Device-related infections in long-term healthcare facilities: the challenge of prevention

2014 ◽  
Vol 9 (4) ◽  
pp. 487-495 ◽  
Author(s):  
Nico T Mutters ◽  
Frank Günther ◽  
Alexandra Heininger ◽  
Uwe Frank
Keyword(s):  
Healthcare Facilities

Discharge of pharmaceuticals into municipal sewers from hospitals and long-term care facilities

2012 ◽  
Vol 47 (2) ◽  
pp. 140-152 ◽  
Author(s):  
Muhammad Riaz ul Haq ◽  
Chris Metcalfe ◽  
Hongxia Li ◽  
Wayne Parker
Keyword(s):  
Long Term Care ◽  
Treatment Plant ◽  
Biological Response ◽  
Care Homes ◽  
Pharmaceutically Active Compounds ◽  
Term Care ◽  
Healthcare Facilities ◽  
Antibiotic Compounds ◽  
Composite Samples

The presence of pharmaceutically active compounds in the aquatic environment has become well established, and their presence is of potential concern because they are designed to produce biological response in the target receptor, may bear intrinsic toxicity (e.g. cytostatic agents, antibiotics) and they possess the potential to foster and maintain drug resistance. For both risk assessment and risk management purposes, it is important to identify the major sources of pharmaceuticals in the environment. Healthcare facilities may be major sources of the discharges of these compounds into municipal sewers. In this study, we investigated the contributions to the wastewater treatment plant (WWTP) influents from two hospitals and two long-term care homes of nine compounds. Twenty-four hour composite samples were collected over 5 consecutive days from the effluents of these facilities. The WWTPs receiving sewage from these facilities were also sampled on the same days to facilitate mass balance calculations. The results showed that the healthcare facilities contributed a greater proportion of the antibiotic compounds to the WWTPs than the other target compounds; with maximum contributions of ciprofloxacin by hospitals and long-term care homes of 26.7 and 37%, respectively.

scholarly journals Addressing the quality and scope of paediatric primary care in South Africa: Evaluating contextual impacts of the introduction of the Practical Approach to Care Kit for children (PACK Child)

2020 ◽  
Author(s):  
Jamie Murdoch ◽  
Robyn Curran ◽  
Ruth Cornick ◽  
Sandy Picken ◽  
Max Bachmann ◽  
...  
Keyword(s):  
South Africa ◽  
Primary Care ◽  
Primary Healthcare ◽  
Routine Care ◽  
Health Systems Strengthening ◽  
Psychosocial Issues ◽  
Healthcare Facilities ◽  
Contextual Features ◽  
Child Intervention

Abstract Background: Despite significant reductions in mortality, preventable and treatable conditions remain leading causes of death and illness in children in South Africa. The PACK Child intervention, comprising clinical decision support tool (guide), training strategy and health systems strengthening components, was developed to expand on WHO’s Integrated Management of Childhood Illness programme, extending care of children under 5 years to those aged 0-13 years, those with chronic conditions needing regular follow-up, integration of curative and preventive measures and routine care of the well child. In 2017-2018, PACK Child was piloted in 10 primary healthcare facilities in the Western Cape Province. Here we report findings from an investigation into the contextual features of South African primary care that shaped how clinicians delivered the PACK Child intervention within clinical consultations.Methods: Process evaluation using linguistic ethnographic methodology which provides analytical tools for investigating human behaviour, and the shifting meaning of talk and text within context. Methods included semi-structured interviews, focus groups, ethnographic observation, audio-recorded consultations and documentary analysis. Analysis focused on how mapped contextual features structured clinician-caregiver interactions. Results: Primary healthcare facilities demonstrated an institutionalised orientation to minimising risk upheld by provincial documentation, providing curative episodic care to children presenting with acute symptoms, and preventive care including immunisations, feeding and growth monitoring, all in children 5 years or younger. Children with chronic illnesses such as asthma rarely receive routine care. These contextual features constrained the ability of clinicians to use the PACK Child guide to facilitate diagnosis of long-term conditions, elicit and manage psychosocial issues, and navigate use of the guide alongside provincial documentation. Conclusion: Our findings provide evidence that PACK Child is catalysing a transition to an approach that strikes a balance between assessing and minimising risk on the day of acute presentation and a larger remit of care for children over time. However, optimising success of the intervention requires reviewing priorities for paediatric care which will facilitate enhanced skills, knowledge and deployment of clinical staff to better address acute illnesses and long-term health conditions of children of all ages, as well as complex psychosocial issues surrounding the child.

