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PubMedDate not supplied

A comprehensive educational approach to improving patient isolation practice.

OBJECTIVE: To describe a workable plan for the successful education of a large, diverse group of healthcare workers in a university hospital setting. DESIGN: A prospective, nonrandomized study of compliance with infection control isolation practice following various educational interventions. SETTING: 300-bed tertiary-care, academic medical center with out-patient clinics. PARTICIPANTS: Hospital employees and contract workers. INTERVENTIONS: The infection control department introduced a plan to implement the Centers for Disease Control and Prevention's new isolation guidelines. A comprehensive proposal was presented to administration. It included a time line for institution and a comprehensive educational and performance-improvement plan, including standard lectures and a video that explained Standard and Transmission-Based Precautions. Follow-up consisted of customized in-services and one-on-one continued education tailored to the individual units. RESULTS: Compliance with isolation procedure after standardized lectures and video alone was poor. Compliance improved after institution of smaller, more intensive in-services tailored to individual departments and given during all shifts. CONCLUSIONS: Intensive, individualized education is the key to compliance. This requires sufficient infection control staffing and administrative support.

Academic Medical Centers↗
PubMed2000

Australian Infection Control Association members' use of skills and resources that promote evidence-based infection control.

BACKGROUND: To adopt an evidence-based approach, professionals must be able to access, identify, interpret, and critically appraise best evidence. Critical appraisal requires essential skills, such as computer literacy and an understanding of research principles. These skills also are required for professionals to contribute to evidence. METHODS: In 1996, members of the Australian Infection Control Association were surveyed to establish a profile including the extent to which they were reading infection control publications, using specific documents for policy and guideline development, developing and undertaking research, publishing research, and using computers. The relationships between demographics, computer use, and research activity were examined. RESULTS: The response rate was 63. 4% (630/993). The study group comprised mostly women (96.1%), and most (66.4%) were older than 40 years of age. Median infection control experience was 4 years (mean, 5.4 years; range, <12 months to 35 years). When developing guidelines and policies (92.7%; 584/630), infection control professionals reviewed State Health Department Infection Control Guidelines and Regulations. Research relating to infection control was undertaken by 21.5% (135/628) of the sample, and 27.6% (37/134) of this group published their research findings. Of the respondents (51.1%; 318/622) who used a computer to undertake infection control tasks, the majority (89.0%) used a personal computer for word processing. CONCLUSION: Regardless of infection control experience, Australian infection control professionals must be adequately prepared to contribute to, access, appraise, and where appropriate, apply best evidence to their practice. We suggest that computer literacy, an understanding of research principles, and familiarity with infection control literature are three essential skills that infection control professionals must possess and regularly exercise.

Adult↗
PubMedDate not supplied

Will nursing ICU patients in semi-recumbent positions reduce rates of nosocomial infection?

Ventilator-associated pneumonia is the main cause of ICU-acquired infection. Infection significantly increases mortality, length of ICU stay and costs (both financial and humanitarian). Ventilator-associated pneumonia is usually caused by aspiration. Ventilator-associated pneumonia risks are highest among patients who are fed through a nasogastric/orogastric tube. A semi-recumbent position reduces the risk of aspiration, so should reduce the risk of acquiring ventilator-associated pneumonia.

Critical Care↗
PubMed2000

Latex sensitivity in Washington State acute care hospitals. A needs assessment and survey of awareness of the issues.

Based on reports from the workers' compensation system and a sentinel health provider network, latex gloves may be one of the most prevalent sources of occupational skin disorders in Washington State's health care industry. To gather information to understand and address this problem, questionnaires were distributed to 105 acute care hospitals in Washington State. Employee health and infection control specialists were queried on their knowledge about latex allergy, the perceived extent of the problem, and the actions taken to address the problem. With 95 of the hospitals returning completed questionnaires (93% response rate), 30% reported having problems with latex allergies among employees in their facility, with most reporting two or fewer cases. Adequate knowledge was found about the causes and effects of latex allergies, but definite knowledge gaps existed. More than 60% of all of the hospitals surveyed had made some type of glove alternatives available to affected employees, 4% had designated latex free zones, 4% had cleaned to remove latex dust, and 7% had done nothing to address the issue.

Data Collection↗
PubMed2000

Prevention of occupational transmission of bloodborne diseases in clinical nurse anesthesia practice.

This article discusses the most commonly recognized bloodborne infectious diseases with which the nurse anesthetist comes into contact during the provision of clinical care: hepatitis B virus, hepatitis C virus, and the human immunodeficiency virus, along with the potential percutaneous and mucocutaneous routes of exposure. The prevention of occupational exposure to these pathogens is discussed by applying standard or universal precaution measures to anesthesia clinical practice. Treatment measures for accidental exposure to bloodborne pathogens is also discussed.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

The effect of a 1-hour training program on the incidence of bacteremia in pediatric patients receiving parenteral nutrition.

The effect of a 1-hour nurse training program on the frequency of bacteremia in patients receiving parenteral nutrition was evaluated in a pediatric tertiary center. All of the nurses had previous instruction on aseptic techniques in nursing school. The current program focused on aseptic management of intravenous catheters and implanted subcutaneous ports in patients receiving parenteral nutrition (PN). One hundred eighty-four nurses had a 1-hour training session in groups of three to five. The frequency of bacteremia in children receiving PN was not reduced (9.2% versus 8.9%), and there was no significant difference in time from the start of PN to the diagnosis of bacteremia (P = 0.31). The authors conclude that a 1-hour training session for the nursing staff was not sufficient. It is suggested that staff training for prevention of bloodstream infections associated with intravascular devices should cover a wider range of topics and take place over a longer period of time.

Bacteremia↗
PubMedDate not supplied

Effect of two different short peripheral catheter materials on phlebitis development.

One of the most common causes of phlebitis in hospitalized patients is intravenous catheters. The material of the catheter is a determining factor in the development of phlebitis, as are factors such as age, gender, and medical diagnosis of the patient. The aim of this study, conducted in the coronary care unit of a 384-bed hospital in Ankara, Turkey, was to determine the effect of two different short peripheral catheters on phlebitis development caused by i.v. treatment. Overall, 255 patients constituted the study sample (130 with Teflon, 125 with Vialon catheters). Both groups were followed up for phlebitis development for 6 days. The total phlebitis rate was 36.8%, with almost half of the patients (49.2%) in the Teflon catheter group and 24.0% of patients in the Vialon catheter group. A significant statistical relationship was found between phlebitis rate and variables such as gender, catheter material, and indwelling time. The results of the study demonstrate that Vialon catheters are associated with less risk of catheter-induced phlebitis than are Teflon catheters.

Adult↗
PubMedDate not supplied

The pediatric nurse's role as health consultant to a child care center.

An experienced pediatric nurse can perform a valuable service by becoming a health consultant to a child care center. Consultation and collaboration with child care providers and parents can foster health and safety for the steadily increasing number of young children being cared for in this type of community setting. The nurse with a strong pediatric background possesses the expert knowledge and skills needed to promote health and prevent illness and injury in this population. To exemplify the typical tasks encountered by a child care health consultant, a case is described in which a daycare director contracts the services of a nurse consultant to address problems with infection control procedures and illness transmission at a particular center. The consultant organizes the approach to this assignment by using a nursing consultation model as an action guide to achieve a positive outcome for the consultee.

Child↗