Continuous monitoring of eating and sleeping behaviors in the home environments of older adults: a case study demonstration.

Accurate observation of patient functioning is necessary for rigorous clinical research and for improving the quality of patient care. However, clinic or laboratory environments systematically differ from the contexts of everyday life. Further, assessments that are completed in a single institutional session may not be generalizable. Here, we describe a computer vision methodology that measures human functioning continuously in the environments where patients live, sleep, and eat.

Benefit of systematic selection of pairs of cases matched by surgical specialty for surveillance of bacterial transmission in operating rooms.

BACKGROUND: Bacterial transmission within and between successive surgical cases occurs in operating rooms (ORs), often includes anesthesia equipment as a reservoir, and can be monitored by collecting samples and identifying bacteria by genetic testing. We evaluated how to choose cases for active surveillance to quantify the effectiveness of interventions in 2 groups of ORs (eg, rooms with germicidal lighting vs those without). METHODS: Data were from a 7 OR single-specialty gastrointestinal endoscopy suite and from a typical 8 OR multispecialty surgical suite. RESULTS: At the multispecialty hospital, 40.3% (SE 1.2%) of the total number of cases could be used for surveillance (ie, followed by another case of the same specialty and matched with a corresponding pair of cases from the other OR group). Random selection obtained fewer matched pairs than deliberate selection: mean ratio of random/deliberate = 0.64 (0.01) for the single-specialty and 0.51 (0.02) for the multispecialty suite (P <.001). CONCLUSIONS: The efficiency of sampling to obtain pairs of successive surgical cases of the same specialty is impaired markedly by randomly selecting pairs of cases (or using convenience sampling) as compared to choosing pairs deliberately. This is important because the number of cases that can be suitably used for surveillance of bacterial transmission will typically be less than one-half the total case number.

Evaluating the effectiveness of ultraviolet-C lamps for reducing keyboard contamination in the intensive care unit: A longitudinal analysis.

BACKGROUND: Ultraviolet (UV) spectrum light for decontamination of patient care areas is an effective way to reduce transmission of infectious pathogens. Our purpose was to investigate the efficacy of an automated UV-C device to eliminate bioburden on hospital computer keyboards. METHODS: The study took place at an academic hospital in Chicago, Illinois. Baseline cultures were obtained from keyboards in intensive care units. Automated UV-C lamps were installed over keyboards and mice of those computers. The lamps were tested at varying cycle lengths to determine shortest effective cycles. Delay after use and prior to cycle initiation was varied to minimize cycle interruptions. Finally, 218 postinstallation samples were analyzed. RESULTS: Of 203 baseline samples, 193 (95.1%) were positive for bacteria, with a median of 120 colony forming units (CFU) per keyboard. There were numerous bacteria linked to health care-associated infections (HAIs), including Staphylococcus, Streptococcus, Enterococcus, Pseudomonas, Pasteurella, Klebsiella, Acinetobacter, and Enterobacter. Of the 193 keyboards, 25 (12.3%) had gram-negative species. Of 218 postinstallation samples, 205 (94%) were sterile. Of the 13 that showed bacterial growth, 6 produced a single CFU. Comparison of pre- and post-UV decontamination median CFU values (120 and 0, respectively) revealed a >99% reduction in bacteria. CONCLUSIONS: The UV lamp effectively decontaminates keyboards with minimal interruption and low UV exposure. Further studies are required to determine reduction of HAI transmission with use of these devices.