Epistemic_Statements  

CORD-19:f22b324eec2eaf85f8e70381b13017e64b1e0e5c JSONTXT 8 Projects

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Id Subject Object Predicate Lexical cue
T1 530-711 Epistemic_statement denotes The club confirmed that 5-10 children and a coach had been affected; at least two children remained symptomatic and the latest case was a new onset, suggesting ongoing transmission.
T2 1286-1412 Epistemic_statement denotes Whilst numbers of cases were too small to allow multivariable analysis, several likely routes of transmission were identified:
T3 1413-1450 Epistemic_statement denotes Sharing of shammy (diving) towels • •
T4 1451-1550 Epistemic_statement denotes Piling shammy towels at poolside • • Infrequent washing of shammy towels • • Shared equipment, e.g.
T5 1823-1971 Epistemic_statement denotes Outcomes of the investigation were shared with the pool management team and diving club with a view to wider dissemination at national competitions.
T6 1972-2038 Epistemic_statement denotes Antimicrobial resistance (AMR) is an urgent public health concern.
T7 2039-2107 Epistemic_statement denotes Resistance can be accelerated with the imprudent use of antibiotics.
T8 2108-2236 Epistemic_statement denotes Previous research suggests that inappropriate prescribing is apparent in practice; however, much of this has focused on doctors.
T9 2237-2349 Epistemic_statement denotes With a growing number of nurses potentially prescribing antimicrobials, their practice is of particular concern.
T10 2350-2711 Epistemic_statement denotes The Reasoned Action Approach (RAA) model proposes that behavioural (advantages/disadvantages of carrying out the behaviour), normative (individuals or groups who would approve/disapprove; likely/unlikely to carry out this behaviour) and control beliefs (enablers or inhibitors to carrying out the behaviour) are the psychological foundation for human behaviour.
T11 3371-3520 Epistemic_statement denotes Other NIPs were most frequently mentioned as being most likely to manage patients without prescribing (n=11, 41%), with GPs least likely (n=16, 60%).
T12 3700-3954 Epistemic_statement denotes Some of these findings are similar to those found in the literature; however, many others have emerged -one of the main categories being patient expectation and the challenges this creates when trying to manage patients without prescribing an antibiotic.
T13 4096-4316 Epistemic_statement denotes Semi-invasive ultrasound probes (SIUPs) are a cornerstone in the diagnosis and treatment of patients; however, infection control concerns exist over the use of probes and their role as a vector for pathogen transmission.
T14 5076-5272 Epistemic_statement denotes Studies have shown residual contamination on SIUPs when high level disinfection (HLD) is not performed and cases of cross-infection where transmission was linked to improper reprocessing of SIUPs.
T15 5273-5403 Epistemic_statement denotes The literature review found limited evidence upon which to make recommendations on universal HLD methods of decontaminating SIUPs.
T16 5912-6131 Epistemic_statement denotes Where evidence was lacking to inform the guidance, expert opinion was sought from the reusable medical devices expert advisory steering group, which consists of national decontamination and infection-prevention experts.
T17 6305-6596 Epistemic_statement denotes An initial data validation took place in 2013, followed by a series of improvement initiatives which included a CS guideline and care plan both reflecting NICE recommendations, asepsis principles awareness for midwives and introduction of an Aquacel dressing left in situ for 5 days in 2015.
T18 7206-7484 Epistemic_statement denotes Feedback from the dressing evaluation suggested that dressings were painful at removal, and when additional staff support was provided patients' experience with the dressing improved, highlighting the power of utilising patient feedback to improve patient safety and experience.
T19 8023-8107 Epistemic_statement denotes The antimicrobial activity of natural honey may offer potential in MRSA eradication.
T20 9450-9523 Epistemic_statement denotes The results from this first RCT of its type confirm the potential of MGH.
T21 9524-9620 Epistemic_statement denotes However, further work is required to confirm the findings and optimise the concentration of MGH.
T22 9873-10021 Epistemic_statement denotes These waterlines can become heavily contaminated with bacteria, leading to microbial biofilm formation despite decontamination and regular flushing.
T23 10022-10251 Epistemic_statement denotes Leeds Dental Institute (LDI) uses a continuous dosing with 1% Alpron to achieve the water quality; however, we experienced repeated microbiological testing failures with the currently used Alpron system for water decontamination.
T24 11769-11866 Epistemic_statement denotes This study investigates whether hand hygiene education reduces absenteeism among school children.
T25 12587-12721 Epistemic_statement denotes Morphology and Gram staining suggested common bacteria were isolated between sites, although formal identification was not undertaken.
T26 13233-13341 Epistemic_statement denotes The null hypothesis was not refuted but secondary goals were successful with older students keen to do more.
T27 13718-13834 Epistemic_statement denotes This leads to uncertainty around how to manage known carriers of CPE while in hospital and on subsequent admissions.
T28 14590-14753 Epistemic_statement denotes Of the 51 that had least three screens, 24 (47.1%) had a "+-+" pattern, suggesting that apparent spontaneous decolonisation reverted to a positive carriage status.
T29 14754-15107 Epistemic_statement denotes Several factors could explain an apparent reversion from a negative to a positive screen in known CPE carriers, including acquisition of a different CPE following genuine spontaneous decolonisation, natural fluctuation in the level of gastrointestinal colonisation perhaps prompted by antibiotic exposure, or a poorly collected microbiological specimen.
T30 15108-15492 Epistemic_statement denotes It is not possible for us to conclude which of these explains the observed apparent changes in carriage status, but the frequent reversion from an apparent negative carriage status to positive carriage status in known CPE carriers suggests that a negative CPE screen should not be interpreted as an indication of loss of colonisation in an individual who has previously been positive.
T31 15545-15732 Epistemic_statement denotes Safety-engineered devices (SED) became mandatory in UK healthcare facilities in May 2013; however, few publications are available as to the impact of the law on adoption of SED in the UK.
T32 15733-15869 Epistemic_statement denotes Monitoring of activation is recommended as non-use and incorrect activation of SED are a common cause of post-procedure sharps injuries.
T33 16736-16918 Epistemic_statement denotes It is disturbing that over 50% of HBN were discarded sharp, indicating that a high proportion of UK clinical staff are unnecessarily at risk of sharps injuries while handling sharps.
T34 17237-17351 Epistemic_statement denotes Flomoxef belongs to cephamycin antibiotics, which cannot be hydrolysed by extended-spectrum beta-lactamase (ESBL).
T35 17352-17435 Epistemic_statement denotes Hence, flomoxef can be used to treat infections caused by ESBL-producing organisms.
T36 17436-17579 Epistemic_statement denotes This study was conducted to evaluate whether the susceptibility rates of flomoxef against ESBLproducing organisms were decreasing year by year.
T37 17748-17865 Epistemic_statement denotes Screening of ESBL production was according to the recommendation of the Clinical and Laboratory Standards Institutes.
T38 18120-18339 Epistemic_statement denotes The interpretive criteria of flomoxef recommended by the manufacturer were as follows: zone size of susceptibility was ≥18 mm, that of intermediate resistance was between 13 and 17 mm, and that of resistance was ≤12 mm.
T39 18735-18872 Epistemic_statement denotes This study found that doripenem had the highest susceptibility rates against CRPA, indicating that doripenem did not readily select CRPA.
T40 18873-18979 Epistemic_statement denotes In contrast, imipenem had the lowest susceptibility rates, indicating that imipenem readily selected CRPA.
T41 18980-19019 Epistemic_statement denotes These findings echoed previous studies.
T42 19020-19211 Epistemic_statement denotes According to the results of this study, we suggest that doripenem should be regarded as the first choice when antipseudomonal carbapenems are used to treat infections caused by P. aeruginosa.
T43 19212-19405 Epistemic_statement denotes In addition, doripenem may be the optimal carbapenem for empiric treatment of hospital-acquired infections because P. aeruginosa should be considered as the likely pathogen in these infections.
T44 19597-19718 Epistemic_statement denotes Notably, A. flavus is the leading cause of invasive aspergillosis in tropical and sub-tropical countries, including Iran.
T45 21507-21798 Epistemic_statement denotes Current Australian antibiotic therapeutic guidelines recommend that symptomatic catheter-associated urinary tract infections (CAUTIs) should be treated by removing or changing catheters and treating CAUTIs based on results of cultures and susceptibility testing obtained from a new catheter.
