accepted: 01/11/2022] [Indexed: 11/15/2022]
Abstract
CONTEXT Surgical activity contributes to global warming though the production of greenhouse gases and consumption of resources. To date, no clinical practice guidelines have been made to promote and implement climate-smart actions. OBJECTIVE To perform a systematic review of the available actions that could limit CO2 emission in the operating room (OR) and their potential benefits upon the environment, whilst preserving quality of care. EVIDENCE ACQUISITION MEDLINE and Cochrane databases were searched from January 1, 1990 to April 2021. We included studies assessing carbon footprint (CF) in the OR and articles detailing actions that limit or reduce CF. EVIDENCE SYNTHESIS Thirty-eight studies met the inclusion criteria. We identified six core climate-smart actions: (1) waste reduction by segregation; (2) waste reduction by recycling, reuse, and reprocessing; (3) sterilisation; (4) anaesthesia gas management; and (5) improvement of energy use. Quantitative analysis regarding the CF was not possible due to the lack of homogeneous data. For climate-smart actions, the analysis was limited by discrepancies in study scope and in the methodology of CO2 emission calculation. Improvement of education and awareness was found to have an important impact on waste segregation and reduction. Waste management is the area where health care workers could have the strongest impact, whereas the main field to reduce CF in the OR was found to be energy consumption. CONCLUSIONS This review provides arguments for many climate-smart actions that could be implemented in our daily practice. Improving awareness and education are important to act collectively in a sustainable way. Further studies are mandatory to assess the impact of these climate-smart actions in the OR. PATIENT SUMMARY We performed a systematic review of the available scientific literature to reference all the climate-smart actions proposed to improve the sustainability of surgical activities. Waste segregation, waste reduction and recycling, reuse and reprocessing, sterilisation, anaesthesia gas changes, and improvement of energy use in the operating room were found to be the main areas of research. There is still a long way to go to homogenise and improve the quality of our climate-smart actions.
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Affiliation(s)
- Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Vienna General Hospital, Medical University of Vienna, Vienna, Austria.
| | - Richard Mallet
- Department of Urology, Hopital Privé Francheville, Périgueux, France
| | - Alexandre de La Taille
- Department of Urology, University Hospital Henri Mondor, AP-HP, UPEC, Créteil Cédex, France
| | - Franck Bladou
- Department of Urology, Pellegrin University Hospital, Bordeaux, France
| | - Denis Prunet
- Department of Urology, Clinique Urologie Royan, Royan, France
| | - Sarah Beurrier
- Department of Urology, Hopital Cochin AP-HP, Paris, France
| | | | - Xavier Game
- Department of Urology, Centre Hospitalier Universitaire de Rangueil, Université Toulouse III, Toulouse, France
| | - Georges Fournier
- Department of Urology, Hôpital de la Cavale Blanche, Université de Brest, Brest, France
| | - Eric Lechevallier
- Department of Urology, Aix-Marseille Université, CHU La Conception, AP-HM, Marseille, France
| | - Paul Meria
- Department of Urology, Hopital Saint Louis, APH-HP, Paris, France
| | - Xavier Matillon
- Department of Urology, Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Thomas Polguer
- Department of Urology, CH Romans-sur-Isère, Hopitaux Drome nord, Romans-sur-Isère, France
| | - Nadia Abid
- Department of Urology, Hôpital Édouard Herriot, Hospices Civils de Lyon, Lyon, France
| | | | | | - Arnaud Mejean
- Department of Urology, Hôpital Européen Georges Pompidou, AP-HP Centre, Université de Paris, Paris, France
| | - Vincent Misrai
- Department of Urology, Clinique Pasteur, Toulouse, France
| | - Ugo Pinar
- Department of Urology, Sorbonne University, GRC 5 Predictive Onco-Uro, AP-HP, Pitie-Salpetriere Hospital, Paris, France
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Rehman TA, Khan AA, Yunus RA, Bu Y, Sohail A, Matyal R, Mahmood F, Sharkey A. Structural and Electrical Integrity of Transesophageal Echocardiography Probes: Importance and Key Concepts. J Cardiothorac Vasc Anesth 2023:S1053-0770(23)00184-2. [PMID: 37062664 DOI: 10.1053/j.jvca.2023.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/07/2023] [Accepted: 03/10/2023] [Indexed: 04/18/2023]
Abstract
The clinical utility of transesophageal echocardiography (TEE) is well-established for patients undergoing cardiac surgery. With the increase in percutaneous structural heart disease procedures that rely on TEE for procedural guidance, the use of TEE probes is expanding. Although there are well-established protocols for routine cleaning and decontaminating TEE probes between patient use, there is a lack of awareness and misconceptions about maintaining TEE probes' structural and electrical integrity. The electrical leakage test (ELT) is routinely performed between patient use. From a patient safety standpoint, the ELT is necessary to ensure the longevity of this expensive equipment and prevent disruptions to the workflow in a busy department caused by TEE probes being decommissioned due to probe damage. This technical communication aims to highlight the importance of maintaining TEE probes' structural and electrical integrity. The article also highlights and discusses probe handling techniques between patient use, emphasizing the ELT to ensure patient safety and compliance with national and international standards.
