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Okwose NC, Russell SL, Rahman M, Steward CJ, Harwood AE, McGregor G, Ninkovic S, Maddock H, Banerjee P, Jakovljevic DG. Validity and reliability of short-term heart-rate variability from disposable electrocardiography leads. Health Sci Rep 2023; 6:e984. [PMID: 36514326 PMCID: PMC9731360 DOI: 10.1002/hsr2.984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/21/2022] [Accepted: 11/27/2022] [Indexed: 12/14/2022] Open
Abstract
Background and Aims Single-use electrocardiography (ECG) leads have been developed to reduce healthcare-associated infection. This study compared the validity and reliability of short-term heart rate variability (HRV) obtained from single-use disposable ECG leads. Methods Thirty healthy subjects (33 ± 10 years; 9 females) underwent 5-min resting HRV assessments using disposable (single use) ECG cable and wire system (Kendall DL™ Cardinal Health) and a standard, reusable ECG leads (CardioExpress, Spacelabs Healthcare). Results Intraclass correlation coefficient (ICC) with 95% confidence interval (CI) between disposable and reusable ECG leads was for the time domain [R-R interval (ms); 0.99 (0.91, 1.00)], the root mean square of successive normal R-R interval differences (RMSSD) (ms); 0.91 (0.76, 0.96), the SD of normal-to-normal R-R intervals (SDNN) (ms); 0.91 (0.68, 0.97) and frequency domain [low-frequency (LF) normalized units (nu); 0.90 (0.79, 0.95), high frequency (HF) nu; 0.91 (0.80, 0.96), LF power (ms2); 0.89 (0.62, 0.96), HF power (ms2); 0.90 (0.72, 0.96)] variables. The mean difference and upper and lower limits of agreement between disposable and reusable leads for time- and frequency-domain variables were acceptable. Analysis of repeated measures using disposable leads demonstrated excellent reproducibility (ICC 95% CI) for R-R interval (ms); 0.93 (0.85, 0.97), RMSSD (ms); 0.93 (0.85, 0.97), SDNN (ms); 0.88 (0.75, 0.95), LF power (ms2); 0.87 (0.72, 0.94), and HF power (ms2); 0.88 (0.73, 0.94) with coefficient of variation ranging from 2.2% to 5% (p > 0.37 for all variables). Conclusion Single-use Kendall DL™ ECG leads demonstrate a valid and reproducible tool for the assessment of HRV.
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Affiliation(s)
- Nduka C. Okwose
- Cardiovascular and Lifestyle Medicine Research Theme, Faculty Research Centre (CSELS), Institute for Health and WellbeingCoventry UniversityCoventryUK
- Department of CardiologyUniversity Hospitals Coventry and Warwickshire NHS TrustCoventryUK
| | - Sophie L. Russell
- Cardiovascular and Lifestyle Medicine Research Theme, Faculty Research Centre (CSELS), Institute for Health and WellbeingCoventry UniversityCoventryUK
- Department of CardiologyUniversity Hospitals Coventry and Warwickshire NHS TrustCoventryUK
| | - Mushidur Rahman
- Cardiovascular and Lifestyle Medicine Research Theme, Faculty Research Centre (CSELS), Institute for Health and WellbeingCoventry UniversityCoventryUK
- Department of CardiologyUniversity Hospitals Coventry and Warwickshire NHS TrustCoventryUK
| | - Charles J. Steward
- Cardiovascular and Lifestyle Medicine Research Theme, Faculty Research Centre (CSELS), Institute for Health and WellbeingCoventry UniversityCoventryUK
| | - Amy E. Harwood
- Cardiovascular and Lifestyle Medicine Research Theme, Faculty Research Centre (CSELS), Institute for Health and WellbeingCoventry UniversityCoventryUK
- Department of CardiologyUniversity Hospitals Coventry and Warwickshire NHS TrustCoventryUK
| | - Gordon McGregor
- Cardiovascular and Lifestyle Medicine Research Theme, Faculty Research Centre (CSELS), Institute for Health and WellbeingCoventry UniversityCoventryUK
- Department of CardiologyUniversity Hospitals Coventry and Warwickshire NHS TrustCoventryUK
| | - Srdjan Ninkovic
- Department of Surgery, Clinical Centre, Faculty of Medical SciencesUniversity of KragujevacKragujevacSerbia
| | - Helen Maddock
- Cardiovascular and Lifestyle Medicine Research Theme, Faculty Research Centre (CSELS), Institute for Health and WellbeingCoventry UniversityCoventryUK
| | - Prithwish Banerjee
- Cardiovascular and Lifestyle Medicine Research Theme, Faculty Research Centre (CSELS), Institute for Health and WellbeingCoventry UniversityCoventryUK
- Department of CardiologyUniversity Hospitals Coventry and Warwickshire NHS TrustCoventryUK
| | - Djordje G. Jakovljevic
- Cardiovascular and Lifestyle Medicine Research Theme, Faculty Research Centre (CSELS), Institute for Health and WellbeingCoventry UniversityCoventryUK
- Department of CardiologyUniversity Hospitals Coventry and Warwickshire NHS TrustCoventryUK
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Rozman U, Duh D, Cimerman M, Turk SŠ. Hygiene of Medical Devices and Minimum Inhibitory Concentrations for Alcohol-Based and QAC Disinfectants among Isolates from Physical Therapy Departments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14690. [PMID: 36429408 PMCID: PMC9691081 DOI: 10.3390/ijerph192214690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
Disinfectants are used intensively to control and prevent healthcare-associated infections. With continuous use and exposure to disinfectants, bacteria may develop reduced susceptibility. The study aimed to check the hygiene of devices in the physiotherapy department. For isolated bacterial strains, we aimed to determine the minimum inhibitory concentration of five different disinfectant wipe products currently in use. Microbiological environmental sampling in four various institutions in four different cities from two counties was performed, followed by CFU calculation and identification using matrix-assisted laser desorption and ionization with time-of-flight analyzer mass spectrometry (MALDI-TOF). The sampling was performed on three different occasions: before patient use, after patient use, and after disinfection. The susceptibility of isolates to three different alcohol-based and three different quaternary ammonium compounds (QAC) disinfectant wipes was examined by determining the minimal inhibitory concentrations (MIC). We identified 27 different bacterial species from 11 different genera. Gram-positive bacteria predominated. The most abundant genera were Staphylococcus, Micrococcus, and Bacillus. The average MIC values of alcohol-based disinfectants range between 66.61 and 148.82 g/L, and those of QAC-based disinfectants range between 2.4 and 3.5 mg/L. Distinctive strains with four-fold increases in MIC values, compared to average values, were identified. The widespread use of disinfectants can induce a reduction in the susceptibility of bacteria against disinfectants and affect the increase in the proportion of antibiotic-resistant bacteria. Therefore, it is urgent to define clear criteria for defining a microorganism as resistant to disinfectants by setting epidemiological cut-off (ECOFF) values and standardizing protocols for testing the resistance of microorganisms against disinfectants.
