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(1) Background: As digital health technology evolves, the role of accurate medical-gloved hand tracking is becoming more important for the assessment and training of practitioners to reduce procedural errors in clinical settings. (2) Method: This study utilized computer vision for hand pose estimation to model skeletal hand movements during in situ aseptic drug compounding procedures. High-definition video cameras recorded hand movements while practitioners wore medical gloves of different colors. Hand poses were manually annotated, and machine learning models were developed and trained using the DeepLabCut interface via an 80/20 training/testing split. (3) Results: The developed model achieved an average root mean square error (RMSE) of 5.89 pixels across the training data set and 10.06 pixels across the test set. When excluding keypoints with a confidence value below 60%, the test set RMSE improved to 7.48 pixels, reflecting high accuracy in hand pose tracking. (4) Conclusions: The developed hand pose estimation model effectively tracks hand movements across both controlled and in situ drug compounding contexts, offering a first-of-its-kind medical glove hand tracking method. This model holds potential for enhancing clinical training and ensuring procedural safety, particularly in tasks requiring high precision such as drug compounding. [ABSTRACT FROM AUTHOR]

The management of wounds by health professionals usually involves aseptic technique. An alternative is the use of clean techniques where the risk of infection is minimised but use of non-sterile materials is considered permissible. This systematic review and meta-analysis compares these two approaches. Nine studies met the inclusion criteria. Overall risk of bias was judged to be low. The random-effects relative risk of infection for clean dressings rather than aseptic dressings was 0.86 (95% CI 0.67, 1.12). There was little evidence of statistical heterogeneity, although the small number of infections in either group resulted in wide confidence intervals. The 95% prediction interval for future studies was 0.63, 1.18. There was therefore no evidence showing inferiority of clean techniques compared to aseptic methods. Before clinical studies are undertaken with higher risk procedures, laboratory simulations should explore safety by investigating the potential for pathogen transmission at each stage in the dressing procedure. [ABSTRACT FROM AUTHOR]

A recent study confirmed significant contamination of syringe tips following routine anaesthesia practice of at least 6 h in duration. We assessed the relative efficacy of clinically relevant syringe tip disinfection techniques following contamination with the hyper transmissible and more pathogenic Staphylococcus aureus sequence type 5 (S. aureus ST5) strain characteristic associated with increased strength of biofilm formation and greater desiccation tolerance. Syringe tips (N= 40) contaminated with S. aureus ST5 were randomized to 70% isopropyl pads with 10 or 60 s of drying time, scrubbing alcohol disinfection caps with 10 or 60 s of dwell time, or to non-scrubbing alcohol disinfection caps with 60 s of dwell time. The primary outcome was residual 24-h colony forming units (cfu) >10. Scrubbing disinfection caps were more effective than alcohol pads (25% (12/48) <10 cfu for scrubbing caps (10- or 60-s dwell times) vs 0% (0/48) <10 cfu for alcohol pads (10 or 60 s of drying time), Holm–Sidak adjusted P =0.0016). Scrubbing disinfection caps were more effective than non-scrubbing alcohol disinfection caps (25% (12/48) <10 cfu for scrubbing alcohol caps (10- or 60-s dwell times) vs 2% (1/48) for non-scrubbing alcohol caps (60-s dwell time), adjusted P =0.0087). Scrubbing alcohol caps are more effective than alcohol pads or non-scrubbing disinfecting caps for microbial reduction of syringe tips contaminated with the more pathogenic S. aureus ST5. [ABSTRACT FROM AUTHOR]

Introduction - Advances in ophthalmology and the discovery of antiangiogenic drugs administered by intravitreal injection have established a new way to treat retina diseases. The appearance of these drugs, in 2006, marked the approach and direction of age-related macular degeneration. The most commonly used anti-VEGF drugs for intravitreal injection are ranibizumab, bevacizumab, and aflibercept. These three drugs are commercially available in vials and do not need to be diluted or reconstituted. The solution only needs to be transferred aseptically into sterile syringes before administration. This method allows the entire content of a single--use vial can be divided into several syringes for storage and subsequent injection to different patients, enabling better management. Aim of the study - Describe a method used for fractionation of aflibercept and ranibizumab, using an aseptic technique. Methods - A narrative review of the literature was carried out. The method used was described according to the experience and procedures at the Professor Doutor Fernando Fonseca (HFF) Hospital pharmacy. Final considerations - In the context of the countless challenges facing healthcare institutions in Portugal and around the world, with a focus on their sustainability, the need to create strategies for managing medicines has become evident. For this reason, the fractionation of these drugs is dune, reducing costs and waste. [ABSTRACT FROM AUTHOR]