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Affiliation(s)
- Taha A Rehman
- Department of Anesthesia, Critical Care & Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Adnan Ali Khan
- Department of Anesthesia, Critical Care & Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Rayaan Ahmed Yunus
- Department of Anesthesia, Critical Care & Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Yifan Bu
- Department of Anesthesia, Critical Care & Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Ahmed Sohail
- Department of Anesthesia, Critical Care & Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Robina Matyal
- Department of Anesthesia, Critical Care & Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Feroze Mahmood
- Department of Anesthesia, Critical Care & Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA
| | - Aidan Sharkey
- Department of Anesthesia, Critical Care & Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA.
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9
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WGO Guideline-Endoscope Disinfection Update. J Clin Gastroenterol 2023; 57:1-9. [PMID: 36084165 DOI: 10.1097/mcg.0000000000001759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 06/23/2022] [Indexed: 12/14/2022]
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10
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Chiannilkulchai N, Bhumisirikul P. Development of a "Scissor-Tip-Separator" for adjustment of scissor blade separation and prevention of scissor blade damage during steam sterilization. Patient Saf Surg 2022; 16:28. [PMID: 35999555 PMCID: PMC9397177 DOI: 10.1186/s13037-022-00338-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/14/2022] [Indexed: 11/10/2022] Open
Abstract
Background Reprocess reusable surgical instruments during steam sterilization; damage occurs to sharp scissor blades in close position, so steam cannot reach the blades. Surgical instruments' management requires standards to ensure patient safety and prevent harmful pathogens, especially in the COVID-19 pandemic. Although various devices can separate scissor blades, they do not prevent damage to cutting edges. To address the above problem, we developed a new scissor protector, the "Scissor-Tip-Separator," and evaluated its efficacy. Methods The "Scissor-Tip-Separator" design follows the steam sterilization guideline that instrument tips must be separated. The locking handles and V groove mechanism keep the scissor blades separated while preventing damage to the cutting edges. For efficacy assessment, purposive sampling was performed to select 44 Thai perioperative nurses at Ramathibodi Hospital, Bangkok, Thailand, to evaluate the "Scissor-Tip-Separators" in 450 sterile instrument containers. All participants evaluated surgical scissors placed in the "Scissor-Tip-Separators" during instrument setup, following a problem record checklist. At the end of the fifth use, participants were asked to complete the "Scissor-Tip-Separator" Effectiveness Scale, which was used to test the structural design of the "Scissor-Tip-Separator" in terms of function, usability, and safety. The Adenosine Triphosphate surface test was also used to validate the "Scissor-Tip-Separator" cleanliness. Data were collected from August 2020 to November 2020, then analyzed via descriptive statistics. Results The "Scissor-Tip-Separator" met the cleaning validation criteria, and in 44 uses, the physical property remained the same. The scissor shank was discovered loose from the handle before it had been unlocked (0.2–0.4%) at the 45th use. Based on participants' opinions, the overall instrument effectiveness was high in terms of function, usability, and safety. Conclusion The "Scissor-Tip-Separator" regulates scissor blade separation under sterilization guidelines; it prevents damage to cutting edges, thus ensuring patient safety. It protects against losses in a sterile field and can prevent hand injuries.
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Affiliation(s)
- Natthacha Chiannilkulchai
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Phayathai, Ratchathewi, Bangkok, 10400, Thailand.
| | - Peinjit Bhumisirikul
- Division of Perioperative Nursing, Department of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Phayathai, Ratchathewi, Bangkok, 10400, Thailand
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11
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Chanchareonsook N, Ling ML, Sim QX, Teoh KH, Tan K, Tan BH, Fong KY, Poon CY. Failure of sterilization in a dental outpatient facility: Investigation, risk assessment, and management. Medicine (Baltimore) 2022; 101:e29815. [PMID: 35945734 PMCID: PMC9351878 DOI: 10.1097/md.0000000000029815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
In 2017, an incident of failed sterilization of dental instruments occurred at a large dental outpatient facility in Singapore. We aim to describe findings of the investigation of the sterilization breach incident, factors related to risk of viral transmission to the potentially affected patients, and the contact tracing process, patient management, and blood test results at a 6-month follow-up. A full assessment of the incident was immediately carried out. The factors related to risk of viral transmission due to affected instruments were analyzed using 3 keys points: breached step(s) and scale of the incident, prevalence of underlying bloodborne diseases and immunity in the Singapore population, health status of potential source patients, and type of dental procedure performed, and health status of affected patients and type of dental procedure received. Up to 72 affected instrument sets were used in 714 potentially affected patients who underwent noninvasive dental procedures. The investigation revealed that there was a lapse in the final step of steam sterilization, resulting in the use of incompletely sterilized items. The assessment determined that there was an extremely low risk of bloodborne virus transmission of diseases to the patients. At the 6-month follow-up, there were no infected/colonized cases found related to the incident. Lapses in the sterilization process for medical and dental instruments can happen, but a risk assessment approach is useful to manage similar incidents. Quick response and proper documentation of the sterilization process can prevent similar incidents.