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Affiliation(s)
- Urška Rozman
- Faculty of Health Sciences, University of Maribor, Žitna ulica 15, 2000 Maribor, Slovenia
| | - Darja Duh
- Chemicals Office of the Republic of Slovenia, Ajdovščina 4, 1000 Ljubljana, Slovenia
| | - Mojca Cimerman
- National Laboratory of Health, Environment and Food, Prvomajska ulica 1, 2000 Maribor, Slovenia
| | - Sonja Šostar Turk
- Faculty of Health Sciences, University of Maribor, Žitna ulica 15, 2000 Maribor, Slovenia
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Ahmed S, Lee Y, Lim YH, Cho SH, Park HK, Cho SH. Noncontact assessment for fatigue based on heart rate variability using IR-UWB radar. Sci Rep 2022; 12:14211. [PMID: 35987815 PMCID: PMC9392064 DOI: 10.1038/s41598-022-18498-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022] Open
Abstract
Physical fatigue can be assessed using heart rate variability (HRV). We measured HRV at rest and in a fatigued state using impulse-radio ultra wideband (IR-UWB) radar in a noncontact fashion and compared the measurements with those obtained using electrocardiography (ECG) to assess the reliability and validity of the radar measurements. HRV was measured in 15 subjects using radar and ECG simultaneously before (rest for 10 min before exercise) and after a 20-min exercise session (fatigue level 1 for 0–9 min; fatigue level 2 for 10–19 min; recovery for ≥ 20 min after exercise). HRV was analysed in the frequency domain, including the low-frequency component (LF), high-frequency component (HF) and LF/HF ratio. The LF/HF ratio measured using radar highly agreed with that measured using ECG during rest (ICC = 0.807), fatigue-1 (ICC = 0.712), fatigue-2 (ICC = 0.741) and recovery (ICC = 0.764) in analyses using intraclass correlation coefficients (ICCs). The change pattern in the LH/HF ratios during the experiment was similar between radar and ECG. The subject’s body fat percentage was linearly associated with the time to recovery from physical fatigue (R2 = 0.96, p < 0.001). Our results demonstrated that fatigue and rest states can be distinguished accurately based on HRV measurements using IR-UWB radar in a noncontact fashion.
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Park JY, Lee Y, Heo R, Park HK, Cho SH, Cho SH, Lim YH. Preclinical evaluation of noncontact vital signs monitoring using real-time IR-UWB radar and factors affecting its accuracy. Sci Rep 2021; 11:23602. [PMID: 34880335 PMCID: PMC8655004 DOI: 10.1038/s41598-021-03069-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 11/24/2021] [Indexed: 12/03/2022] Open
Abstract
Recently, noncontact vital sign monitors have attracted attention because of issues related to the transmission of contagious diseases. We developed a real-time vital sign monitor using impulse-radio ultrawideband (IR-UWB) radar with embedded processors and software; we then evaluated its accuracy in measuring heart rate (HR) and respiratory rate (RR) and investigated the factors affecting the accuracy of the radar-based measurements. In 50 patients visiting a cardiology clinic, HR and RR were measured using IR-UWB radar simultaneously with electrocardiography and capnometry. All patients underwent HR and RR measurements in 2 postures—supine and sitting—for 2 min each. There was a high agreement between the RR measured using radar and capnometry (concordance correlation coefficient [CCC] 0.925 [0.919–0.926]; upper and lower limits of agreement [LOA], − 2.21 and 3.90 breaths/min). The HR measured using radar was also in close agreement with the value measured using electrocardiography (CCC 0.749 [0.738–0.760]; upper and lower LOA, − 12.78 and 15.04 beats/min). Linear mixed effect models showed that the sitting position and an HR < 70 bpm were associated with an increase in the absolute biases of the HR, whereas the sitting position and an RR < 18 breaths/min were associated with an increase in the absolute biases of the RR. The IR-UWB radar sensor with embedded processors and software can measure the RR and HR in real time with high precision. The sitting position and a low RR or HR were associated with the accuracy of RR and HR measurement, respectively, using IR-UWB radar.
