Journal of Patient Safety and Infection Control最新文献

{"title":"Adverse drug reactions in hospitalised pediatric patients: An urgent need for effective pharmacovigilance implementation","authors":"K. Muhammad, Z. Khan, Y. Karataş","doi":"10.4103/jpsic.jpsic_1_20","DOIUrl":"https://doi.org/10.4103/jpsic.jpsic_1_20","url":null,"abstract":"","PeriodicalId":310565,"journal":{"name":"Journal of Patient Safety and Infection Control","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129018477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience with the two-stage (electronic detection and internal validation) health-care-associated infection tracking system in hospital infection control and prevention program","authors":"B. Tarai, D. Jain, Poornima Sen, S. Budhiraja, P. Das, Vibha Jain","doi":"10.4103/jpsic.jpsic_14_19","DOIUrl":"https://doi.org/10.4103/jpsic.jpsic_14_19","url":null,"abstract":"Background: Surveillance of health-care-associated infections (HAIs) plays a key role in the hospital infection control program and reduction of HAIs. Objectives: To study the benefits and limitations of an innovative, two-stage surveillance method of HAIs and effectiveness of infection control measures. Design: It is a retrospective 5-year study of electronic surveillance system to capture HAI cases with high index of suspicion and confirmation with the manual methods of HAI tracking. Methods: The tertiary care hospital, New Delhi, India, adopted an electronic two-stage HAI surveillance system in April 2015. This system automatically detects all microbiology culture-positive cases for patients on central line, ventilator or urinary catheter for more than 48 h in the hospital along with relevant clinical information, which was further validated by infection control team. These all are suspected HAI cases. Hence, the system is screening the cases which can be potential HAI further. Daily clinical assessment to look for initial warning signs related to HAI was done in every individual case irrespective of culture results. Results: HAI incidence rates in pre-period (before implementation of electronic detection system April 2013 to March 2015) of CLABSI, CAUTI, VAP and SSI were 1.36%, 1.41%, 2.65% and 0.16% and post-period (after implementation of electronic detection system April 2015 to March 2018) were 1.25%, 1.30%, 1.16% and 0.09%, respectively. The pre- and post-analysis depicted that rates of CLABSI, CAUTI and VAP declined significantly; however, SSI rate in post-implementation declined but not significantly. Conclusion: The electronic tracking system acts as an early warning system for identification of suspected HAI cases and triggers an early preventive response by both clinician and hospital infection control team. Moreover, the use of electronic monitoring system also led to implementation of many additional infection control measures.","PeriodicalId":310565,"journal":{"name":"Journal of Patient Safety and Infection Control","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123554857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of novel blood culture collection bundle to reduce blood culture contamination rates: An important continuous quality improvement indicator of laboratory medicine","authors":"K. Patel, Trupti Carval, A. Poojary, R. Poojary","doi":"10.4103/jpsic.jpsic_25_19","DOIUrl":"https://doi.org/10.4103/jpsic.jpsic_25_19","url":null,"abstract":"Introduction: Blood cultures play a very important role in the diagnostic algorithm for managing patients with sepsis. Contamination of blood cultures complicate patient care resulting in unnecessary antibiotic use, prolonged hospital stays and more financial burden on the patient. Hence, microbiology laboratories strive to keep contamination rates within <3% as per international standards. Aim: To monitor blood culture contamination rate and reduce contamination using a novel blood culture collection (BCC) bundle. Materials and Methods: A prospective interventional study carried out in a newly set up Microbiology laboratory of a 200 bed tertiary care hospital in North Mumbai. Blood cultures from various clinical areas of the hospital were processed using the BacT/Alert system (BioMereiux, Marcy l'etiole, France). All positive blood cultures were co-related clinically and assigned as pathogens or contaminants. Blood culture contamination rates were actively monitored and BCC bundle was introduced to reduce contamination, which comprised six steps to follow while performing BCC. Active surveillance, audits of the collection process and root cause analysis (RCA) of blood culture contamination were done simultaneously. This was followed by feedback to phlebotomists, nurses and doctors. Periodic and need-based onsite training of health-care