scholarly journals Prospective Evaluation of a Hospital Epidemiologist's Activities at a European Tertiary-Care Medical Center

1999 ◽  
Vol 20 (9) ◽  
pp. 604-606 ◽  
Author(s):  
Christian Ruef
Keyword(s):  
Infection Control ◽  
New Technologies ◽  
Practical Knowledge ◽  
Medical Center ◽  
Tertiary Care ◽  
University Hospital ◽  
Private Hospitals ◽  
Hospital Epidemiology ◽  
Continuous Quality ◽  
Tertiary Care Medical Center

AbstractObjective:Assessment of the distribution of tasks and consultations provided by the hospital epidemiologist (HE) at University Hospital of Zurich (UHZ).Design:Prospective collection of data on hospital epidemiology consultations over a 3-year period (1995-1997). Time spent per consultation and activities of infection control practitioners were not recorded.Setting:A 1,040-bed tertiary-care university hospital in Zurich, Switzerland.Results:Between January 1, 1995, and December 31, 1997, the HE received 1,660 requests for consultation. Advice or action was sought in the following areas: epidemiology (27.5% of requests); quality assurance, including antibiotic utilization and technology assessment (24.8%); infection control and practice guidelines (22.5%); disinfection and sterilization (11.6%); clinical infectious diseases (13.4%). During 1997, 35% of epidemiology consults were related to methicillin-resistant Staphylococcus aureus and 5.8% to tuberculosis. Public or private hospitals not affiliated with UHZ requested 40% of all consults.Conclusions:This study shows that HEs are involved in many different activities. Only 27.5% of hospital epidemiology consultations were directly related to issues of epidemiology. Practical knowledge of the methodologies for continuous quality improvement and assessment of various new technologies is important for HEs. The results of this study may be useful in discussions between HEs and administrators about allocation of resources or issues of reimbursement.

A Prolonged Outbreak of Methicillin-Resistant Staphylococcus aureus in the Burn Unit of a Tertiary Medical Center

1996 ◽  
Vol 17 (12) ◽  
pp. 798-802 ◽  
Author(s):  
Patricia A. Meier ◽  
Cheryl D. Carter ◽  
Sarah E. Wallace ◽  
Richard J. Hollis ◽  
Michael A. Pfaller ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Infection Control ◽  
Healthcare Workers ◽  
Medical Center ◽  
Tertiary Care ◽  
Chromosomal Dna ◽  
Methicillin Resistant ◽  
Persistent Problem ◽  
Tertiary Care Medical Center ◽  
Burn Unit

AbstractObjective:To report an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) in our burn unit and the steps we used to eradicate the organism.Design And Setting:Outbreak investigation in the burn unit of a 900-bed tertiary-care medical center.Outbreak:Between March and June 1993, MRSA was isolated from 10 patients in our burn unit. All isolates had identical antibiograms and chromosomal DNA patterns.Control Measures:Infection control personnel encouraged healthcare workers to wash their hands after each patient contact. The unit cohorted all infected or colonized patients, placed each affected patient in isolation, and, if possible, transferred the patient to another unit. Despite these measures, new cases occurred. Infection control personnel obtained nares cultures from 56 healthcare workers, 3 of whom carried the epidemic MRSA strain. One healthcare worker cared for six affected patients, and one cared for five patients. We treated the three healthcare workers with mupirocin. Subsequently, no additional patients became colonized or infected with the epidemic MRSA strain.Conclusions:The outbreak ended after we treated healthcare workers who carried the epidemic strain with mupirocin. This approach is not appropriate in all settings. However, we felt it was justified in this case because of a persistent problem after less intrusive measures.

Mathematical Modeling of Pathogen Trajectory in a Patient Care Environment

2013 ◽  
Vol 34 (11) ◽  
pp. 1181-1188 ◽  
Author(s):  
Angela L. Hewlett ◽  
Scott E. Whitney ◽  
Shawn G. Gibbs ◽  
Philip W. Smith ◽  
Hendrik J. Viljoen
Keyword(s):  
Mathematical Modeling ◽  
Infection Control ◽  
Patient Care ◽  
Medical Center ◽  
Tertiary Care ◽  
Healthcare Delivery ◽  
Time Lapse ◽  
Infection Control Practice ◽  
Control Practice ◽  
Tertiary Care Medical Center

