GMS Krankenhaushygiene interdisziplinar最新文献

{"title":"Impact of the \"Guidelines for infection prevention in dentistry\" (2006) by the Commission of Hospital Hygiene and Infection Prevention at the Robert Koch-Institute (KRINKO) on hygiene management in dental practices - analysis of a survey from 2009.","authors":"Nils-Olaf Hübner,&nbsp;Stephan Handrup,&nbsp;Georg Meyer,&nbsp;Axel Kramer","doi":"10.3205/dgkh000198","DOIUrl":"https://doi.org/10.3205/dgkh000198","url":null,"abstract":"<p><strong>Aim: </strong>To assess trends in hygiene management in dental practices in comparison to an earlier survey in 2002/2003 and to point out key aspects for future efforts.</p><p><strong>Method: </strong>The infection prevention management of all dental practices in Greifswald (n=35) was determined by a questionnaire in a personal interview in 2008/2009.</p><p><strong>Results: </strong>26% of the dentists did not use sufficient personal protective equipment during the general examination of the patient. In conservative and prosthetic dentistry, 15% still did not use adequate measures and 9% did not even in surgical interventions. Vaccination coverage was clearly too low, as only 35% of dentists were vaccinated against influenza and coverage with other vaccinations was also quite low. 11% of the dentists did not perform a documented anamnesis and in 29% of the dental practices no appointment system for risk patients existed.There were significant deficiencies in the reprocessing of medical devices and in the equipment needed for reprocessing. The opportunity to participate in further training in this field was rejected by 23% of the dentists.In 10 dental practices, the colony count in the dental unit water-conducting system was five times higher than the limit. A contamination with P. aeruginosa was discovered in 4 practices. All units were renovated.</p><p><strong>Discussion: </strong>Overall, both the hygiene management and hygiene equipment in the practices have improved considerably compared to the previous survey in 2002/2003. This demonstrates the positive effect of the KRINKO guidelines from 2006. However, the survey again showed relevant deficiences in the hygiene management of dental practices, which agrees with a Germany-wide online survey from 2009.</p><p><strong>Conclusion: </strong>While the study revealed persistent deficiencies in hygiene management, especially in reprocessing, it confirms that the KRINKO guidelines for dental practices from 2006 led to significant improvements in hygiene management. Doubts about the impact of the guidelines are not backed by evidence.</p>","PeriodicalId":88496,"journal":{"name":"GMS Krankenhaushygiene interdisziplinar","volume":"7 1","pages":"Doc14"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/dgkh000198","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30591912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of needle stick injuries among dental, nursing and midwifery students in Shiraz, Iran.","authors":"Mehrdad Askarian,&nbsp;Leila Malekmakan,&nbsp;Ziad A Memish,&nbsp;Ojan Assadian","doi":"10.3205/dgkh000189","DOIUrl":"https://doi.org/10.3205/dgkh000189","url":null,"abstract":"<p><strong>Background: </strong>The risk of occupational exposure to blood borne pathogens (including hepatitis B, hepatitis C and HIV) via sharp injuries such as needle stick injuries (NSIs) among health care workers, especially dental, nursing and midwifery students is a challenging issue. Inadequate staff, lack of experience, insufficient training, duty overload and fatigue may lead to occupational sharp injuries. The aim of this prospective cross-sectional study was to evaluate the frequency of NSIs in Iranian dental, nursing, and midwifery students and their knowledge, attitude and practices regarding prevention of NSIs.</p><p><strong>Methods: </strong>A questionnaire was provided to 264 dental and 435 nursing and midwifery students during their under graduate clinical training. 52% of dental students and 48% of nursing and midwifery students responded to the questionnaire. The questionnaire was pre-tested for reliability on 9.2% of the 55 sample population and found to have a high (r=0.812) test-retest reliability.