Contamination of pulse oximeter probes before and after decontamination in two intensive care units

Background. The internal surfaces of pulse oximeter probes may be overlooked as hot spots for pathogenic microorganisms in an intensive care unit (ICU), thereby contributing to the high incidence of hospital-acquired infections. Objectives. To determine the growth and identification of microorganisms on pulse oximeter probes in the multidisciplinary ICU (MICU) at Charlotte Maxeke Johannesburg Academic Hospital and the burns ICU (BICU) at Chris Hani Baragwanath Academic Hospital, before and after decontamination. Methods. This was a cross-sectional, comparative and contextual study, using purposive sampling. Data were collected from the internal surfaces of 34 pulse oximeter probes in a MICU and BICU. Each pulse oximeter probe was swabbed before and after decontamination. The endemic microorganism profile for the two ICUs was obtained from a laboratory database. Results. Internal surfaces of 31 (91%; 95% confidence interval (CI) 0.76 - 0.98) pulse oximeter probes were contaminated with 9 different pathogenic microorganisms pre decontamination. Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa were endemic to both ICUs, and were the most-frequently isolated microorganisms. Staphylococcus aureus was the most common microorganism endemic to both ICUs, isolated on the internal surfaces of only 2 pulse oximeter probes. Of the internal surfaces of pulse oximeter probes, 6 (18%; 95% CI 0.07 - 0.35) remained contaminated post decontamination, with a microorganism growth reduction of 80% (p=0.0001). Conclusion. The internal surfaces of pulse oximeter probes may serve as hot spots for an array of pathogens with the potential to cause infection and outbreaks in ICUs. Decontamination of the internal surfaces of pulse oximeter probes should be emphasised

ICU Nurse Allocation in a Cardiothoracic ICU : How many Hands do we Need ?

Aim. To determine the nurse/patient ratios required to render safe; competent ICU nursing. Method. A patient classification system (CritScore) was used to compile an objective 3-month patient profile. The number (of full-time and agency staff) and the professional profiles of nursing staff allocated to the unit during this period were documented. Results. The majority of the patients were class 3 patients. While there was concordance between the total number of nurses present in relation to the number predicted by CritScore; the number of ICU-trained nurses was consistently below that ascertained by CritScore. This unit was staffed on average with more than 50 nonpermanent staff who were employed on a temporary basis via agencies. Conclusion. The number of nursing hands allocated is important; but even more so is the quality; or competence; of these hands. Nursing care without an acceptable level of competence in a critical care unit may be considered as a potentially harmful intrusion for the patient

2006 Profile of Postgraduate Critical Care Nursing Research in South Africa

Aim. The aim of the study was to compile a profile of postgraduate critical care nursing research completed during 2006 in the nursing departments of South African universities; and to determine the extent to which this research contributes to the development of a unique body of specialist South African nursing knowledge. Method. The critical care nursing programme leader at each university completed an electronic questionnaire. Results. A total of 16 critical care master's projects (but no doctorate projects) were completed. Completed projects came from only 7 of the 10 universities that offer a postgraduate programme in critical care nursing. To date; only 1 of the projects (6.3) has been published and 3 (18.8) have been presented at a national critical care congress. Conclusion. The number and focus of the 2006 projects are comparable with the 2000 - 2005 profile. Research dissemination from South African postgraduate critical care nursing research remains poor