Search

Presenteeism, i.e. attending work while ill, is known to be more prevalent among employees with a higher workload and/or job strain. Recently, the COVID-19 pandemic had a significant impact on the workload and strain experienced by environmental service workers (ESW). Drawing on both the Effort-Recovery Model and Organizational Support Theory, the model presented in this study evaluates the direct and indirect relationships (i.e. through depressive symptoms) between presenteeism and job satisfaction amongst ESW amid the pandemic. It also evaluates the moderating role of perceived organizational support in this first relationship. A small sample of ESW working in a Canadian hospital participated in this exploratory study by completing an electronic questionnaire. The results show three main findings. First, presenteeism was positively related to depressive symptoms and negatively related to job satisfaction. Second, depressive symptoms were found to be one of the mechanisms through which presenteeism exerted its effect on job satisfaction. Third, perceived organizational support was found to moderate the negative relationship between depressive symptoms and job satisfaction, so this relationship became weaker as perceived organizational support increased. Overall, this pilot study is one of few that have focused on the experience of hospital-based ESW, and the pandemic's effects on their well-being. [ABSTRACT FROM AUTHOR]

Introduction and aim. The period immediately after leaving the hospital is known as the transition home, which presents a critical time for parents to take on all the responsibilities and care of a child without the support of the hospital environment. The purpose of this study is to culturally adapt the Pediatric Transition Experience Measure (P-TEM) instrument into Turkish and test its validity and reliability. Material and methods. We conducted this methodological study with parents of children who were discharged from the hospital between May 2021 and May 2022. We evaluated linguistic, content, construct, convergent validity, and internal consistency. Results. The P-TEM exhibited a two-factor structure and accounted for 65% of the overall variability. The internal consistency reliability for the transition preparation and transition support subdimensions was 0.779 and 0.793, respectively, while the total measure had a reliability of 0.831. The item-total correlations for the P-TEM ranged from 0.493 to 0.671. Parents who received the highest P-TEM scores experienced a 5.1-point improvement (95% confidence interval: 1.7 to 8.6) in their satisfaction with healthcare services, which was greater than that of parents who reported lower P-TEM scores. Conclusion. It is worth noting that the P-TEM has been validated and has high reliability in Türkiye [ABSTRACT FROM AUTHOR]

Les unités hospitalières spécialement aménagées (UHSA) sont des dispositifs récents en France pour le soin en psychiatrie à des personnes détenues. Celles-ci s'inscrivent dans une histoire et un contexte plus large d'imbrication santé–justice. Cet article propose une lecture contextuelle du soin au sein de l'UHSA où nous exerçons. Autour de l'axe espace–temps nous avons décodé des manières de lire le vécu et l'expression psychopathologie des troubles de personnes incarcérées. L'écrasement de l'espace et du temps nous paraît particulièrement prégnant dans le milieu carcéral et demande parfois des solutions autres. L'hospitalisation dans nos murs en est une et certains patients reviennent régulièrement. L'UHSA au niveau de l'espace, du temps et de la relation, prend en charge et accompagne les patients dans un décalage du monde carcéral. À partir des modes d'entrée dans le soin, avec ou sans consentement, se lisent des manières d'être hospitalisé et de s'approprier les soins. Notre hypothèse est que ce lieu permet une sortie ou un enfermement supplémentaire en milieu hospitalier. Unités hospitalières spécialement aménagées (UHSA) are recent French structures offering psychiatric care to incarcerated persons. UHSA are part of a broader history and context of the interweaving of care and justice. This article proposes a contextual reading of the care processes within the UHSA in which we work. By following a spatio-temporal axis, we have avenues for reading the experience and psychopathological expression of the disorders of incarcerated people. The crushing of space and time seems to us particularly prevalent in the prison environment and sometimes requires other solutions. Hospitalization in a UHSA is now one of them, and some patients return here regularly. UHSA, in terms of space, time and relationships, takes charge of patients and accompanies them in a different way from the prison world. By starting from the ways of entry into care, with or without consent, we can read the ways of being hospitalized and of appropriating care. Our hypothesis is that this place allows an exit or an additional confinement in the hospital environment. [ABSTRACT FROM AUTHOR]

Copyright of Erzincan University Journal of Science & Technology is the property of Erzincan Binali Yildirim Universitesi 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.)

On any given day, about one in 25 hospital patients in the United States has a health care-associated infection (HAI) that the patient contracts as a direct result of his or her treatment. Fortunately, the spread of most HAIs can be halted through proper disinfection of surfaces and equipment. Consequently, cleaners--"environmental services" (EVS) in hospital parlance--must take on the important task of defending hospital patients (as well as staff and the broader community) from the spread of HAIs. Despite the importance of this task, hospitals frequently outsource this function, increasing the likelihood that these workers are under-rewarded, undertrained, and detached from the organization and the rest of the care team. As a result, the outsourcing of EVS workers could have the unintended consequence of increasing the incidence of HAIs. The authors demonstrate this relationship empirically, finding support for their theory by using a self-constructed data set that marries infection data to structural, organizational, and workforce features of California's general acute care hospitals. The study thus advances the literature on nonstandard work arrangements--outsourcing in particular--while sounding a cautionary note to hospital administrators and health care policymakers. [ABSTRACT FROM AUTHOR]