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Affiliation(s)
- Jun-Young Park
- Department of Electronics and Computer Engineering, College of Engineering, Hanyang University, 222 Wangsimni-ro, Sungdong-gu, Seoul, 04763, Republic of Korea
| | - Yonggu Lee
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, 222 Wangsimni-ro, Sungdong-gu, Seoul, 04763, Republic of Korea
| | - Ran Heo
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, 222 Wangsimni-ro, Sungdong-gu, Seoul, 04763, Republic of Korea
| | - Hyun-Kyung Park
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, 04763, Republic of Korea
| | - Seok-Hyun Cho
- Department of Otorhinolaryngology, College of Medicine, Hanyang University, Seoul, 04763, Republic of Korea
| | - Sung Ho Cho
- Department of Electronics and Computer Engineering, College of Engineering, Hanyang University, 222 Wangsimni-ro, Sungdong-gu, Seoul, 04763, Republic of Korea.
| | - Young-Hyo Lim
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, 222 Wangsimni-ro, Sungdong-gu, Seoul, 04763, Republic of Korea.
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Bloe C. The role of single-use ECG leads in reducing healthcare-associated infections. ACTA ACUST UNITED AC 2021; 30:628-633. [PMID: 34109824 DOI: 10.12968/bjon.2021.30.11.628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
An electrocardiogram (ECG), the recording of the electrical activity in the heart, is the most commonly performed cardiac test. It is carried out in a variety of clinical settings in hospitals and primary care, and its use is standard practice among high-risk, critically ill patients, and those who have undergone cardiac surgery. ECG recording is classified into two main categories: monitoring and diagnostic. 12-lead ECGs, which require electrodes to be placed on the chest and each limb, are used for diagnostic purposes, whereas 3- or 5-lead ECGs are used for rhythm monitoring. Cross-infection can arise from reusing ECG cables, even if they have been cleaned. Surgical site infection is a particular risk in patients who have undergone coronary artery bypass grafting, because ECG wires are placed on the chest close to the incision site. Single-use ECG leads, such as the Kendall DL™ ECG cable and lead wire system, reduce the risk of cross-contamination between patients and free nursing time for patient care because they are discarded after use and do not have to be cleaned and disinfected for use with another patient.
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Affiliation(s)
- Charlie Bloe
- Lead Nurse for Cardiology, Critical Care Unit, Raigmore Hospital, NHS Highland
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Wang A, Nguyen D, Sridhar AR, Gollakota S. Using smart speakers to contactlessly monitor heart rhythms. Commun Biol 2021; 4:319. [PMID: 33750897 PMCID: PMC7943557 DOI: 10.1038/s42003-021-01824-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Accepted: 02/09/2021] [Indexed: 12/21/2022] Open
Abstract
Heart rhythm assessment is indispensable in diagnosis and management of many cardiac conditions and to study heart rate variability in healthy individuals. We present a proof-of-concept system for acquiring individual heart beats using smart speakers in a fully contact-free manner. Our algorithms transform the smart speaker into a short-range active sonar system and measure heart rate and inter-beat intervals (R-R intervals) for both regular and irregular rhythms. The smart speaker emits inaudible 18–22 kHz sound and receives echoes reflected from the human body that encode sub-mm displacements due to heart beats. We conducted a clinical study with both healthy participants and hospitalized cardiac patients with diverse structural and arrhythmic cardiac abnormalities including atrial fibrillation, flutter and congestive heart failure. Compared to electrocardiogram (ECG) data, our system computed R-R intervals for healthy participants with a median error of 28 ms over 12,280 heart beats and a correlation coefficient of 0.929. For hospitalized cardiac patients, the median error was 30 ms over 5639 heart beats with a correlation coefficient of 0.901. The increasing adoption of smart speakers in hospitals and homes may provide a means to realize the potential of our non-contact cardiac rhythm monitoring system for monitoring of contagious or quarantined patients, skin sensitive patients and in telemedicine settings. Anran Wang et al. present a contact-free method of monitoring individual heart beats by converting smart-speakers into active sonar systems. Their approach is capable of measuring heart rhythms with high accuracy in both healthy participants and hospitalized patients, and may be a useful healthcare tool for remote diagnosis or patient monitoring.
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Affiliation(s)
- Anran Wang
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, USA.
| | - Dan Nguyen
- Division of Cardiology, University of Washington, Seattle, WA, USA
| | - Arun R Sridhar
- Division of Cardiology, University of Washington, Seattle, WA, USA.
| | - Shyamnath Gollakota
- Paul G. Allen School of Computer Science and Engineering, University of Washington, Seattle, WA, USA.
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7
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Bonner AM, Davidson P. Technical Tips: Keeping It Clean during COVID-19. Neurodiagn J 2020; 60:195-207. [PMID: 33006508 DOI: 10.1080/21646821.2020.1805267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Since 1995, ASET has periodically published updates to recommendations for best practices in infection prevention for Neurodiagnostic technologists. The latest installment was accepted in December 2019 for publication in Volume 60, Issue 1, before we had much knowledge or understanding about the SARS-CoV-2, the virus that causes COVID-19. This Technical Tips article is presented as an addendum to the 2020 update and includes important information about infection prevention measures specific to procedure protocols when working with patients positive or under investigation for a highly infectious disease, and when working with patients in general during the current pandemic. All Neurodiagnostic technologists who have direct patient care are responsible for ensuring the use of best practices to prevent the spread of infection.