T46 22032-22111 Epistemic_statement denotes Current treatment of UTI in SCI is not well standardised with limited evidence.
T47 22112-22259 Epistemic_statement denotes ProSCIUTTU was a randomised controlled trial investigating whether probiotics reduce UTIs in participants with neurogenic bladder secondary to SCI.
T48 22440-22589 Epistemic_statement denotes The aim was to see whether empirical antibiotic therapy suggested by the therapeutic guidelines for severe UTI applies to SCI persons with catheters.
T49 22949-23097 Epistemic_statement denotes However, if there is a history of prior colonisation or infection with Pseudomonas species, amoxy/ampicillin should be substituted with ceftazidime.
T50 23098-23297 Epistemic_statement denotes It is reassuring that, despite prolonged catheterisation and frequent hospitalisation in this cohort of participants, the prevalence of multi-resistant organisms was low in each category of organism.
T51 23439-23546 Epistemic_statement denotes UTIs are increasingly difficult to treat as the organisms that cause them become more antibiotic-resistant.
T52 23637-23907 Epistemic_statement denotes The main aim of this study is to determine whether probiotic therapy with combinations of Lactobacillus reuteri RC-14 + Lactobacillus GR-1 (RC14-GR1) and/or Lactobacillus rhamnosus GG + Bifidobacterium BB-12 (LGG-BB12) are effective in preventing UTI in people with SCI.
T53 25702-25875 Epistemic_statement denotes Further repeat evaluations should be utilised to ensure that this policy change is embedded in our Trust and continues to have a positive impact on patient outcome and care.
T54 25929-26017 Epistemic_statement denotes Like most developed countries, we take the water that comes out of our taps for granted.
T55 26253-26401 Epistemic_statement denotes Lapses in water safety can have devastating results, as the Pseudomonas aeruginosa outbreak in the Neo-natal Units in Northern Ireland demonstrated.
T56 26929-27143 Epistemic_statement denotes Measurements of compliance include regular water sampling, total viable counts (TVC), flushing logs, observations on our "water walk arounds" and a review of sink traps during augmented care environmental sampling.
T57 27420-27613 Epistemic_statement denotes Maintenance and improvement of the Water Safety Care Bundle depends on developing our relationship with South West Water and Pro-economy whilst encouraging clinical engagement within our Trust.
T58 29100-29431 Epistemic_statement denotes Evaluation suggests that compliance with the CPE Toolkit and the introduction of emergency and elective screening of patients who fit the criteria of admission to a hospital within 12 months, full multi-disciplinary team (MDT) outbreak meetings and the introduction of a HPV managed service has played a key part in this reduction.
T59 29432-29612 Epistemic_statement denotes UHSM will continue to identify methods of decontaminating areas we are currently unable to reach with HPV, and potentially look to implement new, faster technology for these areas.
T60 29883-30038 Epistemic_statement denotes It is found in a wide range of moist, nutrient-limited environments and may colonise hospital and domestic water taps, sinks, drains, toilets, and showers.
T61 30156-30458 Epistemic_statement denotes To reduce the risk of transmission we examined: the role of disposal of patient waste water; the installation of new tap outlets that are redesigned either to prevent contamination or enable decontamination; the cleaning of taps appropriately; and the frequency of water sampling to identify outbreaks.
T62 30861-31080 Epistemic_statement denotes New taps are to be installed on part of the unit; in addition to this a new three-cloth cleaning method has been implemented, as well as using gel sheets to solidify patient waste water being disposed of in a macerator.
T63 31480-31713 Epistemic_statement denotes Despite this, they are all known to be fast-acting antimicrobials with a broad spectrum of activity on planktonic micro-organisms, as well as clostridium spores, warranting their usage in the area of infection prevention and control.
T64 31833-31899 Epistemic_statement denotes However, the efficacy of superoxide waters on biofilms is lacking.
T65 31900-32144 Epistemic_statement denotes Consequently, the aim of this study was to investigate the efficacy of a new superoxide composition on in vitro mono-culture and polymicrobial biofilms, utilising a range of different biofilm models relevant to infection prevention and control.
T66 33253-33461 Epistemic_statement denotes Overall, this new superoxide water composition has demonstrated both a broad anti-microbial and anti-biofilm activity that would warrant its usage for applications in the prevention and treatment of biofilms.
T67 33462-33609 Epistemic_statement denotes Recent evidence has shown persistence of viable organisms in dry biofilms found in clinical settings even after terminal cleaning and disinfection.
T68 34451-34737 Epistemic_statement denotes Assessment of efficacy measured biomass reduction by crystal violet staining, biofilm recovery after 24 hours and beyond indicated by a pH indicator colour change in the growth medium and transfer of bacteria from surface to surface immediately and then 24 hours following intervention.
T69 34914-35123 Epistemic_statement denotes The complete removal/destruction of dry biofilms from surfaces appears not to be currently achievable using current disinfectants without damaging the surfaces, although disinfectant wipes were more effective.
T70 35248-35483 Epistemic_statement denotes The results highlight that while the aim of eliminating dry biofilm is not currently achievable, a realistic approach may still involve making surfaces safe by controlling biofilm regrowth and by preventing transfer of micro-organisms.
T71 35613-35743 Epistemic_statement denotes Whilst HPV has demonstrated efficacy against many healthcare pathogens, it remains crucial to consider environmental factors (i.e.
T72 35951-36068 Epistemic_statement denotes BIs require specialist facilities for growth, up to 7 days to confirm decontamination efficacy and can be unreliable.
T73 36069-36221 Epistemic_statement denotes In this study, the possibility of monitoring decontamination efficacy using a thermostable adenylate kinase (tAK) "enzyme indicator" (EI) was evaluated.
T74 36341-36459 Epistemic_statement denotes EIs could provide rapid reassurance on process efficacy for hospital infection control teams and HPV system providers.
T75 37424-37555 Epistemic_statement denotes Biofilms in wounds have been documented and are considered to delay wound healing and increase the wound's propensity to infection.
T76 37771-37958 Epistemic_statement denotes In addition to this, biofilms are also known to house Acanthamoeba spp, enabling them to act as potential reservoirs of opportunistic pathogens and increasing a wound's risk of infection.
T77 37959-38187 Epistemic_statement denotes The aim of this study was to evaluate the anti-microbial and anti-biofilm ability of a new patented broad spectrum anti-biofilm formulation designed to be used in central venous catheters, urinary catheters, skin and wound care.
T78 39466-39592 Epistemic_statement denotes Therefore, a contaminated stethoscope could conceivably confer a significant risk of healthcare-associated infections (HCAIs).
T79 39667-39748 Epistemic_statement denotes This study aims to assess current cleaning practices at four sites across the UK.
T80 39851-40044 Epistemic_statement denotes Both Likert-style and free-text questions were used to capture attitudes towards cleaning stethoscopes, current cleaning behaviours and potential suggestions to increasing stethoscope cleaning.
T81 40045-40205 Epistemic_statement denotes 92.5% of respondents felt it is clinically important to clean the stethoscope regularly and 76.9% felt that clean stethoscopes could reduce the number of HCAIs.
T82 40206-40260 Epistemic_statement denotes Reasons given against were that of a lack of evidence.
T83 40687-40887 Epistemic_statement denotes Despite a consensus among medical professionals about the importance of stethoscope cleaning, current stethoscope cleaning practices are inadequate and could therefore play a role in infection spread.
T84 41093-41257 Epistemic_statement denotes The study highlights that a better availability of antiseptic wipes in clinical areas may motivate healthcare providers to clean their stethoscopes more frequently.
T85 41258-41427 Epistemic_statement denotes Future studies could look at the distribution of antiseptic wipes in clinical areas and also the role of visual reminders such as posters in improving current practices.
T86 41480-41861 Epistemic_statement denotes Emergency Departments (EDs) are facing an unprecedented future: unannounced audits by Infection Prevention and Control Teams and the Healthcare Environmental Inspectorate; arduous waiting time targets set by the government and treatment of an increasing number of patients with ever more complex conditions and needs -all of which contribute to the extreme challenges within an ED.
T87 42932-43092 Epistemic_statement denotes In spite of ED trolleys being cleaned between patient use and as per local protocol, blood and body fluid contamination and substantial bacterial counts remain.
