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E Larson

Publications and source records attributed to E Larson.

At least 127 records · Page 7Linked to original sources
PubMed1985

Quality assurance. Evaluate thyself.

Quality assurance (qa) programs must be documented carefully, systematically, and completely to be of continued value. A literature review revealed that no tools had been developed to evaluate the effectiveness of qa programs. A tool was designed and tested to assess the reports of qa studies, as an initial step in establishing the benefits of qa. The tool was found to yield reproducible results and its use is recommended to others.

Hospital Bed Capacity, 500 and over↗
PubMed1985

Infection control issues in critical care: an update.

NIs continue to be a frequent and serious complication in the critically ill patient. Although not all NIs can be prevented, two essential components of health care practice that are aimed at protecting both patients and staff have been discussed--isolation techniques and handwashing. We have also discussed the infectious complications of intravascular therapy, one of the most essential and common treatments for the critically ill patient. An effective infection control program for critical care must have certain elements: established standards of infection control practice, continual surveillance and feedback regarding infection rates, adequate physical facilities including personnel to maintain a clean environment, orientation and continuing education for personnel, but most important, a staff with a high level of awareness about the need to prevent NI. This awareness is developed by a leader who communicates his/her concern about the issue of infection control.

Attitude of Health Personnel↗
PubMed1984

Bringing the new isolation guideline into focus.

In 1983 the Centers for Disease Control published a new Guideline for Isolation Precautions in Hospitals. This article briefly reviews some general principles of barrier techniques, compares the old and revised isolation guidelines, and discusses the difficulty in obtaining compliance with isolation practices.

Body Fluids↗
PubMed1984

Effects of handwashing agent, handwashing frequency, and clinical area on hand flora.

Six hundred twenty-two isolates from 554 samples taken from hands of 103 hospital personnel and 50 controls were obtained over a mean period of 35 days. Eighty-five were obtained immediately before and after handwashing (HW), the remainder after HW only. The relationship of HW agent used, clinical area and job, and frequency of HW to rates of bacterial colonization and numbers and types of organisms isolated, particularly gram-negative bacteria, were evaluated. The HW agent used ( nonantiseptic , hexachlorophene-based, chlorhexidine-based, or iodophor) was significantly correlated with the number of isolates obtained from each sample. Control subjects, all of whom used nonantiseptic soaps, had 1.42 mean isolates per sample; hospital personnel who used nonantiseptic soap had a mean of 1.00 isolates per sample. Other means were 1.25, hexachlorophene; 1.43, iodophor; 0.79, chlorhexidine; and 0.67 for those who used several different antiseptics, p less than 0.0001. The agent was also correlated with the type of organisms isolated (p = 0.002), but not with the counts of colony-forming units (CFU). Frequency of HW was significantly correlated with CFU counts before (p = 0.03) and after (p = 0.001) HW. In general, numbers decreased with increasing HW frequency, but at the higher HW frequencies there was a slight rise. There were significant differences in numbers of isolates per sample according to clinical area, with personnel working in obstetrics and nonpatient areas having the greatest number and those working on neonatal and medical-surgical units having the least (p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Infective Agents, Local↗
PubMed1984

A decade of nosocomial Acinetobacter.

A review of nosocomial infections (NI) from January 1971 to April 1981 was conducted in a university-affiliated hospital to examine NI caused by Acinetobacter and to determine whether a rising trend in rates could be detected. Acinetobacter accounted for 85 of 6115 (1.4%) NI. Sites of infection were respiratory tract (42.2%), blood (17.8%), peritoneum (16.7%), urinary tract (10%), surgical wounds (7.8%), central nervous system (3.3%), and skin or eye (2.2%). All patients who developed NI from Acinetobacter were receiving systemic antimicrobial therapy; 58.8% were in the intensive care unit (ICU). The highest rates of Acinetobacter infection occurred in the early 1970s (2.3%); the lowest occurred from 1978 to 1981 (0.94%), p approximately 0.06. This decrease primarily resulted from two factors: a reduction in cross-infections, probably related to a structural change in the ICU from open-bed ward to single rooms, and the elimination of peritoneal infections traced to contamination of dialysate solution. We conclude that in this institution no rise in the proportion of NI caused by Acinetobacter has occurred over the past decade; if anything, there is a downward trend.