With the outbreak of the COVID-19, investigating the way in which people react to epidemics from a social point of view seems necessity. A lesser-known societal feature of COVID-19 consists of the trust that COVID-19 patients have in the modern medical institutions, which will be addressed in this research from the standpoint of institutional trust theories, most notably Giddens' Theory of Abstract Systems Trust, and through Braun and Clarke's thematic analysis of the collected data. The statistical population for this study is comprised of COVID-19 patients, who have been infected with the virus between since the outbreak of the disease in September 2020. Twenty-one patients were chosen through a purposive sampling method, and semi-structured interviews were conducted them. According to the research findings, COVID-19 patients' opinions can be classified into three categories: 'medical science and expertise', 'hospital environment,' and 'medical staff,' each of which contains sources of trust and distrust. Among the COVID-19 patients that have been interviewed, there appears to be a boost in public trust in medical personnel, while these patients' trust in medical science and expertise, as well as in the hospital environment, has eroded. [ABSTRACT FROM AUTHOR]

Despite the popularity of the humanization movement in healthcare environments, there has been no systematic implementation of design changes aimed at reducing the negative effects of hospital environments. This article reviews the contributions made by psycho-environmental research about the psycho-social implications of design for users' health and well-being in the areas of healthcare, patient engagement, social interaction, spatial orientation and environmental stress. It also proposes recommendations for spatial design regarding the dual function of hospitals as a place of care for patients and a place of work for staff members. Finally, it discusses the amplification of the negative effects of hospital settings during the COVID-19 pandemic. This review provides a basic guide to the environmental effects of hospitals aimed at health professionals with a view to improving healthcare. [ABSTRACT FROM AUTHOR]

Background: Cleanliness of hospital surfaces helps prevent healthcare-associated infections, but comparative evaluations of various cleaning strategies during COVID-19 pandemic surges and worker shortages are scarce. Purpose and methods: To evaluate the effectiveness of daily, enhanced terminal, and contingency-based cleaning strategies in an acute care hospital (ACH) and a long-term care facility (LTCF), using SARS-CoV-2 RT-PCR and adenosine triphosphate (ATP) assays. Daily cleaning involved light dusting and removal of visible debris while a patient is in the room. Enhanced terminal cleaning involved wet moping and surface wiping with disinfectants after a patient is permanently moved out of a room followed by ultraviolet light (UV-C), electrostatic spraying, or room fogging. Contingency-based strategies, performed only at the LTCF, involved cleaning by a commercial environmental remediation company with proprietary chemicals and room fogging. Ambient surface contamination was also assessed randomly, without regard to cleaning times. Near-patient or high-touch stationary and non-stationary environmental surfaces were sampled with pre-moistened swabs in viral transport media. Results: At the ACH, SARS-CoV-2 RNA was detected on 66% of surfaces before cleaning and on 23% of those surfaces immediately after terminal cleaning, for a 65% post-cleaning reduction (p = 0.001). UV-C enhancement resulted in an 83% reduction (p = 0.023), while enhancement with electrostatic bleach application resulted in a 50% reduction (p = 0.010). ATP levels on RNA positive surfaces were not significantly different from those of RNA negative surfaces. LTCF contamination rates differed between the dementia, rehabilitation, and residential units (p = 0.005). 67% of surfaces had RNA after room fogging without terminal-style wiping. Fogging with wiping led to a -11% change in the proportion of positive surfaces. At the LTCF, mean ATP levels were lower after terminal cleaning (p = 0.016). Conclusion: Ambient surface contamination varied by type of unit and outbreak conditions, but not facility type. Removal of SARS-CoV-2 RNA varied according to cleaning strategy. Implications: Previous reports have shown time spent cleaning by hospital employed environmental services staff did not correlate with cleaning thoroughness. However, time spent cleaning by a commercial remediation company in this study was associated with cleaning effectiveness. These findings may be useful for optimizing allocation of cleaning resources during staffing shortages. [ABSTRACT FROM AUTHOR]

Methicillin-resistant coagulase negative Staphylococcus warneri (MR-CoNS) is the major source of infective diseases because of its capacity to form biofilm inhabiting the hospital environments or community to regulate the sensitivity of S. warneri to lemon oil and also examination of the anti-biofilm activity. Five isolates were taken from urinary tract infection and skin burns, tested by the VITEK-2 compact system (AST and ID) to confirm S. warneri. The diagnosis result showed one isolate due to S. warneri. The susceptibility of S. warneri to the formation of the biofilm was investigated in the presence and absence of glucose, exhibiting greater ability to form the biofilm in its presence. Penicillin G and Mixofloxacin were examined with the concentrations of MIC, sub-MIC and sub-sub-MIC, used to inhibit the formation of biofilm. The synergism activity was tested between lemon oil, penicillin G and moxifloxacin. The result displayed that a synergistic actvitity between the two antibiotics and lemon oil was the most efficient to prevent biofilm formation. [ABSTRACT FROM AUTHOR]

Copyright of Art of Healing / Sztuka Leczenia is the property of Jagiellonian University Medical College 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.)