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Affiliation(s)
- N Chanchareonsook
- Department of Oral and Maxillofacial Surgery, National Dental Centre Singapore, Singapore
| | - ML Ling
- Department of Infection Prevention and Epidemiology, Singapore General Hospital, Singapore
| | - QX Sim
- Department of Oral and Maxillofacial Surgery, National Dental Centre Singapore, Singapore
| | - KH Teoh
- Clinical and Regional Health, National Dental Centre Singapore, Singapore
| | - K Tan
- Clinical Governance and Quality Management, National Dental Centre Singapore, Singapore
| | - BH Tan
- Department of Infectious Disease, Singapore General Hospital, Singapore
| | | | - CY Poon
- Department of Oral and Maxillofacial Surgery, National Dental Centre Singapore, Singapore
- National Dental Centre Singapore, Singapore
- *Correspondence: CY Poon, Department of Oral and Maxillofacial Surgery, National Dental Centre Singapore, 5 Second Hospital Avenue, Singapore 168938, Singapore. (e-mail: )
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12
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Resistance of clinical and environmental Acinetobacter baumannii against quaternary ammonium. Infect Control Hosp Epidemiol 2022; 43:527-530. [PMID: 34593063 DOI: 10.1017/ice.2021.418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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13
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Zeng F, Wang X, Gao Y, Hu L. Influence of Fine Management Combined With PDCA Cycle Method on Disinfection Qualified Rate and Performance Grade of Ophthalmic Precision Instruments. Front Surg 2022; 9:856312. [PMID: 35372479 PMCID: PMC8964488 DOI: 10.3389/fsurg.2022.856312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/08/2022] [Indexed: 12/02/2022] Open
Abstract
Objective The aim of this study is to explore the influence of fine management combined with the plan-do-check-action (PDCA) cycle method on the management of ophthalmic precision instruments. Methods The ophthalmic precision instruments centralized in the disinfection supply room of our hospital were selected as the research objects and divided into groups A and B. Traditional instrument management method was adopted in group A, and fine management combined with the PDCA cycle method based on the group A was adopted in group B. The instrument management risk scores, the qualified rate of disinfection, instrument performance grade, and incidence of toxic anterior segment syndrome (TASS) of the two groups were compared. Results The risk scores of instrument management and incidence of TASS in group B were lower than those in group A (p < 0.05). The qualified rate of disinfection and instrument performance grades in group B were higher than those in group A (p < 0.05). Conclusion Fine management combined with the PDCA cycle method can improve the qualified rate of disinfection of ophthalmic precision instruments, optimize the performance of instruments, reduce the risk of instrument management, and reduce the incidence of TASS.
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Affiliation(s)
- Fanli Zeng
- Department of Anesthesiology, Chongqing General Hospital, Chongqing, China
| | - Xiuling Wang
- Department of Ophthalmology, Chongqing Banan District People's Hospital, Chongqing, China
| | - Yan Gao
- Central Sterile Supply Department, Chongqing General Hospital, Chongqing, China
| | - Ling Hu
- Central Sterile Supply Department, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
- *Correspondence: Ling Hu
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The Supervision and Management Mode of Disinfection Supply Center Improves the Standardization of Sterile Goods Management in Clinical Departments. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:6916212. [PMID: 35265173 PMCID: PMC8901292 DOI: 10.1155/2022/6916212] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 01/25/2022] [Accepted: 02/02/2022] [Indexed: 12/15/2022]
Abstract
