ABSTRACT
Many patients carried into the emergency room or intensive care unit are suspected to have risk factors for deep-seated mycosis. Using the Actions Bundle, which itemizes diagnosis and treatment of invasive candidiasis, we carried out investigations into facts about the use of antifungal drugs in the intensive care unit of our hospital. The subjects of this retrospective study were 11 ICU patients who were given antifungal drugs intravenously between April 2013 and March 2014. Their medication records revealed that micafungin was administered to five patients, fosfluconazole to another five patients and fulconazole to the remaining one patient. The ratio of the cases where the dugs were used in compliance with what the Actions Bundle suggested worked out at 71.4±15.9%. When it came to the collection rate of two sets of blood culture and the proper dosage, the compliance rates were the lowest with 36% each. As regards dosage, 18% was excessive, 36% proper and 45% insufficient. As pharmacists in charge of the ICU, we have to use the checklist more effectively and intervene in the care of patients with invasive candidiasis at an early stage.
ABSTRACT
In August 2001 we began to use WELPAS (a benzalkonium chloride solution) as part of our cost-containment drive, replacing self-made glycerol-added ethanol, which had been used for a long time to prevent nosocomial infections. Since then, blackish stains have become particularly noticeable here and there on the floorboards of the passageways in the hospital wards. The newly adopted quick-drying hand disinfectant was suspected as the culprit. To find the real cause of the dirt, we built a hallway similar to the real passageway for experiment. The disinfectant agents used were WELPAS, WELLUP (chlorhexidine gluconate), HIBISOFT (chlorhexidine gluconate), medicinal ethanol, cationic detergent solution, HIBITANE solution (chlorhexidine hydrochioride) and glycerol solution. These agents and distilled water were dropped on a limited area of the floor respectively for comparison of the degrees of dirt. The cationic detergent solution and WELPAS containing cationic detergent left blackish stains that were hardest to remove. From this finding, it was inferred that the cationic detergent solution was responsible for the dirt on the floor. So we decided to switch to a quick-drying hand disinfectant which does not contain cationic detergents. After considering economic benefit, we chose WELLUP which contains medicinal alcohol plus chlorhexidine gluconate and put it into actual use in October 2003. Since then, the hospitall floors have become unmistakalbly clean.
ABSTRACT
In August 2001 we began to use WELPAS (a benzalkonium chloride solution) as part of our cost-containment drive, replacing self-made glycerol-added ethanol, which had been used for a long time to prevent nosocomial infections. Since then, blackish stains have become particularly noticeable here and there on the floorboards of the passageways in the hospital wards. The newly adopted quick-drying hand disinfectant was suspected as the culprit. To find the real cause of the dirt, we built a hallway similar to the real passageway for experiment. The disinfectant agents used were WELPAS, WELLUP (chlorhexidine gluconate), HIBISOFT (chlorhexidine gluconate), medicinal ethanol, cationic detergent solution, HIBITANE solution (chlorhexidine hydrochioride) and glycerol solution. These agents and distilled water were dropped on a limited area of the floor respectively for comparison of the degrees of dirt. The cationic detergent solution and WELPAS containing cationic detergent left blackish stains that were hardest to remove. From this finding, it was inferred that the cationic detergent solution was responsible for the dirt on the floor. So we decided to switch to a quick-drying hand disinfectant which does not contain cationic detergents. After considering economic benefit, we chose WELLUP which contains medicinal alcohol plus chlorhexidine gluconate and put it into actual use in October 2003. Since then, the hospitall floors have become unmistakalbly clean.