T88 43093-43235 Epistemic_statement denotes The number of HAIs which originate from an ED trolley is unknown; likewise, acceptable colony counts or organism species would be speculative.
T89 43236-43426 Epistemic_statement denotes Therefore, a more proactive, robust approach is required to decrease visual contamination and potentially pathogenic micro-organisms which may compromise the care and safety of our patients.
T90 43773-43930 Epistemic_statement denotes The Infection Prevention Team (IPT) explored ways of improving compliance and it was decided that a combined detergent/disinfectant wipe could be beneficial.
T91 44143-44328 Epistemic_statement denotes Collaborative working with IPT and Procurement enabled the exploration of a single-stage process for decontamination and the opportunity to standardise products across the organisation.
T92 46165-46300 Epistemic_statement denotes The HCUs have been located as far from the patient as possible, and surveillance for water-related organisms in SSIs has been enhanced.
T93 46638-46746 Epistemic_statement denotes We are looking at ways of capturing aerosols from the machines, and potentially moving HCUs out of theatres.
T94 46747-46867 Epistemic_statement denotes Air and water testing for fungi has commenced to evaluate a potential further risk of aerosolising fungi in the theatre.
T95 47383-47498 Epistemic_statement denotes Environmental contamination with CDI spores has been associated, in the literature, with its indirect transmission.
T96 47626-47818 Epistemic_statement denotes This study aims to determine whether the establishment of a structured educational programme based on repetitive teaching and cleaning monitoring could improve environmental cleaning practice.
T97 48877-48966 Epistemic_statement denotes An educational programme may result in improvement of hospital environmental cleanliness.
T98 48967-49098 Epistemic_statement denotes Such a programme should include efforts to control quality with continuous feedback to employees to effectively support the change.
T99 49100-49481 Epistemic_statement denotes This discussion of the evolving role of the Infection Prevention and Control (IPC) Champion takes place in the context of the ever-changing challenge of clinical staff providing support to IPC teams regarding communication and ownership of IPC within a Trust of over 6500 staff, providing mental health and learning disability services to patients across a large geographical area.
T100 50040-50210 Epistemic_statement denotes A contract between the champion, IPC team and ward manager has been developed which is linked to Knowledge Skills Framework and Infection Prevention Society competencies.
T101 50211-50322 Epistemic_statement denotes An Intranet page and specific email account has been established which facilitates communication and education.
T102 50636-50737 Epistemic_statement denotes Modern matrons support the role of champion and information is shared at the IPC Committee quarterly.
T103 51081-51192 Epistemic_statement denotes Introduction day for champions However, nationally, the rate of improvement for CDI has slowed in recent years.
T104 51193-51346 Epistemic_statement denotes A significant proportion of healthcare-acquired infections can be prevented by the adoption of evidence-based infection prevention and control standards.
T105 51347-51536 Epistemic_statement denotes Our acute Trust developed a bespoke Diarrhoea Assessment Management Pathway (DAMP record) to assist in the identification and management of the patient with potentially infective diarrhoea.
T106 51657-51778 Epistemic_statement denotes It is important for clinical staff to understand risk assessment, recognising infection potential in their patient group.
T107 51779-51975 Epistemic_statement denotes Comprehensive assessment is required to establish type and possible cause of diarrhoea, to isolate the patient at the earliest opportunity and submit a stool sample for testing, where appropriate.
T108 51976-52078 Epistemic_statement denotes The DAMP record should commence following the patient's first episode of Bristol Stool Chart type 5-7.
T109 53022-53121 Epistemic_statement denotes HCWs are at risk of occupational exposure, and can act as vectors in the transmission of the virus.
T110 53122-53201 Epistemic_statement denotes Despite the risks associated with influenza, uptake in HCWs remains suboptimal.
T111 53474-53618 Epistemic_statement denotes The aim was to explore potential methods of improving uptake amongst HCWs, based on some of the reasons given for non-acceptance of the vaccine.
T112 53964-54063 Epistemic_statement denotes Although influenza causes high numbers of deaths, vaccination rates amongst HCWs remain suboptimal.
T113 54519-54573 Epistemic_statement denotes Education campaigns need to be innovative and ongoing.
T114 54600-54746 Epistemic_statement denotes Paediatric critical care units (CCUs) are highly specialist areas managing complex patients at increased risk of healthcare-associated infections.
T115 55153-55339 Epistemic_statement denotes The questions were unambiguous and asked nurses to rate their personal IPC knowledge, self-assess their ability to implement IPC best practices and suggest ideas for future IPC training.
T116 55990-56099 Epistemic_statement denotes This will allow the IPC team to develop a more in-depth training programme to fit the needs of our CCU staff.
T117 56152-56420 Epistemic_statement denotes Developments in computer-generated visual imaging and mobile computing devices, combined with new research evidence on the behaviour of people and pathogens in hospitals, present opportunities for innovative training to prevent healthcare-associated infections (HAIs).
T118 57574-57713 Epistemic_statement denotes They offered staff a new perspective on pathogens, being able to "see" them contextualised in the virtual ward, making them seem more real.
T119 57804-57955 Epistemic_statement denotes They increased participants' awareness about pathogens by explaining "why" (through dynamic visuals and information) IPC procedures should be followed.
T120 57956-58083 Epistemic_statement denotes Further applications were suggested, including at clinical induction, education in schools/universities, and refresher courses.
T121 58470-58584 Epistemic_statement denotes The influenza vaccination has been shown to be effective at reducing the severity of illness and preventing death.
T122 59213-59461 Epistemic_statement denotes Education was provided prior to the campaign commencing, with all teams who had a poor uptake being invited to a presentation on influenza which included how it is spread, signs and symptoms, risk groups and examples of outbreaks in the local area.
T123 59881-60005 Epistemic_statement denotes The Trust has increased the uptake from 44% to 77% and has been the top mental health trust in England for the last 2 years.
T124 60006-60188 Epistemic_statement denotes Future steps should involve the further development of the educational element prior to commencing vaccinating staff members, in particular targeting areas with lower uptake figures.
T125 61037-61129 Epistemic_statement denotes However, 49 facilities (66.2%) changed and/or increased the use after seminar participation.
T126 61640-61786 Epistemic_statement denotes Although most dental facilities in Japan already comply with PPE, improvements were observed after participating in the infection control seminar.
T127 61787-61884 Epistemic_statement denotes It was suggested that the seminar served as an effective learning opportunity for proper PPE use.
T128 61885-62040 Epistemic_statement denotes We will continue to promote not only the necessity of PPE but also its correct use, which may contribute to improving infection control in dental settings.
T129 63859-64025 Epistemic_statement denotes The percentage of nursing schools that performed the vaccination programme was fairly high; however, the percentages for other healthcare-related facilities were low.
T130 64227-64412 Epistemic_statement denotes Despite an isolation guideline outlining PPE use, there appears to be confusion from medical and nursing teams around what PPE to wear for certain infectious pathogens and for how long.
T131 64413-64490 Epistemic_statement denotes Research from across the globe indicates this confusion is not a local issue.
T132 64591-64699 Epistemic_statement denotes It was decided a visual tool should be created, that could be used as reference, but also a learning method.
T133 64860-64917 Epistemic_statement denotes Each section is broken down into what PPE should be worn.
T134 65421-65523 Epistemic_statement denotes Staff felt the tool was potentially useful, and multiple requests for the finished tool were received.
T135 65801-65910 Epistemic_statement denotes Provision of infection prevention and control (IPC) training for domiciliary care workers can be challenging.
T136 65911-66040 Epistemic_statement denotes This group of staff are mobile workers with little or no access to electronic training or IPC resources during their working day.
T137 67101-67201 Epistemic_statement denotes Staff should keep the workbook as evidence of learning and a reference guide for day-to-day working.
T138 67277-67304 Epistemic_statement denotes Positive feedback includes:
T139 67305-67393 Epistemic_statement denotes "The workbook is a brilliant resource and staff are lucky you are there to support them.
T140 67394-67504 Epistemic_statement denotes Completion of the workbook would be an ideal way for Domiciliary Care agencies to demonstrate staff training".
T141 67591-67705 Epistemic_statement denotes Future steps should include raising awareness of the workbook with key stakeholders in public and private sectors.
