Reducing Improper and Missed Peri-Procedure Antibiotics Prescriptions in a Regional Oncology Centre.

Background In the realm of oncology care, patients undergoing invasive procedures are particularly vulnerable to infections due to their compromised immune systems. Antibiotics play a pivotal role in preventing such infections. However, inappropriate or missed administration of peri-procedure antibiotics poses a significant risk in the form of treatment complications, contributing to antibiotic resistance and increased healthcare costs. Methods The study was a two-cycle, closed-loop quality improvement project utilizing both retrospective and prospective data analysis of peri-procedure antibiotics prescription in a regional oncology centre. Two audit cycles were carried out in total; the first cycle was carried out in November 2023 where six-week data were collected retrospectively. As a result, formal and informal teaching sessions about the importance of correct peri-procedure antibiotics and the availability of complete institutional peri-procedure antibiotics guidelines in clinical areas were ensured. The second cycle was carried out prospectively for two weeks in January 2024. Patients were included if they underwent selected procedures performed by interventional radiology or gastroenterology while the patients operated on by the general surgeons and any day case procedures were excluded. Results We identified a total of 82 interventional procedures during the first cycle that fulfilled the inclusion criteria. Six out of 82 patients (7.3%) did not receive the correct peri-procedural antibiotics as per hospital antibiotics guidelines. A prospective two-week data after implementing the change revealed that 25 patients had documented interventional procedures done during this period using electronic patient records. Out of 25 patients, only one patient (4%) did not receive the peri-procedural antibiotics as per guidelines. We were able to demonstrate increased adherence to the peri-procedural guidelines (from 93% to 96%) during the two cycles. However, this change was not statistically significant (p = 0.50). Conclusion By educating and engaging healthcare professionals in adhering to evidence-based guidelines and best practices, we have observed notable, although statistically significant improvement in peri-procedure antibiotics prescription practices. Continued educational efforts and reinforcement strategies will be vital in further improvements over time. By providing ongoing support and resources, healthcare providers can be empowered to consistently make informed decisions regarding peri-procedure antibiotic administration. This commitment to maintaining high standards of antibiotic prescribing practices is expected to result in improved patient outcomes, including reduced rates of surgical site infections and antibiotic resistance. It is imperative to recognize the critical role that accurate peri-procedure antibiotic prescriptions play in patient safety and overall healthcare quality. By fostering a culture of continuous improvement and adherence to established guidelines, we can ensure that patients receive optimal care while minimizing the risks associated with antibiotic overuse or misuse.

Multiscale tribology analysis of MHD hybrid nanofluid flow over a curved stretching surface.

In this study, we investigate the interactions of a hybrid nanofluid on a curved surface that is being stretched. The magnetic field is perpendicular to the flow and interacts with a mixture of molybdenum disulfide and argentum nanoparticles suspended in pure water, forming a hybrid nanomaterial. Our investigation considers heat transport analysis under different conditions, such as magnetohydrodynamic, Darcy-Forchheimer porous medium flow, Joule heating, and a convective boundary condition. We employ numerical and statistical methods to study the problem's intricacies comprehensively. Our findings indicate that Darcy-Forchheimer flow includes viscous and inertial forces, which results in higher flow rates and reduced skin friction. Additionally, the convective boundary condition leads to uniform temperature distribution within the hybrid material due to rapid internal heat transfer relative to surface resistance, significantly increasing the heat transfer rate.

Three-dimensional MHD flow of hybrid material between rotating disks with heat generation.

In this study, we investigate the flow of electrically conducting hybrid nanofluid (Ag+Cu/H2O), due to rotating disks, along with thermal slip, heat generation, and viscous dissipation. The nonlinear differential system is modelled and transformed into dimensionless partial differential equations using suitable dimensionless variables. To obtain solutions for the considered model, a finite difference toolkit is implemented, and numerical solutions are achieved. Graphical results are presented to display the influences of different dimensionless variables on flow velocity and temperature. This research contributes to a better understanding of hybrid nanofluid flows and can inform the design of cooling systems and other practical applications.

Thermodynamic irreversibility effects with Marangoni convection for third grade nanofluid flow.

In this study, an analysis was performed to investigate the thermal and mass transport of radiative flow of a third-grade nanofluid with magnetohydrodynamic. The analysis concerns two-dimensional flow around an infinite disk. Heat transport is studied via heat generation/absorption, thermal radiation and Joule heating. Chemical reaction with activation energy is also considered. The nanofluid characteristics, including Brownian motion and thermophoretic diffusion, are explored via the Buongiorno model. Entropy analysis is also conducted. Moreover, the surface tension is assumed to be a linear function of concentration and temperature. Through adequate dimensionless variables, governed PDEs are non-dimensionlized and then tackled by ND-solve (a numerical method in Mathematica) for solutions purposes. Entropy generation, concentration, velocity, Bejan number and temperature are plotted as functions of the involved physical parameters. It is noticed that higher Marangoni number intensify velocity however it causes a decrease in the temperature. Entropy rate and Bejan number boost for large value of diffusion parameter.

Numerical study for bioconvection peristaltic flow of Sisko nanofluid with Joule heating and thermal radiation.

Present work describes the peristaltic flow of Sisko nanomaterial with bioconvection and gyrotactic microorganisms. Slip conditions are incorporated through elastic channel walls. Additionally, we considered the aspects of thermal radiation and viscous dissipation. Further ohmic heating features are also present in the thermal field. Buongiorno's nanofluid model comprising thermophoresis and Brownian movement is taken. The lubrication approach is utilized for the simplification of the problem. Being highly coupled and nonlinear, the resulting system of equations must be solved numerically using the NDSolve technique and bvp4c via Matlab. Velocity, concentration, thermal field and motile microorganisms. are addressed graphically.

Study of Results of Katugampola Fractional Derivative and Chebyshev Inequailities.

In this work, we use generalized form of Caputo-type fractional derivative and Riemann-Liouville fractional Integral which is known as Katugampola fractional derivative. This work deals with some results having applications of Katugampola fractional derivative. We discuss commutative and inverse property of Katugampola fractional derivative. We have also introduced Chebyshev inequalities and some other integrals inequalities applying the Katugampola fractional derivative.

Unsteady Squeezing Flow of Carbon Nanotubes with Convective Boundary Conditions.

Unsteady flow of nanofluids squeezed between two parallel plates is discussed in the presence of viscous dissipation. Heat transfer phenomenon is disclosed via convective boundary conditions. Carbon nanotubes (single-wall and multi-wall) are used as nanoparticles which are homogeneously distributed in the base fluid (water). A system of non-linear differential equations for the flow is obtained by utilizing similarity transformations through the conservation laws. Influence of various emerging parameters on the velocity and temperature profiles are sketched graphically and discussed comprehensively. Analyses of skin fraction coefficient and Nusselt number are also elaborated numerically. It is found out that velocity is smaller for squeezing parameter in the case of multi-wall carbon nanotubes when compared with single-wall carbon nanotubes.