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Found 179 results
  1. Content Article
    Surgical Site Infections (SSIs) can have subtle, early signs that are not readily identifiable. This study aimed to develop a machine learning algorithm that could identify early SSIs based on thermal images. Images were taken of surgical incisions on 193 patients who underwent a variety of surgical procedures, but only five of these patients developed SSIs, which limited testing of the models developed. However, the authors were able to generate two models to successfully segment wounds. This proof-of-concept demonstrates that computer vision has the potential to support future surgical applications.
  2. Content Article
    In this blog, Peter Provonost MD, Chief Quality and Transformation Officer at University Hospitals Cleveland Medical Center, offers advice about what patients and their families can do to prevent health risks associated with hospital stays. He looks ways to mitigate against medication errors, surgical errors, infections, blood clots and other medical complications.
  3. Content Article
    Currently, surgical site infection surveillance relies on labour-intensive manual chart review. Recently suggested solutions involve machine learning to identify surgical site infections directly from the medical record. Deep learning is a form of machine learning that has historically performed better than traditional methods, while being harder to interpret. This study proposed a deep learning model—an explainable long short-term memory network—for the identification of surgical site infection from the medical record. The study found that the model had greater sensitivity when compared to traditional machine learning methods.
  4. Content Article
    Central venous catheters (CVCs) are widely used in US critical care settings for medication administration, monitoring and reliable venous access. Despite the benefits of CVCs, complications, particularly infections, have become a major focus of US hospital quality improvement efforts due to federal and state initiatives that emphasise patient safety, transparency and accountability. In this commentary in JAMA Network, the authors look at recent research surrounding CVC complications and highlight approaches to help tackle these issues.
  5. Content Article
    As the USA's largest health insurer, the Centers for Medicare & Medicaid Services (CMS) has established quality standards, metrics, and programmes to improve healthcare not just for the 170 million individuals supported by its programmes, but for all Americans. The 2024 National Impact Assessment of CMS Quality Measures Report (Impact Assessment Report) assesses the quality and efficiency impact of measures endorsed by the consensus-based entity and used by CMS.
  6. News Article
    A new CMS report reveals disparities in care quality and patient safety within US hospitals before and during the pandemic, finding "a large proportion of measures had worse than expected performance." CMS released its 2024 National Impact Assessment Feb. 28, which is released every three years and evaluates the measures used in 26 CMS quality and value-based incentive payment programs. This edition of the report compares quality measure scores pre-COVID-19 with hospitals' results in 2020 and 2021, the initial years of the COVID-19 public health emergency. Here are eight findings from the 72-page assessment: 1. During 2020 and 2021, a large proportion of measures had worse than expected performance, including significant worsening of key patient safety metrics. 2. Half or more of the performance measures in five priorities had worse results in 2021 than expected from the 2016–2019 baseline. Priorities with the highest proportions of worse-than-expected results in 2021 were wellness and prevention (69%), behavioural health (55%), safety (54%), chronic conditions (52%), and seamless care coordination (50%). 3. Specific to safety, standardised infection ratios worsened significantly in hospitals for central line–associated bloodstream infections (94% worse), MRSA (55% worse) and CAUTI (34% worse). Before the Covid-19 PHE (2015–2019), 34,455 fewer healthcare-associated infections (HAIs) were reported in acute care settings. 4. More than 35% of measures in two priorities had better results in 2021 than expected from 2016–2019 baseline trends. Those priorities are seamless care coordination (50%) and affordability and efficiency (38%). 5. Specific to affordability and efficiency, emergency department visits for home health patients fared 1.4 percentage points better, and acute care hospitalization in the first 60 days of home health in 2021 was 1.5 percentage points better. 6. Accountable entities with the highest proportions of worse than expected results in 2021 were clinicians (64%), accountable care organizations (54%), and acute care facilities (54%). 7. Wellness and prevention had the highest percentage of measures showing health equity disparities; notable examples include pneumococcal and influenza vaccinations among racial and ethnic groups. 8. Comparison racial and ethnic groups fared worse than the White reference group on 40 of 45 (88.9%) affordability and efficiency measures and 32 of 41 (78%) chronic conditions measures. For example, disparities were recorded for Black or African American patients in 32, or 71%, of the affordability and efficiency measures, mostly related to readmissions. Read full story Source: Becker Hospital Review, 29 February 2024
  7. Content Article
    Infection Control Matters is a podcast in which infection control professionals discuss new research and issues on the topic of infection prevention and control. In this episode, Martin Kiernan and Phil Russo talk to Professor Michael Borg from the Faculty of Medicine & Surgery at the University of Malta They discuss a recent paper describing the stages that brought about a 90% reduction in MRSA bloodstream infections over a ten-year period.