Healthcare improvement relating to basic hospital service attributes is one of the most fundamental driving forces to uplifting in economic and social transition for developing countries in an emerging context. The purpose of this paper is to measure patients' trio need satisfaction toward doctor service quality (DSQ), nurse caring quality (NCQ), and hospital environment quality (HEQ) and compare the effects of perceived, expected, and service quality gap on patient satisfaction. Multiple regression analysis was used to explain the patient satisfaction. The result shows that the perceived service quality (67.3%) and the service quality gap (50.8%) can better explain patient satisfaction than the expected service quality (3.0%). Both perception and gap model show that DSQ, NCQ, and HEQ are significant predictors of patient satisfaction, where NCQ is the most important dimension in explaining patient satisfaction. This study focuses on patient need satisfaction research by being one of the few empirical studies relating to the most basic hospital service quality attributes, contributing to the development of hospital service quality in a developing context of Bangladesh. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Health & Nursing Management / Sağlık ve Hemşirelik Yönetimi Dergisi is the property of Logos Medical Publishing 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: SARS-CoV-2 is an RNA virus responsible for the coronavirus disease 2019 (COVID-19) pandemic. Viruses exist in complex microbial environments, and recent studies have revealed both synergistic and antagonistic effects of specific bacterial taxa on viral prevalence and infectivity. We set out to test whether specific bacterial communities predict SARS-CoV-2 occurrence in a hospital setting. Methods: We collected 972 samples from hospitalized patients with COVID-19, their health care providers, and hospital surfaces before, during, and after admission. We screened for SARS-CoV-2 using RT-qPCR, characterized microbial communities using 16S rRNA gene amplicon sequencing, and used these bacterial profiles to classify SARS-CoV-2 RNA detection with a random forest model. Results: Sixteen percent of surfaces from COVID-19 patient rooms had detectable SARS-CoV-2 RNA, although infectivity was not assessed. The highest prevalence was in floor samples next to patient beds (39%) and directly outside their rooms (29%). Although bed rail samples more closely resembled the patient microbiome compared to floor samples, SARS-CoV-2 RNA was detected less often in bed rail samples (11%). SARS-CoV-2 positive samples had higher bacterial phylogenetic diversity in both human and surface samples and higher biomass in floor samples. 16S microbial community profiles enabled high classifier accuracy for SARS-CoV-2 status in not only nares, but also forehead, stool, and floor samples. Across these distinct microbial profiles, a single amplicon sequence variant from the genus Rothia strongly predicted SARS-CoV-2 presence across sample types, with greater prevalence in positive surface and human samples, even when compared to samples from patients in other intensive care units prior to the COVID-19 pandemic. Conclusions: These results contextualize the vast diversity of microbial niches where SARS-CoV-2 RNA is detected and identify specific bacterial taxa that associate with the viral RNA prevalence both in the host and hospital environment. 2dzjuyGksUvQmCNGvHhZ1u Video Abstract [ABSTRACT FROM AUTHOR]

Research regarding the use of mechanical compressions in the setting of a cardiac arrest, either outside of or inside the hospital environment has produced mixed results. The debate whether they can replace manual compressions still remains. The aim of this review is to present current literature contemplating the application of mechanical compressions in both settings, data comparing them to manual compressions as well as current guidelines regarding their implementation in everyday clinical use. Currently, their implementation in the resuscitation protocol seems to benefit the victims of an in-hospital cardiac arrest rather than the victims that sustain a cardiac arrest outside of the hospital. [ABSTRACT FROM AUTHOR]

The private hospital industry in Kuwait is an important contributor in the economy of the country. There has been a major increase in the number of private hospitals and clinics in the past four years, and more hospitals are launching new services in the private healthcare sector. In order to succeed in this sector, it is important for an organization to focus on Customer Relationship Management (CRM) for thriving in the competitive market. A customer relationship management strategy is believed to give a competitive edge to hospitals, as customers nowadays make their decisions based on the type and strength of the relationships that they have with their service providers. Due to the nature of hospital environment, the products and services offered are merely the same in most of the private hospitals. Therefore, in order to differentiate the services offered, CRM should be implemented in hospitals seeking the delivery of high service quality for both its internal and external customers. The quality of the delivered services is reliant on one of the most crucial elements in any service organization structure hence, the employees. Other elements such as processes and technology are also vital for a successful the implementation of CRM. The objective of this research is to explore the Customer Relationship Management strategy development and implementation by examining the components that lead to successful implementation in two private hospitals in Kuwait. The researcher used the qualitative method through conducting in-depth interviews with management staff and other respective middle and lower management in AlSeef and Royale Hayat private hospitals. The study analyzes the primary data collected using a computer software called NVIVO, v.10. The dimensions of CRM strategy and implementation, which were proven in previous research, were assessed in this study. The researcher concluded that the two private hospitals researched developed a CRM strategy to encapsulate CRM among their business strategies; however, they have weaknesses in implementation in some of the dimensions. This research helped in defining a new dimension to fill this weakness observed, which is CRM strategic aligning. [ABSTRACT FROM AUTHOR]

Background: Determining the role of fomites in the transmission of SARS-CoV-2 is essential in the hospital setting and will likely be important outside of medical facilities as governments around the world make plans to ease COVID-19 public health restrictions and attempt to safely reopen economies. Expanding COVID-19 testing to include environmental surfaces would ideally be performed with inexpensive swabs that could be transported safely without concern of being a source of new infections. However, CDC-approved clinical-grade sampling supplies and techniques using a synthetic swab are expensive, potentially expose laboratory workers to viable virus and prohibit analysis of the microbiome due to the presence of antibiotics in viral transport media (VTM). To this end, we performed a series of experiments comparing the diagnostic yield using five consumer-grade swabs (including plastic and wood shafts and various head materials including cotton, synthetic, and foam) and one clinical-grade swab for inhibition to RNA. For three of these swabs, we evaluated performance to detect SARS-CoV-2 in twenty intensive care unit (ICU) hospital rooms of patients including COVID-19+ patients. All swabs were placed in 95% ethanol and further evaluated in terms of RNase activity. SARS-CoV-2 was measured both directly from the swab and from the swab eluent. Results: Compared to samples collected in VTM, 95% ethanol demonstrated significant inhibition properties against RNases. When extracting directly from the swab head as opposed to the eluent, RNA recovery was approximately 2–4× higher from all six swab types tested as compared to the clinical standard of testing the eluent from a CDC-approved synthetic (SYN) swab. The limit of detection (LoD) of SARS-CoV-2 from floor samples collected using the consumer-grade plastic (CGp) or research-grade plastic The Microsetta Initiative (TMI) swabs was similar or better than the SYN swab, further suggesting that swab type does not impact RNA recovery as measured by the abundance of SARS-CoV-2. The LoD for TMI was between 0 and 362.5 viral particles, while SYN and CGp were both between 725 and 1450 particles. Lastly microbiome analyses (16S rRNA gene sequencing) of paired samples (nasal and floor from same patient room) collected using different swab types in triplicate indicated that microbial communities were not impacted by swab type, but instead driven by the patient and sample type. Conclusions: Compared to using a clinical-grade synthetic swab, detection of SARS-CoV-2 from environmental samples collected from ICU rooms of patients with COVID was similar using consumer-grade swabs, stored in 95% ethanol. The yield was best from the swab head rather than the eluent and the low level of RNase activity and lack of antibiotics in these samples makes it possible to perform concomitant microbiome analyses. ESM1 Video abstract [ABSTRACT FROM AUTHOR]