Health professionals frequently conduct procedures requiring asepsis but there is no definitive evidence-based guidance on how aseptic technique should be undertaken. To undertake content and cluster analysis to compare and contrast information relating to the conduct of aseptic technique in national and international guidance. Content and hierarchical cluster analysis. We identified 16 sources of information from: organizations that generate infection prevention guidelines, provide advice about infection prevention in addition to other topics, generate guidance for procedures (e.g., wound care); practice manuals; MeSH and Wikipedia. Content related to: theory underpinning aseptic technique; terminology used; how and when it should be undertaken; and equipment. The nature and amount of information varied widely. Most frequently stated information related to: environment or equipment (N = 13), followed by the absolute nature of asepsis and the importance of hand hygiene (N = 10); general personal protective equipment, the significance of pathogens, and no-touch techniques (N = 8); that it is risk-based (N = 7); the existence of key parts or sites, and that there are different types of aseptic technique (N = 6). The most comprehensive sources were a wound care organization in the USA, and a British internationally used textbook. Least information was provided in some general infection prevention guidelines. Progress with research and practice in relation to aseptic technique suffers through lack of common goals and understanding. This study is one step towards establishing what constitutes aseptic technique, how and when it should be conducted, and the equipment necessary. This is required to support practice, policy and education, and may improve sustainability of healthcare resources. [ABSTRACT FROM AUTHOR]

Invasive devices and breaches to skin and mucous membranes increase susceptibility to infection. Nurses frequently undertake procedures requiring asepsis (PRAs), but report challenges and unwarranted variations in practice. To explore nurses' experiences, perceived gaps in information and support needed to conduct PRAs. Qualitative interviews were undertaken with 20 nurses in the UK National Health Service between September 2021 and January 2022 employing approaches to sampling and data collection adopted in grounded theory. Informants were employed in diverse clinical settings. They thought that outside operating theatres, attempts to maintain asepsis would inevitably be compromised, but that much could still be done to contain the risk of contaminating susceptible sites irrespective of circumstances. Suboptimal practice was reported, and informants were unclear whether asepsis was needed to perform routine procedures (e.g. dressing chronic wounds, manipulating indwelling intravascular lines). Problems were attributed to inadequacies in nursing education, poor access to continuing professional development, and carelessness of junior nurses and medical staff. Informants wanted more detailed guidelines to conduct PRAs. Senior nurses wanted procedures to be conducted in the same way regardless of circumstance. Nurses who undertook PRAs regularly suggested that guidelines should be flexible. There is a need for detailed guidelines to inform PRAs, better access to clinical updating, and improvements in pre-registration nursing education. To meet contemporary standards, guideline generation should adopt recognized methodology. Student nurses should be introduced to the knowledge and skills required to undertake and adjust PRAs according to circumstance during simulated practice before contact with real patients. [ABSTRACT FROM AUTHOR]

Sterile dosage forms are pharmaceutical preparations that require to be free of microorganisms and particles. In health services, sterile preparations often undergo a series of changes in form from their original conditions to new products through dissolution or mixing with other sterile preparations. To maintain sterility, sterile preparation dispensing skills are needed. Regulation of the Minister of Health of the Republic of Indonesia No. 72 of 2016 and No. 74 of 2016 concerning Pharmaceutical Service Standards in Hospitals and Health Centers are intended to improve the quality of pharmaceutical services, guarantee legal certainty for pharmacists and protect patients and the public from irrational drug use in the context of patient safety. Pharmaceutical service standards in hospitals cover the management of pharmaceutical preparations, medical devices, consumable medical materials, and clinical pharmacy services. One of the standards in clinical pharmacy services is aseptic/sterile dispensing sterile. The community service aims to increase the knowledge and skills of pharmacists at Bandar Lampung health facilities and its surroundings in managing sterile preparations. The community service is held through a webinar with a zoom platform followed by discussion and an aseptic dispensing demonstration. The sterile dispensing demonstration are carried out by dividing the participants into four groups in the breakout room and each group was guided by a facilitator. In this activity, participants were provided with material on formulation, compatibility, and stability of pharmaceutical preparations, dispensing sterile preparations, aseptic techniques, and problems in sterile dispensing sterile at the hospital. The activity was attended by 63 pharmacists from 25 hospitals in Bandar Lampung and its surroundings, also academics in Tanjung Karang. The evaluation results showed an increase in participants' knowledge of 19,3% and participants expected that activities could be carried out periodically with various topics. The activities are expected to improve the patient's health status and enhance the role of the Faculty of Pharmacy, Universitas Airlangga in the National Health System. [ABSTRACT FROM AUTHOR]

Hand hygiene is the cornerstone of infection prevention but is poorly undertaken and under-appreciated by medical, nursing, and other health care students. This systematic review aimed to identify and describe strategies used to teach the theory and practice of hand hygiene, determine impact on knowledge and practice, and identify need for future education and research. Ten studies met the criteria for review. Health care students' theoretical knowledge of hand hygiene and their ability to practise are suboptimal and should be improved before they have contact with vulnerable patients. Educational input can increase knowledge and practice but the methodological heterogeneity of the studies and lack of rigour make it impossible to determine which interventions are most likely to be successful. The literature provides little evidence upon which to base educational practice in this area. There is a need for multi-centred longitudinal studies to measure effectiveness of teaching methods over time. [ABSTRACT FROM AUTHOR]

