Showing papers in "Journal of Patient Safety and Infection Control in 2015"
TL;DR: The study revealed that hand hygiene compliance can be effectively increased among HCWs by regular reminders and surveys and training programs on hand hygiene should be systematically planned, regularly conducted, and evaluated for staff nurses so as to keep them motivated.
Abstract: Background Control of nosocomial infections is a major health concern in a hospital setting and hand hygiene is considered as the most important tool in nosocomial infection control. Methods This prospective study about the practice of hand washing by 106 HCWs (Health Care Workers) working in Intensive Care Unit (ICU) before and after patient contact in a tertiary care hospital was conducted to find out the hand washing compliance rate in ICU of GB Pant Institute of Postgraduate Medical Education and Research and the factors associated with noncompliance and to find out the impact of a task-orientated hand hygiene education and intervention program. Results 462 opportunities of hand hygiene were observed in the ICUs over 30 h. Adherence was found to be 52%. A positive intention to comply with hand hygiene was found among 94% of the respondents. Most respondents (78.2%) believed that they could improve compliance with hand hygiene on their own. Intervention included education on hand hygiene indications and technique, hand hygiene performance feedback, and discussion of the previous assessment of HCWs’ beliefs toward hand hygiene. After intensive promotion of hand hygiene, observation sessions were performed on 98 nursing staff, which provided 425 opportunities of hand hygiene, and hand hygiene adherence was increased to 63% as an impact of measures taken. Conclusions The study revealed that hand hygiene compliance can be effectively increased among HCWs by regular reminders and surveys. Training programs on hand hygiene should be systematically planned, regularly conducted, and evaluated for staff nurses so as to keep them motivated.
9 citations
TL;DR: The microbial epidemiology and the antimicrobial resistance profile of the wounds of the patients presenting to the OPD would help in the formulation of antibiotic policy for OPDs and also help in checking inadvertent antibiotic usage.
Abstract: Background Wound is a disruption of normal anatomic structure and function of the skin, and any infection in this constitutes wound infection. Wound infection delays wound healing, and it causes wound breakdown, leading to increased hospital stay, morbidity and mortality. Most of the published data available focus on surgical site infections. In the developing countries, however, wound infection is an important cause of hospital mortality and morbidity. No data are available on the microbial profile of the wounds presenting at our hospital. Objective This study was thus designed to describe the microbial epidemiology and the antimicrobial resistance profile of the wounds of the patients presenting to the OPD. Methodology and results Retrospective review of records of all wound samples sent over 3 years from OPD was done. OPD sent 827 wound samples of 571 patients. Most common organism isolated was Staphylococcus aureus [132 (35%)], followed by Escherichia coli [54 (14%)] and Pseudomonas aeruginosa [49 (13%)]. Of the 145 S. aureus strains, 43 (30%) strains were Methicillin Resistant Staphylococcus aureus, and none were resistant to vancomycin/linezolid/teicoplanin. Gram-negative organisms were resistant to most antibiotics tested. Conclusion Wound healing is halted in the presence of prolonged inflammation such as due to infection. Presence of bacteria delays wound healing, but the presence of low number of microbes is required for wound healing. Absence of appropriate signs to guide treatment becomes a reason for prolonged indiscriminate use of antibiotics which leads to rapid emergence of resistant organisms. Data generated by our study would help in the formulation of antibiotic policy for OPDs and also help in checking inadvertent antibiotic usage.
5 citations
4 citations
TL;DR: An overview of the global health care associated infection surveillance systems and recent innovations therein is provided.
Abstract: HealthCare Associated Infections (HCAIs) are increasingly considered to be preventable adverse events, which require prioritized global attention In the face of increasing antimicrobial resistance, prevention remains the best method to curb these infections Surveillance of HCAIs and antimicrobial resistance using standard methods is becoming a model for prevention Surveillance identifies the rates of HCAIs, the areas for intervention and improvement, as well as the impact of those preventive interventions Objectivized definitions, algorithmic diagnosis and electronic databases have made surveillance systems more user-friendly and effective over time The scope of surveillance is ever-widening with increasing need for post-discharge surveillance, day-care and home-based treatment and the technology revolution This review provides an overview of the global health care associated infection surveillance systems and recent innovations therein
3 citations
TL;DR: It was revealed that although attitude about BMW management was high among health care personnels of the authors' hospital, the knowledge and practice was comparatively low and all health care personnel must undergo regular training in BMW management.
Abstract: Inadequate and inappropriate knowledge of handling biomedical waste (BMW) among health care personnel may have serious health consequences and a significant impact on the environment as well. In view of this, present study was planned to assess knowledge, practices and attitude (KPA) regarding BMW management among our hospital staff. A questionnaire containing 32 questions based on KPA regarding BMW management was filled by 125 study participants [25 each of doctors, interns, nurses, technicians, class IV employees]. Data was analyzed using Stata 11.0.Chi-square test was applied and p value was obtained. Only 15.2% participants could correctly answer about BMW categories. Doctors were found to have significantly better knowledge than auxiliary staff about measures to be taken following accidental exposure to infected blood or sharps (p=0.007). Less than 65% of them could correctly answer use of each colour coded bags. A favorable positive attitude was found among study participants on BMW management. Our study revealed that although attitude about BMW management was high among health care personnels of our hospital, the knowledge and practice was comparatively low.Therefore, all health care personnel must undergo regular training in BMW management. This should be coupled with effective implementation of rules and regular
3 citations
3 citations
2 citations
2 citations
2 citations
2 citations
TL;DR: Incidence of MDR Acinetobacter species is increasingly being encountered in patients admitted with sepsis in IRCU, therefore, prudent use of antibiotics and good infection control practices are advocated.