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Affiliation(s)
- Anna M Bonner
- ASET - The Neurodiagnostic Society , Cary, North Carolina
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8
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Chattopadhyay T, Mondal H, Mondal S, Das D, Biri S. Fabrication of a low-cost strap for holding precordial electrodes on the hirsute chest. J Family Med Prim Care 2020; 9:2359-2363. [PMID: 32754501 PMCID: PMC7380826 DOI: 10.4103/jfmpc.jfmpc_292_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/14/2020] [Accepted: 03/26/2020] [Indexed: 11/04/2022] Open
Abstract
Background: Aim: Materials and Methods: Results: Conclusion:
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9
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Selvaraj N, Nallathambi G, Moghadam R, Aga A. Fully Disposable Wireless Patch Sensor for Continuous Remote Patient Monitoring. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2018:1632-1635. [PMID: 30440706 DOI: 10.1109/embc.2018.8512569] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Continuous remote monitoring with convenient wireless sensors is attractive for early detection of patient deterioration, preventing adverse events and leading to better patient care. This article presents an innovative sensor design of VitalPatch, a fully disposable wireless biosensor, for remote continuous monitoring, and details the performance assessments from bench testing and laboratory validation in 57 subjects. The bench testing results reveal that VitalPatch's QRS detection had a positive predictive value of $> 99$% from testing with ECG databases. The accuracies of HR, BR and skin temp (in mean absolute error, MAE) from bench testing were $< 5$ bpm, $< 1$ brpm, $< 1 ^{ \circ}C$ respectively. The laboratory testing in 57 subjects revealed the accuracy of HR and BR to be $2.2 \pm 1.5$ bpm and $1.7 \pm 0.7$ brpm respectively for stationary periods. The absolute percent error in detecting steps was $4.7 \pm 4.6$%, and the accuracy in detecting posture was $96.4 \pm 3.1$%. Meanwhile, the specificity and sensitivity of fall detection $( \mathrm {n}=20)$ was found to be 100% and 93.8%, respectively. In conclusion, VitalPatch biosensor demonstrated clinically acceptable accuracies for its vital signs and actigraphy metrics applicable for continuous unobtrusive patient monitoring.
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Park JY, Lee Y, Choi YW, Heo R, Park HK, Cho SH, Cho SH, Lim YH. Preclinical Evaluation of a Noncontact Simultaneous Monitoring Method for Respiration and Carotid Pulsation Using Impulse-Radio Ultra-Wideband Radar. Sci Rep 2019; 9:11892. [PMID: 31417149 PMCID: PMC6695386 DOI: 10.1038/s41598-019-48386-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 08/05/2019] [Indexed: 11/09/2022] Open
Abstract
There has been the possibility for respiration and carotid pulsation to be simultaneously monitored from a distance using impulse-radio ultra-wideband (IR-UWB) radar. Therefore, we investigated the validity of simultaneous respiratory rates (RR), pulse rates (PR) and R-R interval measurement using IR-UWB radar. We included 19 patients with a normal sinus rhythm (NSR) and 14 patients with persistent atrial fibrillation (PeAF). The RR, PR, R-R interval and rhythm were obtained simultaneously from the right carotid artery area in a supine position and under normal breathing conditions using IR-UWB radar. There was excellent agreement between the RR obtained by IR-UWB radar and that manually counted by a physician (intraclass correlation coefficient [ICC] 0.852). In the NSR group, there was excellent agreement between the PR (ICC 0.985), average R-R interval (ICC 0.999), and individual R-R interval (ICC 0.910) measured by IR-UWB radar and electrocardiography. In the PeAF group, PR (ICC 0.930), average R-R interval (ICC 0.957) and individual R-R interval (ICC 0.701) also agreed well between the two methods. These results demonstrate that IR-UWB radar can simultaneously monitor respiration, carotid pulse and heart rhythm with high precision and may thus be utilized as a noncontact continuous vital sign monitoring in clinical practice.
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Affiliation(s)
- Jun-Young Park
- Department of Electronics and Computer Engineering, Hanyang University, Seoul, 04763, Republic of Korea
| | - Yonggu Lee
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, 04763, Republic of Korea
| | - Yeon-Woo Choi
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, 04763, Republic of Korea
| | - Ran Heo
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, 04763, Republic of Korea
| | - Hyun-Kyung Park
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, 04763, Republic of Korea
| | - Seok-Hyun Cho
- Department of Otorhinolaryngology, College of Medicine, Hanyang University, Seoul, 04763, Republic of Korea
| | - Sung Ho Cho
- Department of Electronics and Computer Engineering, Hanyang University, Seoul, 04763, Republic of Korea.
| | - Young-Hyo Lim
- Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, 04763, Republic of Korea.
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Lee Y, Park JY, Choi YW, Park HK, Cho SH, Cho SH, Lim YH. A Novel Non-contact Heart Rate Monitor Using Impulse-Radio Ultra-Wideband (IR-UWB) Radar Technology. Sci Rep 2018; 8:13053. [PMID: 30158545 PMCID: PMC6115337 DOI: 10.1038/s41598-018-31411-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/16/2018] [Indexed: 12/03/2022] Open
Abstract
We discovered that impulse-radio ultra-wideband (IR-UWB) radar could recognize cardiac motions in a non-contact fashion. Therefore, we measured the heart rate (HR) and rhythms using an IR-UWB radar sensor and evaluated the validity and reliability of the measurements in comparison to electrocardiography. The heart beats were measured in 6 healthy volunteers (18 samples) with normal sinus rhythm (NSR) and 16 patients (36 samples) with atrial fibrillation (AF) using both an IR-UWB radar sensor and electrocardiography simultaneously. The participants hold their breath for 20 seconds during the data acquisition. In subjects with NSR, there was excellent agreement of HR (intraclass correlation coefficient [ICC] 0.856), average R-R interval (ICC 0.997) and individual R-R intervals between the two methods (ICC 0.803). In subjects with AF, HR (ICC 0.871) and average R-R interval (ICC 0.925) from the radar sensor also agreed well with those from electrocardiography, though there was a small disagreement in the individual R-R intervals between the two methods (ICC 0.697). The rhythms computed by the signal-processing algorithm showed good agreement between the two methods (Cohen's Kappa 0.922). The IR-UWB radar sensor is precise and accurate for assessing HR and rhythms in a non-contact fashion.