T142 67915-68078 Epistemic_statement denotes Dressings coated with highly hydrophilic Dialkylcarbamoylchloride (DACC) irreversibly bind multiple types of bacteria and should prevent their ingress into wounds.
T143 68079-68196 Epistemic_statement denotes We aimed to determine if the use of coated postoperative dressings could reduce SSIs in non-implant vascular surgery.
T144 69207-69331 Epistemic_statement denotes DACC-coated dressings appear to have value in SSI prophylaxis in this patient group and would warrant further investigation.
T145 69384-69528 Epistemic_statement denotes Nosocomial infection is becoming a leading problem for medical practitioners nowadays, placing an extra burden on individual patients worldwide.
T146 69705-69829 Epistemic_statement denotes The aim of this study was to determine the aetiology of nosocomial pneumonia caused by MDR Gram-negative bacterial isolates.
T147 70896-71045 Epistemic_statement denotes In 2010 the Advisory Committee on Antimicrobial Resistance and Healthcare-Associated Infection recommended that CS SSI surveillance become mandatory.
T148 72286-72507 Epistemic_statement denotes While this involves increased effort initially, collaborative working between surgical, midwifery, and infection prevention and control teams can help the programme become embedded within the department to sustain change.
T149 72792-72898 Epistemic_statement denotes Environmental contamination with enterococci can occur and become a source of infection to other patients.
T150 73056-73174 Epistemic_statement denotes In the last 3 years there has been an unexplained increase in beta-lactam and glycopeptide resistance in our hospital.
T151 74327-74423 Epistemic_statement denotes A risk-based screening process may be required locally to limit further spread of this organism.
T152 74623-74810 Epistemic_statement denotes This initiative aimed to better understand the cause of the SAB, to determine the potential avoidance and to intervene to minimise the risk of a SAB occurring due to the same cause again.
T153 74922-75140 Epistemic_statement denotes Focusing on risk and contributory factors, the group aimed to determine if SABs were avoidable or non-avoidable and engaged with the attributed clinical areas in order to identify any quality improvement opportunities.
T154 75542-75652 Epistemic_statement denotes Assessments were made regarding medical history device placement, and whether the patient had any prosthetics.
T155 76425-76614 Epistemic_statement denotes This poster will demonstrate the reduction of surgical site infection (SSI) 3 years after the introduction of a dedicated SSI Surveillance Team (SSIST) into a large acute NHS Trust in 2012.
T156 76615-76765 Epistemic_statement denotes The NHS performed 9.920 million surgical procedures in 2014/2015 (most recent HES data), many posing a risk of SSI which remains largely unquantified.
T157 76766-76907 Epistemic_statement denotes Published evidence is that SSI accounts for 16% of all healthcare-associated infection and remains a significant clinical and costly control.
T158 77505-77619 Epistemic_statement denotes Risk factors are collected; however, these are reported on in response to specific enquiries or variances in data.
T159 78223-78288 Epistemic_statement denotes The benefits should be discussed in the context of the wider NHS.
T160 78481-78651 Epistemic_statement denotes A root cause analysis (RCA) investigation was carried out for each case, including a review with the commissioners to assess whether there have been any "lapses in care".
T161 79016-79061 Epistemic_statement denotes Missed opportunity/delay to sample sending 3.
T162 79959-80060 Epistemic_statement denotes However, the rate of data submission to JANIS is quite high (>95%) and the dropout rate is low (<3%).
T163 80938-81157 Epistemic_statement denotes There was no association between hospital size (bed count) and whether the surveillance involved multiple professions or not (SSI division, 397 beds vs. 299 beds, p=0.57; ARBI division, 380 beds vs. 468.5 beds, p=0.84).
T164 81454-81582 Epistemic_statement denotes This interdisciplinary approach to surveillance may help improve infection control practices in all professions and departments.
T165 81883-82049 Epistemic_statement denotes C. difficile is the major cause of infective hospital-acquired diarrhoea in the UK, and has been associated with more than 16,000 cases per year in England and Wales.
T166 82270-82456 Epistemic_statement denotes Colonisation can occur in one of three ways: contact with a healthcare worker; contact with a contaminated environment and from direct contact with a patient with C. difficile infection.
T167 82457-82613 Epistemic_statement denotes The aim of this work is not to look at the treatment of C. difficile infection, but to explain the measures used to prevent colonisation in the first place.
T168 82863-82984 Epistemic_statement denotes For each intervention, PDSA cycles have been used to evaluate and then disseminate interventions across the organisation.
T169 83147-83288 Epistemic_statement denotes This has been identified by the Trust Improvement agency as exemplary and our approach is discussed to provide ideas for other organisations.
T170 84486-84606 Epistemic_statement denotes Our findings suggest that PVI 10% and CHG 2% products in alcohol are equally efficacious and safe in this patient group.
T171 84607-84700 Epistemic_statement denotes This work can provide assurance to commissioners of the best available evidence for practice.
T172 85127-85349 Epistemic_statement denotes Following improvements in critical care, it was agreed that the principles should be adopted across the whole hospital, ensuring that all patients with central venous access devices (CVAD) received safe and effective care.
T173 85658-85788 Epistemic_statement denotes Potential CRBSI were identified by the microbiologists (numerator) and a process to collect the number of line days (denominator).
T174 86316-86515 Epistemic_statement denotes We are able to monitor the rate of CRBSI for each department with patients with CVAD and we can accurately assess problems and spot trends at an early stage to implement effective change as required.
T175 86708-86800 Epistemic_statement denotes Building works danger on the ward: Works can release high numbers of concentrated organisms!
T176 86801-87079 Epistemic_statement denotes To keep the buildings in good physical condition means hospital renovation, and it has been proven that hospital-acquired infections occur in higher numbers when hospital renovations are taking place (Pini et al, 2007) ; this includes major and minor works (Chang et al, 2008) .
T177 87080-87307 Epistemic_statement denotes Ross et al (2011) state that renovation should be delayed until patients have been moved to an alternative setting; however, this is not always possible and many works are necessary and must be done whilst patients are in situ.
T178 87308-87502 Epistemic_statement denotes When emergency renovation is required then the patients may not be able to be moved, but Ross et al (2011) go on to discuss that measures can be put in place to minimise the risk to the patient.
T179 87503-87672 Epistemic_statement denotes The Trust's "Better Care Together" strategy states that changes will have to be made to existing facilities to ensure they are appropriate for 21 st century health care.
T180 88401-88527 Epistemic_statement denotes We will continue to work with all staff that work within the hospital to ensure a clean and safe environment for our patients.
T181 88638-88773 Epistemic_statement denotes Alteration in the balance of normal vaginal flora can lead to the overgrowth of other organisms that causes abnormal vaginal discharge.
T182 90087-90318 Epistemic_statement denotes Although the syndromic approach for treatment of vaginal discharge is being followed, this study clearly depicted around 43% of those presenting with vaginal discharge had normal vaginal flora and were not in need of any treatment.
T183 90319-90603 Epistemic_statement denotes Therefore, even if simple microbiological tests are employed in the final diagnosis of vaginal discharge, this would avoid unnecessary treatment and thus avoid the economical, social and psychological burden to the women in question, and also will avoid unnecessary exposure to drugs.
T184 91428-91557 Epistemic_statement denotes A comprehensive programme of stakeholder engagement was developed with the aim of using the information obtained to drive change.
T185 92060-92204 Epistemic_statement denotes Contextual data indicated considerable scope to improve both antibiotic stewardship and compliance with audits relevant to infection prevention.
T186 92205-92390 Epistemic_statement denotes Visualisation of broad but relevant data using interactive analytical software has the potential to support the application of research findings to clinical and wider hospital practice.
T187 92391-92478 Epistemic_statement denotes The process of stakeholder engagement to drive action in these areas will be discussed.
T188 92724-92840 Epistemic_statement denotes However, there is a lack of evidence of the effectiveness of daily CHG bathing among patients after cardiac surgery.
T189 94018-94208 Epistemic_statement denotes There was no statistically significant difference on SSI rates between the two groups; however, the incidence rate of the CHG group was decreased compared with the rate of the non-CHG group.
T190 96299-96379 Epistemic_statement denotes Although CAUTI has been well investigated, there are a lack of studies about CO.