Azole-resistant Aspergillus fumigatus is an emerging worldwide problem with increasing reports of therapy failure cases produced by resistant isolates. A case of azole-resistant A. fumigatus hospital colonization in a patient is reported here. Investigations of the hospital environment led to the recovery of A. fumigatus strains harboring the TR34/L98H and the G448S Cyp51A azole resistance mechanisms. Isolate genotyping showed that one strain from the environment was isogenic with the patient strains. These are the first environmental A. fumigatus azole resistant strains collected in a hospital in Spain; it supports the idea of the hospital environment as a source of dissemination and colonization/infection by azole resistant A. fumigatus in patients. The isolation of an azole-resistant strain from an azole-naïve patient is an interesting finding, suggesting that an effective analysis of clinical and environmental sources must be done to detect azole resistance in A. fumigatus. The emergence and spread of these resistance mechanisms in A. fumigatus is of major concern because it confers high resistance to voriconazole and is associated with treatment failure in patients with invasive aspergillosis. [ABSTRACT FROM AUTHOR]

Introduction: Nur sing mentor ing r elationships ar e vital to the advancement of per sonal and professional growth in nursing. Mentoring has been identified as an effective method to decrease turnover resulting in retention of experienced nurses. Despite the benefits of a mentoring relationship, barriers exist in creating and cultivating a formal mentoring program in the hospital setting. Methods: A qualitative descriptive study that explored nurses' perceptions of a mentoring culture within a hospital environment was used. Open-ended, conversational-style interviewing techniques with a semi-structured interview guide were utilized to gain a full description of nurses' perceptions of a mentoring culture within a hospital environment. Results: A str uctur al model of mentor ing as per ceived by hospital nur ses was developed fr om the data. Five overarching themes with corresponding subthemes emerged from nurses' perceptions. (1) Mentoring culture: various mentoring models, informal vs formal, leader focused, and evolving. (2) Experience with mentoring: going above and beyond, lifetime relationships, personal/professional growth, and feeling cared for. (3) Benefits: connections, development, retention, stability, patient safety, and making a difference. (4) Barriers: time, patients/patience, competition, knowledge deficit regarding mentor verses preceptor roles, lack of incentives, and receptiveness. (5) Paradigm shift: match generational and cultural differences, resources, and face-to-face. Discussion: The study r esults have identified mentor ing as an integr al aspect of per sonal and professional growth within the hospital environment. The rewards of mentoring or being mentored can be translated into increased nursing retention and improved nursing job satisfaction. [ABSTRACT FROM AUTHOR]

The contamination of air-handling units is a widespread phenomenon in buildings with air-conditioning systems, including hospitals. The germicide capacity of UV-C rays is known and, in the air-conditioning apparatuses, the UV-C lamps are generally located inside the air ducts. Aim of the paper is to evaluate the effectiveness of UV-C lamps when they are differently placed, i.e. in a position to directly irradiate the HEPA filters surface. We built ad hoc experimental air-conditioning systems, with HEPA filters and UV-C lamps in the two described positions. The results obtained demonstrate that, for disinfection purpose, the direct irradiation of the HEPA filters by UV-C provides better results than irradiation of the air stream and the effectiveness increases when lowering the relative humidity of the air. The survival curves of the tested microorganisms (fungi) show typical tail shaped curves (two steps survival curves). Additional tests using both HEPA filters alone, and HEPA filters plus UV lamps, have been performed measuring the air pressure drop between entrance and exit the HEPA filters and collecting air samples in order to obtain total microbial and fungal count. The results obtained suggest that, at least in experimental conditions described, the radiation on filter surface reduces significantly the microbial load and the pressure drop through the filter, compared to a situation of not-irradiated HEPA filters. [ABSTRACT FROM AUTHOR]

Copyright of Hitit University Journal of Social Sciences Institute is the property of Hitit University 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.)

Our aim was to assess whether airborne particle counting is an immediate indicator of biocontamination in controlled environment rooms with HEPA filters in a hospital. A prospective study was carried out in a tertiary care hospital between 2016 and 2018. The study was divided in two periods and the measurements were performed in different controlled environment rooms with HEPA filters. The Environmental Biosafety Criterion (EBC) was defined as the absence of fungal and bacterial contamination. In the training period, the area under the ROC curve (aROC) of airborne particle counting and EBC was calculated for each particle size as well as the cut-off points that optimize the combination of sensitivity and specificity in the association between them. aROC is created by plotting sensitivity against 1-specificity. In the testing period, the cut-off points previously selected were validated. 328 measurements were carried out in the training period and 301 in the testing period. In the training period, an association was found between airborne particle counting and EBC. An aROC = 0.760, 95% Confidence Interval (95% CI) 0.695–0.825 was observed for 0.3 µm particles; an aROC = 0.797 (95% CI 0.734–0.860) for 0.5 µm particles; and an aROC = 0.751 (95% CI 0.673–0.829) for 5 µm particles. The cut-off points that optimized the combination of sensitivity and specificity were 9.0 × 103 for 0.3 µm particles, 3.6 × 103 particles for 0.5 µm, and 3.2 × 102 particles for 5 µm. In the testing period, the previous cut-off points were validated. We conclude that airborne particle counting is a useful, immediate, and preliminary measure to identify the presence of biocontamination in controlled environment rooms with HEPA filters. [ABSTRACT FROM AUTHOR]

