Implementation of a SBAR sign-out template in the standardized residency training in a neonatal ward / 中华医学教育探索杂志

Objective:To analyze the effect of SBAR (situation, background, assessment, and recommendation) sign-out template in the standardized residency training in a neonatal ward.Methods:Based on SBAR communication mode, we designed and optimized neonatal ward sign-out checklist, and a total of 67 residents were trained for 2 weeks from April 2019 to June 2019, with control group (before training) and observation group (after training). The assessment indicators of sign-out information included sign-out duration, the incidence of sign-out errors, quality assessment scores and shift satisfaction (including sign-out satisfaction and self-evaluation) as well as competencies. A total of 1 553 children's morning shift data were collected, and SPSS 22. 0 was used for t test and chi-square test. Results:In the control group, the sign-out duration was (23.4±4.7) min, the incidence of sign-out errors was (43.6±6.6)%, quality assessment scores were (6.3±0.7) points, the satisfaction degree was (76.5±4.6)%, and the self-evaluation scores were (5.2±2.1) points. While, in the observation group, the sign-out duration was (15.9±3.2) min, the incidence of sign-out errors was (21.1±2.3)%, quality assessment scores were (8.9±0.9) points, the satisfaction degree was (94.1±2.9)%, and the self-evaluation scores were (8.9±0.8) points, with statistically significant difference ( P<0.05). There were statistically significant differences between the two groups in clinical skills and medical service ability [(2.2±0.1) vs. (3.8±0.3)], interpersonal communication ability [(2.6±0.5) vs. (4.2±0.1) points], teamwork ability [(3.1±0.2) vs. (4.6±0.3)], information and management ability [(2.5±0.5) vs. (4.2±0.2)] ( P<0.05). Conclusion:The SBAR template can improve sign-out process and the clinical skills of standardized training residents.

Nosocomial Infection in the Neonatal Ward of a Tertiary Care Hospital: The Role of Active Surveillance in the Control of Klebsiella pneumoniae Outbreak.

Aim: To describe an outbreak which occurred in a neonatal ward and the role of active surveillance in the control of further outbreaks. Study Design: Cross Sectional Observational Study. Place and Duration of Study: Lady Hardinge Medical College and Associated Hospitals, between May 2013 and June 2014. Methodology: The Infection Control Team (ICT) conducts active surveillance in the neonatal ward (NNW) routinely every year. The data regarding the above mentioned period were analysed and infection rates were calculated on monthly basis and compared. Attack rate was calculated as number of patients who acquired hospital acquired infections/ total number of admissions during that month. Results: A sudden increase in bloodstream infection (BSI) from 2 cases to 16 cases were observed over a period of 2 months (November 2013, and December 2013). Therefore an outbreak was suspected. Sixteen cases of primary blood stream infections caused by ceftazidime/ amoxicillin – clavulanic acid -resistant Klebsiella pneumoniae were observed over a two month period. Case definition was made. Recommendations for Infection control practices with immediate effect were sent. The ICT visited NNW and main labour room. Relevant samples were collected and Klebsiella species was isolated from suction tubing, baby cot, feeding katori, fingertip of health care worker (HCW) and soap sludge. Bacterial identification and antimicrobial susceptibility testing was performed by using the automated Vitek 2 instrument. The antibiogram of Klebsiella species from the samples and cases was found to be similar. It was found that NNW staff was changed recently without any training in Infection control practices. There was breach in Infection control practices. Conclusion: Active surveillance plays a very important role in detection of early onset of outbreak. All the HCWs including resident doctors, nursing and subsidiary staff and others must be trained in Infection control practices before they are posted to high risk areas.

Status of Hand Hygiene among Medical Staff in Neonatal Department:An Investigation / 中华医院感染学杂志

0.05); and more 5 years,length of service also between doctors. There were 98.3% of medical staffs being aware of health care law for six-step hand-washing and hand hygiene 97.8% being aware of hand hygiene compliance and 86.7% obtained knowledge after proper training,but most of them did not know the relationship between hand hygiene and hospital infection. CONCLUSIONS A good hand hygiene compliance need not only a reliable and convenient environment,but also training,inspection,supervision and management.