T191 97466-97739 Epistemic_statement denotes Although small sample size and non-equal numbers of both groups were the main limitations of this study, the type of FC could be a possible risk factor for CO. From the results of this study, CO happened more than CAUTI among inpatients with an indwelling urinary catheter.
T192 97740-97924 Epistemic_statement denotes In addition, female gender is a risk factor for CO. Administration of antibiotics during indwelling FC showed a preventive effect on CO; however, this issue should be examined further.
T193 100961-101144 Epistemic_statement denotes Given the preparation, characterisation and efficiency of a modified urinary catheter to prevent CAUTIs, the present data suggest great promise to avert nosocomial biofilm infections.
T194 102919-103012 Epistemic_statement denotes Identifying patients colonised with CPE is vital for preventing "silent transmission" of CPE.
T195 103503-103659 Epistemic_statement denotes Cases of congenital rubella syndrome (CRS) have also fallen significantly, and whilst now rare, three cases have been reported in the UK since January 2014.
T196 104379-104571 Epistemic_statement denotes Infants with CRS can continue to excrete virus for more than a year, and therefore a weekly oral fluid sample was arranged to monitor duration of virus excretion as a marker of infectiousness.
T197 105075-105238 Epistemic_statement denotes This further highlights the importance of asking about history of rash in pregnancy and considering rubella as a possible cause of intrauterine growth restriction.
T198 105634-105699 Epistemic_statement denotes This would release more time for other patient safety activities.
T199 105700-105850 Epistemic_statement denotes Organisations could take advantage of the "Safer hospitals safer wards technology fund" launched in May 2013 to introduce similar suitable IT systems.
T200 106462-106867 Epistemic_statement denotes The expansion could not have been achieved without an efficient IT data management system that eased the burden of data collection and gave us the following benefits: We have reduced the number of non-communicating password-secured IT applications we used for our surveillance from six to two and released time for effective caesarean section post-discharge surveillance and for raising awareness on SSIS.
T201 107389-107482 Epistemic_statement denotes We explore whether increases in CPE screening resulted in the detection of further outbreaks.
T202 108778-108910 Epistemic_statement denotes We believe that enhanced screening for CPE has resulted in the detection of CPE outbreaks that would otherwise have gone undetected.
T203 108911-109059 Epistemic_statement denotes Controlling these outbreaks has led to several challenges, including compliance with admission screening, staff education, and limited single rooms.
T204 109624-109767 Epistemic_statement denotes Cefoxitin (4 μg/ml) added Mueller Hinton Agar media and usual phenotypical tests were used to differentiate MRSA from other possible pathogens.
T205 110025-110185 Epistemic_statement denotes The high rate of MRSA carriage among nurses in North Cyprus should be urgently taken into account, as nurses are the most important route for MRSA transmission.
T206 110290-110408 Epistemic_statement denotes Nurses who stated that they have information about this problem were found to be carriers with a rate of 64% (p=0.43).
T207 110663-110816 Epistemic_statement denotes Ongoing education in MRSA prevention should be provided to nurses, including an evaluation of sufficient knowledge and skills, to come to a better point.
T208 111088-111308 Epistemic_statement denotes A survey was conducted which included questions on the demographic data of IPC professionals, service provision, special interests, IPC activity, CPD opportunities and challenges faced by IPC professionals in the region.
T209 111623-111720 Epistemic_statement denotes Secondary care seems to have more structure and different skill mixes compared with primary care.
T210 112424-112501 Epistemic_statement denotes Priorities must be given to exploring possible solutions to these challenges.
T211 112502-112730 Epistemic_statement denotes There is now a better understanding of the IPC workforce for Trent, which is crucial for supporting fellow IPC colleagues, understanding professional development requirements and developing proactive and innovative project work.
T212 113049-113196 Epistemic_statement denotes As an alternative to bladder catheterisation, it has been shown to significantly reduce urinary tract infection (UTI) and increase patient comfort.
T213 113197-113296 Epistemic_statement denotes However, despite being available for over two decades, its adoption has been slow and inconsistent.
T214 114088-114294 Epistemic_statement denotes The set-up and running costs of a scanner were estimated to be met within 6 to 24 months, depending on usage, after which significant ongoing cost efficiencies would be realised over its 8-10-year lifespan.
T215 114876-115013 Epistemic_statement denotes Commissioning for Quality and Innovation (CQINN) project: Reducing catheter-associated urinary tract infections, can change be sustained?
T216 115194-115337 Epistemic_statement denotes The IP&C team completed a baseline audit in March 2013 to assess urinary catheter usage, management and associated infections within the trust.
T217 115830-116040 Epistemic_statement denotes Key findings: In addition to this, since August 2014 there had been a sustained decrease in the number of hospital-acquired CAUTIs reported via the Trust's "Safety Thermometer" data and this has been sustained.
T218 116041-116313 Epistemic_statement denotes The project has seen a significant decrease in harm to patients, reducing length of stay for this patient group, improved patient flow within the organisation, and equating to potential cost savings of approximately £38,578 for CRHFT in line with evidenced-based research.
T219 116366-116405 Epistemic_statement denotes Cambridgeshire and Peterborough CCG, UK
T220 116406-116511 Epistemic_statement denotes Clostridium difficile can be limited through combinations of good practice and adherence to key policies.
T221 118329-118479 Epistemic_statement denotes A baseline point prevalence audit was completed in March 2013 to assess urinary catheter usage, management and associated infections within the trust.
T222 119462-119725 Epistemic_statement denotes As infection and prevention nurses, we wanted to investigate how to prevent transmission of CDI in the patient areas to prevent further harm to others from asymptomatic carriers, cross-infection, contamination from fomites, staff hands and the equipment they use.
T223 119855-119963 Epistemic_statement denotes The forum, Patient and Public Involvement, aimed to explain the study and how the survey would be conducted.
T224 119964-120069 Epistemic_statement denotes The proposed survey was taken forward to the Ethics Committee for approval, who agreed it could go ahead.
T225 120917-120991 Epistemic_statement denotes It was predicted that the rate of colonisation would be approximately 20%.
T226 121023-121282 Epistemic_statement denotes Isolating identified asymptomatic carriers of as C. difficile potentially confines and prevents further contamination of the environment, and staff employing extra precautions concerned with source isolation protects other vulnerable patients in the vicinity.
T227 121326-121400 Epistemic_statement denotes In reality it can be the perfect medium in which micro-organisms can grow.
T228 121401-121518 Epistemic_statement denotes Legionella, Pseudomonas Aeruginosa and Mycobacteria have all been associated with hospital outbreaks linked to water.
T229 122479-122608 Epistemic_statement denotes A snap shot of actual clinical practice is gained and all parties can raise concerns directly to those who can facilitate action.
T230 123425-123540 Epistemic_statement denotes The two assessment units -male and female -were identified as areas that would benefit from the training programme.
T231 123541-123648 Epistemic_statement denotes The assessment units are very busy clinical areas that can have up to 60 admissions and discharges per day.
T232 123649-123837 Epistemic_statement denotes The aim of the training programme was to increase visibility of the Infection Control Team, to improve infection control practice and identify any learning needs that the areas might need.
T233 123991-124055 Epistemic_statement denotes To clean a discharge bed area thoroughly should take 20 minutes.
T234 124056-124274 Epistemic_statement denotes With the discharges and transfers to other ward areas, it was calculated that up to 6 hours a day could be spent on cleaning discharge bed areas; sometimes, due to pressures on nursing staff, this did not always occur.
T235 125376-125565 Epistemic_statement denotes Diarrhoea Assessment Tools were not being utilised correctly; therefore, the infection prevention and control nurses (IPCNs) attended the areas and taught the nursing staff how to use them.
T236 125566-125756 Epistemic_statement denotes Being visible on the Units allowed the IPCNs to answer any queries that the staff may have had, and also ensured that patients had the correct isolation precautions and isolation stop signs.
T237 125757-125911 Epistemic_statement denotes The aim of the poster was to summarise the enhanced observation project the IPCNs had undertaken and hopefully roll out the project to other wards/ areas.
T238 126143-126332 Epistemic_statement denotes This has proved particularly challenging for nurses when English is not their first language as the lecture is delivered rapidly and provides little or no time for questions and discussion.
T239 126664-126761 Epistemic_statement denotes This suggested that a practical method of education was required to overcome the language issues.
