Effect of Correctly Using Alcohol-Based Hand Rub in a Clinical Setting

2008 ◽  
Vol 29 (10) ◽  
pp. 954-956 ◽  
Author(s):  
Sussie Laustsen ◽  
Elisabeth Lund ◽  
Bo Martin Bibby ◽  
Brian Kristensen ◽  
Ane Marie Thulstrup ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Setting ◽  
Hospital Staff ◽  
University Hospital ◽  
Clinical Procedure ◽  
Bacterial Counts ◽  
Clinical Procedures ◽  
Hand Antisepsis

We evaluated hand antisepsis in clinical practice at Aarhus University Hospital in Skejby, Denmark. The rate of compliance with the correct use of alcohol-based hand rub exceeded 55% of all routine clinical procedures observed. With the correct use of alcohol-based hand rub by hospital staff, bacterial counts were reduced by 90% before and 82% after a clinical procedure; with incorrect use, the bacterial counts were reduced by 60% before and 54% after a clinical procedure.

Cohort Study of Adherence to Correct Hand Antisepsis Before and After Performance of Clinical Procedures

2009 ◽  
Vol 30 (2) ◽  
pp. 172-178 ◽  
Author(s):  
Sussie Laustsen ◽  
Elisabeth Lund ◽  
Bo Martin Bibby ◽  
Brian Kristensen ◽  
Ane Marie Thulstrup ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hand Hygiene ◽  
Hospital Staff ◽  
University Hospital ◽  
Cross Sectional ◽  
Staff Members ◽  
Clinical Procedures ◽  
Hospital Units ◽  
Before And After ◽  
Hand Antisepsis

Objective.To investigate the rate of adherence by hospital staff members to the correct use of alcohol-based hand rub before and after performance of clinical procedures.Design.A cohort study conducted during the period from 2006 through 2007 and 2 cross-sectional studies conducted in 2006 and 2007.Setting.Århus University Hospital, Skejby, in Århus, Denmark.Participants.Various hospital staff members.Methods.Following an ongoing campaign promoting the correct use of alcohol-based hand rub, we observed rates of adherence by hospital staff to the correct use of alcohol-based hand rub. Observations were made before and after each contact with patients or patient surroundings during 5 weekdays during the period from 2006 through 2007 in 10 different hospital units. A logistic regression model was used to estimate the rate of adherence to the correct use of alcohol-based hand rub before and after performance of a clinical procedure.Results.A total of 496 participants were observed during 22,906 opportunities for hand hygiene (ie, 11,177 before and 11,729 after clinical procedures) that required the use of alcohol-based hand rub. The overall rates of adherence to the correct use of alcohol-based hand rub were 62.3% (6,968 ofthe 11,177 opportunities) before performance and 68.6% (8,041 ofthe 11,729 opportunities) after performance of clinical procedures. Compared with male participants, female participants were significantly better at adhering to the correct use of alcohol-based hand rub before performance (odds ratio [OR] 1.51 [95% confidence interval {CI}, 1.09–2.10]) and after performance (OR, 1.73 [95% CI, 1.27–2.36]) of clinical procedures. In general, the rate of adherence was significantly higher after the performance of clinical procedures, compared with before (OR, 1.43 [95% CI, 1.35–1.52]). For our cohort of 214 participants who were observed during 14,319 opportunities, the rates of adherence to the correct use of alcohol-based hand rub were 63.2% (4,469 of the 7,071 opportunities) before performance and 69.3% (5,021 of the 7,248 opportunities) after performance of clinical procedures, and these rates increased significantly from 2006 to 2007, except for physicians.Conclusion.We found a high and increasing rate of adherence to the correct use of alcohol-based hand rub before and after performance of clinical procedures following a campaign that promoted the correct use of alcohol-based hand rub. More hospital staff performed hand hygiene with alcohol-based hand rub after performance of clinical procedures, compared with before performance. Future campaigns to improve the rate of adherence to the correct use of alcohol-based hand rub ought be aware that certain groups of hospital staff (eg, male staff members) are known to exhibit a low level of adherence to the correct use of alcohol-based hand rub.

scholarly journals Using scenario-based training to promote information literacy among on-call consultant pediatricians

