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https://www.readbyqxmd.com/read/29452631/the-evaluation-of-the-implementation-of-the-vascular-preventative-bundle-and-development-of-suggested-interventions-for-improvement-and-sustainability
#1
Jennifer Franklin, Kathleen Turner, John S Hudson, Kimberly Guest, Ellen D Dillavou
Postoperative infections can complicate patient care and increase health care costs. A vascular preventative bundle was implemented at a large teaching/research intensive hospital to decrease surgical site infections (SSIs) with vascular surgery patients. The aim of this study was to measure fidelity to the bundle and determine if implementation of the vascular SSI bundle reduced the rate of SSIs. Three periods of data were collected, and they are identified as preimplementation (period 1), early implementation (period 2), and postimplementation (period 3)...
March 2018: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/29344102/should-preoperative-showering-or-cleansing-with-chlorhexidine-gluconate-chg-be-part-of-the-surgical-care-bundle-to-prevent-surgical-site-infection
#2
Charles E Edmiston, David Leaper
Showering preoperatively with chlorhexidine gluconate is an issue that continues to promote debate; however, many studies demonstrate evidence of surgical site infection risk reduction. Methodological issues have been present in many of the studies used to compile guidelines and there has been a lack of standardisation of processes for application of the active agents in papers pre-2009. This review and commentary paper highlights the potential for enhancing compliance with this low-risk and low-cost intervention and provides some guidance for enhancing implementation of preoperative showering with both chlorhexidine in solution and impregnated wipes...
November 2017: Journal of Infection Prevention
https://www.readbyqxmd.com/read/29340748/lack-of-level-i-evidence-on-how-to-prevent-infection-after-elective-shoulder-surgery
#3
Carola F Eck, Julie A Neumann, Orr Limpisvasti, Christopher R Adams
PURPOSE: Infection is a concern after all orthopedic procedures, including shoulder surgery. This systematic review of literature aimed to determine risk factors for infection as well as the availability and effectiveness of measures utilized to prevent infection after elective shoulder surgery. METHODS: An electronic database search was performed using MEDLINE (1950-October 2017), EMBASE (1980-October 2017), CINAHL (1982-October 2017), and the Cochrane database to identify studies reporting a risk factor or preventive measure for infection after shoulder surgery...
January 16, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29227322/no-clear-benefit-of-chlorhexidine-use-at-home-before-surgical-preparation
#4
Melvin Chugh Makhni, Kolawole Jegede, Joseph Lombardi, Susan Whittier, Prakash Gorroochurn, Ronald A Lehman, K Daniel Riew
INTRODUCTION: Several studies have evaluated the efficacy of home use of chlorhexidine before surgery to reduce bacterial colonization. However, these studies have provided conflicting evidence about the potential efficacy of this strategy in decreasing bacterial loads and infection rates across surgical populations, and no prior study has analyzed the benefit of this intervention before spine surgery. We prospectively analyzed the effectiveness of chlorhexidine gluconate wipes for decreasing bacterial counts on the posterior neck...
January 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28993110/chlorhexidine-gluconate-bathing-practices-and-skin-concentrations-in-intensive-care-unit-patients
#5
Haleema Alserehi, Mala Filippell, Michele Emerick, Marie Kristine Cabunoc, Michael Anne Preas, Corey Sparkes, J Kristie Johnson, Surbhi Leekha
In this 2-phase real-world evaluation of chlorhexidine gluconate (CHG) skin concentrations in intensive care unit patients, we found lower skin CHG concentrations when rinsing with water after CHG solution bath (compared with no rinse), but no significant difference in concentrations between the use of CHG solution without rinse and preimpregnated CHG wipes. CHG concentration audits could be useful in assessing the quality of bathing practice, and CHG solution without rinsing may be an alternative to preimpregnated CHG wipes...
October 6, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28967053/multifaceted-aseptic-protocol-decreases-surgical-site-infections-following-hip-arthroplasty
#6
Ryan E Harold, Bennet A Butler, Joseph Lamplot, Hue H Luu, Cort D Lawton, David Manning
INTRODUCTION: We investigate the effectiveness of a comprehensive aseptic protocol in reducing surgical site infection (SSI) after hip arthroplasty in a single medical centre with a high prevalence of methicillin-resistant Staphylococcus aureus (MRSA). METHODS: A prospectively collected database of all patients undergoing hip arthroplasty in a single centre between 2005 and 2011 was reviewed for SSI using Centers for Disease Control (CDC) criteria and AAOS guidelines...