T240 127556-127631 Epistemic_statement denotes Audit will continue to determine whether the improvement will be sustained.
T241 127778-127858 Epistemic_statement denotes It will be considered whether any other cohorts will benefit from this approach.
T242 128001-128032 Epistemic_statement denotes How could we get back on track?
T243 128285-128401 Epistemic_statement denotes We rewarded areas for the number of C. difficile-"free" days rather than focusing on "how many" infections they had.
T244 129171-129260 Epistemic_statement denotes We took pictures and sent them out to show involvement in making the trajectory possible.
T245 129424-129512 Epistemic_statement denotes We came in on trajectory: at 6 months, if we hadn't changed, we would have been 10 over.
T246 129513-129651 Epistemic_statement denotes Continuing the "Best Practice Express" theme, using the same methodology, we will add topic-specific carriages to the train, each quarter.
T247 130214-130390 Epistemic_statement denotes These differences can result in under or over-dosing of the aminoglycosides (kanamycin/ KM) and polypeptides (capreomycin/CM), which may affect efficacy, or result in toxicity.
T248 130391-130588 Epistemic_statement denotes To achieve this ideal concentration, pharmacokinetics and pharmacodynamics of KM/CM could be considered in reducing toxic effects, (ototoxicity and nephrotoxicity) and improving treatment outcomes.
T249 130589-130745 Epistemic_statement denotes Thus, the aim of this study was to investigate the pharmacokinetics and pharmacodynamics of KM/ CM in patients with DR-TB and the relationship with hearing.
T250 130870-131120 Epistemic_statement denotes The protocol reached saturation of data after enrolment of 20 participants, while undergoing audiological and pharmacological assessments at baseline and every 2 weeks for the first 3 months of treatment where possible, with 71 study visits in total.
T251 131454-131595 Epistemic_statement denotes The Scottish Patient Safety Programme developed a CAUTI care bundle to tackle the problem of CAUTI and assist with its reduction in Scotland.
T252 131596-131759 Epistemic_statement denotes As a recent innovation in patient safety, there is much we can learn from the implementation, embedding and normalising of CAUTI care bundles in everyday practice.
T253 132109-132383 Epistemic_statement denotes Framework analysis methods were applied to explore how clinical leaders make sense of the work of implementing the CAUTI care bundle (coherence); how they engage with it (cognitive participation); enact it (collective action) and appraise its effects (reflexive monitoring).
T254 132647-132738 Epistemic_statement denotes A common challenge to implementation has been lack of consensus on the definition of CAUTI.
T255 134000-134149 Epistemic_statement denotes At this meeting, each patient with a urinary catheter was discussed with the aim of reviewing the clinical indication and facilitating early removal.
T256 134804-134991 Epistemic_statement denotes However, this data provides some assurance that the review of urinary catheters at MDT meetings can facilitate a reduction in the number of catheters in situ and increase staff awareness.
T257 134992-135070 Epistemic_statement denotes It is recommended that this initiative be implemented across the organisation.
T258 137297-137414 Epistemic_statement denotes Therefore, we commenced an improvement plan with the view to ensure, and decrease lapses in, care in relation to CDI.
T259 138727-138994 Epistemic_statement denotes The aim of the visits was to support care providers with key infection prevention and control information, thus promoting safe and effective care: the opportunity for staff to receive IPC training during the visit and promoting the aseptic non touch technique (ANTT).
T260 139759-139911 Epistemic_statement denotes The current methodology of auditing utilising the national Patient-Led Assessment of Care Environment (PLACE) process was not highlighting any concerns.
T261 140936-141109 Epistemic_statement denotes This poster will demonstrate an effective method for sustained environmental controls addressing areas of modern healthcare environment not addressed through national tools.
T262 142524-142626 Epistemic_statement denotes A future area of role development will be supporting the Trust's surgical site surveillance programme.
T263 142834-142999 Epistemic_statement denotes There was an unknown prevalence of CPE but considered low risk based on clinical isolates and no reported incidents of CPE within the region prior to implementation.
T264 144313-144500 Epistemic_statement denotes We propose a combined approach to screening with primary care services, which could address the issue with incomplete screens and offer cost savings, which warrants further consideration.
T265 145088-145194 Epistemic_statement denotes We designed a sepsis recognition tool for nurse triage to determine whether a child is potentially septic.
T266 145195-145331 Epistemic_statement denotes The tool triggers for an immediate senior doctor review and that doctor review determines whether the child requires sepsis 6 treatment.
T267 146476-146715 Epistemic_statement denotes The Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance requires that "registered providers must audit compliance against key policies and procedures for infection prevention".
T268 146716-146792 Epistemic_statement denotes Effective audit of compliance is only possible if documentation is complete.
T269 147773-147863 Epistemic_statement denotes Kirsty Ferguson 1 , Pamela Joannidis 2 , Infection Prevention & Control Team Audit Group 1
T270 147864-148041 Epistemic_statement denotes Healthcare Improvement Scotland (HIS) believes that every person in Scotland should receive the best health care possible every time they come into contact with health services.
T271 148228-148463 Epistemic_statement denotes This, along with recommendation for an annual audit of infection prevention and control (IPC) policy and the implementation of transmission-based precautions (TBPs), led to development of a new tool in infection prevention and control.
T272 148464-148596 Epistemic_statement denotes During 2015 the Infection Prevention and Control Team (IPCT) reviewed existing audit tools to determine gaps as well as duplication.
T273 149033-149176 Epistemic_statement denotes The senior charge nurse (SCN) is sent an automated email, and by accessing the dashboard can view audit data including scores and action plans.
T274 149177-149285 Epistemic_statement denotes The audit dashboard can provide SCNs with data for their area and service leads with data for areas grouped.
T275 150361-150440 Epistemic_statement denotes Staff knowledge of CPE was very limited prior to implementation of the toolkit.
T276 150775-150876 Epistemic_statement denotes Also, a question to identify high-risk cases was added to the current adult risk assessment document.
T277 151303-151456 Epistemic_statement denotes All cases requiring screening had at least one sample submitted; however, only 11.1% had all of the required screening samples in accordance with policy.
T278 151548-151693 Epistemic_statement denotes Continued education to raise CPE awareness and policy across all departments is required; we aim to re-audit compliance with policy in 12 months.
T279 152370-152478 Epistemic_statement denotes For areas of noncompliance, the team made recommendations and assisted with the development of action plans.
T280 152598-152669 Epistemic_statement denotes The aggregated data identified key themes of non-compliance, including:
T281 152670-152964 Epistemic_statement denotes Environmental -challenging environmental conditions, non-compliant taps and hand-washing sinks, tiled splash back with grouted joints, storage of cleaning equipment, storage of vaccines in containers that were not webbed like baskets, and sharps containers not assembled and labelled correctly.
T282 153296-153421 Epistemic_statement denotes The IPC team has produced a newsletter to inform other GPs and GDPs of these themes and guidance to how they may be resolved.
T283 153422-153528 Epistemic_statement denotes The aggregated data provides an opportunity for shared learning across other primary healthcare providers.
T284 153581-153651 Epistemic_statement denotes Konstantinos Tsattalios, Colin Macduff, Sarah Henderson, Richard Laing
T285 153652-153680 Epistemic_statement denotes The Robert Gordon University
T286 153681-153831 Epistemic_statement denotes Healthcare-associated infections (HAIs) remain an important public health problem across the globe, affecting patients, healthcare staff and visitors.
T287 153997-154240 Epistemic_statement denotes However, despite the plethora of these interventions, only a few are structured based on theoretical underpinnings and even fewer authors explicitly describe how the design and development of the intervention is informed by the adopted theory.
T288 154241-154406 Epistemic_statement denotes Yet, no systematic approach has been undertaken for providing clarity as to the importance of theory when conceptualising an intervention within the medical context.
T289 154578-154735 Epistemic_statement denotes More specifically, this systematic approach will answer what and how theory can be embedded and implemented at the design and development stage against HAIs.
T290 154736-154840 Epistemic_statement denotes All levels of evidence will be reviewed as potentially relevant sources of knowledge, from Level I (e.g.
T291 155098-155195 Epistemic_statement denotes Upon its completion, the findings will be disseminated in a health-related peer-reviewed journal.