2017 ◽  
Vol 105 (3) ◽  
Author(s):  
Jonas Pettersson ◽  
Emil Bjorkander ◽  
Sirpa Bark ◽  
Daniel Holmgren ◽  
Per Wekell
Keyword(s):  
Clinical Practice ◽  
Information Literacy ◽  
Medical Information ◽  
Continuing Professional Development ◽  
Hospital Staff ◽  
Literacy Skills ◽  
University Hospital ◽  
Attractive Alternative ◽  
Search Methods ◽  
Participant Satisfaction

Background: Traditionally, teaching hospital staff to search for medical information relies heavily on educator-defined search methods. In contrast, the authors describe our experiences using real-time scenarios to teach on-call consultant pediatricians information literacy skills as part of a two-year continuing professional development program.Case Presentation: Two information-searching workshops were held at Sahlgrenska University Hospital in Gothenburg, Sweden. During the workshops, pediatricians were presented with medical scenarios that were closely related to their clinical practice. Participants were initially encouraged to solve the problems using their own preferred search methods, followed by group discussions led by clinical educators and a medical librarian in which search problems were identified and overcome. The workshops were evaluated using questionnaires to assess participant satisfaction and the extent to which participants intended to implement changes in their clinical practice and reported actual change.Conclusions: A scenario-based approach to teaching clinicians how to search for medical information is an attractive alternative to traditional lectures. The relevance of such an approach was supported by a high level of participant engagement during the workshops and high scores for participant satisfaction, intended changes to clinical practice, and reported benefits in actual clinical practice.

scholarly journals Understanding the Dynamics of Staff Reallocation to Clinical Practice During the First Wave of COVID-19 – a Qualitative Study

2022 ◽  
Author(s):  
Rie Laurine Rosenthal Johansen ◽  
Anita Sørensen ◽  
Mads Seit Jespersen ◽  
Kamilla Hesthaven Mikkelsen ◽  
Christina Emme
Keyword(s):  
Clinical Practice ◽  
Hospital Staff ◽  
University Hospital ◽  
Sequential Data ◽  
Actual Behavior ◽  
Contingency Plan ◽  
Work Related ◽  
Moderating Factors ◽  
Contingency Plans ◽  
Set Up

Abstract BackgroundDuring the COVID-19 pandemic, one responsive strategy to ensure hospital staff capacity was reallocation of staff between departments. Unpredicted factors may influence how the strategy is executed. Knowledge of potential moderating factors is essential to improve future staff contingency plans. To understand barriers and promoters of staff realloctation, this study explored the dynamics of reallocating staff from departments with low activity to clinical practice during the first wave of the COVID-19 pandemic at a 530-bed university hospital in the Capital Region of Denmark. MethodsWe used a mixed-methods explanatory design with sequential data collection and analysis. This paper primarily describes the qualitative part of the study, which consisted of six interviews with staff reallocated to clinical practice as part of the staff contingency plan, and seven interviews with leaders of departments that contributed with staff for reallocation. Data was analyzed using inductive content analysis.ResultsThe results showed that the execution of a staff contingency plan during a pandemic is influenced by a complex set of structural, perceptional, social, individual, and psychological moderating factors. Although staff felt obligated and motivated to cover shifts, their actual behavior and experience was influenced by factors such as uncertainty about tasks, family obligations, other work-related tasks, the contingency plan set-up, how the contingency plan, roles, and sense of urgency were interpreted by staff and leaders, and how the leaders prioritized tasks and staff time. Introduction to the unit and tasks, the feeling of being needed, voluntary participation, transparency, collegial sparring, and familiarity with the workplace were factors that promoted a positive experience.ConclusionsThis study identified a variety of complex moderating factors, which should be considered when hospital contingency plans are developed. The study highlights the importance of understanding how reallocated staff and leaders experience and make interpretations and adjustments to a given plan, as this may have great significance for how the contingency plan is put into practice. Future staff contingency plans should take these factors into consideration to make better use of human resources in times of a crisis and to improve staff’s experience with reallocation.

scholarly journals Seasonal Influenza and Low Flu Vaccination Coverage as Important Factors Modifying the Costs and Availability of Hospital Services in Poland: A Retrospective Comparative Study

2021 ◽  
Vol 18 (10) ◽  
pp. 5173
Author(s):  
Robert Susło ◽  
Piotr Pobrotyn ◽  
Lidia Brydak ◽  
Łukasz Rypicz ◽  
Urszula Grata-Borkowska ◽  
...  
Keyword(s):  
Influenza Season ◽  
Influenza Infection ◽  
Hospital Staff ◽  
University Hospital ◽  
Control Group ◽  
Admission Rates ◽  
Risk Of Death ◽  
The Mean ◽  
Retrospective Comparative Study ◽  
The Cost

