Mercy Hospital for Women

About: Mercy Hospital for Women is a healthcare organization based out in Melbourne, Victoria, Australia. It is known for research contribution in the topics: Pregnancy & Population. The organization has 682 authors who have published 1257 publications receiving 34582 citations.

ADIPS 2020 guideline for pre-existing diabetes and pregnancy

Abstract: This is the full version of the Australasian Diabetes in Pregnancy Society (ADIPS) 2020 guideline for pre-existing diabetes and pregnancy. The guideline encompasses the management of women with pre-existing type 1 diabetes and type 2 diabetes in relation to pregnancy, including preconception, antepartum, intrapartum and postpartum care. The management of women with monogenic diabetes or cystic fibrosis-related diabetes in relation to pregnancy is also discussed.

Prevention of central venous catheter-related infection in the neonatal unit: a literature review.

Abstract: Central venous catheter infections are the leading cause of healthcare-associated bloodstream infections and contribute significantly to mortality and morbidity in neonatal intensive care units. Moreover, infection poses significant economic consequence which increased hospital costs and increased length of hospital stay. Prevention strategies are detailed in guidelines published by the Centers for Disease Control and Prevention (CDC) in the United States; nevertheless, recent surveys in neonatal units in the United States, and Australia and New Zealand demonstrate these are not always followed. This review discusses the numerous evidence-based strategies to prevent catheter infections including hand hygiene, maximal sterile barriers during insertion, skin disinfection, selection of insertion site, dressings, aseptic non-touch technique, disinfection of catheter hubs/ports, administration set management, prompt removal of catheter, antibiotic locks, systemic antibiotic prophylaxis and chlorhexidine bathing. Furthermore, it will describe different strategies that can be implemented into clinical practice to reduce infection rates. These include the use of care bundles including checklists, education and the use of CVC teams.

A quality improvement initiative to reduce central line infection in neonates using checklists.

Abstract: Central line associated blood stream infections (CLABSI) are the most common complication of central catheters in neonates. These infections increase length of hospital stay, hospital costs and impact on mortality and morbidities. We performed a quasi-experimental study, over 24 months, utilising a pre-post design to determine the impact checklists had on central line infections. We introduced checklists for insertion, daily maintenance and procedural access based on the existing clinical guideline. Infections and compliance were monitored and reported back to the unit each month. We utilised the interrupted time series analysis to evaluate the impact of introduction of the checklists. Over the 24 months, 318 infants were included with a total of 509 central lines inserted. In the post intervention phase, definite CLABSI rates declined by 41%, from 13.8 definite CLABSIs per 1000 central-line days to 7.8 definite CLABSIs per 1000 central-line days. There was significant change in the mean levels in the post intervention phase (coefficient crude −0.01015; 95% CI −0.01980–0.00051, p value 0.039). Checklist compliance for insertion was 70%, and daily maintenance compliance overall mean was 66%. Conclusion: Our quality improvement initiative using checklists, supported with education and feedback, significantly reduced CLABSI in our neonatal unit.

Comparison of histological features of vulvar lichen sclerosis with and withoutadjacent squamous cell carcinoma

Abstract: Scurry J, Vanin K, Ostor A. Comparison of histologicalfeatures of vulvar lichen sclerosis with and without adjacent squamous cellcarcinoma. Int J Gynecol Cancer 1997; 7: 392–399. To compare the histological features of vulvar lichen sclerosis with andwithout adjacent squamous cell carcinoma, sections of 132 consecutive cases ofvulvar squamous cellcarcinoma were examined to determine the characteristics of the epidermisadjacent to the carcinoma. Where lichen sclerosis was observed, its featureswere compared to those ofvulvar lichen sclerosis from 86 women without associated carcinoma. Lichensclerosis was seen in adjacent skin of 63 of 132 (48%) women with vulvarsquamous cell carcinoma. In61 of these 63, the epidermis was also significantly thickened. The changescausing the thickened epidermis could not be distinguished from superimposedlichen simplex chronicus in21 women. In the other 40, the main, but not the only, distinguishing featurewas differentiated vulvar intraepithelial neoplasia (basal atypia), which wasseen in 33. Otherdifferences were alterations in the ratios of hyperkeratosis, granulosis,acanthosis, and irregular prolongation of rete ridges. In lichen sclerosiswithout cancer, 73 women hadassociated epidermal thickening and in 69 of these the changes could not bedistinguished from superimposed lichen simplex chronicus; the other 4 showeddifferentiated andundifferentiated vulvar intraepithelial neoplasia in two women each. Weconclude that epidermal thickening is common in vulvar lichen sclerosis,whether occurring alone or inassociation with squamous cell carcinoma. Superimposed lichen simplex chronicuscannot fully explain the histological features of the epidermal thickening inlichen sclerosis inthe majority of women with carcinoma, but can do so in the majority of womenwithout carcinoma. In individual cases, however, there are no definitehistological criteria to distinguish hyperplasia from superimposed lichensimplex chronicus.