T292 155361-155702 Epistemic_statement denotes The final findings not only will summarise theories implemented within interventions but, more importantly, they will form a useful and practical guide for future research in this field, aiding scientists to decide what theory is more appropriate for their own study and how this can be achieved when developing an intervention against HAIs.
T293 155704-155834 Epistemic_statement denotes Dehydration is an increasing problem among older people, with frail, dependent nursing home residents being especially vulnerable.
T294 156049-156230 Epistemic_statement denotes Factors which may lead to inadequate hydration of residents include poor staffing levels, lack of supervision and knowledge, and limited appreciation of the importance of hydration.
T295 156368-156572 Epistemic_statement denotes Process maps and action effect diagrams were developed through observation and input from care home staff and residents/relatives to describe current systems and identify contributory factors and actions.
T296 157471-157628 Epistemic_statement denotes Small changes to practice in care homes have the potential to ensure sustainable long-term service improvement and reduced morbidity and hospital admissions.
T297 157759-157811 Epistemic_statement denotes Learning could be applicable to acute care settings.
T298 157888-157923 Epistemic_statement denotes That is the question Jane Tideswell
T299 157924-157998 Epistemic_statement denotes There are two techniques universally associated with wound swab procedure.
T300 158320-158451 Epistemic_statement denotes Definitive guidelines for this supposedly relatively simple procedure have yet to be established, hence my interest in the subject.
T301 158452-158569 Epistemic_statement denotes IPC standard precautions, to include hand washing, must be applied at all times before and during the swab procedure.
T302 158570-158685 Epistemic_statement denotes In the case of acute wounds which are suspected of being infected, the 10 point, Z-Track method should be executed.
T303 158686-158935 Epistemic_statement denotes In the case of chronic wounds, where Biofilm formation may be present, it is argued that the Levine method of wound swabbing be implemented as it is crucial to apply gentle, downward pressure to release fluid from the deeper layers of the wound bed.
T304 158936-159028 Epistemic_statement denotes Care should be taken to ensure that the swab only comes into contact with the wound surface.
T305 159127-159266 Epistemic_statement denotes Research suggests that in the instances of moist wounds, a wound swab may be used without pre-moistening the cotton tip with normal saline.
T306 159267-159485 Epistemic_statement denotes Conversely, in the case of drier wounds, research suggests that swabs should always be pre-moistened with normal saline prior to collection to increase the chances recovering micro-organisms from the site of the wound.
T307 159486-159528 Epistemic_statement denotes However, much debate surrounds this issue.
T308 159529-159782 Epistemic_statement denotes Necrotic tissue, slough or any other contaminated material should be removed from the wound bed before a representative wound swab sample is taken, as failure to do so may confound the microbiology results and lead to inappropriate antibiotic treatment.
T309 159974-160164 Epistemic_statement denotes Research suggests that there needs to be standardisation around how swabs should be taken, to include the correct labelling and transportation of the specimen to the microbiology laboratory.
T310 160165-160454 Epistemic_statement denotes It is important to ensure that the patient's name, date of birth, specimen source, ongoing treatment, underlying co-morbidities as well as the time that the culture was taken be appropriately noted on the biohazard envelope, and to ensure that it is sent to lab within 4 hours if possible.
T311 160455-160670 Epistemic_statement denotes There is limited substantial quantitative data available for me to include in my abstract, as research studies into wound swabbing are limited and have generally been done using a small-scale sample of participants.
T312 160671-160811 Epistemic_statement denotes Interestingly, numerous studies demonstrate that wound swabbing is historically grounded in ritualistic rather than evidence-based practice.
T313 160812-160917 Epistemic_statement denotes Wound swabbing may appear to be a relatively simple procedure, but it is a subject for future discussion.
T314 161771-161871 Epistemic_statement denotes For this medically vulnerable group the loss of effective antibiotics would have dire ramifications.
T315 161872-162115 Epistemic_statement denotes A cancer hospital can be the setting for the perfect storm, with a collection of vulnerable patients, many from overseas, coupled with aggressive treatments which can cause unpleasant side effects such as leucopoenia, mucositis, and diarrhoea.
T316 162667-162904 Epistemic_statement denotes The poster will equip the reader with an overview and understanding of some of the complexities of preventing infection in cancer patients, promote discussion, and provide ideas for future strategies to help in the battle against cancer.
T317 162966-163056 Epistemic_statement denotes It has been predicted that resistant infections will kill more people than cancer by 2050.
T318 163287-163622 Epistemic_statement denotes The World Health Organization's (WHO) guidance on the Core Components for Infection Prevention and Control (IPC) programmes is being revised with a view to basing this guidance on the best available evidence in order to support the prevention of healthcare-associated infections (HAI) and the global burden of antimicrobial resistance.
T319 164797-164907 Epistemic_statement denotes Individual studies demonstrated effectiveness; however, only three (of the 26) studies had a low risk of bias.
T320 165037-165280 Epistemic_statement denotes The range of interventions and outcomes measured limited synthesis of the findings, but strong policylevel recommendations can be made under the guidance of the WHO secretariat and expert group, as well as an outline of existing research gaps.
T321 165686-165856 Epistemic_statement denotes Despite the move to the new building being meticulously planned and the infection prevention and control team being involved, there have been many challenges to overcome.
T322 166577-166674 Epistemic_statement denotes Being the first site in the UK to introduce equipment or products can create additional problems.
T323 166675-166732 Epistemic_statement denotes You can never have too much storage in wards/departments.
T324 166847-166909 Epistemic_statement denotes The new building with more cubicles can make staff complacent.
T325 166910-167060 Epistemic_statement denotes A new hospital building may be easier to clean and to isolate patients, but commissioning and essential commodities must be available before the move.
T326 167587-167727 Epistemic_statement denotes Themes were associated with the environment and equipment, knowledge and communication, and concerns about how unintended breaches occurred.
T327 167728-168007 Epistemic_statement denotes Two issues identified that appear unique to this unit are a lack of space causing unintended breaches of contact precautions by allowing the staff to multi-task, and delayed removal of signage resulting in some neonates remaining on contact precautions for longer than necessary.
T328 168164-168305 Epistemic_statement denotes Staff suggested changes to their unit that could improve compliance, for example standardisation of cot space, improved signage and training.
T329 168306-168482 Epistemic_statement denotes This research study has identified findings that appear unique to this unit and others which are more common to healthcare staff carrying out contact precautions in other NNUs.
T330 168763-168873 Epistemic_statement denotes The search was limited to sources available in the English language and published between the years 1980-2015.
T331 169353-169496 Epistemic_statement denotes Handrubbing with 3 ml of ABHR for at least 30 seconds using the six-step technique appears to yield the best results in antimicrobial efficacy.
T332 169497-169616 Epistemic_statement denotes An interesting finding was that certain areas on hands might be more important than others during hand decontamination.
T333 169617-169759 Epistemic_statement denotes This review identified factors influencing the effectiveness of the handrubbing procedure which should be standardised for healthcare workers.
T334 169760-170005 Epistemic_statement denotes The importance of covering all surfaces of the hands on the efficacy of handrubbing remains uncertain; thus, further research is required to investigate the contribution of each of the six steps to the effectiveness of the handrubbing procedure.
T335 170007-170217 Epistemic_statement denotes Bacterial transmission in an operating room from patient to equipment and healthcare providers' hands and even to the next patient in the operating room has been associated with healthcare-associated infection.
T336 170218-170338 Epistemic_statement denotes Hand hygiene will interrupt transmission of microbes between patients, healthcare workers and the inanimate environment.
T337 170757-170963 Epistemic_statement denotes Compliance with hand hygiene guidelines has been demonstrated to be an effective method of reducing HCAI; however, it remains suboptimal and poorer amongst physicians compared with other healthcare workers.
T338 170964-171219 Epistemic_statement denotes The aim of this study is to determine the relationship between a multimodal quality improvement intervention, incorporating observational hand hygiene auditing with individualised feedback to physicians, and the incidence of surgical site infection (SSI).
T339 171309-171429 Epistemic_statement denotes The aim was to test the hypothesis that the multimodal intervention would lead to at least a 1% drop (to 0.44%) in SSIs.
