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Objective:To investigate the effect of failure mode and effect analysis (FMEA) based catheter information platform in preventing catheter-related bloodstream infection (CRBSI) in intensive care unit to improve the current status of CRBSI.Methods:In this study, a retrospective cohort study was conducted using the purposive sampling method, and 140 patients with indwelling central venous catheters admitted to the ICU of Peking University Shenzhen Hospital from August to December 2021 were set as the control group; the 140 patients with indwelling central venous catheters admitted to the ICU from January to May 2022 were set as the observation group. The control group used electronic forms to record and manage at the bedside after CRBSI cluster nursing measures were given, and the observation group used the catheter information platform based on FMEA to conduct information management on catheter evaluation and maintenance process after CRBSI cluster nursing measures were given. Compared the implementation rate (6 items), implementation time, qualification rate, and incidence of CRBSI in ICU patients between two groups of ICU nurses.Results:The implementation rate of CRBSI cluster nursing measures among ICU nurses in the observation group: strict hand hygiene by nurses was 87%(122/140), maximum aseptic barrier during puncture was 97%(136/140), aseptic operation during catheter maintenance was 91%(128/140), 75% alcohol disinfection of connectors was 84%(118/140), 24-hour change of infusion lines was 95%(133/140), and timely change of patches/dressings was 89%(125/140), they were greater than those in the control group 70%(98/140), 87%(122/140), 71%(100/140), 61%(86/140), 71%(99/140), 69%(96/140), the differences were statistically significant ( χ2 values were 9.67 to 29.07, all P<0.05); the execution time and qualification rate among ICU nurses in the observation group were (9.11 ± 2.83) minutes and 91.4% (128/140), the control group were (10.00 ± 2.84) minutes and 60.7% (85/140), with statistically significant differences ( t value was -2.64, χ2 values was 36.28, all P<0.05). Conclusions:The FMEA-based catheterization information platform can help enhance the efficiency of the implementation of CRBSI clustering nursing measures by ICU nurses, improve the quality of care, and thus reduce the occurrence of CRBSI, and the feasibility of clinical promotion is high.
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Objective@#To explorethe proper protective measures for pancreaticdiseases treatment during theoutbreak of 2019 coronavirus disease(COVID-19).@*Method@#Clinical data of four cases of patients that suffered COVID-19from February 2nd, 2020 to February 9th, 2020 in pancreatic surgery were reviewed.After the first patientscuffednosocomial infection of COVID-19, the general protective measures in our department wereupdated.Only one patient was admitted to each room alone, with no more than one caregiver.The body temperature of care givers was measuredtwice a day.Primary protections were applied to all staff.The floor was sterilized using disinfectant with an effective chlorine concentration of 1000 mg/L.The protective measures for interventional procedures were as follow.Primary protection was applied to the operators ofcentral venipuncture catheter, percutaneous abdominal/pleural drainage, percutaneous retroperitoneal drainage, percutaneous transhepatic cholangial drainage and other surgical procedures with local anesthesiaand epidural anesthesia.Secondary protection was applied to the operators of endoscopic retrograde cholangiopancreatography and surgical procedures with general anesthesia.@*Results@#During Feb 2nd, 2020 to Feb 9th, 2020, four patients in our department were diagnosed with COVID-19, of which one was died of COVID-19, two were cured, and one is still in hospital for COVID-19.After the update ofprotective measures in our department, no more nosocomial infection of COVID-19occurred.Two central venipuncture catheter, three percutaneous abdominal/pleural drainage, one percutaneous retroperitoneal drainage, one percuteneous transhepatic cholecyst drainage and one open surgery with general anesthesia were performed with no infection of operators.@*Conclusions@#The caregivers of patients are potential infection source of COVID-19.Enhanced protective measures including the management measures of caregivers can decrease the risk of nosocomial infection of COVID-19.
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OBJECTIVE To make the patients using the central venous catheter safely when given chemotherapy and intravenous nutritional therapy,and to decrease the catheter infection by establishing effective infection-preventing systems. METHODS Many infection-preventing actions were carried out,including a three-level management,improving the workers′ training in catheter operation and maintenance,and health education. RESULTS Comparing with the matched group,the infection rate of the experimental group was much lower after the actions.The actions prevented the increase of infection effectively. CONCLUSIONS Building and carrying out the systems are proved to be important measures to decrease the catheter infection and ensure the quality of life among patients during the therapy in hospital.