scholarly journals Fistula as a Public Health challenge in Pakistan

2018 ◽  
Vol 13 (2) ◽  
Author(s):  
Shamoon Noushad ◽  
Shershah Syed ◽  
Sadaf Ahmed
Keyword(s):  
Public Health ◽  
Obstetric Fistula ◽  
Secondary Data ◽  
Health Interventions ◽  
Public Health Interventions ◽  
Healthcare Facilities ◽  
Public Health Challenge ◽  
Effective Public Health ◽  
The Impact

Aims: To explore the impact of obstetric fistula in the county and to propose effective public health interventions that can help to prevent the condition with a long-term goal of eradicating the condition. Methods: The survey and analysis included secondary data addressing women's experiences of fistula; dynamics and limitationsdetermining women's access to in healthcare facilities for fistula management; and restraintsof health professional as well as health inequities. Results: It was assessed that recently, many hospitals and organizations in the country go on board on intercessions to address the impact of the illness, however, much importance is on pinpointing and discussing the existing cases rather than focusing on public health interventions that can help to prevent and eventually eradicate the condition in Pakistan.

scholarly journals Developing Regional Healthcare Facilities in Maldives through Mudharabah Perpetual Sukuk

2019 ◽  
Vol 6 (2) ◽  
pp. 81-96 ◽  
Author(s):  
Fathimath Badeeu ◽  
Aminath Nafiz ◽  
Aishath Muneeza
Keyword(s):  
Healthcare System ◽  
Compliant Mechanism ◽  
Financial Burden ◽  
Healthcare Providers ◽  
Health Facilities ◽  
Healthcare Facilities ◽  
Term Basis

The purpose of this paper is to identify the underlying issues of healthcare system in Maldives in order to provide an understanding of the challenges facing healthcare providers in islands and atolls in a wider context. The paper scrutinizes the financial burden faced by the current healthcare system in Maldives. It also proposes shariah compliant mechanism that can be utilized to minimize financial burden in a long-term basis. It is hoped that the outcome of the research will assist the policymakers of Maldives to devise a shariah compliant mechanism to finance the development of atoll and island health facilities in a sustainable manner.

scholarly journals Digital marketing in the SPA-resort product promoting

2020 ◽  
Vol 164 ◽  
pp. 09037
Author(s):  
Voinova Ianina
Keyword(s):  
Black Sea ◽  
Digital Marketing ◽  
Healthcare Facilities ◽  
Consumer Interest ◽  
New Methods ◽  
Lack Of Information ◽  
Product Promotion

Digital marketing technologies create new ways for driving customers in spa-product purchasing, providing feedbacks and endorsements due to new methods of communication, supporting and reinforcing Spa-resort product producers and distributors promises. Actually, at this time resort market has no effective and united strategy for SPA-resort product promotion and sales, which has to be based on modern digital marketing instruments. The review of digital SPA-resort market in Black Sea resorts and Caucasian Spas areas revealed the lack of coordination between providers of natural curative resources, tourist’s accommodation means, healthcare facilities and travel organizers. Ignoring the specifics of SPA-resort product and uniqueness of its nature in its promotion and merchandising causes the drop-in sales because of the decrease in consumer interest and lack of information about variety of product benefits for health resumption. Thus, recommendations and suggestions about possible ways of joining efforts in SPA-product rout-to market with use of digital marketing technologies would show a large return to the resort industry in a long-term period.