Background. In daily inspection, the nonstandard management of sterile articles in clinical departments of hospitals often leads to the destruction of the sterilization effectiveness of sterile articles. Therefore, it is necessary to strengthen governance and improve this phenomenon. This study intends to investigate the mode in which the disinfection supply center participates in the supervision and management of the management of sterile items in clinical departments. It played a role in improving the standardization of the management of sterile articles in clinical departments and ensured the closed-loop management of the sterilization effectiveness of sterile articles. Methods. Every quarter, the disinfection supply center of our hospital will inspect the standardized management of sterile articles in all clinical departments of the hospital, mainly including the storage environment and facilities of sterile articles, the cleanliness of storage cabinets, placement principles, whether they are stored by category, and the quality and validity management of sterile articles. The quarterly inspection results were summarized and analyzed to find the existing problems and the causes. The disinfection supply center shall supervise the improvement. After the disinfection supply center inspected the standardized management of sterile articles in all clinical departments of the hospital for the first time according to the inspection contents, under the guidance and assistance of the nursing department and the hospital infection department, it improved the sterile article management system, conducted knowledge training for the whole hospital, and incorporated the standardized management of clinical sterile articles into the quality control inspection of the nursing department. In the later stage, the disinfection supply center is responsible for conducting routine inspection and supervision on the standardized management of sterile articles in all clinical departments of the hospital every quarter according to the inspection contents, including summarizing, analyzing, and urging the clinical departments to achieve the improvement of the management of sterile articles in clinical departments. Results. The standardization of aseptic articles after improvement was significantly higher than before and during improvement, and the qualified rate was significantly different (99.4% vs 97.9% vs 89.5%,
). The average number of lost packages caused by nonstandard management in the department was significantly reduced. The average rate of lost sterile packages during and after the improvement was significantly lower than that before the improvement (10.5% vs 97.9% vs 89.5%,
). It also effectively reduced the cost caused by the loss of sterile packages. Conclusion. The disinfection supply center participates in the quality control and management of sterile articles in the nursing department and regularly inspects and supervises the management of sterile articles in clinical departments. It can effectively improve the standardized management of sterile articles in clinical departments, ensure the safety of sterile articles, and form a closed loop of sterilization effectiveness.
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15
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Shinzato Y, Sakihara E, Kishihara Y, Kashiura M, Yasuda H, Moriya T. Clinical application of skin antisepsis using aqueous olanexidine: a scoping review. Acute Med Surg 2022; 9:e723. [PMID: 35028157 PMCID: PMC8741875 DOI: 10.1002/ams2.723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 11/22/2021] [Accepted: 12/02/2021] [Indexed: 11/30/2022] Open
Abstract
Surgical site infections (SSIs) and catheter‐related bloodstream infections (CRBSIs) caused by bacteria from surfaces poorly disinfected with chlorhexidine gluconate (CHG) and povidone‐iodine (PVP‐I) are increasing. Olanexidine gluconate (OLG) was developed in 2015 in Japan to prevent SSI and CRBSI caused by bacteria resistant to CHG and PVP‐I. This scoping review aimed to identify the knowledge gap between what is known and what is not known about the disinfection efficacy of OLG. We searched MEDLINE through PubMed, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the International Clinical Trials Registry Platform search database, ClinicalTrials.gov, and the Web‐based database of Japanese medical articles for works published to July 18, 2021. Manual reference searches were also carried out. A total of 131 studies were screened. Forty‐seven studies were included in this review and classified into two major categories: studies on pharmacological effects and spectrum (n = 29) and studies on clinical and adverse effects (n = 18). Olanexidine gluconate showed bactericidal activity against methicillin‐resistant Staphylococcus aureus and vancomycin‐resistant enterococci, in addition to common Gram‐positive and Gram‐negative bacteria. In clinical settings, although there is limited evidence on SSI prevention, 1.5% OLG might be more effective than 10% PVP‐I and 1% CHG in preventing SSI. However, the clinical usefulness of OLG is unclear due to the limited number of clinical studies. Also, clinical research is limited to studies targeting SSI prevention, and there are no clinical studies on CRBSI. Further clinical studies are needed on SSI and CRBSI prevention.