Objective.Minimizing healthcare worker exposure to airborne infectious pathogens is an important infection control practice. This study utilized mathematical modeling to evaluate the trajectories and subsequent concentrations of particles following a simulated release in a patient care room.Design.Observational study.Setting. Biocontainment unit patient care room at a university-affiliated tertiary care medical center.Methods. Quantitative mathematical modeling of airflow in a patient care room was achieved using a computational fluid dynamics software package. Models were created on the basis of a release of particles from various locations in the room. Computerized particle trajectories were presented in time-lapse fashion over a blueprint of the room. A series of smoke tests were conducted to visually validate the model.Results.Most particles released from the head of the bed initially rose to the ceiling and then spread across the ceiling and throughout the room. The highest particle concentrations were observed at the head of the bed nearest to the air return vent, and the lowest concentrations were observed at the foot of the bed.Conclusions.Mathematical modeling provides clinically relevant data on the potential exposure risk in patient care rooms and is applicable in multiple healthcare delivery settings. The information obtained through mathematical modeling could potentially serve as an infection control modality to enhance the protection of healthcare workers.

scholarly journals A 5-Year Audit of Accidental Dural Punctures, Postdural Puncture Headaches, and Failed Regional Anesthetics at a Tertiary-Care Medical Center

2009 ◽  
Vol 9 ◽  
pp. 715-722 ◽  
Author(s):  
Sukhdip Singh ◽  
Shagufta Y. Chaudry ◽  
Amy L. Phelps ◽  
Manuel C Vallejo
Keyword(s):  
Medical Center ◽  
Tertiary Care ◽  
Obstetric Anesthesia ◽  
Epidural Block ◽  
Complication Rates ◽  
Continuous Quality ◽  
Tertiary Care Medical Center ◽  
Labor Epidural ◽  
Anesthesia Complications ◽  
Perinatal Database

Obstetric anesthesia-related complications occur as a result of labor epidural or spinal placement. The purpose of this continuous quality-improvement audit was to review the occurrence of accidental dural punctures (ADPs), postdural puncture headaches (PDPHs), and failed regional anesthetics at an academic tertiary-care medical center over a 5-year period. Obstetric anesthesia complications contained in three databases consisting of ADPs, PDPHs, and failed regional anesthetics were matched to a perinatal database, with no complications serving as controls. Of the 40,894 consecutive parturients, there were 765 documented complications. Complication rates were 0.73% (95% CI: 0.65–0.82) for ADP, 0.49% (95% CI: 0.43–0.56) for PDPH, and 0.65% (95% CI: 0.57–0.73) for failed regional anesthetic. When compared to the no complication group, factors associated with obstetric anesthesia complications included increased weight and BMI (p< 0.01), epidural block (p< 0.01), and vaginal delivery (p< 0.01).

scholarly journals EVALUATION OF FACTORS ASSOCIATED WITH MORTALITY AMONGST PATIENTS ADMITTED TO A TERTIARY CARE MEDICAL CENTER FOR COVID-19 INFECTION

2021 ◽  
Vol 77 (18) ◽  
pp. 3123
Author(s):  
Anish Samuel ◽  
Ashesha Mechineni ◽  
Robin Craven ◽  
Wilbert Aronow ◽  
Mourad Ismail ◽  
...  
Keyword(s):  
Medical Center ◽  
Tertiary Care ◽  
Factors Associated ◽  
Tertiary Care Medical Center

scholarly journals Evaluation of post-ERCP pancreatitis after biliary stenting with self-expandable metal stents vs. plastic stents in benign and malignant obstructions

2021 ◽  
Vol 09 (06) ◽  
pp. E888-E894
Author(s):  
Nichol S. Martinez ◽  
Sumant Inamdar ◽  
Sheila N. Firoozan ◽  
Stephanie Izard ◽  
Calvin Lee ◽  
...  
Keyword(s):  
Pancreatic Duct ◽  
Medical Center ◽  
Tertiary Care ◽  
Plastic Stents ◽  
Metal Stents ◽  
Limited Data ◽  
Sems Group ◽  
Tertiary Care Medical Center ◽  
Stent Type ◽  
Pancreatic Duct Stent