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Affiliation(s)
- Yonggu Lee
- Division of Cardiology, Department of Internal medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Jun-Young Park
- Department of Electronics and Computer Engineering, College of Engineering, Hanyang University, Seoul, Republic of Korea
| | - Yeon-Woo Choi
- Division of Cardiology, Department of Internal medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Hyun-Kyung Park
- Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Seok-Hyun Cho
- Department of Otorhinolaryngology, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Sung Ho Cho
- Department of Electronics and Computer Engineering, College of Engineering, Hanyang University, Seoul, Republic of Korea.
| | - Young-Hyo Lim
- Division of Cardiology, Department of Internal medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea.
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The relationship between a single-patient-use electrocardiograph cable and lead system and coronary artery bypass graft surgical site infection within a Medicare population. Am J Infect Control 2018. [PMID: 29525368 DOI: 10.1016/j.ajic.2018.01.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Surgical site infection incidence following coronary artery bypass graft surgery was observed across 27,296 procedures within a Medicare population. A facility-level case-control claims analysis demonstrated a significant 25% reduction (P = .04) in suspected surgical site infection at 90 days after coronary artery bypass graft surgery at facilities utilizing a single-patient-use electrocardiography cable and lead wire system.
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13
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Aljadi SH, Al-Shemmari M, Al-Ramzi J, Al-Abdullatif S, Hajeyah Z, Jamal L, Al-Bahar S. Bacterial contamination in physical therapy departments in the State of Kuwait. J Phys Ther Sci 2017. [PMID: 28626312 PMCID: PMC5468187 DOI: 10.1589/jpts.29.1014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
[Purpose] Interferential therapy and electrical stimulation are electrophysical modalities commonly used in physical therapy departments to treat patients with musculoskeletal problems. These machines are applied directly to the patient’s skin via a medium or electrodes, which can facilitate the transmission of microorganisms from one patient to another. The purpose of this study was to determine the extent of microorganism contamination in the machines sponges at physical therapy departments in Kuwait hospitals. [Subjects and Methods] Sixty samples comprising sponges from interferential therapy and electrical stimulation machines, and water from hot pack units were collected from 5 physical therapy departments in 5 different hospitals. The samples were analyzed at a Medical Laboratory to explore the extent and type of microorganisms present. [Results] Forty-one of the 60 samples (68.3%) were positive for microorganism contamination. Of the 41 contaminated samples, 28 (68.3%) were sponges and 13 (31.7%) were water samples. The major microorganisms found were Acinetobacter baumannii (21.9%), Serratia marcescens (12.2%), and Staphylococcus lentus (7.3%). [Conclusion] Interferential therapy and electrical stimulation in physical therapy departments have a high probability of causing cross contamination between patients. Physical therapists are encouraged to adhere to safety guidelines, such as disinfection management, disposal of used sponges, and regular sponge replacement.
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Affiliation(s)
- Sameera H Aljadi
- Physical Therapy Department, Faculty of Allied Health Sciences, Kuwait University, State of Kuwait
| | - Mashael Al-Shemmari
- Medical Laboratory Sciences Department, Faculty of Allied Health Sciences, Kuwait University, State of Kuwait
| | - Jumana Al-Ramzi
- Medical Laboratory Sciences Department, Faculty of Allied Health Sciences, Kuwait University, State of Kuwait
| | - Shoug Al-Abdullatif
- Physical Therapy Department, Faculty of Allied Health Sciences, Kuwait University, State of Kuwait
| | - Zahraa Hajeyah
- Physical Therapy Department, Faculty of Allied Health Sciences, Kuwait University, State of Kuwait
| | - Laila Jamal
- Physical Therapy Department, Faculty of Allied Health Sciences, Kuwait University, State of Kuwait
| | - Sara Al-Bahar
- Physical Therapy Department, Faculty of Allied Health Sciences, Kuwait University, State of Kuwait
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Bridges E, McNeill M, Munro N. Research in Review: Driving Critical Care Practice Change. Am J Crit Care 2016; 25:76-84. [PMID: 26724298 DOI: 10.4037/ajcc2016564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
During the past year, studies were published that will lead to practice change, address challenges at the bedside, and introduce new care strategies. This article summarizes some of this important work and considers it in the context of previous research and practice. Examples of research-based practice changes include the performance and assessment of septic shock resuscitation, and the integration of tourniquets and massive transfusions in civilian trauma. Care challenges addressed include ethical considerations in light of the Ebola epidemic, infection prevention associated with chlorhexidine bathing, bedside alarm management, evidence to enhance moral courage, and interventions to mitigate thirst in critically ill patients. Research that portends future care includes a discussion of fecal microbiota transplant for patients with refractory infection with refractory infection with Clostridium difficile.