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Affiliation(s)
- Yutaro Shinzato
- Department of Emergency and Critical Care Medicine Jichi Medical University Saitama Medical Center Saitama Japan
| | - Eiryu Sakihara
- Department of Emergency and Critical Care Medicine Jichi Medical University Saitama Medical Center Saitama Japan
| | - Yuki Kishihara
- Department of Emergency and Critical Care Medicine Jichi Medical University Saitama Medical Center Saitama Japan
| | - Masahiro Kashiura
- Department of Emergency and Critical Care Medicine Jichi Medical University Saitama Medical Center Saitama Japan
| | - Hideto Yasuda
- Department of Emergency and Critical Care Medicine Jichi Medical University Saitama Medical Center Saitama Japan
| | - Takashi Moriya
- Department of Emergency and Critical Care Medicine Jichi Medical University Saitama Medical Center Saitama Japan
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Zaman SU, Sadia I, Yasmin N, Islam KN, Rahman MM, Haq A, Mou TJ, Azmuda N, Haque M, Adnan N. Application of Rapid Biological Indicators Coupled With Auto-Reader for the Quality Assurance of Surgical Instruments After Sterilization at a Cardiac Hospital in Bangladesh. Cureus 2021; 13:e19428. [PMID: 34926019 PMCID: PMC8654048 DOI: 10.7759/cureus.19428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2021] [Indexed: 12/02/2022] Open
Abstract
Background Sterilization failure is one of the main reasons for surgical site infections (SSIs). The biological indicator (BI) test is the most reliable test to check sterilization efficiencies. But 48 hours BI test result makes the monitoring process time-consuming. Rapid BI testing can be time demanding in this regard. Therefore, the objective is to determine the importance of rapid BI monitoring for the quality assurance of sterile surgical instruments. Methods This study was conducted in the Labaid Cardiac Hospital, Bangladesh from April 1, 2021, to July 8, 2021. A total of 100 steam and 100 ethylene oxide (EO) rapid BIs and an auto reader incubator were used to conduct this research. Quick BI of steam and EO were used once per day and tested by the auto reader. Later, all the tested BIs were incubated for 48 hours by a conventional incubator to confirm the auto reader's rapid BI test results. Result All the EO BI results were found negative, but the BI was found positive twice in steam sterilization. Surgical items of those two loads were re-sterilized. Again, after checking the BI result, the items were released. All BIs except positive steam rapid BIs were found with no growth after 48 hours of incubation for cross-checking of auto reader results. In positive rapid BI of steam, growth was found after 48 hours of incubation. Conclusion When sterilization failure occurred, process recall could not be possible at that time if rapid BI tests were not performed. So, integration of a rapid BI test with an auto reader can save the patient from critical SSI.
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Affiliation(s)
- Sifat U Zaman
- Department of Microbiology, Jahangirnagar University, Dhaka, BGD
- Division of Infection Prevention and Control, Medlife Healthcare Limited, Dhaka, BGD
| | - Israt Sadia
- Department of Infection Control, Labaid Cardiac Hospital, Dhaka, BGD
| | - Nawzia Yasmin
- Department of Public Health, State University of Bangladesh, Dhaka, BGD
| | | | | | - Ahsanul Haq
- Department of Statistics, Gonoshasthaya-RNA Molecular Diagnostic & Research Center, Dhaka, BGD
| | - Taslin Jahan Mou
- Department of Microbiology, Jahangirnagar University, Dhaka, BGD
| | - Nafisa Azmuda
- Department of Microbiology, Jahangirnagar University, Dhaka, BGD
| | - Mainul Haque
- Department of Pharmacology and Therapeutics, National Defence University of Malaysia, Kuala Lumpur, MYS
| | - Nihad Adnan
- Department of Microbiology, Jahangirnagar University, Dhaka, BGD
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Avasarala SK, Muscarella LF, Mehta AC. Sans Standardization: Effective Endoscope Reprocessing. Respiration 2021; 100:1208-1217. [PMID: 34488219 DOI: 10.1159/000517335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/14/2021] [Indexed: 01/10/2023] Open
Abstract
Bronchoscopy is a commonly performed procedure within thoracic and critical care medicine. Modern bronchoscopes are technologically advanced tools made of fragile electronic components. Their design is catered to allow maximum maneuverability within the semi-rigid tracheobronchial tree. Effective cleaning and reprocessing of these tools can be a challenge. Although highly functional, the design poses several challenges when it comes to reprocessing. It is a very important step, and lapses in the procedure have been tied to nosocomial infections. The process lacks universal standardization; several organizations have developed their own recommendations. Data have shown that key stakeholders are not fully versed in the essentials of endoscope reprocessing. A significant knowledge gap exists between those performing bronchoscopy and those who are stewards of effective endoscope reprocessing. To service as a resource for bronchoscopists, this study summarizes the steps of effective reprocessing, details the important elements within a health-care facility that houses this process, and reviews some of the current data regarding the use of disposable endoscopes.
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Affiliation(s)
- Sameer K Avasarala
- Division of Allergy, Pulmonary, and Critical Care, Vanderbilt University Medical Center, Nashville, Tennessee, USA,
| | | | - Atul C Mehta
- Respiratory Institute, Cleveland Clinic, Cleveland, Ohio, USA
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18
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da Fonseca EP, Pereira-Junior EA, Palmier AC, Abreu MHNG. A Description of Infection Control Structure in Primary Dental Health Care, Brazil. BIOMED RESEARCH INTERNATIONAL 2021; 2021:5369133. [PMID: 34373834 PMCID: PMC8349252 DOI: 10.1155/2021/5369133] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/13/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This study is aimed at describing a score to assess infection control structures in Oral Health Teams (OHT) in Primary Health Care (PHC) in Brazil. METHODS Secondary data from a national external evaluation of PHC conducted in 2017 and 2018 were analyzed. The construction of the score used 14 variables, divided into the following: structural characteristics of the PHC, infection control equipment under conditions of use, and biosafety supplies in sufficient quantity. The questions were mostly dichotomous (yes/no). Descriptive analyses were carried out to characterize the OHT and factor analyses to reduce the number of observed variables to a specific number of factors. RESULTS Among 20,301 health units with OHT, 4,510 (22.2%) units did not have washable floors, ceilings, and walls; 8,406 (41.4%) did not have a sealer; 16,780 (82.7%) did not have taps with noncontact activation, and 4,663 (23.0%) units did not have rubber gloves. Regarding personal protective equipment (PPE), 1,618 (8.0%) units did not have a sufficient quantity of basic PPE. Three factors were defined to explain the 14 evaluated variables. The South region had the best score of infection control, while the North had the worst. CONCLUSIONS Regional inequalities in the failures in infection control structures identified in PHC with OHT were related to the physical structure, equipment, and supplies used for infection control and the absence of PPE for OHT.