</p><p><strong>Results: </strong>73% of students reported at least one NSI during the past year. Activities most frequently associated with injuries involved use of a hollow-bore needle during venous sampling or IV injection in both groups, followed by wound suturing in nursing and midwifery students and recapping in dental students. NSIs and non-reporting of NSIs were highly prevalent in these participants. The reason for not reporting injuries included not knowing the reporting mechanism or not knowing to whom to report.</p><p><strong>Conclusion: </strong>Education about transmission of blood borne infections, standard precaution and increasing availability of protective strategies must be enforced. Furthermore, an optimization of the management for reporting is warranted.</p>","PeriodicalId":88496,"journal":{"name":"GMS Krankenhaushygiene interdisziplinar","volume":"7 1","pages":"Doc05"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/dgkh000189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30594201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of indicators for cross-sectoral optimization of nosocomial infection prophylaxis - a perspective from structurally- and process-oriented hygiene.","authors":"Nils-Olaf Hübner,&nbsp;Steffen Fleßa,&nbsp;Ralf Jakisch,&nbsp;Ojan Assadian,&nbsp;Axel Kramer","doi":"10.3205/dgkh000199","DOIUrl":"https://doi.org/10.3205/dgkh000199","url":null,"abstract":"In the care of patients, the prevention of nosocomial infections is crucial. For it to be successful, cross-sectoral, interface-oriented hygiene quality management is necessary. The goal is to apply the HACCP (Hazard Assessment and Critical Control Points) concept to hospital hygiene, in order to create a multi-dimensional hygiene control system based on hygiene indicators that will overcome the limitations of a procedurally non-integrated and non-cross-sectoral view of hygiene. Three critical risk dimensions can be identified for the implementation of three-dimensional quality control of hygiene in clinical routine: the constitution of the person concerned, the surrounding physical structures and technical equipment, and the medical procedures. In these dimensions, the establishment of indicators and threshold values enables a comprehensive assessment of hygiene quality. Thus, the cross-sectoral evaluation of the quality of structure, processes and results is decisive for the success of integrated infection prophylaxis. This study lays the foundation for hygiene indicator requirements and develops initial concepts for evaluating quality management in hygiene.","PeriodicalId":88496,"journal":{"name":"GMS Krankenhaushygiene interdisziplinar","volume":"7 1","pages":"Doc15"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/dgkh000199","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30591914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"XTT assay of ex vivo saliva biofilms to test antimicrobial influences.","authors":"Ina Koban,&nbsp;Rutger Matthes,&nbsp;Nils-Olaf Hübner,&nbsp;Alexander Welk,&nbsp;Rabea Sietmann,&nbsp;Jürgen Lademann,&nbsp;Axel Kramer,&nbsp;Thomas Kocher","doi":"10.3205/dgkh000190","DOIUrl":"https://doi.org/10.3205/dgkh000190","url":null,"abstract":"<p><strong>Objective: </strong>Many dental diseases are attributable to biofilms. The screening of antimicrobial substances, in particular, requires a high sample throughput and a realistic model, the evaluation must be as quick and as simple as possible. For this purpose, a colorimetric assay of the tetrazolium salt XTT (sodium 3'-[1-[(phenylamino)-carbony]-3,4-tetrazolium]-bis(4-methoxy-6-nitro)benzene-sulfonic acid hydrate) converted by saliva biofilms is recommended. Cleavage of XTT by dehydrogenase enzymes of metabolically active cells in biofilms yields a highly colored formazan product which is measured photometrically.</p><p><strong>Materials and method: </strong>The suitability of the XTT assay for detecting the vitality of ex vivo saliva biofilms was tested to determine the efficacy of chlorhexidine and ozone versus saliva biofilms grown on titanium discs.</p><p><strong>Results: </strong>The XTT method lends itself to testing the vitality of microorganisms in saliva biofilms. The sensitivity of the arrays requires a specific minimum number of pathogens, this number being different for planktonic bacteria and those occurring in biofilms. The antibacterial effect after treatment with chlorhexidine or ozone was measured by XTT conversion that was significantly reduced. The antimicrobial efficacy of 60 s 0.5% and 0.1% chlorhexidine treatment was equal and comparable with 60 s ozone treatment.