Abstract: Sepsis in Intensive Respiratory Care Unit (IRCU) is mainly due to gram negative bacteria, followed by gram positive bacteria.A retrospective study was undertaken for a period of one year to find out the bacterial etiology of sepsis in IRCU and their antimicrobial susceptibility pattern. Ten ml of blood was collected in 100 ml of tryptic soy broth from all adults admitted in IRCU with clinical suspicion of sepsis. Blood cultures were processed as per standard techniques and all organisms were identified by standard biochemical tests. Antibiotic susceptibility test was performed on Muller Hinton Agar by Kirby Bauer Disc Diffusion method, according to CLSI guidelines. Out of total 169 blood cultures received from IRCU, males compromised 74%. Pulmonary causes comprised 58.15%. Out of 169, 15.98% showed growth, of which Gram negative bacilli (GNB) predominated (77.78%). Amongst GNB, Acinetobacter species was commonest (76.2%). Acinetobacter species showed 93.75% and 100% susceptibility to tigecycline and colistin respectively. Multidrug resistant (MDR)-GNB encountered in this study was 71.4% and carbapenem resistance was 9.5%. All Methicillin Resistant Staphylococcus aureus were 100% susceptible to vancomycin and linezolid. Of the culture positive cases 96.3% were on mechanical ventilation and 7.69% developed Acute Respiratory Distress Syndrome. Mortality amongst culture positive cases was 37.04%. Incidence of MDR Acinetobacter species is increasingly being encountered in patients admitted with sepsis in IRCU. Therefore, prudent use of antibiotics and good infection control practices are advocated.
TL;DR: There is a need to improve knowledge about patient safety in dentistry among dentists in India and to create a more open culture in reporting adverse incidents.
Abstract: Aim To record the knowledge and attitude of dentists in India towards patient safety in dentistry. Materials and method An online questionnaire of 13 questions was prepared to determine dentist's knowledge and attitudes towards patient safety in dentistry. Members of an online closed discussion group of dentists ( n = approximately 5000) working in India were contacted on three separate occasions during October 2013–January 2014. Results 1025 responses were obtained. 19% of respondents stated that they actively took steps to improve safety standards but only 8% of the total sample believed that their employing organisation or professional body would support them to improve patient safety. In addition, only 8% believed that senior staff members encouraged open discussion on surgical errors or how to prevent them. 67% of dentists stated that they had inadequate knowledge on patient safety issues and 97% recommended that patient safety in dentistry be given a higher priority in the undergraduate dental curriculum. Conclusion There is a need to improve knowledge about patient safety in dentistry among dentists in India and to create a more open culture in reporting adverse incidents.
[...]
TL;DR: Open appendectomy was the most common surgery that was performed on an emergency basis and anemia followed by hypoalbuminemia were the two important comorbid conditions.
Abstract: Background The risk of surgical site infection (SSI) is approximately 1–3% for elective surgery and more for emergency surgeries. Apart from patient endogenous factors, the role of external risk factors in the pathogenesis of SSI is well recognized. However, among the various measures to prevent SSI, only some are based on strong evidence, and there is insufficient evidence to show whether one method is superior to any other. Therefore, this study was carried out to find out the various factors causing post-operative wound infection, the commonly associated microorganisms, and antibiotic sensitivity and resistance pattern. Methods The study was conducted in tertiary care hospital, Pondicherry between September 2012 and September 2014. All the patients who underwent emergency surgeries in the Department of General Surgery were included in the study. An elaborative clinical study of post-operative wound infection was conducted. The suture site was inspected for any sign of infection starting from the second post-operative day till discharge from hospital. Wound swabs were collected and sent for aerobic culture and sensitivity. Results In this study, open appendectomy was the most common surgery that was performed on an emergency basis. Anemia followed by hypoalbuminemia were the two important comorbid conditions. The rate of infection for clean-contaminated, contaminated, and dirty wound were 16.88%, 38%, and 20% respectively. Conclusion SSI occupies a significant proportion among various hospital-acquired infections. SSI not only prolongs the hospitalization but also markedly increases the expenditure and morbidity.
TL;DR: The results encourage us to continue with the screening program so as to prevent the high risk patients contracting endogenous infections thus controlling the transmission and spread and also the addition of extra-nasal site; either axilla or groin might increase the screening efficiency in non nasal colonisers.
Abstract: Background Methicillin resistant Staphylococcus aureus (MRSA) is an important nosocomial pathogen. A strong correlation between the invasive and the nasal carriage strains in the patients has been well established indicating the need to eliminate the carriage of MRSA to prevent the transmission. The objectives of this study are to assess the prevalence of MRSA colonisation in patients from ICUs and high risk wards for a period of 33 months, (2011–2013) by routine active surveillance culture, and also to evaluate the role of extra-nasal sites in the screening. Methods The nasal and extra-nasal specimens were obtained from patients using sterile cotton swab. Staphylococci were identified based on colony morphology on blood agar, Gram's staining and coagulase test. The Staphylococcus aureus ( S. aureus ) isolates were screened for methicillin resistance by Kirby–Bauer disc diffusion method using oxacillin (1 μg) and cefoxitin (30 μg) discs and reported according to CLSI guidelines. Results Out of the 5372 nasal samples tested, S. aureus was identified in 14.1% patients. The rate of methicillin resistance was 31.7% of the total S. aureus isolates. The overall prevalence of MRSA was 4.5%. Out of 219 extra-nasal samples tested, 4.1% of the patients carried MRSA in sites like axilla and groin without nasal carriage. Conclusion Our results encourage us to continue with the screening program so as to prevent the high risk patients contracting endogenous infections thus controlling the transmission and spread and also the addition of extra-nasal site; either axilla or groin might increase the screening efficiency in non nasal colonisers.