  8. Content Article
    This systematic review and meta-analysis in JAMA Internal Medicine aimed to explore whether there is an association between daily toothbrushing among hospitalised patients and prevention of hospital-acquired pneumonia. The authors found that hospital-acquired pneumonia rates were lower among patients randomised to daily toothbrushing, particularly among patients receiving invasive mechanical ventilation. Toothbrushing was also associated with shorter duration of mechanical ventilation, shorter intensive care unit (ICU) length of stay and lower ICU mortality, whereas hospital length of stay and use of antibiotics showed no differences.
  9. Content Article
    This project aims to develop peer consensus centred on specific themes defined by the steering group covering topics relevant to the optimal, universal and evidence-based care bundle to reduce surgical site infections (SSIs). It will support building expert consensus around best practices when selecting the care bundle to reduce surgical site infections in practice. It is hoped that the output will support best practice patient management in Europe. The survey takes under 10 minutes to complete. Please review each statement and indicate your level of agreement with it (tick one box only per statement). Please only complete this questionnaire once. Your anonymous responses will be a source of data for the development of a consensus publication. This project has been initiated and funded by Becton Dickinson and is being managed and delivered by Triducive.
  10. Content Article
    Postoperative surgical site infection is a serious problem. Coverage of sterile goods may be important to protect the goods from bacterial air contamination while awaiting surgery. This study from Wistrand and colleagues, evaluated the effectiveness of this practice in a systematic review covering five databases using search terms related to bacterial contamination in the operating room and on surgical instruments. No negative effects regarding bacterial contamination were found and the authors conclude that protection with a sterile cover decreases bacterial air contamination of sterile goods while waiting for surgery to start.
  11. Content Article
    Connections are critical junctures and points of access along intravenous (IV) lines. Microorganisms may colonise these connections, potentially leading to catheter-related bloodstream infections (CRBSIs). For patients, CRBSIs are a significant cause of morbidity and death, and for healthcare facilities these infectious complications lead to unnecessary costs. Safe connections may help reduce the risk of needlestick injuries for healthcare professionals (HCPs) and the occurrence of CRBSIs for patients. In this webinar recording, Nancy Trick, Registered Nurse and Adjunct Instructor at Perdue Global University in West Lafayette, USA, discusses CRBSIs and presents solutions to help prevent them. After watching this webinar, you should be able to: describe open versus closed infusion systems in VAM. briefly discuss the clinical risks of open infusion systems. discuss clinical practice change. consider how evidence-based standards of practice recommend using closed IV access/needleless connectors.
  12. Content Article
    Research funded by the NIHR has found that air cleaning technologies designed to make social interactions safer in indoor spaces are not effective. The research was funded by the NIHR Health Protection Research Unit (HPRU) in Emergency Preparedness and Response. The researchers looked at technologies including: air filtration germicidal lights ionisers. They studied evidence about whether the technologies reduce the risk of catching airborne respiratory or gastrointestinal infections. The researchers found the technologies do not stop the spread of infections in buildings.
  13. News Article
    A hospital that unnecessarily delayed a man’s surgery at the last minute because he had HIV failed in their care, according to England’s Health Ombudsman. The 48-year-old from Walsall, who does not want to be named, had been due to have prostate surgery at Walsall Manor Hospital on 10 March 2020. His surgery was scheduled to be the first of the morning. As he was about to enter the operating room, he was told that due to his HIV status his surgery would now be moved to last on the operating list that afternoon. The hospital claimed that this was due to the level of cleaning and infection control that would need to take place following his surgery to reduce the risk to others. However, the Parliamentary and Health Service Ombudsman (PHSO), found that Walsall Healthcare NHS Trust acted inappropriately and failed the man. This is because the universal precautions that apply to all patients having surgery are enough to protect and prevent infections from spreading among patients and staff. Therefore, no additional cleaning should have been necessary. The policy of placing a patient at the end of an operating list usually relates to patients with a high-risk bacterial infection. It should not be applied to a person who has HIV and is receiving treatment. The Ombudsman also found that although the Trust had made some changes since this happened, they had not done enough to make sure the same mistake did not reoccur. PHSO recommended the Trust apologise to the man and create an action plan to stop this happening again. The Trust has complied with these recommendations. Read full story Source: Parliamentary and Health Service Ombudsman, 1 December 2023
  14. Content Article
    This study in the American Journal of Surgery aimed to understand the impact of operating room temperature and humidity on surgical site infection (SSI). The authors found that large deviations in operating theatre temperature and humidity do not increase the risk of SSI.