workers was also done. Results: Different types of Health Care Workers were performing the procedure. The most common contaminant grown were Gram-positive cocci 159 (25.5%), followed by Gram-negative bacilli 58 (9.32%), and Bacillus spp. 37 (5.95%). It was observed that skin disinfection and incorrect order of draw were two main reasons for the contamination. Over a period of 18 months, BCC bundle implementation reduced the contamination from 17% to 4%. Conclusion: RCA, training, surveillance and audits are essential to improve the quality of blood culture results. Implementation of the BCC bundle benefits both the microbiology laboratory and the clinical teams by decreasing the growth of contaminants and improving the utility of blood culture for better management of patients in sepsis bringing in favorable outcomes.","PeriodicalId":310565,"journal":{"name":"Journal of Patient Safety and Infection Control","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133494644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stethoscope hygiene and barriers among physicians – A cross-sectional study from National Guard Health Affairs in Dammam, Saudi Arabia","authors":"Suha Al Saleh, Aidah Al Rammah, W. Syed, Rawan Al Duhailan, Sufanah Kattan, Fawiziah Al-Mana","doi":"10.4103/jpsic.jpsic_19_19","DOIUrl":"https://doi.org/10.4103/jpsic.jpsic_19_19","url":null,"abstract":"Objectives: This study aims to evaluate the stethoscope hygiene Disinfection practice and barriers among National Guard Health Affairs physicians in Dammam, Saudi Arabia. Methods: A paper-based cross sectional prospective study was conducted among physicians practicing at the Imam Abdurrahman Al-Faisal Hospital over a period of 3 months from October to December 2018. We assessed the frequency and method of disinfection, perception of contamination, and barriers to disinfection. Results: Ninety-three respondents completed the survey. The results of the study found that Isopropyl alcohol 70% or an alcohol swab was the most common disinfecting agent, reported by 77 (82.8%) of respondents. The majority of the respondents 33 (35.5%) were spend 5-10 seconds to disinfect the stethoscope, 24 (25.8%) were <5 seconds, 12 (12.9%) were never disinfect stethoscope. Half of the respondents 51 (54%) were disinfect stethoscope after every use, 10 (10.8%) were disinfect multiples times per week, while 6 (6.5%) were disinfect stethoscope. The most common reported barriers to cleaning stethoscopes were forgetfulness/laziness 42 (45.2%), lack of time 30 (32.3%), or lack of knowledge regarding the best disinfectant 21 (22.6%). Conclusion: This study found that the vast majority of respondents reported cleaning of stethoscope using a suitable method of their choice. Increasing physicians' access to appropriate disinfectants and providing visual reminders in health care facilities may improve stethoscope disinfection practices.","PeriodicalId":310565,"journal":{"name":"Journal of Patient Safety and Infection Control","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128813236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preventing infection from indwelling intravascular devices: Hospital infection society India consensus group recommendations for Indian healthcare","authors":"R. Sardana, A. Mandal, Deepthi Nair, Leena Mendiratta, H. Butta, T. Jain, A. Kapil, C. Wattal, C. Hans, R. Mani, G. Sagar, N. Jaggi, P. Khilnani, P. Mathur, S. Jasuja, S. Kansal, V. Manchanda, V. Nangia, Anita Sharma, Fatima Khan, Geeta Mehta, G. Nataraj, R. Kelkar, S. Todi, S. Baveja, V. Balaji, Aarti Gupta, A. Arora, Anuragini Gupta, A. Hasan, L. Raman, Madhu Choudhry, M. Haider, M. Mani, Neha Rathor, N. Aggarwal, P. Barman, R. Kaur, S. Malhotra, S. Malik, Suresh Kumar, T. Chugh, V. Malhotra, V. Patwardhan, Angela Stephens, Reena Ligin, S. Kumari, Shilpi Singh","doi":"10.4103/jpsic.jpsic_17_19","DOIUrl":"https://doi.org/10.4103/jpsic.jpsic_17_19","url":null,"abstract":"Raman Sardana1, Amit Kumar Mandal2, Deepthi Nair3, Leena Mendiratta1, Hena Butta4, T. S. Jain5, Arti Kapil6, Chand Wattal7, Charoo Hans8, R. K. Mani9, Gaurav Sagar10, Namita Jaggi11, Praveen Khilnani12, Purva Mathur6, Sanjiv Jasuja10, Sudha Kansal13, Vikas Manchanda14, Vivek Nangia15, Anita Sharma16, Fatima Khan17, Geeta Mehta18, Gita Nataraj19, Rohini Kelkar20, Subhash Todi21, Sujata Baveja22, V. Balaji23, Aarti Gupta24, Anita Arora25, Anu Gupta26, Azra Hasan27, Lakshmy A. Raman28, Madhu Choudhry29, Mahvash Haider27, Manju Mani30, Neha Rathor31, Nitika Aggarwal32, Purabi Barman33, Ravneet Kaur34, Shalini Malhotra8, Sonia Khatter Malik35, Suresh Kumar36, T. D. Chugh37, V. L. Malhotra38, Vrushali Patwardhan39, Angela Stephens40, Reena Ligin40, Sapna Kumari40, Shilpi Singh40","PeriodicalId":310565,"journal":{"name":"Journal