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STUDY DESIGN: This is a retrospective preparative study and prospective study OBJECTIVE: We instituted and verified the precautions against postoperative spinal infection. SUMMARY OF THE LITERATURE REVIEW: Postoperative infection comes from contamination during the operation and various strategies have been recommended to prevent it. MATERIALS AND METHODS: 583 cases that underwent instrumented posterior spinal fusion during two years (group I), were reviewed to discover the risk factors, and intraoperative cultures were done to detect the contamination routes and the causative microorganisms for the next 4 months. Six precautions, based on the results, were instituted. We analyzed 354 cases that underwent operation in the following year (group II) using the precautions. RESULTS: Twenty cases (3.4%) were infected in group I and the types of infection were superficial wound infection (4 cases), deep wound infection (4 cases), osteomyelitis around the interbody space (7 cases), osteomyelitis around the pedicle screws (4 cases) and a combination of wound infection and osteomyelitis around the pedicle screws (1 case). Infections happened more frequently in the cases of interbody fusion (p=0.034), revision (p=0.087) and those done in the summer season (p=0.025). S. epidermidis, as the causative bacteria, was cultured from both the operation environments and wounds. Six precautions based on the preliminary results were instituted as follows; irrigation method reformation, delayed opening of instruments, turning-off local air conditioners, changing of gowns before instrumentation, local bone irrigation and limited indications for interbody fusion. After implementation, two cases (0.6%) of infection developed in group II (p=0.002, odds ratio=0.160; 95% confidence interval = 0.037 to 0.688). CONCLUSION: Wounds, grafted bones or instruments can be contaminated under longer-time exposure to operating room air and so produce interbody or pedicle osteomyelitis without wound infection. The precautions were effective to decrease the postoperative infection rates following posterior spinal fusion.
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Bacteria , Operating Rooms , Osteomyelitis , Prospective Studies , Retrospective Studies , Risk Factors , Seasons , Spinal Fusion , Transplants , Wound InfectionABSTRACT
[Objective] In this study, the pain of receiving acupuncture was evaluated with or without individual finger stalls.<BR>[Design] In a randomized, subject- and operating person-blind, controlled study.<BR>[Methods] Sixteen acupuncturists and same number of normal volunteers participated in this study. Two needles were inserted into each side of the lumbar muscles. The trials were carried out twice using finger stalls and with bare fingers. These trials were performed in random order. Right after the insertion of needles and at the beginning of electrical stimulation, the subjects were asked to answer a questionnaire about the severity and quality of pain on receiving acupuncture. Durations of procedures were measured. We asked the acupuncturists whether they felt any difficulty in performing acupuncture using finger stalls.<BR>[Result] The majority of acupuncturists reported that using the finger stalls during treatment was inconvenient. Although the severity of pain of acupuncture did not significantly differ between that with and that without finger stalls, the average value was slightly higher with finger stalls. The qualities of pain on receiving acupuncture did not significantly differ between the two methods, however, the numbers of selected words differed on some items. The subjects could not recognize the use of individual finger stalls. The use of finger stalls did not influence the duration of the procedure.<BR>[Conclusion] In this study, the qualities of pain on receiving acupuncture did not significantly differ between that with and that without finger stalls. The subjects could not recognize the use of individual finger stalls.
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Infection is one of the most serious complications of acupuncture. But no infection ever appears without contamination, so the best method for preventing infection is to avoid contamination.<BR>There are two causes of contamination by acupuncture, namely, unsatisfactory disinfection of skin and contaminated neeedles. The former involves incomplete skin cleaning and inadequate disinfection. The latter is caused by contact with unsanitary matter. Some factors which are usually considered insignificant, such as contamination by needle tube, finger push technique, needle insertion technique or contamination in the needle case, should be re-examined.<BR>The author never touches the part of the needle which can penetrate the skin. This simple measure can help to prevent contamination of needles and consequent infection.