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Biomedical subjects

A M Emmerson

Publications and source records attributed to A M Emmerson.

At least 19 recordsLinked to original sources
PubMed2000

Surgical site infection surveillance.

Surgical site infection (SSI) is the third most commonly reported nosocomial infection and accounts for 14-16% of all nosocomial infections among hospital inpatients. A successful SSI surveillance programme includes standardized definitions of infection, effective surveillance methods and stratification of the SSI rates according to risk factors associated with the development of SSI. Surveillance with feedback of information to surgeons and other relevant staff has been shown to be an important element in the overall strategy to reduce the numbers of SSIs. This paper examines the essential components of a SSI surveillance system including surveillance methods, data collection and handling, analysis and presentation of results to clinical staff.

Cross Infection↗
PubMed2000

Prevalence of lower respiratory tract infections in hospitalized patients in the United Kingdom and Eire--results from the Second National Prevalence Survey.

During 1993 and 1994, the Hospital Infection Society conducted its Second National Prevalence Survey of infections in patients in British hospitals. The prevalence rates for hospital-acquired (HA) and community-acquired (CA), lower respiratory tract infections (LRTIs) were 2.4% and 6.1%, respectively; this shows an increase over that reported in the First National Prevalence Study. The prevalence rate of HA infections for ventilated patients was 18.6%. The prevalence was greater in males, odds ratio (OR, 95% CI) for HA-LRTIs (1.4, 1.1-1.6) and CA-LRTIs (1.2, 1.1-1.3) than in females. In the case of both HA-LRTIs and CA-LRTIs, there was an increase in prevalence in patients with age >75 years, (HA-LRTIs 1.7, 1.3-2.2; CA-LRTIs 1.7, 1.0-2.7). Results of multivariable logistic regression analysis showed an increased risk of HA-LRTIs in patients who had a nasogastric tube (3.6, 2.3-3.6), were ventilated (2.3, 1.6-3.2), trauma patients (2.2, 1.5-3.0), chronic obstructive airway disease (COAD), (1.9, 1.5-2.3), a tracheostomy (1.9, 1.3-2.7), prior blood transfusion (1.5, 1.2-1.8), smokers (1.4, 1.1-1.6) or on systemic corticosteroid therapy (OR 1.3, 1.1-1.6). Community-acquired LRTIs were positively associated with cystic fibrosis (33.7, 19.1-59.3), HIV (9.8, 6.5-14.8), COAD (4.8, 3.8-4.8), systemic corticosteroid therapy (2.5, 2.2-2.8), tracheostomy (1.8, 1.1-2.9), males (1.2, 1.1-1.3) and smoking (1.2, 1.1-1.4).

Adolescent↗
PubMed1997

Diploma in Hospital Infection Control (Dip HIC)

The London School of Hygiene and Tropical Medicine (LSHTM) has established a Diploma in Hospital Infection Control (Dip-HIC). The course for this new Diploma is run under the auspices of the Hospital Infection Society (HIS) and the Public Health Laboratory Service (PHLS) and will commence in October 1997. The aim of this course is to provide infection control staff with systematic training in the sciences relevant to hospital infection control which will allow them to provide, and to take responsibility for, a broad-based infection control service. Topics will include the epidemiology of infectious diseases, clinical microbiology, health care economics, statistics, surveillance methods and patient management. The course will be multi-disciplinary and open to UK and overseas students, both medical and non-medical.

Certification↗
PubMed1996

Survey of infection in hospitals: use of an automated data entry system.

This paper describes an automated approach to data entry which substantially reduced time and effort involved in infection control surveillance within a large teaching hospital. As part of our involvement in the Second National Prevalence Survey of infection in hospitals, a hospital-wide prevalence survey of infection was carried out during January and February 1994. We simultaneously entered the results manually into an "in-house' database to enable analysis of data within the hospital. The prevalence survey was repeated during January and February 1995 using a paper questionnaire designed "in-house' and read automatically using a sheet-fed optical scanner. There was a substantial 17-fold decrease in data entry time using this method compared with manual entry. The new approach enabled more rapid analysis of surveillance data and feedback to hospital staff. If hospital clinical data is collected routinely in a format suitable for scanning, then potentially useful data could be rendered accessible. Automated data entry systems are invaluable in reducing time spent on data input and should be considered by all those involved in surveillance and audit. There would appear to be little hope in the near future of having all patient clinical data in an electronic format so that the prospects for scanning initiatives are excellent.