September 21, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28803661/daily-bathing-strategies-and-cross-transmission-of-multidrug-resistant-organisms-impact-of-chlorhexidine-impregnated-wipes-in-a-multidrug-resistant-gram-negative-bacteria-endemic-intensive-care-unit
#7
Jesus Ruiz, Paula Ramirez, Esther Villarreal, Monica Gordon, Inmaculada Saez, Alfonso Rodríguez, María Jesús Castañeda, Álvaro Castellanos-Ortega
BACKGROUND: Health-care associated infections are a major cause of morbidity and mortality in critical care units. The aim of this study is to evaluate the effectiveness of chlorhexidine gluconate (CHG)-impregnated wipes in the daily bathing of patients in an intensive care unit (ICU) to prevent cross-transmission and colonization by multidrug-resistant organisms (MDROs) METHODS: Prospective cohort study with an intervention of 11 months. The intervention consisted of using CHG-impregnated wipes for the daily bathing of patients on mechanical ventilation or colonized by MDROs...
October 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28738398/the-compatibility-of-chlorhexidine-and-a-skin-care-product-line-a-real-world-analysis-of-hospital-acquired-infection-rates
#8
Priscilla L Phillips, Daniel Young, Debashish Chakravarthy
Chlorhexidine gluconate (CHG) use helps reduce hospital-acquired infections (HAIs). Chlorhexidine gluconate effectiveness can be reduced by use of skin care products. Although laboratory work can be performed to prove compatibility, such work has limitations. The purpose of this study was to compare HAI rates when CHG antiseptic wipes were used in conjunction with a silicone- and micronutrient-based skin care product line (SMSP) and when CHG wipes were used without the SMSP. Using commercial distribution data, 17 hospitals that purchased both CHG wipes and SMSP were identified...
July 2017: Health Care Manager
https://www.readbyqxmd.com/read/28694729/the-alcohol-used-for-cleansing-the-venipuncture-site-does-not-jeopardize-blood-and-plasma-alcohol-measurement-with-head-space-gas-chromatography-and-an-enzymatic-assay
#9
Giuseppe Lippi, Ana-Maria Simundic, Giacomo Musile, Elisa Danese, Gianluca Salvagno, Franco Tagliaro
INTRODUCTION: This study aimed to establish whether an alcoholic antiseptic, wiped or not before venipuncture, may jeopardize alcohol testing with a commercial enzymatic assay and a reference head-space gas chromatography (GC) technique. MATERIALS AND METHODS: Venous blood was collected from 23 healthy volunteers, with two sequential procedures. In the first blood collection, 2 mL of alcoholic antiseptic (0.5% chlorhexidine, 70% ethanol) were place on a gauge pad, the venipuncture site of right arm was cleaned but the antiseptic was not let to dry before phlebotomy...
June 15, 2017: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/28655955/comparison-of-efficacy-and-cost-effectiveness-of-0-55-ortho-phthalaldehyde-and-2-glutaraldehyde-for-disinfection-of-laryngoscopes-a-prospective-pilot-study
#10
Priyanka Pradeep Karnik, Nandini Malay Dave, Gita Nataraj, Rajarshi Gupta, Madhu Garasia
BACKGROUND AND AIMS: The laryngoscope is a potential source of cross-infection as it involves contact with the mucous membrane, saliva and occasionally blood. This study compared efficacy and cost-effectiveness of two Centre for Disease Control approved agents for disinfection of laryngoscope blades. METHODS: One hundred and sixty patients requiring laryngoscopy and intubation for general anaesthesia were randomly allocated into two groups. After tracheal intubation, used laryngoscope blades were cleaned with tap water...