T340 172708-172849 Epistemic_statement denotes Reasons for poor hand hygiene compliance among healthcare workers in sub-Saharan countries Yetunde Ataiyero, Dr Judith Dyson, Dr Moira Graham
T341 172850-173201 Epistemic_statement denotes The prevalence of healthcare-associated infections (HCAI) in developing countries, especially sub-Saharan African (SSA) countries, has been underreported, and whilst the actual magnitude remains unknown due to deficient surveillance studies and lack of reliable data, estimates suggest this to be 2-20 times more prevalent than in developed countries.
T342 173423-173603 Epistemic_statement denotes Conscientious hand hygiene practice is the simplest, most accessible, affordable and effective preventive method, although compliance with hand hygiene guidelines remains very low.
T343 173604-173781 Epistemic_statement denotes In developed countries, reasons for poor compliance have been attributed to lack of hand hygiene facilities, type of ward, specialty and procedure and the professional category.
T344 174273-174446 Epistemic_statement denotes A critical appraisal of the included studies will be done using the Critical Appraisal Skills Programme (CASP) tool to identify the strengths and weaknesses of the articles.
T345 175229-175362 Epistemic_statement denotes Reducing healthcare-associated infections through improving hand hygiene compliance amongst healthcare professionals remains topical.
T346 175363-175510 Epistemic_statement denotes However, research evidence suggests that hand hygiene compliance remains sub-optimal across various geographical locations and healthcare settings.
T347 175511-175733 Epistemic_statement denotes The aim of this poster is to report the outcomes of a recently published systematic review of peer-reviewed published studies, notably clinical trials, which focus on hand hygiene compliance among healthcare professionals.
T348 175999-176124 Epistemic_statement denotes A lack of homogeneity in research design made meta-analysis difficult to achieve; however, comparative analysis was possible.
T349 176893-177151 Epistemic_statement denotes The WHO multimodal hand hygiene framework is transferable to a variety of healthcare and education settings globally, and international research evidence suggests that moderate improvements in hand hygiene compliance rates can be achieved when it is adopted.
T350 177601-177751 Epistemic_statement denotes Indirect transmission from the male patient to the female patient via a shared blood pressure monitor was identified as the likely transmission route.
T351 178160-178277 Epistemic_statement denotes Non-compliance with isolation, screening and appropriate antibiotics posed particular challenges to outbreak control.
T352 178478-178692 Epistemic_statement denotes This aimed to support a multi-disciplinary team in developing individual screening and treatment plans for each patient to, as far as possible, identify carriers and treat all patients within a defined time period.
T353 179101-179176 Epistemic_statement denotes The perceived threat would mean non-specialist units could encounter cases.
T354 179463-179553 Epistemic_statement denotes The approach to PPE with EVD was far more complex than the usual procedures involving PPE.
T355 179554-179722 Epistemic_statement denotes There was concern that the transmission of EVD in West Africa to some healthcare workers was by an undetermined route, but potentially through incorrect removal of PPE.
T356 179924-180074 Epistemic_statement denotes Myth and misinformation about the virus abounded and was difficult to counter, causing a disproportionate level of fear and making planning difficult.
T357 180341-180539 Epistemic_statement denotes Only staff that had volunteered and were prepared to manage potentially infected patients should be trained; this could limit the pool of available staff, although this was not found to be the case.
T358 180832-181007 Epistemic_statement denotes Despite these challenges, the Trust plan ran smoothly and there was increased confidence in managing these patients, although maintaining training standards will be difficult.
T359 182159-182454 Epistemic_statement denotes The Saudi Ministry of Health (MoH) has published annual recommendations for pilgrims, with special advice for elderly adults, children, pregnant women and those with chronic diseases, to preferably postpone their travel to Mecca, and for those who attend to maintain optimum preventive measures.
T360 182455-182558 Epistemic_statement denotes However, many pilgrims are not aware of MERS-CoV infection in Saudi Arabia and its preventive measures.
T361 182559-182833 Epistemic_statement denotes For instance, a study conducted in France that addressed MERS-CoV and its prevention among French Hajj pilgrims in pre-Hajj outpatient clinics showed that only 64.3% of the study participants were aware of MERS-CoV, and only 35.5% were aware of the Saudi MoH recommendation.
T362 182834-182979 Epistemic_statement denotes Another study among Australian pilgrims showed that only about one-third of the pilgrims responded to the warnings they heard regarding MERS-CoV.
T363 183488-183677 Epistemic_statement denotes During this time period the patient would have been, by virtue of a vigorous cough, highly infectious to patients and staff, and contamination of the environment would have been inevitable.
T364 184775-184873 Epistemic_statement denotes Despite the initial high level of spread of MDR-AB the outbreak was controlled relatively rapidly.
T365 185513-185632 Epistemic_statement denotes Infection occurs via the respiratory route and may be caused by patient-to-patient transmission or via the environment.
T366 186013-186315 Epistemic_statement denotes The format of this report was recently updated to include a formalised risk assessment and gap analysis to determine if existing health protection programmes, currently available national surveillance intelligence and infection prevention and control guidance are sufficient to mitigate emerging risks.
T367 186920-187070 Epistemic_statement denotes Since the introduction of a risk assessment and gap analysis, 36 "threats" have been identified: 10 in the literature and 26 reported by NHS Scotland.
T368 187071-187282 Epistemic_statement denotes Of the 36 "threats", 27 were assessed as a moderate or greater risk; a gap analysis found that guidance, tools or other health protection programmes were already in place to mitigate the risk from these threats.
T369 187558-187719 Epistemic_statement denotes The addition of a risk assessment and gap analysis ensures NHS Scotland is sufficiently prepared to respond to current and emerging threats, including epidemics.
T370 189075-189231 Epistemic_statement denotes Pneumocystis jirovecii pneumonia (PCP) remains a very real threat to renal transplant recipients, and is associated with high mortality and morbidity rates.
T371 189232-189345 Epistemic_statement denotes Clusters have been reported worldwide, but evidence to support the source and associated risk factors is lacking.
T372 189894-190002 Epistemic_statement denotes However, an increase in measles cases was observed at the end of 2015 across London and the East of England.
T373 190095-190133 Epistemic_statement denotes To date, 46 cases have been confirmed.
T374 190252-190340 Epistemic_statement denotes One of the main challenges is delay in diagnosis in cases presenting to A&E departments.
T375 190649-190866 Epistemic_statement denotes Despite national recommendations that healthcare staff should have evidence of protection from measles, this is not always known and some exposed staff have had to be excluded from work until immunity was established.
T376 190970-191183 Epistemic_statement denotes Systems should be in place so that all relevant Trust staff are aware of their responsibilities with regards to diagnosis and investigation of measles, and that all suspected cases are notified in a timely manner.
T377 191184-191266 Epistemic_statement denotes Suspected cases should be isolated until a diagnosis of measles has been excluded.
T378 191267-191453 Epistemic_statement denotes In addition, occupational health teams in hospitals and primary care should ensure that the measles immune status of all their staff has been assessed and MMR provided where appropriate.
T379 192029-192148 Epistemic_statement denotes The epidemiology of this year's outbreak is still being studied to determine whether it was two outbreaks or two peaks.
T380 192497-193036 Epistemic_statement denotes Challenges included: specimens not being collected and sent promptly; delays in obtaining Norovirus results; a prolonged outbreak or second outbreak; the majority of wards have shared facilities; the pressure of managing the outbreak, resources, time, prolonged working and team exhaustion; staff vacancy rate is still high despite a number of new nurses in post from the UK and abroad; low hand hygiene scores in some wards; some commode staining; insufficient patient care equipment on wards to segregate equipment for affected patients.
T381 193037-193167 Epistemic_statement denotes Despite higher numbers of Norovirus-positive patients in May 2016 during the second peak, hospital transmission decreased quickly.
T382 193207-193263 Epistemic_statement denotes Will sending the Norovirus isolates for sequencing help?
T383 193804-193957 Epistemic_statement denotes To identify the link of the ice-making machine to the outbreak, an inspection was carried out using a known audit tool with question-set recommendations.
T384 194549-194646 Epistemic_statement denotes However, a thick biofilm was found inside the lumen of the tubing connecting to the water supply.
T385 194689-194809 Epistemic_statement denotes Microbiological testing confirmed that the ice-making machine was the likely source of the Mycobacterium avium outbreak.
T386 194937-195082 Epistemic_statement denotes This incident was an opportunity to review our audit tools for ice-making machines and assurance processes to prevent recurrence of the outbreak.