Abstract Background and study aims There are conflicting data regarding the risk of post-ERCP pancreatitis (PEP) with self-expandable metallic stents (SEMS) compared to polyethylene stents (PS) in malignant biliary obstructions and limited data related to benign obstructions. Patients and methods A retrospective cohort study was performed of 1136 patients who underwent ERCP for biliary obstruction and received SEMS or PS at a tertiary-care medical center between January 2011 and October 2016. We evaluated the association between stent type (SEMS vs PS) and PEP in malignant and benign biliary obstructions. Results Among the 1136 patients included in our study, 399 had SEMS placed and 737 had PS placed. Patients with PS were more likely to have pancreatic duct cannulation, pancreatic duct stent placement, double guidewire technique, sphincterotomy and sphincteroplasty as compared to the SEMS group. On multivariate analysis, PEP rates were higher in the SEMS group (8.0 %) versus the PS group (4.8 %) (OR 2.27 [CI, 1.22, 4.24]) for all obstructions. For malignant obstructions, PEP rates were 7.8 % and 6.6 % for SEMS and plastic stents, respectively (OR 1.54 [CI, 0.72, 3.30]). For benign obstructions the PEP rate was higher in the SEMS group (8.8 %) compared to the PS group (4.2 %) (OR 3.67 [CI, 1.50, 8.97]). No significant differences between PEP severity were identified based on stent type when stratified based on benign and malignant. Conclusions PEP rates were higher when SEMS were used for benign obstruction as compared to PS. For malignant obstruction, no difference was identified in PEP rates with use of SEMS vs PS.

Utility of electroencephalography: Experience from a U.S. tertiary care medical center

2016 ◽  
Vol 127 (10) ◽  
pp. 3335-3340 ◽  
Author(s):  
Kapil Gururangan ◽  
Babak Razavi ◽  
Josef Parvizi
Keyword(s):  
Medical Center ◽  
Tertiary Care ◽  
Tertiary Care Medical Center

Nosocomial Methicillin-Resistant and Methicillin-SusceptibleStaphylococcus AureusPrimary Bacteremia: At What Costs?

1999 ◽  
Vol 20 (6) ◽  
pp. 408-411 ◽  
Author(s):  
Murray A. Abramson ◽  
Daniel J. Sexton
Keyword(s):  
Hospital Stay ◽  
Medical Center ◽  
A Priori ◽  
Tertiary Care ◽  
Length Of Hospital Stay ◽  
Bloodstream Infections ◽  
Methicillin Resistant ◽  
Tertiary Care Medical Center ◽  
Matching Criteria ◽  
Nested Case Control

Objective:To determine the attributable hospital stay and costs for nosocomial methicillin-sensitive Staphylococcus aureus (MSSA) and methicillin-resistantS aureus(MRSA) primary bloodstream infections (BSIs).Design:Pairwise-matched (1:1) nested case-control study.Setting:University-based tertiary-care medical center.Patients:Patients admitted between December 1993 and March 1995 were eligible. Cases were defined as patients with a primary nosocomialS aureusBSI; controls were selected according to a priori matching criteria.Measurements:Length of hospital stay and total and variable direct costs of hospitalization.Results:The median hospital stay attributable to primary nosocomial MSSA BSI was 4 days, compared with 12 days for MRSA (P=.023). Attributable median total cost for MSSA primary nosocomial BSIs was $9,661 versus $27,083 for MRSA nosocomial infections (P=.043).Conclusion:Nosocomial primary BSI due toS aureussignificantly prolongs the hospital stay. Primary nosocomial BSIs due to MRSA result in an approximate threefold increase in direct cost, compared with those due to MSSA.

scholarly journals Independent risk factors for surgical site infection after cesarean delivery in a rural tertiary care medical center

2016 ◽  
Vol 31 (1) ◽  
pp. 120-126 ◽  
Author(s):  
Manuel C. Vallejo ◽  
Ahmed F. Attaallah ◽  
Robert E. Shapiro ◽  
Osama M. Elzamzamy ◽  
Michael G. Mueller ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Cesarean Delivery ◽  
Medical Center ◽  
Tertiary Care ◽  
Site Infection ◽  
Tertiary Care Medical Center ◽  
Independent Risk Factors

scholarly journals Quality of Hepatitis C Care at an Urban Tertiary Care Medical Center

2014 ◽  
Vol 25 (2) ◽  
pp. 705-716 ◽  
Author(s):  
Sabrina A. Assoumou ◽  
Wei Huang ◽  
C. Robert Horsburgh ◽  
Mus ◽  
Benjamin P. Linas
Keyword(s):  
Hepatitis C ◽  
Medical Center ◽  
Tertiary Care ◽  
Tertiary Care Medical Center
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