Radar systems allow for contactless measurements of vital signs such as heart sounds, the pulse signal, and respiration. This approach is able to tackle crucial disadvantages of state-of-the-art monitoring devices such as the need for permanent wiring and skin contact. Potential applications include the employment in a hospital environment but also in home care or passenger vehicles. This dataset consists of synchronised data which are acquired using a Six-Port-based radar system operating at 24 GHz, a digital stethoscope, an ECG, and a respiration sensor. 11 test subjects were measured in different defined scenarios and at several measurement positions such as at the carotid, the back, and several frontal positions on the thorax. Overall, around 223 minutes of data were acquired at scenarios such as breath-holding, post-exercise measurements, and while speaking. The presented dataset contains reference-labeled ECG signals and can therefore easily be used to either test algorithms for monitoring the heart rate, but also to gain insights about characteristic effects of radar-based vital sign monitoring. Measurement(s) heart function measurement • heart rate • Respiration • heart sounds Technology Type(s) radar system Factor Type(s) sex • age • weight • height • BMI Sample Characteristic - Organism Homo sapiens Machine-accessible metadata file describing the reported data: 10.6084/m9.figshare.11778900 [ABSTRACT FROM AUTHOR]

Background. Healthcare acquired infections (HAIs) represent a significant burden for hospitalized patients in terms of mortality, morbidity, length of stay and costs. Also cause medical liability and medical malpractice litigation. Methods. Specific keywords combinations were analitically searched in PubMed and Scopus databases. Publications concerning medical liability, medical malpractice and litigation issues were reviewed. Results. The authors outlined the healthcare workers and healthcare settings mandatory duties in consideration of the Italian law. In case of infections occurred in hospital environment the patients must demonstrate the guilty nature of the physicians and healthcare settings, the existence of a harm and causal connection. Physicians and healthcare facilities defence is mainly based on demonstration that protocols and aseptic measures were adopted scrupulously applying the up to date scientific knowledge. Conclusions. HAI are a complex issue which need a multitask strategy and a surveillance system to control the phenomenon and help physicians and healthcare facilities to reduce malpractice litigation. [ABSTRACT FROM AUTHOR]

This research explores how co-creation and a design-led approach to the traditional notion of symposium brought together industry, academia and the voice of patients in a hospital-based environment. The symposium 'designing together' provided a primer to consider what opportunities and constraints might influence how design could thrive in a hospital environment. The qualitative survey based response, from 21 participants, was analyzed using a general inductive approach to uncover themes relating to the need for change versus resistance to change within the hospital, the need for a patient-centred approach balanced with the need to engage staff throughout design processes, and demonstrating the value of design balanced against financial constraints. Encouraging collaborative co-creation and insight from patients, staff and designers within a free public hospital event was a unique approach that may provide a useful template for designers, researchers and public health professionals in developing the future design in health collaborations. [ABSTRACT FROM AUTHOR]

Upon its recurrent nosocomial infections and that it is multidrug resistant pathogen, after its isolation from both patients and hospital environment and its macroscopic, microscopic and biochemical characterization Acinetobacter baumannii was detected using PCR technique, through the amplification of blaOXA51like gene, in addition to the detection of transposable elements coding genes. At the molecular detection 20 as a positive results of our study, the results of PCR reaction explain the presence of blaOXA51like gene in all isolates (98%) and these results for transposable element (TEM-1 beta-lactames, Tnp-R, Tnp-A26, Tnp-A), Tnp-R were positive result in (8) eight of A. baumannii isolate while another transpose Tnp-A26, Tnp-A, TEM-1 beta-lactames were negative results for all A. baumannii isolate. These eight positive isolates were transmitted from A. baumannii to A. pittii by fadH2 gene which proved as a receptor gene for transposon, which represented as a resistance gene to be confirmed by A. pittii sequencing. [ABSTRACT FROM AUTHOR]

Objective: Research on serious infections/sepsis has focused on the hospital environment, while potentially the most delay, and therefore possibly the best opportunity to improve quality of care, lies in the prehospital setting. In this study we investigated the prehospital phase of adult emergency department (ED) patients with an infection. Methods: In this prospective pilot study all adult (≥18y) patients with a suspected/proven infection, based on the notes in the patient’s ED chart, were included during a 4-week period in 2017. Prehospital course, ED findings, presence of sepsis and 30-day outcomes were registered. Results: A total of 440 patients were identified, with a median symptom duration before ED visit of 3 days (IQR 1–7 days). Before arrival in the ED, 23.9% of patients had used antibiotics. Most patients (83.0%) had been referred by a general practitioner (GP), while 41.1% of patients had visited their GP previously during the current disease episode. Patients referred by a GP were triaged as high-urgency less often, while vital parameters were similar. Emergency Medical Services (EMS) transported 268 (60.9%) of patients. Twenty-two patients (5.0%) experienced an adverse outcome (30-day all-cause mortality and/or admission to intensive care). Conclusions: Patients with a suspected infection had symptoms for 3 (IQR 1–7) days at the moment of presentation to the ED. During this prehospital phase patients often had consulted, and were treated by, their GP. Many were transported to the ED by EMS. Future research on severe infections should focus on the prehospital phase, targeting patients and primary care professionals. [ABSTRACT FROM AUTHOR]