ABSTRACT Evidence-based studies on the benefits of integrating STEM into the arts are limited; however, some suggest that it can lead to improved scientific literacy and new approaches for artistic scholarship. Unfortunately, undergraduate education often creates disciplinary silos where the two are not integrated. Here, we discuss a unique collaboration between professors in the art and biology departments. Our goal was to integrate science into art courses using an agar art activity. We hypothesized that art students could effectively learn microbiology laboratory techniques and use them as novel tools for artistic practice. The activity was integrated into two to four sessions of introductory and advanced art courses over four semesters. After learning aseptic technique to culture bacteria, the students were supplied with a variety of media and bacterial strains and tasked with recreating a famous artist’s drawing or using their own artistic concept. Student learning was assessed using a rubric to evaluate their art and demonstrate that the learning outcomes were met. Improvement in aesthetic, conception, and technical proficiency in handling the bacteria were demonstrated when comparing their first attempt at creating agar art to their second. Advanced art students earned higher scores than introductory students; however, the average scores for all students were “proficient” or above suggesting that the learning outcomes were met. The art was externally evaluated through American Society for Microbiology's (ASM's) Agar Art Contest and each time, at least one of our student artworks was chosen as a finalist for the People’s Choice Award, providing validation of the success of our collaboration.

Objective: To implement the Comprehensive Unit-based Safety Program (CUSP) in four neonatal intensive care units (NICUs) in Pune, India, to improve infection prevention and control (IPC) practices.Design: In this quasi-experimental study, we implemented CUSP in four NICUs in Pune, India, to improve IPC practices in three focus areas: hand hygiene, aseptic technique for invasive procedures, and medication and intravenous fluid preparation and administration. Sites received training in CUSP methodology, formed multidisciplinary teams, and selected interventions for each focus area. Process measures included fidelity to CUSP, hand hygiene compliance, and central line insertion checklist completion. Outcome measures included the rate of healthcare-associated bloodstream infection (HA-BSI), all-cause mortality, patient safety culture, and workload.Results: A total of 144 healthcare workers and administrators completed CUSP training. All sites conducted at least 75% of monthly meetings. Hand hygiene compliance odds increased 6% per month [odds ratio (OR) 1.06 (95% CI 1.03–1.10)]. Providers completed insertion checklists for 68% of neonates with a central line; 83% of checklists were fully completed. All-cause mortality and HA-BSI rate did not change significantly after CUSP implementation. Patient safety culture domains with greatest improvement were management support for patient safety (+7.6%), teamwork within units (+5.3%), and organizational learning—continuous improvement (+4.7%). Overall workload increased from a mean score of 46.28 ± 16.97 at baseline to 65.07 ± 19.05 at follow-up (p < 0.0001).Conclusion: CUSP implementation increased hand hygiene compliance, successful implementation of a central line insertion checklist, and improvements in safety culture in four Indian NICUs. This multimodal strategy is a promising framework for low- and middle-income country healthcare facilities to reduce HAI risk in neonates.

Incorporation of aseptic technique validation testing in a pharmacy curriculum consistent with United States Pharmacopeia Chapter 797 Standards is not well described. Validation testing is optimally placed prior to assignment to health-system introductory and advanced pharmacy practice experiences. Environmental and engineering controls consistent with a segregated compounding area were implemented. Medium risk media fill and gloved fingertip test (GFT) testing were incorporated to achieve initial and subsequent training in the second and third curricular years, respectively. For the graduating classes of 2018 through 2020, 234 students completed validation testing and knowledge assessment. Failure of the media fill test was uncommon. Failure of the initial GFT testing occurred in 16.1% to 22.1% of second-year students and 3.2% to 5.8% of third-year students. No significant differences were seen between three consecutive student classes. Incorporation of validation testing was successful, with consistent results. Procedures and results provide guidance with respect to student class size, available facility/equipment needs, implementation of validation protocols, and associated resources. Each student is provided with documentation of annual training and validation testing consistent with existing standards for health-system pharmacy practice. [ABSTRACT FROM AUTHOR]

Aim: To appraise and synthesize empirical studies exploring undergraduate nursing students' education and training in aseptic technique. Design: Mixed methods, systematic literature review adopting Joanna Briggs Institute methodology. Data sources: Thirteen electronic databases were searched 1996–2020, followed by searches with a general browser, hand‐searching key journals and reviewing reference lists of retrieved papers. Review methods: Potentially eligible papers were scrutinised by two reviewers. Those eligible were critically appraised and quality assessed using the Critical Appraisal Skills Programme and Specialist Unit for Review Evidence checklists. Results: Of 538 potentially eligible studies, 27 met the inclusion criteria. There was limited evidence of the effectiveness of different teaching methods. Students' knowledge, understanding and competency varied and were often poor, although they reported confidence in their ability to perform aseptic technique. Students and qualified nurses perceived that education and training in aseptic techniques might be improved. Conclusion: Education and training in aseptic technique might be improved but the review findings should be viewed cautiously because the studies lacked methodological rigour. Impact: This appears to be the first systematic review to explore undergraduate nursing students' education and training in relation to aseptic technique. There was limited evidence to support the effectiveness of different teaching methods and scope for improving nursing students' knowledge, understanding and competency in aseptic technique. Students and qualified nurses suggested that education and training might be enhanced. More robust studies are required to support education, practice and policy. [ABSTRACT FROM AUTHOR]