</p><p><strong>Conclusion: </strong>The XTT assay is a suitable method to determine the vitality in saliva biofilms, permitting assessment of the efficacy of antimicrobial substances. Its quick and easy applicability renders it especially suitable for screening.</p>","PeriodicalId":88496,"journal":{"name":"GMS Krankenhaushygiene interdisziplinar","volume":"7 1","pages":"Doc06"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/dgkh000190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30594202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic comparison of conventional maintenance and electrochemical oxidation to warrant water safety in dental unit water lines.","authors":"Sebastian Fischer,&nbsp;Georg Meyer,&nbsp;Axel Kramer","doi":"10.3205/dgkh000192","DOIUrl":"https://doi.org/10.3205/dgkh000192","url":null,"abstract":"<p><strong>Background: </strong>In preparation for implementation of a central water processing system at a dental department, we analyzed the costs of conventional decentralized disinfection of dental units against a central water treatment concept based on electrochemical disinfection.</p><p><strong>Methods: </strong>The cost evaluation included only the costs of annually required antimicrobial consumables and additional water usage of a decentralize conventional maintenance system for dental water lines build in the respective dental units and the central electrochemical water disinfection system, BLUE SAFETY™ Technologies.</p><p><strong>Results: </strong>In total, analysis of costs of 6 dental departments reviled additional annual costs for hygienic preventive measures of € 4,448.37. For the BLUE SAFETY™ Technology, the additional annual total agent consumption costs were € 2.18, accounting for approximately 0.05% of the annual total agent consumption costs of the conventional maintenance system. For both water processing concepts, the additional costs for energy could not be calculated, since the required data was not obtainable from the manufacturers.</p><p><strong>Discussion: </strong>For both concepts, the investment and maintenance costs were not calculated due to lack of manufacturer's data. Therefore, the results indicate the difference of costs for the required consumables only. Aside of the significantly lower annual costs for required consumables and disinfectants; a second advantage for the BLUE SAFETY™ Technology is its constant and automatic operation, which does not require additional staff resources. This not only safety human resources, but add additionally to cost saving.</p><p><strong>Conclusion: </strong>Since the antimicrobial disinfection capacity of the BLUE SAFETY™ was demonstrated previously and is well known, this technology, which is comparable or even superior in its non-corrosive effect, may be regarded as method of choice for continuous disinfection and prevention of biofilm formation in dental units' water lines.</p>","PeriodicalId":88496,"journal":{"name":"GMS Krankenhaushygiene interdisziplinar","volume":"7 1","pages":"Doc08"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/dgkh000192","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30594204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial efficacy of amine fluoride based tooth gels compared to a toothpaste in a phase 2/step 2 in-vitro test model.","authors":"Anne Schiller,&nbsp;Beatrice Großjohann,&nbsp;Alexander Welk,&nbsp;Nils-Olaf Hübner,&nbsp;Dagmar Braun,&nbsp;Ojan Assadian,&nbsp;Axel Kramer","doi":"10.3205/dgkh000191","DOIUrl":"https://doi.org/10.3205/dgkh000191","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the present study was to determine the antimicrobial effect of various gel formulations on plaque formation; different tooth gels were compared to a toothpaste containing comparable antimicrobial ingredients with regard to its microbiocidal activity. The study was conducted under the assumption, that a chief requirement for the prevention of plaque formation is the combination of mechanical removal and antimicrobial activity, and not the sole capability of mechanical plaque removal.</p><p><strong>Methods: </strong>Ledermix(®) fluoride gel as commercially available with preservative, and without preservative and perfume oils, Elmex(®) gelée, and Meridol(®) toothpaste were tested in a standardized in-vitro test modification of the quantitative suspension test EN 1040. Instead of testing in a suspension, the respective product was directly placed on a standardized contaminated sterile stainless steel disk without adding any bio-burden. 