Game-based training to promote handwashing, handrub and gloving for hospital pharmacy operators.

OBJECTIVES: Adherence to handwashing, handrub and gloving procedures is mandatory for safe, aseptic drug compounding in hospital pharmacies. This study measured participants' satisfaction and effectiveness of a game-based training tool (Handtastic Box) developed to improve adherence. METHODS: Handtastic Boxes were played by pairs of pharmacy operators (introductory video, 1 min study of guidelines, game). In module 1, players watched videos of somebody handwashing and had to find the missing step. They examined wooden models of hands under ultraviolet (UV) light, with some areas stained with fluorescein, to find the hand showing contamination. In module 2, players used a fluorescein hydroalcoholic solution and placed their hands under UV light to highlight missing areas. In module 3, players identified major errors that could compromise glove sterility and linked them to a problem explanation. Then, they applied paint to their fingertips and donned gloves-the paint had to stay inside them. Satisfaction about the training was assessed with a 10-question survey; knowledge about procedures was assessed using a before-and-after questionnaire of nine questions, a 100-point confidence score (modules 1 and 2), and the number of before-and-after errors made during donning gloves (module 3). RESULTS: Operators were very satisfied and felt more competent after training. Average knowledge score increased from 56.3% (SD 18.2%) to 93.7% (SD 9.5%), and confidence in answers increased from 66.4% (SD 18.7%) to 95.7% (SD 5.52%) (n=14, both modules 1 and 2). The mean error score for gloving procedure decreased from 1.7 (SD 0.8%) to 0.3 (SD 0.5%) (n=10, module 3). CONCLUSION: Handtastic Boxes proved to be a highly effective training method for improving knowledge of handwashing, handrub and gloving.

Mechanistic studies on the catalytic asymmetric Mannich-type reaction with dihydroisoquinolines and development of oxidative Mannich-type reactions starting from tetrahydroisoquinolines.

Detailed mechanistic studies on our recently reported asymmetric addition reactions of malonates to dihydroisoquinolines (DHIQs) catalyzed by chiral Pd(II) complexes were carried out. It was found that an N,O-acetal was generated in situ by the reaction of DHIQ with (Boc)2O, and cooperative action of the Pd(II) complex as an acid-base catalyst allowed the formation of a chiral Pd enolate and a reactive iminium ion via alpha-fragmentation. The iminium ion was also accessible via oxidation with DDQ as an oxidant, and a catalytic asymmetric oxidative Mannich-type reaction was achieved with tetrahydroisoquinolines (THIQs) as starting materials. This oxidation protocol was applicable to N-acryloyl-protected THIQs, allowing the efficient synthesis of optically active tetrahydrobenzo[a]quinolizidine derivatives via intramolecular Michael reaction.

Pd(II)-catalyzed asymmetric addition of malonates to dihydroisoquinolines.

We have developed a highly efficient reaction for catalytic asymmetric addition of malonates to dihydroisoquinolines using chiral Pd(II) complexes. In the reactions, substrates with various substitution patterns were available, and the reactions were complete within several hours (<3 h in most cases) under mild reaction conditions, affording various optically active C1-substituted tetrahydroisoquinoline derivatives (up to 98% yield, up to 97% ee). Furthermore, slow addition of DDQ allowed the in situ generation of the reactive intermediate from the corresponding N-Boc-protected amine, and dehydrogenative addition reaction was successfully demonstrated.

A new method for the conversion of allyl alcohol into pi-allyl species promoted by nucleophilic interaction with a CO ligand.

Upon treatment with an iridium carbonyl complex, [(PN)Ir(CO)2]+, allyl alcohol can be smoothly converted into pi-allyliridium species at ambient temperature via nucleophilic interaction of the alcohol with a CO ligand followed by C(allyl)-O bond cleavage in the resultant protonated allyloxycarbonyl intermediate.

Selective synthesis of isomeric heterodinuclear complexes with switched metal arrangements via proton-induced reversible metal migration.

Pairs of isomeric heterodinuclear complexes, [(cod)Ir(mu-PNNN)M(L)]BF4 and [(L)M(mu-PNNN)Ir(cod)]BF4, with switched metal arrangements are prepared in a specific manner by simply changing the addition order of the reagents.