June 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28405039/disinfection-of-laryngoscopes-a-survey-of-practice
#11
Vaishali Prabhakar Chaskar, Nandini Malay Dave, Raylene Dias, Priyanka Karnik
BACKGROUND AND AIMS: The laryngoscope is a common piece of equipment used by anaesthesiologists. It has been identified as a potential source of cross infection. Although guidelines exist regarding appropriate disinfection practices, recent reviews suggest ineffectiveness of current methods of disinfection and poor compliance with the established protocols. We conducted a questionnaire-based survey to study the current disinfection practices being followed by a cross section of anaesthesiologists...
March 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28332593/injections-through-skin-colonized-with-staphylococcus-aureus-biofilm-introduce-contamination-despite-standard-antimicrobial-preparation-procedures
#12
Yi Wang, Valery Leng, Viraj Patel, K Scott Phillips
While surgical site preparation has been extensively studied, there is little information about resistance of skin microbiota in the biofilm form to antimicrobial decontamination, and there are no quantitative models to study how biofilm might be transferred into sterile tissue/implant materials during injections for joint spine and tendon, aspiration biopsies and dermal fillers (DF). In this work, we develop two in vitro models to simulate the process of skin preparation and DF injection using pig skin and SimSkin (silicone) materials, respectively...
March 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28141597/genital-region-cleansing-wipes-effects-on-urine-culture-contamination
#13
Mehmet Burak Selek, Bayhan Bektöre, Ogün Sezer, Tuğba Kula Atik, Orhan Baylan, Mustafa Özyurt
INTRODUCTION: Urine culture is the gold standard test for revealing the microbial agent causing urinary tract infection (UTI). Culture results are affected by sampling techniques; improper sampling leads to contamination of urine and thus contamination of the culture with urogenital flora. We aimed to evaluate the effect of urogenital cleansing, performed with chlorhexidine-containing genital region cleansing wipes (GRCW) on contamination rates. METHODOLOGY: A total of 2,665 patients with UTI-related complaints and with urine culture requests from various outpatient clinics were enrolled in the study...
January 30, 2017: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/28107301/implementation-of-a-pediatric-orthopaedic-bundle-to-reduce-surgical-site-infections
#14
Jan Schriefer, James Sanders, Julie Michels, Kori Wolcott, Connor Ruddy, Jenna Hanson
Surgical site infections (SSIs) cost an estimated $27,288 per case. An analysis of the National Surgical Quality Improvement Program data at the University of Rochester Medical Center suggested that rates of SSIs could be lowered in comparison with both peers and baseline. The aim of this study was to reduce the number of SSIs to zero through the implementation of a "bundle" or a combination of practices. Meetings were held with the multidisciplinary care team that includes surgeons and staff from pediatric pharmacy, pediatric infectious diseases, anesthesia, and nursing to create a care bundle for all pediatric orthopaedic surgery patients...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/27852955/microbiological-efficacy-of-early-mrsa-treatment-in-cystic-fibrosis-in-a-randomised-controlled-trial
#15
Marianne Sponer Muhlebach, Valeria Beckett, Elena Popowitch, Melissa B Miller, Arthur Baines, Nicole Mayer-Hamblett, Edith T Zemanick, Wynton C Hoover, Jill M VanDalfsen, Preston Campbell, Christopher H Goss
OBJECTIVE: To evaluate microbiological effectiveness, that is, culture negativity of a non-blinded eradication protocol (Rx) compared with observation (Obs) in clinically stable cystic fibrosis participants with newly positive methicillin resistant Staphylococcusaureus (MRSA) cultures. DESIGN: This non-blinded trial randomised participants ages 4-45 years with first or early (≤2 positive cultures within 3 years) MRSA-positive culture without MRSA-active antibiotics within 4 weeks 1:1 to Rx or Obs...
April 2017: Thorax
https://www.readbyqxmd.com/read/27828836/the-impact-of-a-universal-decolonization-protocol-on-hospital-acquired-methicillin-resistant-staphylococcus-aureus-in-a-burn-population
#16
Arthur T Johnson, Rachel M Nygaard, Ellie M Cohen, Ryan M Fey, Anne Lambert Wagner
Hospital-acquired (HA) methicillin-resistant Staphylococcus aureus (MRSA) is a leading cause of HA infections and a significant concern for burn centers. The use of 2% chlorhexidine-impregnated wipes and nasal mupirocin significantly decreases the rate of HA-MRSA in adult intensive care units. The aim of this study was to examine the impact of universal decolonization on the rate of MRSA conversion in an American Burn Association verified adult and pediatric burn center. Universal decolonization protocol consisting of daily chlorhexidine baths and a 5-day course of nasal mupirocin was implemented in the burn unit...