Student-compounded sterile preparations have been evaluated using observational scores, sterility testing, and potency determinations. Observational scores and potency determinations can be evaluated simultaneously, and three studies have been published using these assessment tools. One study found a significant number of students could not compound an acceptably potent preparation despite receiving very good observational scores. The previous study was judged to have an inferior instructional flaw, so a new teaching design, a "practice makes perfect" model, was utilized and was expected to increase the number of students compounding acceptably potent preparations. The "practice makes perfect" method provided students with more practice and one-on-one instruction time in aseptic techniques. First-year pharmacy students received both group practice sessions and individualized instruction on six occasions interspersed between three compounding assessments. Observational scores and potency results were compared between this study and the previously published study. The "practice makes perfect" strategy improved students' observational scores but showed inconsistent results in the percentage of students who compounded an acceptably potent preparation and in the potency of preparations compounded by all students. There was no correlation between observational scores and potency values or between observational scores and the percentage of students compounding acceptably potent preparations at each individual observational score. The study demonstrated that there was either a systematic error in the analytical potency protocol or that the observations made during student compounding were not adequate to identify problems that led to poor potency. [ABSTRACT FROM AUTHOR]

Abstract Background Catheter-related bloodstream infections (CR-BSI) cause high neonatal mortality and are related to inadequate aseptic technique during the care and maintenance of a catheter. The incidence of CR-BSI among neonates in Hung Vuong Hospital was higher than that of other neonatal care centres in Vietnam. Methods An 18-month pre- and post-intervention study was conducted over three 6-month periods to evaluate the effectiveness of the intervention for CR-BSI and to identify risk factors associated with CR-BSI. During the intervention period, we trained all nurses in the Department of Neonatology on BSI preventive practices, provided auditing and feedback about aseptic technique during catheter care and maintenance, and reorganised preparation of total parenteral nutrition. All neonates with intravenous catheter insertion ≥48 h in the pre- and post-intervention period were enrolled. A standardised questionnaire was used to collect data. Blood samples were collected for cultures. We used Poisson regression to calculate rate ratio (RR) and 95% confidence interval (CI) for CR-BSI incidence rates and logistic regression to identify risk factors associated with CR-BSI. Results Of 2225 neonates enrolled, 1027 were enrolled in the pre-intervention period, of which 53 CR-BSI cases occurred in 8399 catheter-days, and 1198 were enrolled in the post-intervention period, of which 32 CR-BSI cases occurred in 8324 catheter-days. Incidence rates of CR-BSI significantly decreased after the intervention (RR = 0.61, 95% CI 0.39–0.94). Days of hospitalisation, episodes of non-catheter–related hospital-acquired infections, and the proportion of deaths significantly decreased after the intervention (p

The objective of our study was to evaluate the aseptic technique used in interventional rheumatology by Moroccan and Tunisian rheumatologists. We performed an online survey among rheumatologists from Morocco and Tunisia. The questionnaire included 15 questions with single and multiple-choice answers and three open sections for freetext comments. An online survey was prepared and sent to 380 rheumatologists. One hundred and four rheumatologists (27.36%) replied to the survey. More than half of the participants (56.7%) were from Tunisia and 43.3% were from Morocco. Interventional procedures on superficial joints were performed by all participants. Ultrasonography was used by 41.3% of respondents to guide interventional procedures. Regarding the aseptic precautions taken to avoid infection, the majority of participants used povidone iodine to clean the skin and only 8.7% wore a mask. Hand washing alone without gloves wearing was done by 19.2% of participants. 2.9% of participants reported a history of iatrogenic septic arthritis and the duration of practice was the only factor associated with its occurrence (P=0.007). Our study showed that aseptic technique used during interventional rheumatologic procedures is heterogeneous. However, the majority of participants were aware of its necessity to avoid iatrogenic septic arthritis.

Introduction Recent endeavors from governing bodies such as the AAMC have formally recognized the importance of aseptic technique. AAMC guidelines include activities that all graduating physicians should be able to perform with minimum indirect supervision and were developed to recognize these needs. For example, the skills necessary for aseptic technique include daily safety habits and general physician procedures. Methods We developed a scrub training curriculum and evaluated the program through a quasi-experimental study with a pre- and posttest design. Questions were developed to examine students' perceived knowledge and skills as related to the objectives of the course and to their anxieties, concerns, and future training needs. Results Between February 2020 and March 2020, 44 students completed the curriculum. Students indicated that self-efficacy significantly increased in all aspects of the curricular goals following curriculum completion. Students identified understanding OR etiquette as the most anxiety-provoking element associated with scrub training. They felt that more time could be spent elucidating this etiquette. On the other hand, tasks such as surgical hand hygiene were the least anxiety-inducing. Discussion We share this multimodal scrub training curriculum, mapped to the AAMC's guidelines, to reduce variability in teaching strategies and skills acquisition through a standardized curriculum. Also, we effectively imparted these skills and instilled a sense of confidence in learners as they worked to provide their best in patient care and safety.

