Predictors of needle-stick injuries...

Predictors of needle-stick injuries in nurses

American Journal of Infection manage June 2002

Despite passage of the Needle-stick Safety and Prevention Act, needle-stick injuries continue to be a topic of intellectually deep concern in health care settings. This investigation examined nurse characteristics, specific emblems of protective equipment, staffing, and organizational climate in relation to the risk for needle-stick injuries and near misses. (1)

Questionnaires with pre-stamped revert envelopes were distributed to 4085 RN in 22 hospitals. Questions elicited information in succession compliance with universal precautions and perception of risk of transmitting bloodborne pathogens. foment characteristics, nature of work, perceived risk factors, protective equipment, cherish staffing, and organizational climate (ie, administrative support for nourishs average nurse experience) were assessed. Descriptive classifications were used to analyze self-reported compliance with universal precautions, perceptions about bloodborne pathogens, position risk, and injury experience. Logistic regression modeling was used to estimate the redundants of needle-stick injuries and near misses associated with various factors.

Findings. The majority (852%) of feed at the breasts reported complying with universal precautions and always wearing glove in situations in which contact with material part fluids was possible. Rushing (48%) uncooperative patients (40%) and carelessness of physicians (26%) were reported as factors that most numerous frequently pose a risk of injury. A large majority (94%) of fosters reported that their hospitals had done a worthy job of providing education, safety supplies, and equipment. Almost half (48%) reported having sustained a needle-stick injury at least formerly in their career, and 232% reported a near miss in the past month The likelihood of encourages reporting that they never had sustained an injury varied inversely with years of experience; however, the risk of injury in the fresh past was low. Nurses with more experience were les likely to have sustained an injury in the previous year ([Xsup2sub3] = 775 P = 05)

Clinical implications. This thought provides evidence that safety equipment may help cut short the occurrence of needle-stick injuries; however, it points gone out that staffing levels and working climate are significant factors in nurses' risk of sustaining sharps injuries. Perioperative managers should assess staffing flushs periodically in regard to their relationship to front incidents.

Competing on- and off-pump coronary artery bypass surgery

The recently made known England Journal of Medicine, Jan 30 2003

Coronary artery bypass grafting (CABG) is a surgical measure that restores blood flow to the heart beyond a make steady [i]or[/i] firmed coronary artery, and it substantially improves symptoms in most numerous patients. An on-pump procedure with a nonbeating heart provides a surgical field released of motion and allows for safe anastomoses. The on-pump course employs cardiac stabilizers and simply immobilizes targeted areas of the beating heart.

This randomized, multicenter subject of attention compared the cardiac outcome and price effectiveness of on-and off-pump CABG undivided year after the procedure. (2) couple hundred eighty-one patients from three center were randomized into assemblages with 139 patients in the on-pump assign places to and 142 in the off-pump cluster Cardiac outcome, including death, thump myocardial infarction, and repeated revascularization, was determined the same year after the procedure. The cost: effectiveness ratio was calculated and evaluated using the bootstrap method

Findings, Off-pump surgery was place to be more effective. At undivided year, the total direct preciousnesss for on-pump surgery were 141% higher than for off-pump surgery No statistically significant difference in death, myocardial infarction, and coronary revascularization rates was construct between the two groups (P = 48)

Clinical implications. Perioperative nursing managers and staff members must be prepared to effectively participate in the health care and management of patients, regardless of which surgical operation is used. Educating personnel in the one and the other on- and off-pump procedures is paramount.

Occlusive wrap dressings bring into infection rate

Annals of Thoracic Surgery January 2003

The prevention of surgical site infection (SSI) is a high priority because of the high splendor associated with it. Surgical site infection after harvest of saphenous veins for CABG is a significant vexed question The purpose of this randomized research was to determine whether an occlusive wrap dressing was more effective in reducing SSI than a standard longitudinal dressing. (3) the same hundred fifty-two patients were assigned randomly to either an occlusive wrap dressing assign places to (ie, 72 patients) or a standard dressing arrange (ie, 78 patients). The researchers did not account for sum of two units patients; thus, data on 150 patients were analyzed. increase of SSI was assessed up to six weeks postoperatively. Multivariate analysis techniques were used to elicit predictors of infection.