This research was undertaken to assess acoustical conditions in the hospital environment, researcher aimed at investigating sound levels of local hospitals and to evaluate how much their current status complied with recommendations levels given by World Health Organization. To assess the actual noise impact, sound levels of six local hospitals were measured using non -probability sampling technique at five different locations of every hospital i.e. Waiting Area, Emergency Department, Corridor, Intensive Care Unit and General Ward. All readings obtained during morning, afternoon and night intervals were then compared with World Health Organization acoustic guidelines for hospitals (30-40dB) Findings revealed that sound levels of all hospitals studied were significantly high as compared to standards given by WHO, the hypothesis was significant with p<.005, twice as high sound levels were observed in comparison to the recommended limits. Equivalent continuous sound levels (Leq) in most hospitals of Lahore ranged between (70-80dB), irrespective of time of the day, indicating a serious issue of noise pollution. Results also indicated that the highest sound levels were observed in waiting area at Hameed Latif hospital (110dBA). While the lowest sound levels were observed in Intensive Care Unit of Sheikh Zayed hospital (59dBA), which despite being the lowest were high in comparison to standards given by World Health Organization. Furnishings and interiors of a hospital usually have easy-to-clean surfaces that are hard and reflective in order to prevent infections, but such surfaces tend to propagate noise into the patient rooms and down the corridors causing sound to reverberate. Optimal sound levels in hospitals can only be achieved through regular sound assessment, proper zoning of high and low activity areas and use of sound absorbing materials in building design that do not compromise hygiene requirements of the place. Only then patients can truly receive the quality of care they deserve. [ABSTRACT FROM AUTHOR]

For inpatients who spend a longer time in the hospital, the built environment plays a significant role in their experience. While many hospital boards aim to create a patient-centered hospital, few have a specific idea about what this means in terms of spatial qualities. This creates a major challenge for those involved in designing hospital environments. Therefore, we aimed to identify which elements play a role in inpatients’ spatial experience, and how these elements relate and interact. Patients were followed during transport and afterward interviewed. In this way, we gained insight into their spatial experience, static, and in motion. This experience turns out to be shaped by material, social, and time-related aspects. An analysis of the interactions between these aspects yields a nuanced understanding of how inpatients’ experience of the hospital environment is shaped by the spatial and social organization, movement, and perspective. This understanding should allow informing hospital boards, architects, and staff to start designing hospital buildings in a more patient-centered way. [ABSTRACT FROM AUTHOR]

Context: The deployment and long-term acceptance of clinical information systems (CISs) are faced with multiple difficulties. They include insufficient quality of the systems in place and resistance to the multiple changes they induce in care processes. Permanent evaluation of deployed solutions is a prerequisite to their continuous improvement.Objective: The purpose of this study was twofold: (1) To validate the post-adoption unified model of information systems continuance (UMISC) progressively developed at the Georges Pompidou University Hospital (HEGP) in Paris (internal validation); and (2) To compare, using the same evaluation model, the results observed at HEGP with those of the Saint-Joseph Hospital Group (HPSJ), another Paris acute care institution (external validation).Methods: The UMISC post-adoption model is built around nine dimensions: end-user characteristics, social norm (SN), IS quality (ISQ), facilitating conditions (FC), perceived usefulness (PU), confirmation of expectations (CE), profession-adjusted use (PAU), satisfaction (SAT), and continuance intention (CI). Two semi-quantitative evaluation surveys were performed at HEGP in 2014 and 2015, and one at HPSJ in 2015. Statistical analysis included multiple regression analysis and structural equation modeling (SEM).Results: The analysis concerned 459 responders, 264 at HEGP and 195 at HPSJ. UMISC indicators, with the exception of SN, are superior at HEGP than at HPSJ, which had a shorter CIS anteriority than HEGP. In SEM analysis, the UMISC model explained 25% and 40% of the CIS use, 92% and 93% of health professionals' satisfaction, and 72% and 71% of continuance intention at HEGP and HPSJ, respectively. Seventeen of the 21 tested UMISC hypotheses were supported in at least one of the two sites.Conclusion: The UMISC evaluation model can be used as a comparison and explanatory model of CIS use, satisfaction and continuance intention in post-CIS adoption situations that become prevalent in current electronic hospitals. [ABSTRACT FROM AUTHOR]

Highlights • 8% of surveyed veterinary personnel carried MRSA. • MRSA carriage in veterinary personnel was not shared by their pets or patients. • 7% of canine patients and 8% personnel-owned dogs carried MRSP. • Patients and veterinary-owned dogs did not share the same clones of MRSP. • MRSP was not carried by any veterinary personnel. Abstract This study investigated the transmission cycle of methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus pseudintermedius (MRSP) in small companion animal veterinary practice. Sampling was undertaken at two small animal veterinary hospitals in Sydney, Australia. Samples were collected from 46 veterinary personnel, 79 personnel-owned dogs and cats, 151 clinically normal canine hospital admissions and 25 environmental sites. Nasal swabs were collected from veterinary personnel. Nasal, oral and perineal swabs were collected from animals. Methicillin resistance was detected by growth on Brilliance TM MRSA 2 Agar and confirmed by cefoxitin and oxacillin broth microdilution for S. aureus and S. pseudintermedius, respectively. MRSA and MRSP isolates were characterised using whole genome sequencing including mecA gene screening and multilocus sequence typing. MRSA was isolated from four (8%) veterinary personnel but no animals. MRSP was isolated from 11/151 (7%) of canine hospital admissions and 4/53 (8%) of personnel-owned dogs but no veterinary personnel or cats. No MRSA or MRSP was isolated from the environment. MRSP isolates were resistant to significantly more antimicrobial classes than MRSA. The main MRSP clone carried by canine patients (ST496) was distinct to that carried by personnel-owned dogs (ST64). One veterinary nurse, who carried Panton Valentine leucocidin-positive ST338 MRSA, also owned a ST749 MRSP-positive dog. Besides MRSP-positive dogs from the same household sharing the same clone of MRSP, MRSA and MRSP were not shared between humans, animals or environment. Therefore, in the non-outbreak setting of this study, there was limited MRS transmission between veterinary personnel, their pets, patients or the veterinary environment. [ABSTRACT FROM AUTHOR]

