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Katharina D Hauck, Shaolin Wang, Charles Vincent, Peter C Smith
BACKGROUND: There is little satisfactory evidence on the harm of safety incidents to patients, in terms of lost potential health and life-years. OBJECTIVE: To estimate the healthy life-years (HLYs) lost due to 6 incidents in English hospitals between the years 2005/2006 and 2009/2010, to compare burden across incidents, and estimate excess bed-days. RESEARCH DESIGN: The study used cross-sectional analysis of the medical records of all inpatients treated in 273 English hospitals...
October 6, 2016: Medical Care
Víctor Daniel Rosenthal, Hail M Al-Abdely, Amani Ali El-Kholy, Safa A Aziz AlKhawaja, Hakan Leblebicioglu, Yatin Mehta, Vineya Rai, Nguyen Viet Hung, Souha Sami Kanj, Mona Foda Salama, Estuardo Salgado-Yepez, Naheed Elahi, Rayo Morfin Otero, Anucha Apisarnthanarak, Braulio Matias De Carvalho, Bat Erdene Ider, Dale Fisher, Maria Carmen S G Buenaflor, Michael M Petrov, Ana Marcela Quesada-Mora, Farid Zand, Vaidotas Gurskis, Tanja Anguseva, Aamer Ikram, Daisy Aguilar de Moros, Wieslawa Duszynska, Nepomuceno Mejia, Florin George Horhat, Vladislav Belskiy, Vesna Mioljevic, Gabriela Di Silvestre, Katarina Furova, Gloria Y Ramos-Ortiz, May Osman Gamar Elanbya, Hindra Irawan Satari, Umesh Gupta, Tarek Dendane, Lul Raka, Humberto Guanche-Garcell, Bijie Hu, Denis Padgett, Kushlani Jayatilleke, Najla Ben Jaballah, Eleni Apostolopoulou, Walter Enrique Prudencio Leon, Alejandra Sepulveda-Chavez, Hector Miguel Telechea, Andrew Trotter, Carlos Alvarez-Moreno, Luis Kushner-Davalos
BACKGROUND: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. METHODS: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days...
October 11, 2016: American Journal of Infection Control
Rajeev Soman, Neha Gupta, Mitesh Suthar, Jatin Kothari, Alan Almeida, Anjali Shetty, Camilla Rodrigues
BACKGROUND: Central-line-associated blood-stream infection (CLABSI) is a highly consequential nosocomial infection. The most effective management includes the removal of the infected catheter. Retention of the catheter and antibiotic lock therapy (ALT) along with systemic antibiotics may be attempted only if there are unusual extenuating circumstances. CLABSIs due to Gram-negative bacteria (GNB) is more common in our setting and the organisms are often highly resistant. Hence, there is a need to explore the use of novel antimicrobials for catheter lock solutions along with antibiofilm agents...
February 2016: Journal of the Association of Physicians of India
A Dramowski, A Whitelaw, M F Cotton
BACKGROUND: In most African countries the prevalence and effects of paediatric healthcare-associated infection (HCAI) and human immunodeficiency virus (HIV) infection are unknown. AIM: To investigate the burden, spectrum, risk factors, and impact of paediatric HCAI by prospective clinical surveillance at a South African referral hospital. METHODS: Continuous prospective clinical and laboratory HCAI surveillance using Centers for Disease Control and Prevention (CDC)/National Healthcare Safety Network (NHSN) definitions was conducted at Tygerberg Children's Hospital, South Africa, from May 1(st) to October 31(st) in 2014 and 2015...
September 1, 2016: Journal of Hospital Infection
Meredith Degnan, Jessica Brodt, Yiliam Rodriguez-Blanco
AIM: The aim of this study was to describe our institutional experience, primarily with general anesthesiologists consulting with cardiac anesthesiologists, caring for left ventricular assist device (LVAD) patients undergoing noncardiac surgery. MATERIALS AND METHODS: This is a retrospective review of the population of patients with LVADs at a single institution undergoing noncardiac procedures between 2009 and 2014. Demographic, perioperative, and procedural data collected included the type of procedure performed, anesthetic technique, vasopressor requirements, invasive monitors used, anesthesia provider type, blood product management, need for postoperative intubation, postoperative disposition and length of stay, and perioperative complications including mortality...
October 2016: Annals of Cardiac Anaesthesia
Yuki Ichinoseki, Yoshio Machida
Our purpose in this study was to elucidate the relation between the one-dimensional (1D) and two-dimensional (2D) noise power spectra (NPSs) in magnetic resonance imaging (MRI). We measured the 1D NPSs using the slit method and the radial frequency method. In the slit method, numerical slits 1 pixel wide and L pixels long were placed on a noise image (128 × 128 pixels) and scanned in the MR image domain. We obtained the 1D NPS using the slit method (1D NPS_Slit) and the 2D NPS of the noise region scanned by the slit (2D NPS_Slit)...