scholarly journals The SHIELD Orange County Project: Multidrug-resistant Organism Prevalence in 21 Nursing Homes and Long-term Acute Care Facilities in Southern California

2019 ◽  
Vol 69 (9) ◽  
pp. 1566-1573 ◽  
Author(s):  
James A McKinnell ◽  
Raveena D Singh ◽  
Loren G Miller ◽  
Ken Kleinman ◽  
Gabrielle Gussin ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Acute Care ◽  
Orange County ◽  
Multidrug Resistant ◽  
Resistant Organism ◽  
Healthcare Intervention ◽  
Healthcare Facilities ◽  
Care Facilities ◽  
Acute Care Facilities

Abstract Background Multidrug-resistant organisms (MDROs) spread between hospitals, nursing homes (NHs), and long-term acute care facilities (LTACs) via patient transfers. The Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County is a regional public health collaborative involving decolonization at 38 healthcare facilities selected based on their high degree of patient sharing. We report baseline MDRO prevalence in 21 NHs/LTACs. Methods A random sample of 50 adults for 21 NHs/LTACs (18 NHs, 3 LTACs) were screened for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus spp. (VRE), extended-spectrum β-lactamase–producing organisms (ESBL), and carbapenem-resistant Enterobacteriaceae (CRE) using nares, skin (axilla/groin), and peri-rectal swabs. Facility and resident characteristics associated with MDRO carriage were assessed using multivariable models clustering by person and facility. Results Prevalence of MDROs was 65% in NHs and 80% in LTACs. The most common MDROs in NHs were MRSA (42%) and ESBL (34%); in LTACs they were VRE (55%) and ESBL (38%). CRE prevalence was higher in facilities that manage ventilated LTAC patients and NH residents (8% vs <1%, P < .001). MDRO status was known for 18% of NH residents and 49% of LTAC patients. MDRO-colonized adults commonly harbored additional MDROs (54% MDRO+ NH residents and 62% MDRO+ LTACs patients). History of MRSA (odds ratio [OR] = 1.7; confidence interval [CI]: 1.2, 2.4; P = .004), VRE (OR = 2.1; CI: 1.2, 3.8; P = .01), ESBL (OR = 1.6; CI: 1.1, 2.3; P = .03), and diabetes (OR = 1.3; CI: 1.0, 1.7; P = .03) were associated with any MDRO carriage. Conclusions The majority of NH residents and LTAC patients harbor MDROs. MDRO status is frequently unknown to the facility. The high MDRO prevalence highlights the need for prevention efforts in NHs/LTACs as part of regional efforts to control MDRO spread.

Clostridium difficileOutbreak Strain BI Is Highly Endemic in Chicago Area Hospitals

2011 ◽  
Vol 32 (9) ◽  
pp. 897-902 ◽  
Author(s):  
Stephanie R. Black ◽  
Kingsley N. Weaver ◽  
Roderick C. Jones ◽  
Kathleen A. Ritger ◽  
Laurica A. Petrella ◽  
...  
Keyword(s):  
Severe Disease ◽  
Restriction Endonuclease Analysis ◽  
Term Care ◽  
Healthcare Facilities ◽  
Chicago Area ◽  
Crude Mortality Rate ◽  
Crude Mortality ◽  
Endemic Strain ◽  
Acute Healthcare

Objective.Describe the clinical and molecular epidemiology of incidentClostridium difficileinfection (CDI) cases in Chicago area acute healthcare facilities (HCFs).Design and Setting.Laboratory, clinical, and epidemiologic information was collected for patients with incident CDI who were admitted to acute HCFs in February 2009. Stool cultures and restriction endonuclease analysis typing of the recoveredC. difficileisolates was performed.Patients.Two hundred sixty-three patients from 25 acute HCFs.Results.Acute HCF rates ranged from 2 to 7 patients with CDI per 10,000 patient-days. The crude mortality rate was 8%, with 20 deaths occurring in patients with CDI. Forty-two (16%) patients had complications from CDI, including 4 patients who required partial, subtotal, or total colectomy, 3 of whom died.C. difficilewas isolated and typed from 129 of 178 available stool specimens. The BI strain was identified in 79 (61%) isolates. Of patients discharged to long-term care who had their isolate typed, 36 (67%) had BI-associated CDI.Conclusions.Severe disease was common and crude mortality was substantial among patients with CDI in Chicago area acute HCFs in February 2009. The outbreak-associated BI strain was the predominant endemic strain identified, accounting for nearly two-thirds of cases. Focal HCF outbreaks were not reported, despite the presence of the BI strain. Transfer of patients between acute and long-term HCFs may have contributed to the high incidence of BI cases in this investigation.