Introduction Sterile technique is a basic technical skill used for a number of bedside procedures. Proper use of sterile technique improves patient safety by reducing infection risk. Methods We applied the principles of mastery learning to develop a simulation-based mastery learning module for sterile technique that was used as part of a 2-week internship preparatory course for fourth-year medical students. Forty-one medical students entering surgical or emergency medicine internships completed the module. Learners demonstrated baseline skills with a pretest, watched a didactic online video, participated in supervised deliberate practice sessions, and then completed a posttest. Physicians evaluated performance using a nine-item mastery checklist validated by a multispecialty panel of board-certified physicians. Learners who did not demonstrate mastery by correctly performing all nine checklist items received formative feedback and repeated the posttest as needed until mastery was achieved. Results No learners demonstrated mastery of sterile technique during pretesting. A total of 100% of learners demonstrated mastery of sterile technique during either their first or second attempt of the posttest. The learners reported statistically significantly higher levels of confidence at the end of the module. Discussion Our module highlights the skills gap that exists in the transition from undergraduate to graduate medical education and offers a cheap, effective, and easily reproducible curriculum for sterile technique that could be widely adopted for many learner populations.

This article discusses the importance of effective skin antisepsis prior to the insertion of peripheral intravenous catheters (PIVCs) and how best clinical practice is promoted by application of an appropriate method of skin disinfection integrated effectively with a proprietary aseptic non touch technique, or other standard aseptic technique. Historically under-reported, incidence of infection and risk to patients from PIVCs is now increasingly being recognised, with new research and evidence raising concern and helping to drive new clinical guidance and improvement. The risks posed by PIVCs are particularly significant given increasing PIVC dwell times, due to cannula removal now being determined by new guidance for clinical indication, rather than predefined time frames. Clinical ‘best practice’ is considered in context of the evidence base, importantly including availability and access to appropriate skin antisepsis products. In the UK, and other countries, ChloraPrep is the only skin antisepsis applicator licensed as a drug to disinfect skin and help prevent infections before invasive medical procedures, such as injections, blood sampling, insertion of PIVCs and minor or major surgery. [ABSTRACT FROM AUTHOR]

Copyright of Kufa Journal for Nursing Sciences is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Midazolam hydrochloride is an injection form of benzodiazepines and included in the high alert category in the Dr. Soetomo Teaching Hospital Intensive Care Unit (ICU), Surabaya, Indonesia. Nowadays, the technical preparation of midazolam drugs in the ICU room by doctors and nurses was performed by reconstituting drugs in the injection syringes to be stored for a while in the room. Objectives: To evaluate the preparation process for midazolam hydrochloride injection which has been analyzed in Dr. Soetomo Teaching Hospital. Methods: Physical, chemical, and microbiological stability of 1 mg/mL midazolam hydrochloride in aqua pro injection solvents have been evaluated at points 0, 8, 12, and 24 hours after preparation, as well as a comparison of stability in storage conditions at room temperature compared to refrigerator temperatures. Results: The results showed all the preparations were no foreign particles in the sample container. The midazolam did not experience precipitation in both room and refrigerator temperatures. The pH of midazolam solution during storage proved that the preparation was relatively stable (pH 4.3-4.5). There were no significant differences of midazolam levels in both storages which was in range of 95%. The Miccrobiology Stability Test showed negative germ growth after 24 hours incubation in both storage. Conclusion: This study showed no changes in physical, chemical, or microbiological stability in the midazolam injection samples up to 24 hours after the manufacturing process. [ABSTRACT FROM AUTHOR]

Objective: To determine the bio-burden of isolated bacteria from multi-vitamin syrups manufactured by local industry of Peshawar. Methodology: This cross-sectional study was conducted at Sarhad University of Information Technology and Khyber Medical University Peshawar, from July 2017 to December 2017. Microbiological quantification of nine different multivitamin syrups purchased randomly from different medicine stores was performed. The microbial load was determined by using the viable cell count method. Sample preparation was done through serial dilution and identification of bacteria was made on the basis of morphological and colonial characteristics, and by using biochemical tests. Antibiotic susceptibility profiles were determined by the Kirby Bauer disk diffusion method and interpretations were made according to Clinical and Laboratory Standards Institute (CLSI) guidelines. A total of 9 different antibiotics were tested against gram-positive bacteria while 7 different antibiotics were tested against gram-negative bacteria. Results: All samples were found to be contaminated and the bio-burden exceeded the permissible limit set by the United States Pharmacopeia (USP). The overall frequency of Staphylococcus aureus was 55 % followed by Escherichia coli at 44%, Pseudomonas aeruginosa at 33% and Salmonella spp at 22%. All samples showed a pH within range of 5 to 9. Out of the gram-positive isolates, highest sensitivity (100%) was observed to Gentamycin, Ciprofloxacin, Chloramphenicol and Vancomycin. Pseudomonas aeruginosa was 100% sensitive to Ofloxacin, Gentamicin and Meropenem. Escherichia coli showed high sensitivity to Meropenem (100%) and Oflaxacin (100%) followed by Gentamicin (75%). Salmonella spp showed maximum sensitivity to Gentamicin (100%), Ofloxacin (100%) and Meropenem (100%). While high resistance was observed to Amoxicillin (100%), Cefotaxime (100%) and Clindamycin (50%). Conclusion: All samples were contaminated with pathogenic bacteria. Most of the bacteria were sensitive to antibiotics. [ABSTRACT FROM AUTHOR]