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Affiliation(s)
- Elizabeth Bridges
- Elizabeth Bridges is a clinical nurse researcher and associate professor at the University of Washington Medical Center/School of Nursing, Seattle, Washington. Margaret McNeill is a clinical nurse specialist, perianesthesia, Department of Professional and Clinical Development, Frederick Regional Health System, Frederick, Maryland. Nancy Munro is senior acute care nurse practitioner, Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland
| | - Margaret McNeill
- Elizabeth Bridges is a clinical nurse researcher and associate professor at the University of Washington Medical Center/School of Nursing, Seattle, Washington. Margaret McNeill is a clinical nurse specialist, perianesthesia, Department of Professional and Clinical Development, Frederick Regional Health System, Frederick, Maryland. Nancy Munro is senior acute care nurse practitioner, Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland
| | - Nancy Munro
- Elizabeth Bridges is a clinical nurse researcher and associate professor at the University of Washington Medical Center/School of Nursing, Seattle, Washington. Margaret McNeill is a clinical nurse specialist, perianesthesia, Department of Professional and Clinical Development, Frederick Regional Health System, Frederick, Maryland. Nancy Munro is senior acute care nurse practitioner, Critical Care Medicine Department, National Institutes of Health, Bethesda, Maryland
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Russotto V, Cortegiani A, Raineri SM, Giarratano A. Bacterial contamination of inanimate surfaces and equipment in the intensive care unit. J Intensive Care 2015; 3:54. [PMID: 26693023 PMCID: PMC4676153 DOI: 10.1186/s40560-015-0120-5] [Citation(s) in RCA: 156] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 12/02/2015] [Indexed: 11/24/2022] Open
Abstract
Intensive care unit (ICU)-acquired infections are a challenging health problem worldwide, especially when caused by multidrug-resistant (MDR) pathogens. In ICUs, inanimate surfaces and equipment (e.g., bedrails, stethoscopes, medical charts, ultrasound machine) may be contaminated by bacteria, including MDR isolates. Cross-transmission of microorganisms from inanimate surfaces may have a significant role for ICU-acquired colonization and infections. Contamination may result from healthcare workers’ hands or by direct patient shedding of bacteria which are able to survive up to several months on dry surfaces. A higher environmental contamination has been reported around infected patients than around patients who are only colonized and, in this last group, a correlation has been observed between frequency of environmental contamination and culture-positive body sites. Healthcare workers not only contaminate their hands after direct patient contact but also after touching inanimate surfaces and equipment in the patient zone (the patient and his/her immediate surroundings). Inadequate hand hygiene before and after entering a patient zone may result in cross-transmission of pathogens and patient colonization or infection. A number of equipment items and commonly used objects in ICU carry bacteria which, in most cases, show the same antibiotic susceptibility profiles of those isolated from patients. The aim of this review is to provide an updated evidence about contamination of inanimate surfaces and equipment in ICU in light of the concept of patient zone and the possible implications for bacterial pathogen cross-transmission to critically ill patients.
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Affiliation(s)
- Vincenzo Russotto
- Department of Biopathology and Medical Biotechnologies (DIBIMED), Section of Anaesthesia, Analgesia, Intensive Care and Emergency, University Hospital Paolo Giaccone, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Andrea Cortegiani
- Department of Biopathology and Medical Biotechnologies (DIBIMED), Section of Anaesthesia, Analgesia, Intensive Care and Emergency, University Hospital Paolo Giaccone, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Santi Maurizio Raineri
- Department of Biopathology and Medical Biotechnologies (DIBIMED), Section of Anaesthesia, Analgesia, Intensive Care and Emergency, University Hospital Paolo Giaccone, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
| | - Antonino Giarratano
- Department of Biopathology and Medical Biotechnologies (DIBIMED), Section of Anaesthesia, Analgesia, Intensive Care and Emergency, University Hospital Paolo Giaccone, University of Palermo, Via del Vespro 129, 90127 Palermo, Italy
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Addison N, Quatrara B, Letzkus L, Strider D, Rovnyak V, Syptak V, Fuzy L. Cleanliness of disposable vs nondisposable electrocardiography lead wires in children. Am J Crit Care 2014; 23:424-8. [PMID: 25179038 DOI: 10.4037/ajcc2014601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Mediastinitis costs hospitals thousands of dollars a year and increases the incidence of patient morbidity and mortality. No studies have been done to evaluate adenosine triphosphate (ATP) counts on disposable and nondisposable electrocardiography (ECG) lead wires in pediatric patients. OBJECTIVE To compare the cleanliness of disposable and nondisposable ECG lead wires in postoperative pediatric cardiac surgery patients by measuring the quantity of ATP (in relative luminescence units [RLUs]). ATP levels correlate with microbial cell counts and are used by institutions to assess hospital equipment and cleanliness. METHODS A prospective, randomized trial was initiated with approval from the institutional review board. Verbal consent was obtained from the parents/guardians for each patient. Trained nurses performed ATP swabs on the right and left upper ECG cables on postoperative days 1, 2, and 3. RESULTS This study enrolled 51 patients. The disposable ECG lead wire ATP count on postoperative day 1 (median, 157 RLUs) was significantly lower (P < .001) than the count for nondisposable ATP lead wires (median, 610 RLUs). On postoperative day 2, the ATP count for the disposable ECG lead wires (median, 200 RLUs) was also lower (P = .06) than the count for the nondisposable ECG lead wires (median, 453 RLUs). CONCLUSION Results of this study support the use of disposable ECG lead wires in postoperative pediatric cardiac surgery patients for at least the first 48 hours as a direct strategy to reduce the ATP counts on ECG lead wires.