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Affiliation(s)
- Emílio Prado da Fonseca
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Andréa Clemente Palmier
- Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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19
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Robertson D, Gnanaraj J, Wauben L, Huijs J, Samuel VM, Dankelman J, Horeman-Franse T. Assessment of laparoscopic instrument reprocessing in rural India: a mixed methods study. Antimicrob Resist Infect Control 2021; 10:109. [PMID: 34301325 PMCID: PMC8300979 DOI: 10.1186/s13756-021-00976-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 07/06/2021] [Indexed: 11/23/2022] Open
Abstract
Background Laparoscopy is a minimally-invasive surgical procedure that uses long slender instruments that require much smaller incisions than conventional surgery. This leads to faster recovery times, fewer post-surgical wound infections and shorter hospital stays. For these reasons, laparoscopy could be particularly advantageous to patients in low to middle income countries (LMICs). Unfortunately, sterile processing departments in LMIC hospitals are faced with limited access to equipment and trained staff which poses an obstacle to safe surgical care. The reprocessing of laparoscopic devices requires specialised equipment and training. Therefore, when LMIC hospitals invest in laparoscopy, an update of the standard operating procedure in sterile processing is required. Currently, it is unclear whether LMIC hospitals, that already perform laparoscopy, have managed to introduce updated reprocessing methods that minimally invasive equipment requires. The aim of this study was to identify the laparoscopic sterile reprocessing procedures in rural India and to test the effectiveness of the sterilisation equipment. Methods We assessed laparoscopic instrument sterilisation capacity in four rural hospitals in different states in India using a mixed-methods approach. As the main form of data collection, we developed a standardised observational checklist based on reprocessing guidelines from several sources. Steam autoclave performance was measured by monitoring the autoclave cycles in two hospitals. Finally, the findings from the checklist data was supported by an interview survey with surgeons and nurses. Results The checklist data revealed the reprocessing methods the hospitals used in the reprocessing of laparoscopic instruments. It showed that the standard operating procedures had not been updated since the introduction of laparoscopy and the same reprocessing methods for regular surgical instruments were still applied. The interviews confirmed that staff had not received additional training and that they were unaware of the hazardous effects of reprocessing detergents and disinfectants. Conclusion As laparoscopy is becoming more prevalent in LMICs, updated policy is needed to incorporate minimally invasive instrument reprocessing in medical practitioner and staff training programmes. While reprocessing standards improve, it is essential to develop instruments and reprocessing equipment that is more suitable for resource-constrained rural surgical environments. Supplementary Information The online version contains supplementary material available at 10.1186/s13756-021-00976-x.
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Affiliation(s)
- Daniel Robertson
- Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands.