50% egg yolk in Aqua dest. was used as a neutralizer.</p><p><strong>Results: </strong>Within 1 min, Elmex(®) gelée showed a RF >5 log(10) against S. pyogenes and S. sanguinis. Against S. mutans, a log(10) RF of ≥5 was achieved after 2 min, against C. albicans after 5 min, and against P. aeruginosa after 10 min S. aureus was the most difficult organisms to be reduced. After an application time of 10 min, only a log(10) RF of 2.4 was achieved. Ledermix exceeded the antimicrobial efficacy of Elmex(®) gelée against S. mutans and C. albicans and was already effective against these organisms after 1 min, but did not show the same antimicrobial efficacy as Elmex(®) gelée against P. aeruginosa. Similar to Elmex(®) gelée, a required reduction of >5 log(10) for antimicrobials under no organic challenge was not achieved against S. aureus. Ledermix(®) fluoride gel without preservatives and Ledermix(®) fluoride gel without preservatives and perfume oil did not show the antimicrobial efficacy of the standard Ledermix(®) fluoride gel formulation, indicating that the observed antimicrobial efficacy is chiefly based on the preservative, and possibly the perfume oil. Compared to the tested gels, Meridol(®) toothpaste was less effective and reached any antimicrobial effect >5 log(10) only against S. sanguinis after 10 min.</p><p><strong>Conclusion: </strong>All unmodified tested gels showed an antimicrobial effect. Because no relevant antimicrobial efficacy against plaque forming bacteria was achieved within 2 min, in practice, an anti-plaque forming effect based on the antimicrobial action of gels cannot be assumed when used in the oral cavity. However, the results of the present study indicate that the antimicrobial efficacy of gels is determined by their formulation and that for the prevention of plaque formation the combination of mechanical removal and antimicrobial activity is not the chief requirement only, but a sustained antimicrobial effect may be of greater importance.</p>","PeriodicalId":88496,"journal":{"name":"GMS Krankenhaushygiene interdisziplinar","volume":"7 1","pages":"Doc07"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/dgkh000191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30594203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refurbishment works in a hospital during normal operation.","authors":"Birgit Ross,&nbsp;Dorothea Hansen,&nbsp;Tim Lieske,&nbsp;Joschka Krude,&nbsp;Fuat Saner,&nbsp;Günter Marggraf,&nbsp;Andreas Paul,&nbsp;Heinz G Jakob,&nbsp;Walter Popp","doi":"10.3205/dgkh000168","DOIUrl":"https://doi.org/10.3205/dgkh000168","url":null,"abstract":"<p><strong>Background: </strong>Construction and renovation work in hospitals pose risks of fungal airborne infections for immunosuppressed patients. If possible, reconstruction work will be postponed to periods without patient treatment. However, in many situations urgent damage demands immediate refurbishment works before the transferring of patients to other wards or closure of wards is possible. Reported here are infection control related measures and implemented procedures after two incidents of water damage which occurred on a surgical ward and an intensive care unit at the University hospital of Essen.</p><p><strong>Methods: </strong>Between January and April 2009 and between September and October 2009, respectively, concentration of air-borne particles and number of viable fungi were measured at two surgical wards and one ICU. Preventive Infection Control Measures included erection of protective walls and HEPA filtration of air from the renovation area.</p><p><strong>Results: </strong>During the renovation work on the surgical ward concentrations of moulds and particles ≥5 µm were significantly higher on the left side of the renovation area than on the right side (p=0.036 and p<0.001). Concentrations of particles ≥1 µm and particles ≥5 µm on both sides of the renovation area were significantly increased when compared with the control ward on the same floor but not when compared with the control ward on the other floor. Particles of all size were significantly elevated on the ICU during the renovation work. Aspergillus fumigatus could neither be cultured of the air of cardiac surgery intensive care unit nor of the intermediate care unit (control ward). During renovation works there was no nosocomial mould infection of patients treated on the two wards.