Copyright of Meandros Medical & Dental Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Hand hygiene and aseptic techniques are essential preventives in combating hospital-acquired infections. However, implementation of these strategies in the operating room remains suboptimal. There is a paucity of intervention studies providing detailed information on effective methods for change. This study aimed to evaluate the process of implementing a theory-driven knowledge translation program for improved use of hand hygiene and aseptic techniques in the operating room. Methods The study was set in an operating department of a university hospital. The intervention was underpinned by theories on organizational learning, culture and person centeredness. Qualitative process data were collected via participant observations and analyzed using a thematic approach. Results Doubts that hand-hygiene practices are effective in preventing hospital acquired infections, strong boundaries and distrust between professional groups and a lack of psychological safety were identified as barriers towards change. Facilitated interprofessional dialogue and learning in “safe spaces” worked as mechanisms for motivation and engagement. Allowing for the free expression of different opinions, doubts and viewing resistance as a natural part of any change was effective in engaging all professional categories in co-creation of clinical relevant solutions to improve hand hygiene. Conclusion Enabling nurses and physicians to think and talk differently about hospital acquired infections and hand hygiene requires a shift from the concept of one-way directed compliance towards change and learning as the result of a participatory and meaning-making process. The present study is a part of the Safe Hands project, and is registered with ClinicalTrials.gov (ID: NCT02983136 ). Date of registration 2016/11/28, retrospectively registered.

Background and aims:Aloe vera has been used medicinally for several thousands of years in many cultures from Egypt, Greece, and Rome to China, India, and etc. Although Aloe barbadensis propagates vegetative manner in its natural state, but propagation is too slow for commercial plant production. To overcome slow propagation rate, micropropagation will be a very useful technique for mass multiplication of Aloe vera. The aim of this study was to investigate and establish an effective method for aseptic micropropagation of Aloe vera.Methods: This researchwas an experimental study that was conducted in tissue culture lab, Department of Genetics and Plant Breeding, BHU, Varanasi, India to develop a protocol for surface sterilization of Aloe vera explants. 42 treatments carried out for the shoot tip, apical meristem and rhizome discs of Aloe explant.Results: Using of Tween 20 (5 drops) for 10 mints, Bavistin 1% for 10 mints and NaOCl (1.0%) for 6 minutes followed by rinsing sterilized distilled water showed the higher survival explants (70%) and asepsis was 81% and just 11% percent of the explants contaminated after 2 weeks. But the highest survived explants was for Tween 20 (5 drops) 10 minutes, Bavistin 1%; 10 minutes and Ca(ClO)2 (3.25.0%) 6 minutes (77% survival) and asepsis was 81% and only 11% of the explants contaminated after 2 weeks.Conclusion: In the present study, calcium hypochlorite with the highest asepsis, survival of explant and normally growth were more suitable than sodium hypochlorite for surface sterilization of Aloe vera.

Surgical site infection is a significant clinical problem leading to morbidity and mortality as it can result to infections, pain, misery and unnecessary increase in health cost. Thus, this study sought to identify challenges and barriers that nurse face in the use of aseptic technique and its application in wound dressing at the surgical unit of the Bamenda Regional Hospital. This was a cross-sectional hospital based survey. Questionnaires were administered to 20 nurses randomly selected. Demographics and nurses' knowledge and barriers faced in the implementation of the aseptic techniques and was analyzed. It was observed that 20% of the nurses follow aseptic techniques strictly, while a majority (80%) have never followed aseptic techniques seriously, with major reasons mentioned by the participants being restrained supply of equipment's and financial constraints of patients. From this study, it can be deduced that despite the awareness, of nurses on the importance of aseptic techniques, its application still remains low among them due to the various challenges they face with limited resources of patients and also inadequate materials at their disposals for use in wound management.

The article focuses on nursing and medical personnel and their attitudes and engagement toward the implementation of a new standardized aseptic technique (AT) practice at an emergency department (ED) of a tertiary hospital in Perth, Australia. According to the article, themes of facilitating adaptive change include consistency, acknowledgement, communication, and understanding.

Background: Catheter-related bloodstream infections (CR-BSI) cause high neonatal mortality and are related to inadequate aseptic technique during the care and maintenance of a catheter. The incidence of CR-BSI among neonates in Hung Vuong Hospital was higher than that of other neonatal care centres in Vietnam. Methods: An 18-month pre- and post-intervention study was conducted over three 6-month periods to evaluate the effectiveness of the intervention for CR-BSI and to identify risk factors associated with CR-BSI. During the intervention period, we trained all nurses in the Department of Neonatology on BSI preventive practices, provided auditing and feedback about aseptic technique during catheter care and maintenance, and reorganised preparation of total parenteral nutrition. All neonates with intravenous catheter insertion ≥48 h in the pre- and post-intervention period were enrolled. A standardised questionnaire was used to collect data. Blood samples were collected for cultures. We used Poisson regression to calculate rate ratio (RR) and 95% confidence interval (CI) for CR-BSI incidence rates and logistic regression to identify risk factors associated with CR-BSI. Results: Of 2225 neonates enrolled, 1027 were enrolled in the pre-intervention period, of which 53 CR-BSI cases occurred in 8399 catheter-days, and 1198 were enrolled in the post-intervention period, of which 32 CR-BSI cases occurred in 8324 catheter-days. Incidence rates of CR-BSI significantly decreased after the intervention (RR = 0.61, 95% CI 0.39–0.94). Days of hospitalisation, episodes of non-catheter–related hospital-acquired infections, and the proportion of deaths significantly decreased after the intervention (p < 0.01). The CR-BSI was associated with days of intravenous catheter (odds ratio [OR] = 1.05, 95% CI 1.03–1.08), use of endotracheal intubation (OR = 2.27, 95% CI 1.27–4.06), and intravenous injection (OR = 8.50, 95% CI 1.14–63.4). Conclusions: The interventions significantly decreased the incidence rate of CR-BSI. Regular refresher training and auditing and feedback about aseptic technique during care and maintenance of catheters are critical to reducing CR-BSI. [ABSTRACT FROM AUTHOR]