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Affiliation(s)
- Nancy Addison
- Nancy Addison is a research nurse clinician in the pediatric intensive care unit, Beth Quatrara is director and Lisa Letzkus is assistant director of nursing research for the medical center, David Strider is a nurse practitioner at the medical center, Virginia Rovnyak is a statistician at the school of nursing, and Virginia Syptak and Lisa Fuzy are nurse clinicians in the pediatric intensive care unit. All are employed at the University of Virginia Health System in Charlottesville
| | - Beth Quatrara
- Nancy Addison is a research nurse clinician in the pediatric intensive care unit, Beth Quatrara is director and Lisa Letzkus is assistant director of nursing research for the medical center, David Strider is a nurse practitioner at the medical center, Virginia Rovnyak is a statistician at the school of nursing, and Virginia Syptak and Lisa Fuzy are nurse clinicians in the pediatric intensive care unit. All are employed at the University of Virginia Health System in Charlottesville
| | - Lisa Letzkus
- Nancy Addison is a research nurse clinician in the pediatric intensive care unit, Beth Quatrara is director and Lisa Letzkus is assistant director of nursing research for the medical center, David Strider is a nurse practitioner at the medical center, Virginia Rovnyak is a statistician at the school of nursing, and Virginia Syptak and Lisa Fuzy are nurse clinicians in the pediatric intensive care unit. All are employed at the University of Virginia Health System in Charlottesville
| | - David Strider
- Nancy Addison is a research nurse clinician in the pediatric intensive care unit, Beth Quatrara is director and Lisa Letzkus is assistant director of nursing research for the medical center, David Strider is a nurse practitioner at the medical center, Virginia Rovnyak is a statistician at the school of nursing, and Virginia Syptak and Lisa Fuzy are nurse clinicians in the pediatric intensive care unit. All are employed at the University of Virginia Health System in Charlottesville
| | - Virginia Rovnyak
- Nancy Addison is a research nurse clinician in the pediatric intensive care unit, Beth Quatrara is director and Lisa Letzkus is assistant director of nursing research for the medical center, David Strider is a nurse practitioner at the medical center, Virginia Rovnyak is a statistician at the school of nursing, and Virginia Syptak and Lisa Fuzy are nurse clinicians in the pediatric intensive care unit. All are employed at the University of Virginia Health System in Charlottesville
| | - Virginia Syptak
- Nancy Addison is a research nurse clinician in the pediatric intensive care unit, Beth Quatrara is director and Lisa Letzkus is assistant director of nursing research for the medical center, David Strider is a nurse practitioner at the medical center, Virginia Rovnyak is a statistician at the school of nursing, and Virginia Syptak and Lisa Fuzy are nurse clinicians in the pediatric intensive care unit. All are employed at the University of Virginia Health System in Charlottesville
| | - Lisa Fuzy
- Nancy Addison is a research nurse clinician in the pediatric intensive care unit, Beth Quatrara is director and Lisa Letzkus is assistant director of nursing research for the medical center, David Strider is a nurse practitioner at the medical center, Virginia Rovnyak is a statistician at the school of nursing, and Virginia Syptak and Lisa Fuzy are nurse clinicians in the pediatric intensive care unit. All are employed at the University of Virginia Health System in Charlottesville
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Analysis and recommendations for reducing risks of patient crosscontaminations via noncritical medical devices. Health Care Manag (Frederick) 2014; 33:205-13. [PMID: 25068874 DOI: 10.1097/hcm.0000000000000015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Based on the serious problem of health care-associated infections and the understanding that patient crosscontamination is essentially preventable, opinions were sought from health care providers for insight into likely sources of crosscontamination in US hospitals, probable causes, and areas for additional investigation. Respondents indicated that inadequate disinfection of noncritical, patient care devices pose an underrecognized threat to patient crosscontamination. This led the researchers to question reliance upon the current Centers for Disease Control and Prevention (CDC) Guideline for Disinfection and Sterilization in Healthcare Facilities for such items. The CDC Guideline follows the Spaulding approach, which categorizes items and their disinfection treatment based on the risk of infection from the intended use of the item. A failure modes, effects, and criticality analysis approach is recommended as an additional refinement to the CDC Guideline whereby likely sources of cross-contamination are identified irrespective of intended use. Enhancing infection control practices with this approach promotes the development of preventive plans for cleaning and disinfection that can mitigate such risk.
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Pettersen TR, Fålun N, Norekvål TM. Improvement of in-hospital telemetry monitoring in coronary care units: an intervention study for achieving optimal electrode placement and attachment, hygiene and delivery of critical information to patients. Eur J Cardiovasc Nurs 2013; 13:515-23. [PMID: 24304659 DOI: 10.1177/1474515113515585] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND In-hospital telemetry monitoring is important for diagnosis and treatment of patients at risk of developing life-threatening arrhythmias. It is widely used in critical and non-critical care wards. Nurses are responsible for correct electrode placement, thus ensuring optimal quality of the monitoring. The aims of this study were to determine whether a complex educational intervention improves (a) optimal electrode placement, (b) hygiene, and (c) delivery of critical information to patients (reason for monitoring, limitations in cellular phone use, and not to leave the ward without informing a member of staff). METHODS A prospective interventional study design was used, with data collection occurring over two six-week periods: before implementation of the intervention (n=201) and after the intervention (n=165). Standard abstraction forms were used to obtain data on patients' clinical characteristics, and 10 variables related to electrode placement and attachment, hygiene and delivery of critical information. RESULTS At pre-intervention registration, 26% of the electrodes were misplaced. Twelve per cent of the patients received information about limiting their cellular phone use while monitored, 70% were informed of the purpose of monitoring, and 71% used a protective cover for their unit. Post-intervention, outcome measures for the three variables improved significantly: use of protective cover (p<0.001), information about the purpose of monitoring (p=0.005) and information about limitations in cellular phone use (p=0.003). Nonetheless, 23% of the electrodes were still misplaced. CONCLUSION The study highlights the need for better, continued education for in-hospital telemetry monitoring in coronary care units, and other units that monitor patients with telemetry.