In indoor comfort research, thermal comfort of care-professionals in hospital environment is a little explored topic. To address this gap, a mixed methods study, with the nursing staff in hospital wards acting as participants, was undertaken. Responses were collected during three weeks in the summer (n = 89), and four weeks in the autumn (n = 43). Analysis of the subjective feedback from nurses and the measured indoor thermal conditions revealed that the existent thermal conditions (varying between 20 and 25 °C) caused a slightly warm thermal sensation on the ASHRAE seven point scale. This led to a slightly unacceptable thermal comfort and a slightly obstructed self-appraised work performance. The results also indicated that the optimal thermal sensation for the nurses — suiting their thermal comfort requirements and work performance — would be closer to ‘slightly cool’ than neutral. Using a design approach of dividing the hospital ward into separate thermal zones, with different set-points for respectively patient and care-professionals’ comfort, would seem to be the ideal solution that contributes positively to the work environment and, at the same time, creates avenues for energy conservation. [ABSTRACT FROM AUTHOR]

Private hospital rooms are believed to offer some protective effect against hospital-acquired infections, including central line-associated bloodstream infections. Yet a recent meta-analysis found the evidence-base to be lacking from a policy perspective. We sought to determine whether private rooms were associated with a lower risk of central-line infections. We examined the discharge records of more than one million inpatients from 335 Texas hospitals to determine patients that stayed in private rooms. Patients who stayed in bay rooms had 64 percent more central line infections than patients who stayed in private rooms. Even after adjusting for relevant covariates, patients assigned to bay rooms had a 21 percent greater relative risk of a central line infection (p = 0.005), compared with patients assigned to private rooms. At the hospital level, a 10% increase in private rooms was associated with an 8.6% decrease in central line infections (p<0.001), regardless of individual patients' room assignment. This study demonstrates and validates the use of private rooms as a structural measure and independent predictor of hospital quality. [ABSTRACT FROM AUTHOR]

Copper and its alloys are effective antimicrobial surface materials in the laboratory and in clinical trials. Copper has been used in the healthcare setting to reduce environmental contamination, and thus prevent healthcare-associated infections, complementing traditional protocols. The addition of copper nanoparticles to polymer/plastic matrices can also produce antimicrobial materials, as confirmed under laboratory conditions. However, there is a lack of studies validating the antimicrobial effects of these nanocomposite materials in clinical trials. To satisfy this issue, plastic waiting room chairs with embedded metal copper nanoparticles, and metal hospital IV pools coated with an organic paint with nanostructured zeolite/copper particles were produced and tested in a hospital environment. These prototypes were sampled once weekly for 10 weeks and the viable microorganisms were analysed and compared with the copper–free materials. In the waiting rooms, chairs with copper reduced by around 73% the total viable microorganisms present, showing activity regardless of the microorganism tested. Although there were only low levels of microorganisms in the IV pools installed in operating rooms because of rigorous hygiene protocols, samples with copper presented lower total viable microorganisms than unfilled materials. Some results did not have statistical significance because of the low load of microorganisms; however, during at least three weeks the IV pools with copper had reduced levels of microorganisms by a statistically significant 50%. These findings show for the first time the feasibility of utilizing the antimicrobial property of copper by adding nanosized fillers to other materials in a hospital environment. [ABSTRACT FROM AUTHOR]

In recent years, accumulation of pharmaceutical compounds in the environment has been an issue of growing concern. Conventional wastewater treatment has limited effectiveness with many pharmaceuticals at concentrations of ppb or ppt scale. An intuitive solution would be to treat the pharmaceuticals-contaminated wastewaters at the source sites before dilution in sewer networks. Health institutions with concentrated drug consumption provide logical point sources for pharmaceuticals entering the sewage. This paper describes the pilot-scale removal of a wide range of pharmaceuticals from real wastewaters via gas-phase pulsed corona discharge oxidation. The process was studied for raw sewage from a public hospital and for biologically treated wastewater of a health-care institute. The non-selective oxidation of the observed pharmaceuticals (32 compounds) was effective at reasonable energy cost: 87-% reduction in residual pharmaceuticals (excluding biodegradable caffeine) from raw sewage was attained with 1 kWh m −3 from the raw sewage and 100% removal was achieved for biologically treated wastewater at only 0.5 kWh m −3 . The impact for affected aquatic environments upon the present solution would be a dramatically reduced load of pharmaceutical accumulation. [ABSTRACT FROM AUTHOR]

Purpose This study assessed employees’ perceptions of their hospital work environment, its quality and functionality, as well as their satisfaction and well-being both before and after relocation within the hospital campus.Design/methodology/approach The study was carried out in a Finnish University Hospital. Employees from the anesthesia, orthopedics and physiatrics department took part in the study. The data were collected from the employees with online questionnaires before and after the relocation. The statistical differences between the questionnaire variables were analyzed using the Chi-square test.Findings Remarkable improvements in the quality of the new workplace included ability to adjust temperature, ventilation and furniture, ability to see out of windows, accessibility, number of meeting rooms, places to discuss confidential matters, quality of interior design, improved work satisfaction and desire to implement Lean. Significant deteriorations after relocation included unsettled work environment, impaired quality of cooperation and decreased interaction between employees.Originality/value This study discovered several improvements in the new facilities that had a visible effect on the assessed employee satisfaction and well-being parameters. The paper contains new, significant information that is relevant to the hospital facilities management and provides insight about the pros and cons of relocation and wherein their focus should be placed. [ABSTRACT FROM AUTHOR]