Introduction: Influenza infection is associated with potential serious complications, increased hospitalization rates, and a higher risk of death. Materials and Methods: A retrospective comparative analysis of selected indicators of hospitalization from the University Hospital in Wroclaw, Poland, was carried out on patients with confirmed influenza infection in comparison to a control group randomly selected from among all other patients hospitalized on the respective wards during the 2018–2019 influenza season. Results: The mean laboratory testing costs for the entire hospital were 3.74-fold higher and the mean imaging test costs were 4.02-fold higher for patients with confirmed influenza than for the control group; the hospital expenses were additionally raised by the cost of antiviral therapy, which is striking when compared against the cost of a single flu vaccine. During the 2018–2019 influenza season, influenza infections among the hospital patients temporarily limited the healthcare service availability in the institution, which resulted in reduced admission rates to the departments related to internal medicine; the mean absence among the hospital staff totaled approximately 7 h per employee, despite 7.3% of the staff having been vaccinated against influenza at the hospital’s expense. Conclusions: There were significant differences in the hospitalization indicators between the patients with confirmed influenza and the control group, which markedly increased the hospital care costs in this multi-specialty university hospital.

Shortening the Application Time of Alcohol-Based Hand Rubs to 15 Seconds May Improve the Frequency of Hand Antisepsis Actions in a Neonatal Intensive Care Unit

2017 ◽  
Vol 38 (12) ◽  
pp. 1430-1434 ◽  
Author(s):  
Axel Kramer ◽  
Didier Pittet ◽  
Romana Klasinc ◽  
Stefan Krebs ◽  
Torsten Koburger ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Practice ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Application Time ◽  
Improve Hand Hygiene ◽  
Independent Observer ◽  
Hand Antisepsis

BACKGROUNDFor alcohol-based hand rubs, the currently recommended application time of 30 seconds is longer than the actual time spent in clinical practice. We investigated whether a shorter application time of 15 seconds is microbiologically safe in neonatal intensive care and may positively influence compliance with the frequency of hand antisepsis actions.METHODSWe conducted in vitro experiments to determine the antimicrobial efficacy of hand rubs within 15 seconds, followed by clinical observations to assess the effect of a shortened hand antisepsis procedure under clinical conditions in a neonatal intensive care unit (NICU). An independent observer monitored the frequency of hand antisepsis actions during shifts.RESULTSAll tested hand rubs fulfilled the requirement of equal or even significantly higher efficacy within 15 seconds when compared to a reference alcohol propan-2-ol 60% (v/v) within 30 seconds. Microbiologically, reducing the application time to 15 seconds had a similar effect when compared to 30-second hand rubbing, but it resulted in significantly increased frequency of hand antisepsis actions (7.9±4.3 per hour vs 5.8±2.9 per hour; P=.05).CONCLUSIONTime pressure and workload are recognized barriers to compliance. Therefore, reducing the recommended time for hand antisepsis actions, using tested and well-evaluated hand rub formulations, may improve hand hygiene compliance in clinical practice.Infect Control Hosp Epidemiol 2017;38:1430–1434

Impact of different hemodiafiltration solutions on ionemia in long-term CRRT

2021 ◽  
pp. 039139882110432
Author(s):  
Federico Nalesso ◽  
Francesco Garzotto ◽  
Leda Cattarin ◽  
Georgie Innico ◽  
Laura Gobbi ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Balance Control ◽  
Kidney Injury ◽  
Critical Issue ◽  
University Hospital ◽  
Electrolyte Balance ◽  
Standard Clinical Practice ◽  
The Impact

Critical patients with Acute Kidney Injury (AKI) requiring renal replacement therapy are in most cases eligible only for continuous modalities where the electrolyte balance control is a critical issue. The standard solutions used for hemodiafiltration, containing potassium at 2 mmol/L and no phosphorus, determines during the extended renal replacement therapy hypokalemia and hypophosphatemia. Therefore, solutions containing potassium and phosphate in physiological concentrations were formulated to avoid electrolyte imbalances and reduce ion alterations in prolonged treatments, these solutions are not routinely used in the standard clinical practice. To avoid electrolyte imbalances, we have first introduced in our practice two different solutions and then we have retrospectively analyzed the electrolyte balance upon these two solutions in order to identity the impact of these solutions on potassium and phosphate according to our clinical practice. We retrospectively analyzed 96 patients treated with Continuous Renal Replacement Therapy (CRRT) in the intensive care units (ICU) at Padua’s University Hospital to evaluate the role on electrolyte balance of Phoxilium® and Prismasol 2® that differ in their composition and the need for electrolytes infusions. In the Phoxilium group the frequency of hypokalemia, hypophosphatemia, and the need of potassium and phosphate replacement were significantly reduced resulting in a reduction in complications, workload, and clinical risk associated with infusions of electrolytes. Our data demonstrated that the use of these two different hemodiafiltration solutions can reduce the occurrence of hypokalemia and hypophosphatemia during CRRT performing personalized treatments without the use of potassium and phosphate infusions.

