The Role of an Assistant Nurse in Implementing the WHO Surgical Safety Checklist: Perception and Perspectives

Introduction The World Health Organization (WHO) Surgical Safety Checklist is a tool developed by the WHO to promote safer surgical practices and reduce the incidence of surgical errors and complications. This study aims to describe the role of assistant nurses in the implementation of this checklist by surgical teams. Materials and methods This descriptive study utilized a questionnaire-based survey conducted between September 2018 and March 2019 among 196 healthcare professionals at two surgical units in a university hospital in Sweden. The questionnaire covered demographic information such as age, gender, and occupation, as well as details about their workplace, experience, education/training on using the WHO checklist, the adaptation of the checklist to their department, their responsibilities in implementing and using the checklist, the frequency of use in emergency situations, and the impact on patient safety. Results The results of the study showed that assistant nurses, despite having the lowest level of education among healthcare professionals, were highly trusted and valued by other members of the surgical team. Most healthcare professionals were unsure who was responsible for using the WHO checklist but believed it was the assistant nurse's responsibility to ensure its implementation. Assistant nurses reported little to no training on using the checklist but noted that it had been adapted to the department's needs. Almost half (48.8%) of assistant nurses believed that the checklist was often used in emergency surgery, and most believed that it improved patient safety. Conclusions Improved understanding of the significance of assistant nurses in implementing the WHO Surgical Safety Checklist may enhance adherence to the checklist and potentially improve patient safety, as they were the most valued and trusted healthcare professionals in the surgical team according to the study's findings.

An ELISA for recombinant Lepidoglyphus destructor, Lep d 2, and the monitoring of exposure to dust mite allergens in farming households

BACKGROUND

Exposure to indoor allergens, such as dust mites, has been recognized as a risk factor for sensitization and symptoms.

OBJECTIVE

To develop a two-site ELISA for the determination of Lep d 2 in the reservoir, to measure dust mite allergen exposure (Lep d 2, Der p 1, Der f 1 and Der 2) in farm households, and to investigate whether exposure to these allergens is associated with sensitization, asthma and rhinoconjunctivitis.

METHODS

Monoclonal antibodies to recombinant (r)Lep d 2 were produced with standard hybridoma technique. Dust samples from 393 households were analysed for allergen content by two-site ELISA methods.

RESULTS

A two-site Lep d 2 ELISA was developed with a detection limit of 0.09 microg/g. The assay was highly reproducible and levels of Lep d 2 showed a strong correlation with the number of Lepidoglyphus mites (r(s): 0.7; P = 0.0002). Lep d 2 was detected in 20% of the homes; levels ranged from 0.09 to 1.7 microg/g of dust. Der p 1 was recorded in 59% of the samples, ranging from 0.055 to 139 microg/g, and Der f 1 and Der 2 in 40% and 50% of the samples, ranging from 0.055 to 24.5 microg/g and 24.3 microg/g, respectively. Dermatophagoides allergens were significantly higher in mattresses than in carpets (P < 0.0001), but this difference was not observed with Lep d 2. A strong relationship between immunoglobulin (Ig)E to rLep d 2 and asthma (OR = 10.4) and rhinoconjunctivitis (OR = 7.5) was seen. Furthermore, sensitization to D. pteronyssinus was significantly associated with asthma (OR: 13.7) and rhinoconjunctivitis (OR: 5.7).

CONCLUSION

When assessing mite allergen exposure in rural homes, not only the Der p 1, Der f 1 and Der 2 allergens, but also the Lep d 2 allergen should be taken into consideration.

A new method for collecting airborne allergens

BACKGROUND

Measurement of airborne allergens has hitherto been done with the use of fixed-location pumps or personal air samplers. Our objective was to find out whether ionizers could be good tools for collecting airborne allergens. As a model we have used cat allergen (Fel d l). We have compared Fel d l levels collected by the ionizer at different time periods, as well as comparing Fel d l levels obtained with the ionizer with those of low- and high-volume pumps.

METHODS

Dust samples from floors and air samples collected with ionizers and pumps, obtained in 31 homes with cat, 23 homes without cats, and 28 day-care centres, were analysed for cat allergen content (Fel d I) by ELISA.

RESULTS

Fel d l was present in the reservoir in all homes with cats, ranging from 660 to 375,000 ng/g (GM 75,000) and in the air collected by the ionizer from 2.0 to 204 ng/24 h (GM 19.3). The allergen in homes without cat varied from < 55 to 1,800 ng/g (GM 166). Corresponding levels in air were found in two of these homes (2.3 and 7.3 ng/24 h). There was a correlation between the number of cats and the amount of airborne cat allergen (r: 0.47; P < 0.05). The levels in day-care centres were < 55 to 3,070 ng/g in dust (GM 360) and < 1.1 to 7.9 ng/24 h in the air (GM 1.6). We obtained a moderately strong correlation between air and dust samples in homes with cats (rs: 0.64; P< 0.001) and in day-care centres (rs: 0.49; P<0.05). We found that a collection period of 24 h is preferable for the ionizer. The intrahome reliability coefficient was nearly two times higher for the ionizer (r: 0.69) than the pump (r: 0.39).

CONCLUSIONS

The ionizer seems to be a good tool for monitoring the environment. It is easy to use and silent and does not disturb the airflow in the room.

Exposure to an abundance of cat (Fel d 1) and dog (Can f 1) allergens in Swedish farming households

BACKGROUND

Earlier studies have shown that farmers are to a low degree sensitized to animal allergens. We have measured the amount of cat (Fel d 1) and dog (Can f 1) in farm households and examined the relationship between exposure and sensitization to cat and dog allergens.

METHODS

Dust samples from the homes of 403 farmers who had participated in an epidemiologic follow-up study on respiratory symptoms were analyzed for allergen content by two-site ELISA methods.

RESULTS

Fel d 1 was detected in 99.5% of the farmers' households ranging from 0.055 to 1455 microg/g dust in mattresses (GM 13.2) and to 3775 microg/g dust in living-room carpets (GM 17.1). Can f 1 was detected in 90.6% of the households from 0.2 to 116 microg/g dust in mattresses (GM 2.0) and to 504 microg/g dust in carpets (GM 4.3). Homes with pets present had the highest levels of the allergens (P<0.001). A total of 8.4% and 7.4% of the farmers were sensitized to cat and dog, respectively. A significant correlation was noted between exposure to the allergens and specific IgE to cat and dog, respectively (P<0.001). Sensitization to cat (OR = 4.9) and dog (OR = 17.8) was significantly associated with asthma.

CONCLUSIONS

In spite of the abundance of Fel d 1 and Can f 1, farmers are only to a low degree sensitized to cats and dogs.