The healthcare setting is predisposed to harbor potential pathogens, which in turn can pose a great risk to patients. Routine cleaning of the patient environment is critical to reduce the risk of hospital-acquired infections. While many approaches to environmental cleaning exist, manual cleaning supplemented with ongoing assessment and feedback may be the most feasible for healthcare facilities with limited resources. [ABSTRACT FROM AUTHOR]

Ionizing radiation is one of the main risks affecting healthcare workers and patients worldwide. Special attention has to be paid to medical staff in the vicinity of radiological equipment or patients undergoing radioisotope procedures. To measure radiation values, traditional area meters are strategically placed in hospitals and personal dosimeters are worn by workers. However, important drawbacks inherent to these systems in terms of cost, detection precision, real time data processing, flexibility, and so on, have been detected and carefully detailed. To overcome these inconveniences, a low cost, open-source, portable radiation measurement system is proposed. The goal is to deploy devices integrating a commercial Geiger-Muller (GM) detector to capture radiation doses in real time and to wirelessly dispatch them to a remote database where the radiation values are stored. Medical staff will be able to check the accumulated doses first hand, as well as other statistics related to radiation by means of a smartphone application. Finally, the device is certified by an accredited calibration center, to later validate the entire system in a hospital environment. [ABSTRACT FROM AUTHOR]

Background: Nosocomial infections has always been a major problem for health care and lead to increases in morbidity and mortality in hospitalized patients. The aim of this study was to determine the contamination of personnel and hospital environment and device with nosocomial infections pathogens. Methods: Wet swab was used to sampling from the hospital personnel and equipment in different wards of a hospital in Isfahan, Iran. Culture and isolation of strains were done according to the standard microbial methods. Identification was based on gram staining, microbial and biochemical tests. Results: Overall 236 samples; 123 and 113 samples were collected from 91 hospital personnel and hospital environment and devices respectively. S. aureus was isolated from 14.2%, 15.3% and 5.4% of personnel hands, uniform and throat respectively. The cases of Enterobacteriaceae were isolated from personnel hands, uniform and throat as 13.9%, 4.3% and 3.27% respectively. P. aeruginosa was isolated from personnel hands (4.3%), uniform (6.5%) and throat (6.5%). Conclusion: S. aureus, Enterobacteriaceae and P. aeruginosa were the most prevalence bacteria that isolated from the personnel hands, uniforms, throats and hospital environment and devices. Personnel hands were the most contaminated part considering both the numbers and diversity in isolated organisms. Contamination of the hospital personnel and hospital environment and devices have a main role in dispersion of the nosocomial pathogens in hospital environment. With a good hygienic administration and an excellent healthy management planning in hospitals can be inhibit the dispersion of nosocomial pathogens in hospitals environment. [ABSTRACT FROM AUTHOR]

Background: While research has demonstrated the importance of a clean health care environment, there is a lack of research on the role portable medical equipment (PME) play in the transmission cycle of healthcare-acquired infections (HAIs). This study investigated the patterns and sequence of contact events among health care workers, patients, surfaces, and medical equipment in a hospital environment.Methods: Research staff observed patient care events over six different 24 h periods on six different hospital units. Each encounter was recorded as a sequence of events and analyzed using sequence analysis and visually represented by network plots. In addition, a point prevalence microbial sample was taken from the computer on wheels (COW).Results: The most touched items during patient care was the individual patient (850), bedrail (375), bed-surface (302), and bed side Table (223). Three of the top ten most common subsequences included touching PME and the patient: computer on wheels ➔ patient (62 of 274 total sequences, 22.6%, contained this sequence), patient ➔ COW (20.4%), and patient ➔ IV pump (16.1%). The network plots revealed large interconnectedness among objects in the room, the patient, PME, and the healthcare worker.Conclusions: Our results demonstrated that PME such as COW and IV pump were two of the most highly-touched items during patient care. Even with proper hand sanitization and personal protective equipment, this sequence analysis reveals the potential for contamination from the patient and environment, to a vector such as portable medical equipment, and ultimately to another patient in the hospital. [ABSTRACT FROM AUTHOR]

Aim: To examine whether introducing a national standard to improve the recognition of and response to clinical deterioration, was associated with a reduction in cardiovascular events in the hospital environment.Method: Interrupted time series was used to analyse the trajectories of monthly complication rates for 4.69 million admissions in 218 hospitals. Trajectory slopes determined for the "baseline period" (1 July 2007-30 June 2010) and the "Intervention period" (1 January 2013-30 June 2014) were compared (slope ratio).Results: Before the intervention, complication rates due to arrhythmias were increasing, acute coronary syndrome (ACS) and all-cause mortality decreasing, but were constant for cardiac arrest and heart failure and pulmonary oedema. Analysis of the overall data suggested reduction in the rate of cardiac and ACS complications after the intervention, but no significant change in overall hospital mortality. Analysis by age category showed significant reductions in monthly rate trajectories in the 80 plus years age group for cardiac arrest (slope ratio 0.983, 95% CI: 0.972-0.994) and ACS (0.989, 95% CI: 0.981-0.997) complications. Slope ratios indicating reduced monthly rates were seen in females for cardiac arrest (0.985, 95% CI: 0.977-0.994), ACS (0.991, 95% CI: 0.984-0.998) and heart failure (0.993, 95% CI: 0.986-1.000) complications. There were also significant reductions in cardiac arrest (0.983, 95% CI: 0.969-0.996), ACS (0.991, 95% CI: 0.982-1.000) and arrhythmia (0.996, 95% CI: 0.994-0.998) complications for surgical patients.Conclusions: Introduction of a national standard for deteriorating hospitalised patients was associated with a reduction in the rates of in-hospital cardiac arrests and acute coronary syndromes in acute hospitals. Greatest benefit was seen in the elderly, female and surgical patients. [ABSTRACT FROM AUTHOR]