scholarly journals Introduction of Criterion-Based Audit of Postpartum Hemorrhage in a University Hospital in Eastern Ethiopia: Implementation and Considerations

2020 ◽  
Vol 17 (24) ◽  
pp. 9281
Author(s):  
Abera Kenay Tura ◽  
Yasmin Aboul-Ela ◽  
Sagni Girma Fage ◽  
Semir Sultan Ahmed ◽  
Sicco Scherjon ◽  
...  
Keyword(s):  
Postpartum Hemorrhage ◽  
Hospital Setting ◽  
Hospital Staff ◽  
University Hospital ◽  
Local Hospital ◽  
Eastern Ethiopia ◽  
Self Reflection ◽  
Intervention Plan ◽  
Cross Matching

With postpartum hemorrhage (PPH) continuing to be the leading cause of maternal mortality in most low-resource settings, an audit of the quality of care in health facilities is essential. The purpose of this study was to identify areas of substandard care and establish recommendations for the management of PPH in Hiwot Fana Specialized University Hospital, eastern Ethiopia. Using standard criteria (n = 8) adapted to the local hospital setting, we audited 45 women with PPH admitted from August 2018 to March 2019. Four criteria were agreed as being low: IV line-setup (32 women, 71.1%), accurate postpartum vital sign monitoring (23 women, 51.1%), performing typing and cross-matching (22 women, 48.9%), and fluid intake/output chart maintenance (6 women, 13.3%). In only 3 out of 45 women (6.7%), all eight standard criteria were met. Deficiencies in the case of note documentation and clinical monitoring, non-availability of medical resources and blood for transfusion, as well as delays in clinical management were identified. The audit created awareness, resulting in self-reflection of current practice and promoted a sense of responsibility to improve care among hospital staff. Locally appropriate recommendations and an intervention plan based on available resources were formulated.

scholarly journals Effects of high-fidelity simulation education on medical students’ anxiety and confidence

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251078
Author(s):  
Ji Hye Yu ◽  
Hye Jin Chang ◽  
Soon Sun Kim ◽  
Ji Eun Park ◽  
Wou Young Chung ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Medical Students ◽  
Patient Care ◽  
Clinical Setting ◽  
Clinical Performance ◽  
High Fidelity ◽  
High Fidelity Simulation ◽  
Simulation Education ◽  
Before And After ◽  
Care Situation

Introduction Psychological factors such as anxiety and confidence that students have in the patient care situation are important in that this affects the actual clinical performance. Students who are just starting clinical practice have a lack of clinical knowledge, skill proficiency, and patient communication skills, so they experience anxiety and lack of confidence in clinical setting. Practice in a safe environment, such as simulation education, can help students perform more settled and competently in patient care. The purpose of this study was to analyze the effect of high-fidelity simulation experience on anxiety and confidence in medical students. Materials and methods This study enrolled 37 5th-year students at Ajou University School of Medicine in 2020. Two simulation trainings were implemented, and a survey was conducted to measure students’ level of anxiety and confidence before and after each simulation. Based on the research data, a paired t-test was conducted to compare these variables before and after the simulation, and whether this was their first or second simulation experience. Results Students had a significantly lower level of anxiety and a significantly higher level of confidence after the simulation than before. In addition, after one simulation experience, students had less anxiety and more confidence before the second simulation compared to those without simulation experience. Conclusions We confirmed that medical students need to be repeatedly exposed to simulation education experiences in order to have a sense of psychological stability and to competently deliver medical treatment in a clinical setting. There is a practical limitation in that medical students do not have enough opportunities to meet the patients during clinical practice in hospitals. Therefore, in order to produce excellent doctors, students should have the expanded opportunities to experience simulation education so they can experience real-world medical conditions.

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