Wound care is an expansive and multifaceted topic, which has evolved into a highly specialised field of practice within the modern-day healthcare setting. The overall incidence of wounds is high, as might be expected, but the variety, circumstances and challenges that pertain to wound care are just as extensive. The latter fact makes an in-depth discussion of wound care, in an article of limited scope, impossible. Therefore, this article aims to provide a high-level overview only and is meant to serve as a mere introduction to, and basic overview of, this fascinating topic. [ABSTRACT FROM AUTHOR]

Community nurses often face challenges when going into a patient's home to change a dressing, particularly if the surroundings are likely to be contaminated by multiple strains of bacteria or viruses. For housebound patients, cleaning the house can be an extremely difficult task due to physical or mental illness. They may also experience a large amount of exudate as a result of possibly debilitating painful wounds, for example, leg ulcers, and may be prone to infection as a result of the difficulties posed in keeping a dressing covering a heavily exuding wound in a possibly unclean environment. Therefore, it is of the utmost importance that a community nurse or healthcare worker be able to change the wound dressing in the cleanest and most supportive manner. This article covers the most recent guidance and research relevant to the practice of aseptic or clean technique when changing dressings in the community. [ABSTRACT FROM AUTHOR]

The lower periorbital area shows signs of ageing before other parts of the face and hyaluronic acid is an increasingly popular choice for patients concerned with the cosmetic appearance of this area. Administering treatment to the lower periorbital area takes skill and an understanding of the underlying anatomy to provide the desired outcome without triggering complications. Aseptic technique is also crucial for safe treatment. [ABSTRACT FROM AUTHOR]

Background: Infectious complications following neuraxial block, although being of low incidence, may lead to morbidity and mortality. Two common methods utilised for skin disinfection before skin anaesthesia prior to a neuraxial block are the isopropanol only method (isopropanol method) and the full aseptic technique (classic method). The objective of this study was to survey government-employed South African anaesthesiologists' preference regarding the disinfection practices before the administration of local anaesthetic agents to the skin prior to the performance of a neuraxial block. Methods: Ethics approval was obtained prior to commencing the study. An electronic, web-based questionnaire in the form of a survey was distributed to various anaesthetic departments in various government teaching hospitals in South Africa. Descriptive statistics were used on the raw data using the Fisher exact test to measure associations between the different categorical variables. Results: A significant response rate of 60.3% was achieved. Regarding subarachnoid blocks, more than half of the participants (52.0%) that participated in the survey utilise the isopropanol method whereas less than half of the participants utilise the isopropanol method when performing an epidural block. Close to 75% of participants with zero to five years anaesthetic experience prefer the isopropanol method whilst only 20.9% of anaesthetists with more than ten years' experience prefer the isopropanol method when performing a subarachnoid block (p < 0.01). Conclusion: Both methods described in this study (classic and isopropanol methods) are practised commonly by the participants in the survey and neither the classic nor the isopropanol method dominates. Local guidelines need to address the technique used to disinfect the skin before the administration of the local anaesthetic agent to the skin prior to performing a neuraxial block. [ABSTRACT FROM AUTHOR]

We describe an interdisciplinary research project for undergraduate students involving microbiology and public health. Students designed and carried out two research studies on hand hygiene and the use of gloves by mobile food vendors in New York City and in a New Jersey mall. Students received training in aseptic techniques and survey methodology to carry out the multifaceted study. We discuss the importance of interdisciplinary collaboration and research in the context of its value in preparing professionals in the fields of biology and public health. [ABSTRACT FROM AUTHOR]

Abstract Background Clinicians play an essential role in the implementation of infection prevention policy. Despite this, little is known about how infection control policy is implemented at an organizational level or what factors influence this process. In this study, we explore these factors and the policy implementation process in the context of the introduction of a national large-scale, government-directed infection prevention policy in Australia. Methods Focus groups with infection control professionals were held in 3 states to investigate the perspectives of infection control professionals involved in the implementation of aseptic technique policy requirements in Australian hospitals. Data were analyzed using an interpretive description approach, with themes mapped to the Consolidated Framework for Implementation Research. Results Common contextual factors were identified across all levels of the healthcare system that influenced implementation of the infection control policy, including external factors associated with the policy itself and the regulatory nature of government-directed policy. Conclusions This study suggests that there may be particular constructs and contextual factors that are specific to policy implementation in the hospital setting. A better understanding of these factors and their influence on policy implementation would present an opportunity for improved implementation planning, resource allocation, and more effective policy development. [ABSTRACT FROM AUTHOR]