of Patient Safety and Infection Control","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127731436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study to assess the degree of adherence of prescription to WHO and MCI guidelines at a tertiary health care teaching hospital in North India","authors":"Richa Mishra, R. Harsvardhan, Ritika Rai, H. Chandra","doi":"10.4103/jpsic.jpsic_12_19","DOIUrl":"https://doi.org/10.4103/jpsic.jpsic_12_19","url":null,"abstract":"Background: Prescription errors are one of the most common preventable medication errors. The occurrence of medication errors can compromise the patient confidence in the healthcare system and also increase healthcare costs. The aim of this study was to randomly audit medical prescriptions and associated factors at the outpatient department of a tertiary care teaching institute in Lucknow. Methodology: A total of 420 prescriptions were randomly selected and reviewed. Data on the prescribed drugs were collected from prescription papers using a structured format and analysed using SPSS software. Data on patient demographics, indication for each medication, dosage, dosage form, regimen and concurrent medications were collected. Data on duration of medication were not evaluated. Results: Out of 420 prescriptions included for review, date of prescription was documented in only 59% of cases. Signature of doctor was present in 94.2% prescriptions although the name of the prescriber was mentioned in only 27% prescriptions. The average number of drugs per prescription was 3.89%. Errors related to dosing were documented in 44% cases. Injectable drugs were prescribed in 26.6% prescriptions, whereas antibiotics were written in 13.8%. The percentage of drugs prescribed by generic name was only 7.61%. The understanding of patients regarding prescription of medication given to them, especially with regards to legibility of dose and timing was 55.7%. Conclusion: The results of our study prove that prescribing errors are a major cause of preventable iatrogenic injury to patients. They may be rectified by educational intervention as well as standardised prescription charts.","PeriodicalId":310565,"journal":{"name":"Journal of Patient Safety and Infection Control","volume":"150 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115891248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An analysis of health economics related to hospital-associated infections: A prospective case–control analysis of 7-year data from a tertiary referral corporate hospital in India","authors":"M. Chakravarthy, R. Gore, Navin Yellappa, Antony George, Sukanya Rangaswamy, Rajathadri Hosur, Sumant Pargaonkar, Chidananda Harivelam, P. Senthilkumar, T.K.V. Saravanan, S. Rose","doi":"10.4103/JPSIC.JPSIC_20_18","DOIUrl":"https://doi.org/10.4103/JPSIC.JPSIC_20_18","url":null,"abstract":"Objective: Healthcare associated infections cause significant morbidity, mortality and escalation of cost of care. It is the responsibility of all concerned to work towards reducing this potentially preventable increase in morbidity, mortality and cost caused by healthcare associated infections. Such data in Indian subcontinent has been studied sparingly. The objective of this study was to understand the degree of the cost escalation, morbidity and mortality associated with healthcare associated infections. Design: This prospective case controlled observational study was carried out from the year 2007 onwards. All the infections that occurred unto 2014 were included. Cost, morbidity and mortality of two similar matched controls for each infected case were chosen. Setting: Tertiary referral hospital. Participants: All patients with healthcare associated infections and twice that number as control. Interventions: None. Main outcome measure: Escalation of cost, morbidity and mortality due to healthcare. Results: There were five hundred fifteen infections during the study period. The escalation of cost due to infection was $ 4611. The mean mortality in the infected group was 8.75% in contrast to 2.5 in the non infected group. The mortality due to central line associated blood stream infection and ventilator associated pneumonia was more than 30% each. The length of stay in the intensive care unit was 8 days in the infected group in contrast to 2.27 days in the non infected group. Length of stay in the hospital was 33.5 days in the infected patients in contrast to 10.3 days in the non infected group. Conclusions: Healthcare associated infections caused escalation of cost, length of stay in the intensive care unit and hospital. Mortality in the infected cohort was more in contrast to the controls.","PeriodicalId":310565,"journal":{"name":"Journal of Patient Safety and Infection