Acinetobacter↗
PubMed1984

A decentralized approach to maintenance of intravenous therapy.

A prospective experiment was conducted in a university-affiliated hospital to evaluate the effectiveness of a core of specially trained staff nurses in the maintenance of IV therapy. Five staff nurses for each of two experimental units were trained for 1 month by an IV nurse educator and were expected to perform venipuncture and monitor peripheral IV care on their units. On three control units, IV therapy continued to be a shared function of all medical house staff and nurses. During this study, 876 IV infusions on 707 patients were studied. There was a decrease in the phlebitis rate on experimental units from baseline to study periods of from 33.5% to 20.9% (relative risk, controlled for duration of the use of an IV device, 0.53, p = 0.05), whereas the rate on control units increased slightly (23.8% to 26.7%, p = greater than 0.5). Regardless of duration of use, steel needles were associated with lower phlebitis rates than were plastic catheters. The mean duration that each infusion device was in place was significantly shorter on experimental units than on control units (2.4 vs. 3.3 days, p = less than 0.001). However, bacterial colonization of IV devices occurred more often on experimental units than on control units both at baseline (12.7% vs. 7.1%; p = 0.25) and during the study phase (19.4% vs. 5.9%; p = less than 0.01). This increased colonization occurred with IV infusions started by both physicians and nurses. There were no septic complications of IV therapy in the patients studied. Patient comfort, measured by number of sticks for each venipuncture and patient interview, was significantly improved (p = less than 0.001) on experimental units during the study phase. Costs to start such a decentralized IV program on 10 clinical units was calculated to be about +10,000. This study provides information useful to those making administrative decisions regarding the value of IV teams or other methods for IV therapy maintenance. We concluded that a decentralized program can be successful with commitment of time and money resources and with a system of monitoring to ensure compliance with written IV guidelines.

Adult↗
PubMed1984

Storage of human breast milk.

The bacteriologic content of expressed breast milk was studied in 30 mothers at the time of expression and after 24 and 48 hours of refrigeration. There were no significant differences in colony counts between the three time intervals. All samples contained Staphylococcus epidermidis. In addition, eight other species were found, including four which were gram-negative. All samples contained less than 10(6) colonies/ml, and there were no significant differences in mean colony counts between samples expressed at home and at the hospital. We conclude that it is bacteriologically safe to refrigerate expressed breast milk for up to 48 hours.

Adult↗
PubMed1984

Kawasaki disease.

Explore the source record for details and available documents.

Blood Platelet Disorders↗
PubMed1984

Job satisfaction. Assumptions and complexities.

It has long been assumed that job satisfaction relates to employee turnover and quality of care. In this article the difficulties of measuring job satisfaction are discussed in light of results from a 6-month assessment by nurse employees in a university-affiliated acute care hospital. The authors found that job satisfaction scores were significantly predicted by respondents' job expectations and the importance they placed on various components of the work situation. The authors conclude that job satisfaction measurement is most valid and reliable when these two predictors are taken into account.

Attitude↗
PubMed1983

Compliance with isolation technique.

We found that compliance with isolation precautions was less than optimal. It appeared that personnel were unaware of instances in which they had become contaminated. Increasing such awareness is indicated as an incentive to improve compliance. In addition, there were two areas in which education seemed to be indicated: for housekeeping staff to assure that they understood the need to contain infectious organisms within the isolation room as well as protecting themselves and for all personnel to identify the need for handwashing after removing gloves. Others have found that a careful monitoring program by an ICP can significantly reduce the overuse, but not underuse, of isolation. Such monitoring leads to considerable cost savings. We recommend that compliance with isolation technique be monitored on a periodic basis in other acute care institutions.

Cooperative Behavior↗