Long-Term Implications of the Infomedic during the COVID-19 Pandemic to US Adolescents’ HPV Vaccination Rates: Maternal Engagement with Pro- and Anti-vaccine Social Media Posts and Overarching Vaccine Hesitancy (Preprint)

2020 ◽  
Author(s):  
Young Argyris ◽  
Yongsuk Kim ◽  
Won Song
Keyword(s):  
Hpv Vaccine ◽  
Negative Impact ◽  
Hpv Vaccination ◽  
Population Based ◽  
Vaccine Hesitancy ◽  
Healthcare Facilities ◽  
Vaccination Rates ◽  
Novel Coronavirus ◽  
The Impact

BACKGROUND The propagation of vaccine misinformation during the COVID-19 pandemic suggests that the pandemic may pose long-term harm on public health via depressed immunization rates. Between February 2020 and April 2020, the uptake rates of the HPV vaccine have decreased by 73%. Missing the critical age for HPV vaccination (i.e., 11-12 years old) will make adolescents susceptible to HPV-associated cancers in the next 20-30 years. Despite the importance, very few pro-vaccine interventions conducted on SM have succeeded in increasing HPV vaccination rates. OBJECTIVE Our overall objective is to identify the reasons why anti-vaccine messages effectively lower HPV vaccination rates while pro-vaccine messages do not increase such rates. In so doing, we suggest that overarching vaccine hesitancy is a reason for the discrepant outcomes of anti- vs. pro-vaccine SM posts. Our objective is pursued in two specific aims: we compare anti- and pro-vaccine posts in terms of (i) their roles in fostering overarching vaccine hesitancy among mothers (the main HPV vaccine decision-makers), and (ii) accompanying HPV vaccination rates among their adolescent children. METHODS In late December of 2019-mid January of 2020, we conducted a population-based survey among 426 mothers of US adolescents aged 13–18. The outbreak of the novel coronavirus in China occurred in December 2019, and awareness regarding the virus was increasing in the US during this time. Therefore, our data collected during this time allow us to infer the impact of increasing overarching vaccine hesitancy on HPV vaccination rates, while excluding the effects of access restrictions to healthcare facilities imposed since March of 2020. We developed a rigorous scale for engagement with anti- and pro-vaccine SM posts, measured adolescents’ HPV vaccination rates along the series initiation to completion, and conducted path analyses to assess the associations among them. RESULTS Our survey results show that mothers’ engagement with anti-vaccine content is negatively associated with their children’s HPV vaccine vaccination rates via their increased overarching vaccine hesitancy. In contrast, maternal engagement with pro-vaccine SM content is not associated with either overarching vaccine hesitancy or HPV vaccine vaccination rates. These results remained significant after controlling for socioeconomic, demographic, and accessibility factors, suggesting that mothers’ engagement with anti-vaccine messages on SM explains above and beyond what other known factors explain. CONCLUSIONS Our results suggest that increasing overarching vaccine hesitancy, heightened by the infodemic, can substantially reduce HPV vaccination rates, even after accessibility factors are controlled. Our results imply that the negative impact of the COVID-19 pandemic can be extended for many years to come through depressed HPV vaccination rates. As a result, there is an urgent need to develop interventions to increase HPV vaccination rates and to address vaccine hesitancy among mothers who feel emotionally challenged during the pandemic. CLINICALTRIAL N/A

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