Control","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128161182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABC's of hand hygiene: An aid to improve adherence","authors":"Chepsy C Philip, S. Abraham, Amrith Mathew, M. John","doi":"10.4103/JPSIC.JPSIC_21_18","DOIUrl":"https://doi.org/10.4103/JPSIC.JPSIC_21_18","url":null,"abstract":"","PeriodicalId":310565,"journal":{"name":"Journal of Patient Safety and Infection Control","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128719649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Objective assessment of hand hygiene: When we see it, we believe it!","authors":"S. Ranjan, D. Venkatesan, Ramya Devi","doi":"10.4103/JPSIC.JPSIC_10_18","DOIUrl":"https://doi.org/10.4103/JPSIC.JPSIC_10_18","url":null,"abstract":"Background: Hand hygiene is the fundamental and leading measure to prevent the spread of antimicrobial resistance and to reduce hospital-acquired infections. Several strategies are recommended to increase the compliance for hand hygiene practice; however, health-care worker (HCW) compliance with optimal practices remains low in most settings. Aim: This study aims to assess the efficacy of hand hygiene practice in HCWs at our hospital, and to demonstrate objective result of their practices, followed by a questionnaire-based study to assess their attitude towards hand hygiene, and effect of workshop on their hand hygiene practice pattern. Materials and Methods: Participants were asked to disinfect their hands using a hand rub solution mixed with the fluorescent dye. Photos were taken under an ultraviolet lamp. A self-designed questionnaire was given to all the participants. Results: A total of 94 HCWs participated in the hand hygiene workshop. Only 11.11% nurses (6/54) and 17.5% doctors (7/40) were able to use disinfectant solution with complete coverage of hand areas. Incomplete coverage of dorsum of hand was more common than that of palms. About 84.21% doctors (32/38) and 80% nurses (36/45) wanted to participate in such hand hygiene workshop in future with majority of them opting for frequent workshop. All the participants admitted that such workshop changed their attitude towards their practice pattern. Conclusion: It is important to carry out hand hygiene training programmes regularly to achieve increased compliance with hand hygiene practices. This study also emphasises that an objective technique of demonstration has a greater effect in changing professional's attitude towards hand hygiene.","PeriodicalId":310565,"journal":{"name":"Journal of Patient Safety and Infection Control","volume":"247 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131386005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A study of microbial flora of mobile phones used by health-care professionals in a tertiary care hospital in North India","authors":"G. Singh, Raksha Singh","doi":"10.4103/jpsic.jpsic_19_18","DOIUrl":"https://doi.org/10.4103/jpsic.jpsic_19_18","url":null,"abstract":"Context: Mobile phones give all the advantages to its users but it also acted as a house for harbour the bacteria and causing health hazard that should not be over looked. Aim of study was study the prevalence of bacterial and fungal pathogens on mobile phones and their identification. Aims: 1. To study the prevalence of bacterial and fungal pathogens on mobile phones. 2. Identification of bacterial and fungal pathogens to species level. Settings and Design: The study was conducted in the Department of Microbiology, N. C. Medical College and Hospital, Israna, Panipat. Methods and Material: A total of 100 mobile phones were randomly sampled with sterile moistened swabs from doctors, nurses, laboratory technicians and attendants working in the hospital on the days of sampling. Statistical Analysis Used: Statistical analysis was done using SPSS 20.0 v. Descriptive analysis was done to estimate the percentage of microorganisms and Chi Square test was done to assess the difference in proportions. Level of significance was taken at p<0.05 Results: Total 100 mobile phones of health care professional were swabbed to check microbial flora harboured on mobile phones. Out of 100 mobile phones 79 (79%) were found with contaminated with microbial flora. Conclusions: Mobile phones may act as carrier for cross contamination among patients and healthcare personnel. Simple cleaning with isopropyl alcohol reduced the microbial load of the cellular phones. Hence it is recommended that medical colleges should develop strict guidelines concerning cell phone use and hygiene.","PeriodicalId":310565,"journal":{"name":"Journal of Patient Safety and Infection Control","volume":"24 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113960722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}