</p><p><strong>Conclusion: </strong>Provided that the renovation area is tightly insulated from the areas of patient care on a ward, closure does not seem to be necessary during renovation works because variation of airborne fungi is similar to that of outdoor or control air. However a multidisciplinary team should be established. This team should perform risk assessment and determine necessary protective measures before starting any construction, renovation or maintenance work in health care settings.</p>","PeriodicalId":88496,"journal":{"name":"GMS Krankenhaushygiene interdisziplinar","volume":"6 1","pages":"Doc11"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/dgkh000168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30383602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endowashers: an overlooked risk for possible post-endoscopic infections.","authors":"Nils-Olaf Hübner,&nbsp;Ojan Assadian,&nbsp;Rosmarie Poldrack,&nbsp;Oliver Duty,&nbsp;Heinrich Schwarzer,&nbsp;Hiltraud Möller,&nbsp;Paul Kober,&nbsp;Malte Räther,&nbsp;Lutz Werner Schröder,&nbsp;Jeanette Sinha,&nbsp;Markus M Lerch,&nbsp;Axel Kramer","doi":"10.3205/dgkh000170","DOIUrl":"https://doi.org/10.3205/dgkh000170","url":null,"abstract":"<p><strong>Background: </strong>Prevention of post-endoscopy infections is an important objective to assure patient safety. Endowashers, or high throughput irrigation water pumps, are a frequently used device on endoscopes. Recommendations published by professional bodies and regulatory health agencies cover not only adequate reprocessing of fiber-endoscopes but also state accepted methods of regular microbial sampling. Although major instruments like endoscopes are covered by these recommendations, other devices used as optional add-ons for endoscopes are not included.</p><p><strong>Objective: </strong>The aim of this prospective study was to investigate the potential for endowashers to act as a possible source of infection.</p><p><strong>Method: </strong>24 endowashers were sampled. Sterile rinse-water was pumped through the endowasher and tested microbiologically according to standardised tests. Sampling was performed in 18 hospitals, including 2 university teaching hospitals, in northern Germany. If endowashers were contaminated, devices were reprocessed and re-tested.</p><p><strong>Results: </strong>Of 44 samples, 6 (14%) were contaminated with pathogens of up to >20,000 cfu/ml. Pseudomonas aeruginosa and other Gram-negative non-fermenters such as Stenotrophomonas spp. (18x) and Acinetobacter spp. (2x), followed by Staphylococcus aureus (1x), Enterobacter cloacae (1x), Candida albicans (1x), Serratia spp. (1x), Streptococcus spp. (1x) and others (2x).</p><p><strong>Conclusion: </strong>Endowashers can be a potential source of infection. Despite their common use, they are not routinely sampled microbiologically. Endowashers should be clearly mentioned in respective guidelines and routine quality control sampling of endowashers should be part of such recommendations. If endowashers are not monitored regularly, devices with single-use hoses should be used.</p>","PeriodicalId":88496,"journal":{"name":"GMS Krankenhaushygiene interdisziplinar","volume":"6 1","pages":"Doc13"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/dgkh000170","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30384998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacterial contamination of anesthesia machines' internal breathing-circuit-systems.","authors":"Verena Spertini,&nbsp;Livia Borsoi,&nbsp;Jutta Berger,&nbsp;Alexander Blacky,&nbsp;Magda Dieb-Elschahawi,&nbsp;Ojan Assadian","doi":"10.3205/dgkh000171","DOIUrl":"https://doi.org/10.3205/dgkh000171","url":null,"abstract":"<p><strong>Background: </strong>Bacterial contamination of anesthesia breathing machines and their potential hazard for pulmonary infection and cross-infection among anesthetized patients has been an infection control issue since the 1950s. Disposable equipment and bacterial filters have been introduced to minimize this risk. However, the machines' internal breathing-circuit-system has been considered to be free of micro-organisms without providing adequate data supporting this view. The aim of the study was to investigate if any micro-organisms can be yielded from used internal machines' breathing-circuit-system. Based on such results objective reprocessing intervals could be defined.</p><p><strong>Methods: </strong>The internal parts of 40 anesthesia machines' breathing-circuit-system were investigated. Chi-square test and logistic regression analysis were performed. An on-site process observation of the re-processing sequence was conducted.