October 3, 2016: Radiological Physics and Technology
Sean van Diepen, Wendy I Sligl, Jeffrey B Washam, Ian C Gilchrist, Rakesh C Arora, Jason N Katz
Over the past half century, coronary care units have expanded from specialized ischemia arrhythmia monitoring units into intensive care units (ICUs) for acutely ill and medically complex patients with a primary cardiac diagnosis. Patients admitted to contemporary coronary intensive care units (CICUs) are at risk for common and preventable critical care complications, yet many CICUs have not adopted standard-of-care prevention protocols and practices from general ICUs. In this article, we (1) review evidence-based interventions and care bundles that reduce the incidence of ventilator-associated pneumonia, excess sedation during mechanical ventilation, central line infections, stress ulcers, malnutrition, delirium, and medication errors and (2) recommend pragmatic adaptations for common conditions in critically ill patients with cardiac disease, and (3) provide example order sets and practical CICU protocol implementation strategies...
July 1, 2016: Canadian Journal of Cardiology
M Alharbi, A Husakou, M Chafer, B Debord, F Gérôme, F Benabid
Trapping or cooling molecules has rallied a long-standing effort for its impact in exploring new frontiers in physics and in finding new phase of matter for quantum technologies. Here we demonstrate a system for light-trapping molecules and stimulated Raman scattering based on optically self-nanostructured molecular hydrogen in hollow-core photonic crystal fibre. A lattice is formed by a periodic and ultra-deep potential caused by a spatially modulated Raman saturation, where Raman-active molecules are strongly localized in a one-dimensional array of nanometre-wide sections...
2016: Nature Communications
Jay N Nathwani, Rebekah M Fiers, Rebecca D Ray, Anna K Witt, Katherine E Law, ShannonM DiMarco, Carla M Pugh
OBJECTIVE: The purpose of this study is to coevaluate resident technical errors and decision-making capabilities during placement of a subclavian central venous catheter (CVC). We hypothesize that there would be significant correlations between scenario-based decision-making skills and technical proficiency in central line insertion. We also predict residents would face problems in anticipating common difficulties and generating solutions associated with line placement. DESIGN: Participants were asked to insert a subclavian central line on a simulator...
September 23, 2016: Journal of Surgical Education
Michelle Ribeiro Viana Taveira, Luciana Santana Lima, Cláudia Corrêa de Araújo, Maria Júlia Gonçalves de Mello
BACKGROUND: Totally implantable venous access ports (TIVAPs) are used for prolonged central venous access, allowing the infusion of chemotherapy and other fluids and improving the quality of life of children with cancer. TIVAPs were developed to reduce the infection rates associated with central venous catheters; however, infectious events remain common and have not been fully investigated in pediatric oncology patients. PROCEDURE: A retrospective cohort was formed to investigate risk factors for central line-associated bloodstream infection (CLABSI) in pediatric cancer patients...
September 26, 2016: Pediatric Blood & Cancer
Noa Eliakim-Raz, Roi Babaoff, Dafna Yahav, Shirly Yanai, Hila Shaked, Jihad Bishara
BACKGROUND: The clinical characteristics of internal medicine ward (IMW) patients with candidemia are unclear. The aim of this study was to define the clinical characteristics of candidemic IMW patients and to study the incidence, species distribution, and outcomes of these patients compared to surgical and intensive care unit (ICU) candidemic patients. METHODS: A retrospective cohort of candidemic patients in IMWs, general surgery wards, and an ICU at Beilinson Hospital during the period 2007-2014 was analyzed...
September 20, 2016: International Journal of Infectious Diseases: IJID
Marie-Caroline Husson, Manuel Schiff, Alain Fouilhoux, Aline Cano, Dries Dobbelaere, Anais Brassier, Karine Mention, Jean-Baptiste Arnoux, François Feillet, Brigitte Chabrol, Nathalie Guffon, Caroline Elie, Pascale de Lonlay
BACKGROUND: The efficacy and safety of intra-venous (i.v.) sodium benzoate for treating acute episodes of hyperammonemia in urea cycle enzyme disorders (UCD) is well known. However, published data do not provide a clear picture of the benefits and risks of this drug. We report a retrospective multicentre study on the use of i.v. sodium benzoate in patients treated for UCD between 2000 and 2010 in the 6 French reference centres for metabolic diseases. RESULTS: Sixty-one patients with UCDs - 22 ornithine transcarbamylase (20 confirmed, 2 suspected), 18 arginino-succinate synthetase, 15 carbamoyl phosphate synthetase, 3 arginosuccinate lyase, 1 arginase deficiency, 1 N-acetylglutamate synthetase, 1 HHH syndrome - required i...