  15. News Article
    Liquid bleach does not kill off a hospital superbug that can cause fatal infections, researchers have found. Clostridium difficile, also known as C diff, is a type of bacteria found in the human gut. While it can coexist alongside other bacteria without problem, a disruption to gut flora can allow C diff to flourish, leading to bowel problems including diarrhoea and colitis. Severe infections can kill, with 1,910 people known to have died within 30 days of an infection in England during financial year 2021-2022. Those at greater risk of C diff infections include people aged over 65, those who are in hospital, people with a weakened immune system and people taking antibiotics, with some individuals experiencing repeated infections. According to government guidance, updated in 2019, chlorine-containing cleaning agents with at least 1,000 ppm available chlorine should be used as a disinfectant to tackle C diff. But researchers say it is unlikely be sufficient, with their experiments suggesting that even at high concentrations, sodium hypochlorite – a common type of bleach – is no better than water at doing the job. “With antimicrobial resistance increasing, people need to recognise that overuse of biocides can cause tolerance in certain microbes, and we’re seeing that definitely with chlorine and C diff,” said Dr Tina Joshi, co-author of the research, from the University of Plymouth. While chlorine-based chemicals used to be effective at killing such bacteria, that no longer appears to be the case, she said. “The UK doesn’t seem to have any written new gold standard for C diff disinfection. And I think that needs to change immediately,” she said. Read full story Source: The Guardian, 22 November 2023
  16. Content Article
    Antimicrobial Resistance (AMR) occurs when bacteria, viruses, fungi and parasites no longer respond to antimicrobial agents. As a result of drug resistance, antibiotics and other antimicrobial agents become ineffective and infections become difficult or impossible to treat, increasing the risk of disease spread, severe illness and death. The World AMR Awareness Week (WAAW) is a global campaign to raise awareness and understanding of AMR and promote best practices among One Health stakeholders to reduce the emergence and spread of drug-resistant infections. WAAW is celebrated from 18-24 November every year. The World Health Organization (WHO) explains what antimicrobial resistance is and provides resources for organisations wanting to take part in WAAW 2023, on their campaign webpage.
  17. News Article
    Hospital-acquired infections, which became substantially more common during the pandemic, have returned to pre-pandemic levels, according to a new report from a US patient safety watchdog group. It's key to note, researchers say, that infection rates before March 2020 were nothing to celebrate. On top of that moderately good news, the Leapfrog Group found other metrics that measure patient safety and satisfaction have fallen significantly, likely because of hospital staffing shortages and other pandemic-era challenges. "We're encouraged and relieved to see that infections are rapidly decreasing in hospitals following the spike during the pandemic, but we remain very concerned about a number of major problems in hospitals," said Leah Binder, president and CEO of Leapfrog, an independent, national nonprofit founded by large employers and other purchasers. Patient surveys following hospital visits found declines in experiences for the second year in a row in all states. Particularly significant drops were reported in “communication about medicines” and “responsiveness of hospital staff." Preventable errors have been linked to these problems. "Hospitals need to take a hard look at what they are unnecessarily continuing post-pandemic that are not helping patients," Binder said. Read full story Source: USA Today News, 6 November 2023
  18. Content Article
    This bulletin from the Canadian Institute for Health Information (CIHI) describes two new in-hospital infections indicators for Clostridium difficile (C. difficile) and Methicillin-Resistant Staphylococcus aureus (MRSA). It includes a table listing CIHI’s selected patient safety performance indicators and definitions.
  19. Content Article
    A series of podcasts from Molnlycke UK, with host Steve Feast, discussing topics such as sustainability, patient safety and more.
  20. Content Article
    This study in Intensive and Critical Care Nursing examined the association between safety attitudes, quality of care, missed care, nurse staffing levels and the rate of healthcare-associated infection (HAI) in adult intensive care units (ICUs). The authors concluded that positive safety culture and better nurse staffing levels can lower the rates of HAIs in ICUs. Improvements to nurse staffing will reduce nursing workloads, which may reduce missed care, increase job satisfaction, and, ultimately, reduce HAIs.