| | | | - Linda Wauben
- Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands
| | - Jan Huijs
- Heart Consultancy, Renkum, The Netherlands
| | - Vasanth Mark Samuel
- Surgery Unit 1, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | - Jenny Dankelman
- Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands
| | - Tim Horeman-Franse
- Department of BioMechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD, Delft, The Netherlands
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20
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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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21
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Otieno BO, Kihara EN, Mua BN. Infection Control Practices Among Private Practicing Dentists in Nairobi During the Pre-coronavirus Disease 2019 Period. FRONTIERS IN ORAL HEALTH 2020; 1:587603. [PMID: 35047984 PMCID: PMC8757696 DOI: 10.3389/froh.2020.587603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 11/16/2020] [Indexed: 12/21/2022] Open
Abstract
Background: Cross-infection control is a dynamic field that requires frequent updates due to emerging diseases, advancement in technology, and scientific knowledge. Despite wide publication of guidelines, a laxity in compliance to the standard precautions for infection control by dental health-care personnel (DHCP) has been reported globally. Therefore, there is need to review previous shortcomings in order to adequately secure dental practices during the coronavirus disease 2019 (COVID-19) pandemic. The aim of the study was to determine knowledge and infection control practices by dentists in private practices. The study was done a few months before the first COVID-19 case was confirmed in Kenya. Materials and Methods: The study design was a descriptive cross-sectional study that was carried out in selected private dental clinics located in Nairobi. Data were collected using an interviewer-administered questionnaire. Convenience sampling method was utilized, while data were analyzed using SPSS 20.0.0.0. Results: A total of 71 private dentists participated in the study. Their mean age was 38 years with an age range of 27-55 years. Almost all (70, 98.6%) the dentists were able to define cross infection correctly. Majority (62, 87.3%) correctly differentiated between sterilization and disinfection, while 9 (12.7%) had difficulties. Most (68, 95.8%) of the respondents were aware of the standard precautions for cross-infection control. All participants used face masks and gloves. About half of them (38, 54%) practiced hand washing after removal of gloves and 31 (43.7%) before and after wearing of gloves, while 2 (2.8%) washed hands only before wearing gloves. Only 31 (42.3%) and 26 (36.6%) participants reported use of rubber dam isolation and impervious barrier, respectively. All the dentists reported disposal of sharps into especially labeled containers, while about half reported use of disposable suction traps and amalgam separators. Conclusion: The dentists had a good knowledge on various aspects of infection control measures that were studied. Use of basic personal protective equipment was widely practiced. There were irregularities in hand hygiene, use of rubber dam, surface barriers, and waste management. The work highlights that many dentists were unprepared to manage infectious risk during the COVID-19 outbreak, which justified the closure of the dental facilities. Development of strategies to promote adequate and safe practice is highly recommended.
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Affiliation(s)
- Benedict Odhiambo Otieno
- Department of Periodontology/Community and Preventive Dentistry, School of Dental Sciences, University of Nairobi, Nairobi, Kenya
| | - Eunice Njeri Kihara
- Department of Oral and Maxillofacial Surgery, Oral Pathology and Oral Medicine, School of Dental Sciences, University of Nairobi, Nairobi, Kenya
| | - Bernard Nzioka Mua
- Department of Periodontology/Community and Preventive Dentistry, School of Dental Sciences, University of Nairobi, Nairobi, Kenya
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Laryngeal Edema, Metabolic Acidosis, and Acute Kidney Injury Associated with Large-Volume Kohrsolin TH® Ingestion. J Emerg Med 2020; 59:900-905. [PMID: 32917443 DOI: 10.1016/j.jemermed.2020.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 06/04/2020] [Accepted: 07/01/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Glutaraldehyde is a commonly used disinfectant in most hospitals. It is known to be an irritating agent to the airway. With the exception of one small-quantity (75 mL) ingestion, no large-volume ingestion has been previously reported. CASE REPORT A 59-year-old man presented with history of large-volume (500 mL) consumption of a solution containing 10% glutaraldehyde and developed respiratory distress, as well as gastrointestinal and kidney injury. His ingestion necessitated a feeding jejunostomy tube placement and tracheostomy. His condition improved with supportive care and he was discharged after 1 month with no long-term sequelae. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Ingestion of this easily accessible agent, which may initially seem clinically benign, warrants close observation. Emergent airway stabilization and supportive care is crucial to the survival of the patient.
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Klumdeth J, Jantaratnotai N, Thaweboon S, Pachimsawat P. Sterility maintenance of reused disposable paper/plastic sterilization pouches in actual clinical practice. Heliyon 2020; 6:e03672. [PMID: 32258497 PMCID: PMC7113629 DOI: 10.1016/j.heliyon.2020.e03672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/25/2019] [Accepted: 03/23/2020] [Indexed: 11/30/2022] Open
Abstract
Paper/plastic sterilization pouches are commonly used packaging material for steam sterilization. Reuse of these pouches is a general practice in Thailand despite a single-use recommendation. This study aimed to determine microbial contamination after reusing paper/plastic sterilization pouches in a dental clinic and storage in a closed environment for 6 months. Three hundred and twenty pouches underwent 3 times of clinical use in terms of packaging, autoclave sterilization, handling, and unpacking. A mouth mirror was packed in each pouch to be used in a clinic. After each use, a pouch would be carefully inspected for reusability and undergone packaging, sterilization, handling again. In all steps, sterilization monitoring was rigorously applied. After 3 times of use, a piece of filter paper was placed inside each pouch (instead of a mouth mirror), the pouch was autoclaved and stored in a closed environment for 6 months. Then the filter paper was retrieved for microbial cultivation. A negative control group comprised new pouches containing filter paper without storage and a positive control group comprised pouches with impaired integrity. All samples in both the reuse and the negative control groups had no microbial contamination. All samples in the positive control group showed contamination. These results suggested that reusing paper/plastic sterilization pouches could be a safe practice provided careful monitoring and inspection were employed.