Cross Infection↗
PubMed1996

The Second National Prevalence Survey of infection in hospitals--overview of the results.

This study was designed to assess the overall prevalence of infection among the patients in hospitals in the UK and the Republic of Ireland. Patient data were collected and entered directly into a portable Olivetti (A12 notebook) computer with a custom-designed program (Epi-Info version 5.01). The statistical analysis was performed using the Statistical Package for Social Sciences software (SPSS). In all, 37,111 patients from 157 centers were studied, and a mean hospital acquired infection (HAI) prevalence rate of 9.0% (range 2-29%) was calculated. HAI rates were higher in teaching hospitals (11.2%) than in non-teaching hospitals (8.4%) P < 0.001. Four major sites of infections--infections of the urinary tract (23.2%), surgical-wound infections (10.7%), lower-respiratory tract (22.9%) and skin infections (9.6%)--accounted for 66.5% (2559 of 3848) of the total infections identified.

Adolescent↗
PubMed1996

Hospital hygiene in Great Britain.

ICT's in the UK are experienced, well trained and are enthusiastic. However, their efforts are frustrated through lack of resources. Infection Control is now a quality issue and defined separate budgets are being established and hospital contracts now contain elements of infection control as part of the service. Infection control is coming of age in the UK after 25 years of earnest effort.

Cost-Benefit Analysis↗
PubMed1995

The impact of surveys on hospital infection.

The major impact of surveys of hospital infection has been the improvement in the quality of infection control programmes. The earlier surveys became an incentive to others to find out their infection rates and risk factors for infection. Surveys are now more sophisticated in design and the surveillance methods more refined, but they have had little impact on the rates of infection. Without doubt, the greatest improvements have been made by carrying out targeted surveillance with interpretive feedback to clinical staff. This has led to the use of guidelines for good practice and measures of outcome. This strategy has been shown to decrease infection rates, decrease the need for antibiotics therapy, alleviate morbidity and save on hospital costs.

Cross Infection↗
PubMed1995

The Second National Prevalence Survey of infection in hospitals: methodology.

This paper describes the methods used to perform a very large multicentred prevalence survey of infection in hospitals. Infection control teams were trained centrally to use a standardized questionnaire and agreed definitions to collect prevalence data on a portable computer. The study was coordinated from a single centre and the analysis performed by the statistics department at Central Public Health Laboratory, Colindale, London. The survey included 157 centres throughout England and Wales, Scotland and all Ireland. The survey was carried out as a joint venture by members of The Hospital Infection Society, The Public Health Laboratory Service and the Infection Control Nurses' Association of the British Isles and was organized by a Steering Committee.

Cross Infection↗
PubMed1992

Postoperative complications due to methicillin-resistant Staphylococcus aureus (MRSA) in an elderly patient: management and control of MRSA.

An elderly lady was admitted to hospital for elective resection of an adenocarcinoma of the colon. Following an anastomotic leak she developed intra-abdominal sepsis and underwent abdominal drainage of pus. During recovery from her second operation, she developed pneumonia and a bacteraemia due to methicillin-resistant Staphylococcus aureus (MRSA). She was treated with vancomycin and co-trimoxazole and survived without further sequelae. Details of the development and treatment of this case are discussed. Procedures for the control and eradication of MRSA infections in hospitals are reviewed.

Adenocarcinoma↗
PubMed1990

The epidemiology of infections in intensive care units.

This report identifies some of the risk factors underlying the acquisition of hospital infections in patients admitted to Intensive Care Units (ICUs). Infection rates vary in different institutes and in different types of ICUs. Patients are particularly prone to septicaemia and respiratory infections and the underlying risk factors are frequently related to poor invasive techniques or contaminated equipment used in supportive therapy. In trauma patients, wound sepsis is common and polymicrobial sepsis is a major problem. Patients in ICUs are temporarily immunocompromised and are at risk from acquiring multiply antibiotic resistant gram negative bacilli. The majority of these are of an endogenous nature and necessitate the empirical use of antibiotics. The misuse of antibiotics however often leads to the selection of difficult to treat gram negative bacilli. Antibiotic usage in ICUs should be strictly controlled and used appropriately, preferably after appropriate microbiological specimens have been collected.

Anti-Bacterial Agents↗