  21. News Article
    The NHS is falling behind in the race to tackle antibiotic-resistant infections, with the service set to miss two key targets. As part of the government’s 2019 five-year-action plan to tackle the growth in antimicrobial resistance (AMR), the NHS was set the target of reducing the number of healthcare-associated bloodstream infections of three gram-negative bacteria by 25% by March this year, and 50% by the end of March 2024. Infections caused by E. coli, pseudomonas aeruginosa and klebsiella can cause urine or wound infection, blood poisoning or pneumonia. The AMR action plan said: “In the UK, the biggest drivers of resistance [include] a rise in the incidence of infections, particularly gram-negatives.” Last week, health and social care secretary Sajd Javid stressed the continuing importance of the issue, stating that antimicrobial resistance is “one of the biggest health threats facing the world”. Analysis by HSJ has shown there has been only a small decline in the numbers of cases involving the three bacteria since monitoring started. The baseline for measuring the reduction was 2016-17, when there were 23,037 healthcare associated infections related to the bacteria. Read full story (paywalled) Source: HSJ, 21 April 2022
  22. News Article
    Scientists have developed a virus-killing plastic that could make it harder for bugs, including Covid, to spread in hospitals and care homes. The team at Queen's University Belfast say their plastic film is cheap and could be fashioned into protective gear such as aprons. It works by reacting with light to release chemicals that break the virus. The study showed it could kill viruses by the million, even in tough species which linger on clothes and surfaces. The research was accelerated as part of the UK's response to the Covid pandemic. Studies had shown the Covid virus was able to survive for up to 72 hours on some surfaces, but that is nothing compared to sturdier species. Norovirus - known as the winter vomiting bug - can survive outside the body for two weeks while waiting for somebody new to infect. "This is the first time that anything like this has been developed," said Prof Andrew Mills, from the university's chemistry department. He added: "This film could replace many of the disposable plastic films used in the healthcare industry as it has the added value of being self-sterilising at no real extra cost." He said current personal protective equipment used in hospitals did a good job, but "infections can take place when you take off or put on the PPE, so this can help". Read full story Source: BBC News, 8 September 2022
  23. News Article
    Half of healthcare facilities worldwide lack basic hygiene services with water and soap or alcohol-based hand rub where patients receive care and at toilets in these facilities, according to a new report by WHO and UNICEF. Around 3.85 billion people use these facilities, putting them at greater risk of infection, including 688 million people who receive care at facilities with no hygiene services at all. “Hygiene facilities and practices in health care settings are non-negotiable. Their improvement is essential to pandemic recovery, prevention and preparedness. Hygiene in health care facilities cannot be secured without increasing investments in basic measures, which include safe water, clean toilets, and safely managed health care waste,” said Dr Maria Neira, WHO Director, Department of Environment, Climate Change and Health. “I encourage Member States to step up their efforts to implement their 2019 World Health Assembly commitment to strengthen water, sanitation and hygiene (WASH) services in health care facilities, and to monitor these efforts.” The latest report, “Progress on WASH in health care facilities 2000–2021: special focus on WASH and infection prevention and control”, has for the first time established this global baseline on hygiene services – which assessed access at points of care as well as toilets – as more countries than ever report on critical elements of WASH services in their hospitals and other health centres. For hygiene, data are now available for 40 countries, representing 35% of the world’s population, up from 21 countries in 2020 and 14 in 2019. The newly established global estimate reveals a clearer and more alarming picture of the state of hygiene in health care facilities. Though 68% of health care facilities had hygiene facilities at points of care, and 65% had handwashing facilities with water and soap at toilets, only 51% had both and therefore met the criteria for basic hygiene services. Furthermore, 1 in 11 (9%) of health care facilities globally have neither. “If health care providers don’t have access to a hygiene service, patients don’t have a health care facility,” said Kelly Ann Naylor, UNICEF Director of WASH and Climate, Environment, Energy, and Disaster Risk Reduction (CEED). “Hospitals and clinics without safe water and basic hygiene and sanitation services are a potential death trap for pregnant mothers, newborns, and children. Every year, around 670,000 newborns lose their lives to sepsis. This is a travesty – even more so as their deaths are preventable.” Read full story Source: WHO, 30 August 2022
  24. News Article
    Dentists in the UK should be encouraged to give antibiotics to patients at high risk of life-threatening heart infection before invasive procedures, a study has found. Research suggests bacteria from the mouth entering the bloodstream during dental treatment could explain 30% to 40% of infective endocarditis cases. The rare but life-threatening condition occurs when the inner lining of the heart chambers and valves become infected. Antibiotics could limit the number of cases and reduce the risk of heart failure, stroke and premature death in high-risk patients, the study says. Current guidelines from the National Institute for Health and Care Excellence (Nice) advise against the routine use of antibiotics before invasive dental procedures for those at risk of infective endocarditis. “Ours is the largest study to show a significant association between invasive dental procedures and infective endocarditis, particularly for extraction and surgical procedures,” said Prof Martin Thornhill from the University of Sheffield, who led the study. Nice should review its guidelines advising against antibiotic prophylaxis, the researchers said. Read full story Source: The Guardian, 19 August 2022
  25. News Article
    People who go to hospital for non-covid treatment are at higher risk of the virus compared with the general public, which is why high levels of hospital-acquired Covid-19 in England are worrying some doctors. They fear that the coronavirus is becoming a potential hazard of a hospital stay for older or vulnerable people, in a similar way to “superbugs” such as methicillin-resistant Staphylococcus aureus (MRSA). People who go to hospital for non-covid-19 treatment are at higher risk from the virus compared with the general public, says Tom Lawton, an intensive care doctor in Bradford, UK. Read full story (paywalled) Source: The New Scientist, 21 July 2022
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