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Affiliation(s)
| | - Nina Fålun
- Department of Heart Disease, Haukeland University Hospital, Norway Institute of Nursing, Bergen University College, Norway
| | - Tone M Norekvål
- Department of Heart Disease, Haukeland University Hospital, Norway Department of Clinical Science, University of Bergen, Norway
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Reshamwala A, McBroom K, Choi YI, LaTour L, Ramos-Embler A, Steele R, Lomugdang V, Newman M, Reid C, Zhao Y, Granger BB. Microbial colonization of electrocardiographic telemetry systems before and after cleaning. Am J Crit Care 2013; 22:382-9. [PMID: 23996417 DOI: 10.4037/ajcc2013365] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND Nosocomial infections caused by multidrug-resistant organisms are commonly associated with longer hospital stays up to 12 to 18 days and annual estimated costs of $5.7 billion to $6.8 billion. One common mode of transmission is cross-contamination between patients and providers via surface contaminants on devices such as telemetry systems. OBJECTIVES To determine the effect of a cleaning protocol on colonization of surface contaminants on electrocardiographic telemetry systems in 4 cardiovascular step-down units and to compare colonization in medical vs surgical units. METHODS A prospective, randomized, case-controlled study (the Descriptive Evaluation of Electrocardiographic Telemetry Pathogens [DEET] study) was designed to evaluate microbial colonization on telemetry systems before and after cleaning with sodium hypochlorite wipes. Each randomly selected telemetry system served as its own control. Nurses used a standardized culture technique recommended by personnel in infection control. Colonization before and after cleaning was analyzed by using the McNemar test and frequency tables. A standard cost-comparison analysis was conducted. RESULTS A total of 30 telemetry systems in medical units and 29 in surgical units were evaluated; 41 telemetry systems (69%) were colonized before the intervention, and 14 (24%) were colonized after it (P < .001). Before cleaning, surface organisms were present in 14 instances (35%) in surgical units and in 27 instances (66%) in medical units (P < .001). The cleaning strategy was cost-effective. CONCLUSIONS The cleaning intervention was effective, and cost-comparison analysis supported implementing a cleaning strategy for reusable leads rather than investing in disposable leads.
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Lestari T, Ryll S, Kramer A. Microbial contamination of manually reprocessed, ready to use ECG lead wire in intensive care units. GMS HYGIENE AND INFECTION CONTROL 2013; 8:Doc07. [PMID: 23967393 PMCID: PMC3746603 DOI: 10.3205/dgkh000207] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: A number of studies have shown that non-critical medical devices can be contaminated with pathogens, including those resistant to antibiotics and thus become a potential vector for transmission. Electrocardiography (ECG) lead wire are non-critical medical device which are always attached on patient skin during their stay in intensive care unit (ICU). In view of the patient’s critical conditions and exposure to invasive procedures, identification and prevention of possible risks are important to prevent infection in ICUs. Objective: The objective of this study was to determine the presence of bacterial and fungal contamination on cleaned and disinfected reusable ECG lead wires in intensive care units in a hospital. Methods: A total of 408 cleaned ECG lead wires from 93 bed-side ECG devices and 43 ECG lead wires from 5 portable ECG devices from 4 intensive care units (ICUs) and 1 post-anaesthesia care unit (PACU) were sampled. ECG lead wires were stirred in 0.89% NaCl with added neutralizer for 30 seconds. Samples of the solutions were cultured directly on blood agar. The remaining solution was cultured on blood agar after sterile filtration. The number of colony forming units (CFUs) was counted and the microorganisms were identified. Results: More than half of examined ECG lead wires (n=232; 51.4%) were contaminated with >30 CFUs/mL sample of bacteria or with risk pathogens. Gram-positive bacteria were the most frequently isolated organisms; particularly, coagulase negative staphylococci (96%) and aerobic spore forming bacteria (71.2%). Compared to ICUs, PACU had significantly lower proportion of contaminated ECG lead wires (p<0.05). The proportion of contaminated ECG lead wires, as well as mean number of cfus per ECG lead wire, was also significantly lower among multi-wire ECG leads compared to single-wire ECG leads. Conclusions: Manually cleaned ECG lead wires may serve as a vector for transmission of nosocomial pathogens. The current reprocessing technique for ECG lead wires needs to be improved.
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Affiliation(s)
- Trisasi Lestari
- Hospital Management Graduate Program, Gadjah Mada University, Yogyakarta, Indonesia
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Lewis VR, Parker SH, Stephens RJ, Clark L, Fairbanks RJ. Why Aren’t We Achieving Better Results? A Literature Review of Healthcare Associated Infection Interventions. ACTA ACUST UNITED AC 2012. [DOI: 10.1177/1071181312561173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Healthcare-associated infections (HAIs) represent a considerable threat to patient and provider safety, healthcare quality, and cost of care. Given the extent of the HAI challenge, there is substantial pressure to reduce and mitigate HAIs. Viewing healthcare as a sociotechnical system (STS) allows us to design interventions to consider all of the STS factors; that is, the internal environment (people, technology, organization, and physical factors) and the external environment (outside influences, politics, policies). Although the clinical indicators of HAIs are well-studied, it is unclear what STS factors have been examined. This paper aims to determine what STS factors have been examined or involved with the development of solutions. The research team identified 213 articles and an in-depth review was conducted. Inventions to address HAIs were classified according to the aspects of an STS which were addressed. This paper summarizes findings and discusses the research gaps. Identification of gaps will allow human factors and health systems researchers design interventions that, if addressed, could potentially reduce HAIs.
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