</p><p><strong>Results: </strong>Bacterial growth was found in 17 of 40 machines (43%). No significant difference was ascertained between the contamination and the processing intervals. The most common contaminants retrieved were coagulase negative Staphylococci, aerobe spore forming bacteria and Micrococcus species. In one breathing-circuit-system, Escherichia coli, and in one further Staphylococcus aureus were yielded.</p><p><strong>Conclusion: </strong>Considering the availability of bacterial filters installed on the outlet of the breathing-circuit-systems, the type of bacteria retrieved and the on-site process observation, we conclude that the contamination found is best explained by a lack of adherence to hygienic measures during and after re-processing of the internal breathing-circuit-system. These results support an extension of the re-processing interval of the anesthesia apparatus longer than the manufacturer's recommendation of one week. However, the importance of adherence to standard hygienic measures during re-processing needs to be emphasized.</p>","PeriodicalId":88496,"journal":{"name":"GMS Krankenhaushygiene interdisziplinar","volume":"6 1","pages":"Doc14"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/dgkh000171","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30384999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of leg and pressure ulcer in hospitalized patients: direct costs are lower than expected.","authors":"Ojan Assadian,&nbsp;Joseph S Oswald,&nbsp;Rainer Leisten,&nbsp;Peter Hinz,&nbsp;Georg Daeschlein,&nbsp;Axel Kramer","doi":"10.3205/dgkh000164","DOIUrl":"https://doi.org/10.3205/dgkh000164","url":null,"abstract":"<p><strong>Background: </strong>In Germany, cost calculations on the financial burden of wound treatment are scarce. Studies for attributable costs in hospitalized patients estimate for pressure ulcer additional costs of € 6,135.50 per patient, a calculation based on the assumption that pressure ulcers will lead to prolonged hospitalization averaging 2 months. The scant data available in this field prompted us to conduct a prospective economical study assessing the direct costs of treatment of chronic ulcers in hospitalized patients.</p><p><strong>Study design: </strong>The study was designed and conducted as an observational, prospective, multi-centre economical study over a period of 8 months in three community hospitals in Germany.</p><p><strong>Patients: </strong>Direct treatment costs for leg ulcer (n=77) and pressure ulcer (n=35) were determined observing 67 patients (average age: 75±12 years). 109 treatments representing 111 in-ward admissions and 62 outpatient visits were observed. During a total of 3,331 hospitalized and 867 outpatient wound therapies, 4,198 wound dressing changes were documented.</p><p><strong>Main outcome measure: </strong>Costs of material were calculated on a per item base. Direct costs of care and treatment, including materials used, surgical interventions, and personnel costs were determined.</p><p><strong>Results: </strong>An average of € 1,342 per patient (€ 48/d) was spent for treatment of leg ulcer (staff costs € 581, consumables € 458, surgical procedures € 189, and diagnostic procedures € 114). On average, each wound dressing change caused additional costs of € 15. For pressure ulcer, € 991 per patient (€ 52/d) was spent on average (staff costs € 313, consumables € 618, and for surgical procedures € 60). Each wound dressing change resulted in additional costs of € 20 on average.</p><p><strong>Conclusion: </strong>When direct costs of chronic wounds are calculated on a prospective case-by-case basis for a treatment period over 3 months, these costs are lower than estimated to date. While reduction in prevalence of chronic wounds along with optimised patient care will result in substantial cost saving, this saving might be lower than expected. Our results, however, do not serve as basis for making any conclusions on cost-benefit analysis for both, the affected individual, as well as for the society.</p>","PeriodicalId":88496,"journal":{"name":"GMS Krankenhaushygiene interdisziplinar","volume":"6 1","pages":"Doc07"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.3205/dgkh000164","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30383598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}