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Biomedical subjects

S Crow

Publications and source records attributed to S Crow.

At least 37 records · Page 2Linked to original sources

Health care personnel's perception of infection control.

Although the administration believes the 20-year-old infection program at the authors' institution has been effective in reducing nosocomial infection risk, the perceptions of nurses and physicians were unknown. Two hundred and twenty-seven nurses and 50 physicians were surveyed to determine their concept of infection control. Of all surveyed, 97% considered handwashing the most critical aspect of infection control and felt that additional teaching would increase this practice. Although physicians (40%) and nurses (30%) surmised the major infection control problem was lack of handwashing, 95% of physicians and 90% of nurses believed they personally washed their hands correctly and appropriately. One-half of all surveyed were not able to define 'asepsis' correctly. Sixty percent of nurses and 70% of physicians were not familiar with a monthly nosocomial report. On-site inspections and more educational programs were the primary recommendations of nurses and physicians. Of all participants, 99% could name the infection control nurse, whereas only 11% could name the infection control committee chairman. Although most infection control nurses feel they create a negative impression when they make rounds, the attitudes of nurses (81%) and physicians (68%) were positive. It is concluded that the perception of infection control differs among nurses and physicians. An effective infection control program must address the specific needs of all groups.

Attitude of Health Personnel

Detection of linkage disequilibrium between the myotonic dystrophy locus and a new polymorphic DNA marker.

We have examined the linkage of two new polymorphic DNA markers (D19S62 and D19S63) and a previously unreported polymorphism with an existing DNA marker (ERCC1) to the myotonic dystrophy (DM) locus. In addition, we have used pulsed-field gel electrophoresis to obtain a fine-structure map of this region. The detection of linkage disequilibrium between DM and one of these markers (D19S63) is the first demonstration of this phenomenon in a heterogeneous DM population. The results suggest that at least 58% of DM patients in the British population, as well as those in a French-Canadian subpopulation, are descended from the same ancestral DM mutation. We discuss the implications of this finding in terms of strategies for cloning the DM gene, for a possible role in modification of risk for prenatal and presymptomatic testing, and we speculate on the origin and number of existing mutations which may result in a DM phenotype.

Chromosomes, Human, Pair 19

It's second nature to me now. OR rituals.

Insufficient data exist relating to surgical asepsis; relying solely on data collection to determine practices limits patient care. Until clinical data are available that support or disclaim established traditions, it may be wise to hold customs that we believe have kept the patient safe. Rituals define and maintain sterility and provide freedom; certain traditions become part of the OR team's practice so that attention can be focused on the surgical procedure. As professional nurses, it is our responsibility to question dogma and to change our rituals when studies indicate the need for change.

Asepsis

Microbial contamination of arterial infusions used for hemodynamic monitoring: a randomized trial of contamination with sampling through conventional stopcocks versus a novel closed system.

Arterial catheters are now commonly used to monitor blood pressure and obtain blood samples for arterial blood gas and other laboratory determinations. Stopcocks inserted into the pressure monitoring circuit have been the primary means of obtaining blood from arterial catheters. However, these stopcock systems have been associated with nosocomial contamination and bacteremias. Because of the problems of bacterial contamination and blood wasting with the stopcock sampling systems, we compared the frequency and extent of contamination of external sampling ports and the monitoring tubing fluid in stopcocks with that of a novel closed needle-sampling system (Lab-Site, Migada Ltd, Rehovot, Israel), incorporated into pressure monitoring tubing (Abbott Laboratories Inc., North Chicago, Illinois). We found that use of the novel sampling system resulted in significantly fewer episodes of internal bacterial contamination of the arterial monitoring line (7%) than did the use of a stopcock system (61%). External contamination of the sampling port was also lower in the novel system (8%) than in the stopcock system (37%). This suggests that the closed system may reduce the risk of nosocomial infections in patients requiring arterial pressure monitoring.

Adult

Caveat emptor: how to evaluate products.

1. The first two questions to consider when evaluating a product are: will it provide better patient care, and will it save time? 2. The cost effectiveness of the product is also an important consideration in addition to how well it will protect healthcare personnel. 3. Carefully examine the data supplied to support the product's efficacy, particularly the methods of studies. 4. Above all, common sense and experience are the best guides to product evaluation.

Equipment and Supplies, Hospital

Much ado about nothing.

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Acquired Immunodeficiency Syndrome

Searchin'.

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Attitude of Health Personnel

Training of personnel for infection control.

The overall objectives for implementing an infection control program are to make hospital personnel aware of nosocomial infections and to educate these persons in their role in decreasing the risk of these infections. The infection control practitioner (ICP) implements these objectives by performing surveillance to determine problem areas and by developing policies and procedures that prevent and control nosocomial infections. Appropriate qualities for an ICP include initiative, leadership, communication skills, commitment, and charisma. Expertise in patient care practices, aseptic principles, sterilization practices, education, research, epidemiology, microbiology, infectious diseases, and psychology are acquired skills. Local, state, and national organizations, as well as universities, are responsible for ICP training, In the US the Centers for Disease Control have established a training program for the beginning ICP and the Association of Practitioners in Infection Control (APIC) has developed a study guide for developing infection control skills. The ultimate responsibility for education is an individual obligation, however. Certification of the ICP would insure a minimum level of knowledge, thereby standardizing and upgrading the practice of infection control.

Asepsis