2016: Orphanet Journal of Rare Diseases
Francisco Matias, Edgar Semedo, Cláudia Carreira, Paula Pereira
BACKGROUND AND OBJECTIVES: Central venous catheterization of the internal jugular vein is a commonly performed invasive procedure associated with a significant morbidity and even mortality. Ultrasound-guided methods have shown to improve significantly the success of the technique and are recommended by various scientific societies, including the American Society of Anesthesiologists. The aim of this report is to describe an innovative ultrasound-guided central line placement of the internal jugular vein...
September 17, 2016: Revista Brasileira de Anestesiologia
Hossein Mohamadipanah, Chembian Parthiban, Jay Nathwani, Drew Rutherford, Shannon DiMarco, Carla Pugh
BACKGROUND: Due to the increased use of peripherally inserted central catheter lines, central lines are not performed as frequently. The aim of this study is to evaluate whether a virtual reality (VR)-based assessment of fine motor skills can be used as a valid and objective assessment of central line skills. METHODS: Surgical residents (N = 43) from 7 general surgery programs performed a subclavian central line in a simulated setting. Then, they participated in a force discrimination task in a VR environment...
October 2016: American Journal of Surgery
David P Hall, Lise J Estcourt, Carolyn Doree, Sally Hopewell, Marialena Trivella, Timothy S Walsh
BACKGROUND: The insertion of central venous catheters (CVCs) may be associated with peri- and post-procedural bleeding. People who require a central line often have disorders of coagulation as a result of their underlying illness, co-morbidities or the effects of treatment. Clinical practice in some institutions is to mitigate the risk of bleeding in these patients by prophylactically transfusing fresh frozen plasma (FFP) in order to correct clotting factor deficiencies prior to central line insertion...
September 20, 2016: Cochrane Database of Systematic Reviews
Hidenori Tanabe, Ryoko Murayama, Koichi Yabunaka, Makoto Oe, Toshiaki Takahashi, Chieko Komiyama, Hiromi Sanada
INTRODUCTION: Peripheral intravenous catheters (PIVCs) are frequently removed due to phlebitis. We hypothesized that catheters made of polyurethane, which is more flexible than Teflon, would decrease phlebitis, and that flexibility could be estimated by measuring the catheter-tip angle. Ultrasonography in two groups of patients with different catheter types was then used to compare catheter-tip angles and phlebitis. METHODS: Observational studies were carried out at a medical ward in a university hospital...
September 20, 2016: Journal of Vascular Access
Mohamad G Fakih, Boguslow Skierczynski, Angelo Bufalino, Clariecia Groves, Phillip Roberts, Michelle Heavens, Ann Hendrich, Ziad Haydar
BACKGROUND: The standardized infection ratio (SIR) evaluates individual publicly reported health care-associated infections, but it may not assess overall performance. METHODS: We piloted an infection composite score (ICS) in 82 hospitals of a single health system. The ICS is a combined score for central line-associated bloodstream infections, catheter-associated urinary tract infections, colon and abdominal hysterectomy surgical site infections, and hospital-onset methicillin-resistant Staphylococcus aureus bacteremia and Clostridium difficile infections...
September 16, 2016: American Journal of Infection Control
Catarina Cardoso de Almeida, Susana Maria Saraiva Pissarra da Silva, Filipa Silveira Dias Flor de Lima Caldas de Oliveira, Maria Hercília Ferreira Guimarães Pereira Areias
OBJECTIVE: To evaluate nosocomial infections preventive bundle, implemented in April 2010 in Centro Hospitalar de São João (CHSJ) Neonatal Intensive Care Unit (NICU) effectiveness. METHODS: Newborns admitted to level-III NICU of CHSJ, between 1 April 2007 and 31 March 2013, with sepsis as discharge diagnosis, were selected and divided into two periods (Period 1 and 2, before and after new preventive bundle introduction). Data from the two periods were compared...
October 3, 2016: Journal of Maternal-fetal & Neonatal Medicine
Mahmood Shamshiri, Boudouin Fuh Suh, Nooredin Mohammadi, Reza Nabi Amjad
BACKGROUND: Healthcare-associated infections (HAIs) are acquired by patients while receiving care. The highest incidence of HAIs has been documented in admissions to intensive care units. Adherence to evidence-based practices is the most important step for preventing HAIs. OBJECTIVES: To determine the rate of adherence to evidence-based post-insertion recommended care practices after admission into the intensive care unit for the following devices: central line catheter, indwelling urinary catheter, and mechanical ventilator...
June 2016: Iranian Red Crescent Medical Journal
Maria H Curlej, Elizabeth Katrancha
In an effort to take advantage of the Highmark Quality Blue Initiative () requiring information from hospitals detailing their central line-associated blood stream infections (CLABSIs) surveillance system, quality improvement program, and statistics regarding the CLABSI events, this institution investigated the latest evidence-based recommendations to reduce CLABSIs. Recognizing the baseline rate of 2.4 CLABSIs per 1,000 central line days and its effect on patient outcomes and medical costs, this hospital made a commitment to improve their CLABSI outcomes...
September 2016: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
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