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Affiliation(s)
- Jenjira Klumdeth
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | | | - Sroisiri Thaweboon
- Department of Oral Microbiology, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Praewpat Pachimsawat
- Department of Advanced General Dentistry, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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24
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Bundles for the central sterile supply department. Am J Infect Control 2019; 47:1352-1357. [PMID: 31324496 DOI: 10.1016/j.ajic.2019.05.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/11/2019] [Accepted: 05/12/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Traditional resources, such as bundles, can help experts define essential steps of health product processing to prevent infections. The present study developed bundle content construction and validation criteria for central sterile supply departments (CSSDs). METHODS The present study employed a Delphi technique modified for content evaluation. Eleven professionals with at least 4 years of experience in sterilization were enlisted. Participants discussed main stages of the process virtually and compiled a list of items based on scientific references justified by law and/or logical reasoning. Agreement, disagreement, and/or suggestions on each step resulted in bundles for a CSSD. Items were then reassessed by experts using a Likert scale with a 90% approval criterion. RESULTS Six bundles were developed: cleaning, inspection, preparation and packaging, sterilization, and storage resulting from 384 responses and 373 agreements (Interassessor coefficient = 97%). DISCUSSIONS Items obtained from the criteria assessment received majority agreement from the first document. CONCLUSIONS Agreement among varying professionals was achieved, and bundles were successfully developed to evaluate the processing of goods in CSSDs.
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25
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Appropriate use of chemical indicators in the steam sterilization process: Assured sterility and economy. Infect Control Hosp Epidemiol 2019; 40:831-832. [PMID: 31092298 DOI: 10.1017/ice.2019.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Sterilisation in Dentistry: A Review of the Literature. Int J Dent 2019; 2019:6507286. [PMID: 30774663 PMCID: PMC6350571 DOI: 10.1155/2019/6507286] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 12/03/2018] [Accepted: 12/25/2018] [Indexed: 11/18/2022] Open
Abstract
In a small and medium-sized dental facility, the correct management of the sterilisation and presterilisation phases plays a fundamental role in good management of instruments and personnel, in order to ensure conditions that are more efficient with less down time. Nowadays, instrument sterilizers are increasingly efficient in achieving results, both in terms of time and size, and ensure that materials are sterile and ready to be stocked in a reasonable time. A literature search for articles related to revision work was performed using electronic databases such as PubMed, Scopus, and Google Scholar. The following keywords have been entered in the previously mentioned databases: sterilisation instruments; dental autoclave; precleaning; instruments disinfectants. The records obtained were screened by three reviewers, and only relevant articles were read full text. In addition, the timings of dental and sterilisation procedures were measured, and from these, suggestions are made in order to improve the efficiency of instrumentation management (facility used as study subject: University Dental Clinic, University of Foggia) as a function of the health-care interventions. We arrived at the conclusion that without doubt, sterilisation of instruments and products plays a fundamental role, but the efficiency of the sterilisation and presterilisation procedures cannot be separated from managing the personnel in charge by giving them specific and precise tasks.
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Kampf G, Fliss PM, Martiny H. Is peracetic acid suitable for the cleaning step of reprocessing flexible endoscopes? World J Gastrointest Endosc 2014; 6:390-406. [PMID: 25228941 PMCID: PMC4163721 DOI: 10.4253/wjge.v6.i9.390] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 08/01/2014] [Accepted: 09/04/2014] [Indexed: 02/05/2023] Open
Abstract
The bioburden (blood, protein, pathogens and biofilm) on flexible endoscopes after use is often high and its removal is essential to allow effective disinfection, especially in the case of peracetic acid-based disinfectants, which are easily inactivated by organic material. Cleaning processes using conventional cleaners remove a variable but often sufficient amount of the bioburden. Some formulations based on peracetic acid are recommended by manufacturers for the cleaning step. We performed a systematic literature search and reviewed the available evidence to clarify the suitability of peracetic acid-based formulations for cleaning flexible endoscopes. A total of 243 studies were evaluated. No studies have yet demonstrated that peracetic acid-based cleaners are as effective as conventional cleaners. Some peracetic acid-based formulations have demonstrated some biofilm-cleaning effects and no biofilm-fixation potential, while others have a limited cleaning effect and a clear biofilm-fixation potential. All published data demonstrated a limited blood cleaning effect and a substantial blood and nerve tissue fixation potential of peracetic acid. No evidence-based guidelines on reprocessing flexible endoscopes currently recommend using cleaners containing peracetic acid, but some guidelines clearly recommend not using them because of their fixation potential. Evidence from some outbreaks, especially those involving highly multidrug-resistant gram-negative pathogens, indicated that disinfection using peracetic acid may be insufficient if the preceding cleaning step is not performed adequately. Based on this review we conclude that peracetic acid-based formulations should not be used for cleaning flexible endoscopes.
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