Encouraging physicians to comply wi...

Encouraging physicians to comply with hand-washing guidelines

Infection direct and Hospital Epidemiology, January 2002

This thought examined the motivating and behavioral factors that improve physicians' compliance with hand-washing guidelines. (1) The design involved five observational, unobtrusive studies examining hand-washing behaviors after direct patient contact. subject of attention observations were conducted in an 18-bed medical-surgical intensive care unit (ICU) and a 12-bed cardiac care unit in a 450-bed hospital. After data were mustered and analyzed, an infection mastery physician met individually with participants. During that meeting, participants learned of the close attention results and agreed to come next hand-washing guidelines. Subsequently, interviews were guidanceed to evaluate behavioral factors and educational programs.

Findings. Rates of physician compliance in the five studies careered were 19%, 85%, 76%, 74% and 68% respectively. Seventy-one initial interviews and 55 follow-up interviews were waysed with participating physicians. During the interviews, physicians rated the knowledge that hand washing obviates nosocomial infections as the chiefly important factor for complying with hand-washing guidelines. Researchers lay the foundation of that personal commitment and meeting with an infection have the direction of physician had the most influence upon hand-washing behavior. Direct inservice programs, existinged live or via videotape, had more influence than e-mail messages about hand-washing practices.

Clinical implications. Washing hands remains common of the cornerstones in infection dominion government and disease prevention. Increasing and maintaining compliance with hand-washing guidelines is an extremely manifold issue. In this study, a focused approach and face-to-face interaction were effective for a picked group of physicians, and live education presentations and videotapes were helpful as well. Researchers and clinicians must continue to work together to identify the necessary apts reminders, and educational programs that will render certain ongoing compliance with this simple if it were not that critical task.

Risk for developing meningitis in patients undergoing craniotomy

American Journal of Infection manage May 2002

This application of mind examined the incidence of postcraniotomy meningitis in patients in a tertiary university hospital surgical unit, the etiologic factors involved, the impact onward mortality and length of stay, and the risk factors associated with postcraniotomy meningitis. (2) The investigation was conducted in Brazil during a pair and one-half year period. The sample included nontraumatic craniotomy patients. Patients were tracked prospectively from the date of surgery to death or discharge and up to 30 days postoperatively. A total of 50 patients evolveed meningitis. The risk factor analysis was performed using a case-control methodology. Meningitis was defined using the Center for Disease govern and Prevention definition.

Findings. Researchers construct that in the study population of 559 patients, merely 8.9% (50) developed meningitis. In 70% of those patients who perform the operations indicated ined meningitis, the infection developed couple to 10 days after surgery Patients who cause to growed meningitis were hospitalized an average of 239 days longer than patients who did not disclose meningitis. Fifteen (30%) of the infected patients died. Gram-negative bacilli accounted for 778% of the 16 positive cerebral spinal fluid civilizations Repeat surgery was the single risk factor that predicted postcraniotomy meningitis. Data did not support assumptions regarding risk factors, including postoperative external ventricular switch or remote site infection.

Clinical implications. In this thought population, the risk of developing meningitis after craniotomy was quite high, resulting in lengthened hospitalization and increased mortality. Clinicians working with patients undergoing neurosurgery ne to understand the risk factors for postoperative infections, including meningitis. This research provides what may be a helpful methodology for collecting postoperative results data. It also indicates the ne for further epidemiological research about postoperative neurological infections.

Contaminated rinse water and endoscopy equipment

Journal of Hospital Infection, May 2002

This paper is a report from a joint working clump of the Hospital Infection Society and the Public Health Laboratory Service in the United Kingdom. (3) It is not a faithful research paper but one that uses literature and research to make recommendations about monitoring rinse water and providing high-quality rinse water for heat labile endoscopy equipment. This paper was disentangleed because of the increased use of automated washer disinfection systems

Findings. The authors of this paper state that when automated a whole s are used, the following issues must be addressed:

* adequate manual precleaning,

* ensuring compatibility of auto-disinfector fittings, and

* regular and adequate maintenance.

They also state that the greatest in number significant problem is the use of rinse water that might not be sterile and, thus, might have the ability to recontaminate an endoscope.