Background Even though hand hygiene and aseptic techniques are essential to provide safe care in the operating room, several studies have found a lack of successful implementation. The aim of this study was to describe facilitative mechanisms supporting the implementation of hand hygiene and aseptic techniques. Methods This study was set in a large operating room suite in a Swedish university hospital. The theory-driven implementation process was informed by the literature on organizational change and dialogue. Data were collected using interviews and participant observations and analyzed using a thematic approach. The normalization process theory served as a frame of interpretation during the analysis. Results Three facilitating mechanisms were identified: (1) commitment through a sense of urgency, requiring extensive communication between the managers, operating room professionals, and facilitators in building commitment to change and putting the issues on the agenda; (2) dialogue for co-creation, increasing and sustaining commitment and resource mobilization; and (3) tailored management support, including helping managers to develop their leadership role, progressively involving staff, and retaining focus during the implementation process. Conclusions The facilitating mechanisms can be used in organizing implementation processes. Putting the emphasis on help and support to managers seems to be a crucial condition in complex implementation processes, from preparation of the change process to stabilization of the new practice. [ABSTRACT FROM AUTHOR]

Objective: To develop and apply a novel surgical aseptic technique curriculum in specialty training for operating room (OR) nurses. Methods: As surgical environments were improved, related specifications were revised. The proposed surgical aseptic procedure was discussed, improved, and recorded as procedure videos. In the new training program, traditional theoretical lecture training was replaced with sequential theoretical lessons and video demonstration, operation presentation, and skill competition. At the end of the training, the trainees were given questionnaires to assess training outcomes. Differences in student satisfaction regarding the proposed training program and conventional training programs were then compared. Results: A GPA of 3.61 ± 0.58 was recorded after the new training program was implemented. The minimum and maximum average scores of each item were 3.05 ± 0.43 and 4.61 ± 0.33, respectively The satisfaction rate of the trainees in 2013 was significantly higher than that in 2011 (t = 2.14, P = 0.039). Conclusion: Novel surgical aseptic technique and application in the curriculum design of training for OR nurses should be developed to enhance their mastery of theoretical and practical skills and to modify their behaviors.

Infection is kolonalisasi conducted by foreign species of host organisms, and are Pilang harm the host (Brunner and Suddarth, 2002). Based on preliminary survey Kenanga room Sunan Kalijaga Demak Hospital in January - March 2010 there were 109 patients with open wounds stage I-III due to accidents, there were 9% (9 patients), wound infection characterized by pus out of wounds, sores and dirty looks wet. The purpose of the research was to determine the effect of the management of aseptic techniques in open wound treatment stage II-III on the incidence of infection in Kenanga room Hospitals Sunan Kalijaga Demak. Quasi-experimental research design, methods of correlation. The population of patients open wounds with stage II -III in hospitals Sunan Kalijaga Demak (15 September to 30 October 2010 and 14 - 24 January 2011), the sample is 25 patients. Research tool dalah observation sheet. To determine the influence of the management of aseptic technique in handling the open wound stage II-III on the incidence of infection in Kenanga room hospitals Sunan Kalijaga Demak. Respondents were male sex (88 %), surgery or an open wound for wound surgery hernia respondents (44%) and average treatment time 6 days. Type of clean wounds 24 (96 %) clean contaminated wounds 1 (4 %). Respondents were infected wound 4 (16 %). From the analysis wilcoxon nilai p value 0,048 < 0,05, so that there is effect the management of aseptic technique in handling the open wound stage II-III on the incidence of infection in Kenanga room hospitals Sunan Kalijaga Demak. The results can be used as a reference in improving and developing methods of prevention and treatment of infection is open sores, especially stage II-III in Kenanga room hospitals Sunan Kalijaga Demak.

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It is with interest how I have seen the care, management and review of patients with intravenous catheters (IVCath) over the years. How our attitudes and approaches have (and always will) continue to change as we learn more about the body, the healing process, the dos and the don’ts through our own experiences and learning. There have been a number of articles recently that have highlighted the correct method of placing an IVCath and the management behind this; however, I feel there is a small hole here behind what is considered a patency check over that of a phlebitis check. [ABSTRACT FROM AUTHOR]

Background In many countries, aseptic procedures are undertaken by nurses in the general ward setting, but variation in practice has been reported, and evidence indicates that the principles underpinning aseptic technique are not well understood. Methods A survey was conducted, employing a brief, purpose-designed, self-reported questionnaire. Results The response rate was 72%. Of those responding, 65% of nurses described aseptic technique in terms of the procedure used to undertake it, and 46% understood the principles of asepsis. The related concepts of cleanliness and sterilization were frequently confused with one another. Additionally, 72% reported that they not had received training for at least 5 years; 92% were confident of their ability to apply aseptic technique; and 90% reported that they had not been reassessed since their initial training. Qualitative analysis confirmed a lack of clarity about the meaning of aseptic technique. Conclusion Nurses' understanding of aseptic technique and the concepts of sterility and cleanliness is inadequate, a finding in line with results of previous studies. This knowledge gap potentially places patients at risk. Nurses' understanding of the principles of asepsis could be improved. Further studies should establish the generalizability of the study findings. Possible improvements include renewed emphasis during initial nurse education, greater opportunity for updating knowledge and skills post-qualification, and audit of practice. [ABSTRACT FROM AUTHOR]