November 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27583685/chlorhexidine-vaginal-wipes-prior-to-elective-cesarean-section-does-it-reduce-infectious-morbidity-a-randomized-trial
#17
Magdy R Ahmed, Nisreen K Aref, Waleed A Sayed Ahmed, Farzana R Arain
OBJECTIVE: To evaluate the efficacy of preoperative vaginal cleansing using chlorhexidine 0.25% antiseptic wipes on rates of postcesarean section (CS) infectious morbidities (endometritis, febrile morbidity and wound infection). METHODS: This prospective randomized trial was conducted among 218 pregnant women scheduled for term elective CS. Patients were equally divided into two groups by simple randomization. After spinal anesthesia and catheterization under aseptic technique, the study group had preoperative vaginal cleansing using chlorhexidine 0...
September 1, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27528869/predictors-of-staphylococcus-aureus-colonization-and-results-after-decolonization
#18
Tennison L Malcolm, Le Don Robinson, Alison K Klika, Deepak Ramanathan, Carlos A Higuera, Trevor G Murray
Protocols for the screening and decolonization of Staphylococcus aureus prior to total joint arthroplasty (TJA) have become widely adopted. The goals of this study were to determine: (1) whether implementation of a screening protocol followed by decolonization with mupirocin/vancomycin and chlorhexidine reduces the risk of revision compared with no screening protocol (i.e., chlorhexidine alone) and (2) whether clinical criteria could reliably predict colonization with MSSA and/or MRSA. Electronic medical records of primary patients undergoing TJA that were screened (n = 3,927) and were not screened (n = 1,751) for Staphylococcus aureus at least 4 days prior to surgery, respectively, were retrospectively reviewed...
2016: Interdisciplinary Perspectives on Infectious Diseases
https://www.readbyqxmd.com/read/27492790/reduction-of-methicillin-resistant-staphylococcus-aureus-infection-in-long-term-care-is-possible-while-maintaining-patient-socialization-a-prospective-randomized-clinical-trial
#19
Lance R Peterson, Susan Boehm, Jennifer L Beaumont, Parul A Patel, Donna M Schora, Kari E Peterson, Deborah Burdsall, Carolyn Hines, Maureen Fausone, Ari Robicsek, Becky A Smith
BACKGROUND: Antibiotic resistance is a challenge in long-term care facilities (LTCFs). The objective of this study was to demonstrate that a novel, minimally invasive program not interfering with activities of daily living or socialization could lower methicillin-resistant Staphylococcus aureus (MRSA) disease. METHODS: This was a prospective, cluster-randomized, nonblinded trial initiated at 3 LTCFs. During year 1, units were stratified by type of care and randomized to intervention or control...
December 1, 2016: American Journal of Infection Control
https://www.readbyqxmd.com/read/26956247/does-preadmission-cutaneous-chlorhexidine-preparation-reduce-surgical-site-infections-after-total-knee-arthroplasty
#20
Bhaveen H Kapadia, Peter L Zhou, Julio J Jauregui, Michael A Mont
BACKGROUND: Many preventive methodologies seek to reduce the risk of surgical site infections after total knee arthroplasty (TKA), including the use of preoperative chlorhexidine baths and cloths. Although we have demonstrated in previous studies that this may be an efficacious method for infection prevention, our study was underpowered and we therefore set out to evaluate this with a larger sample size. QUESTIONS/PURPOSES: (1) Does a preadmission chlorhexidine cloth skin preparation protocol decrease the risk of surgical site infection in patients undergoing TKA? (2) When stratified using the National Healthcare Safety Network (NHSN) risk categories, which categories are associated with risk reduction from the preadmission chlorhexidine preparation protocol? METHODS: In our study, all patients (3717 total) who had undergone primary or revision TKA at a single institution between January 1, 2007, and December 31, 2013, were identified, of whom 991 patients used the chlorhexidine cloths before surgery and 2726 patients did not...
July 2016: Clinical Orthopaedics and related Research
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