Measuring environmental contamination in critical care using dilute hydrogen peroxide (DHP) technology: An observational cross-over study.

BACKGROUND: The environment has an important role in the transmission of healthcare associated infections. This has encouraged interest in novel methods to improve hygiene in hospitals. One such technology is the use of hydrogen peroxide to decontaminate rooms and equipment; there are, however, few studies that have investigated the effect of continuous dilute hydrogen peroxide (DHP) in the clinical environment. The aim of this study was to examine the use of dilute hydrogen peroxide (DHP) in a critical care unit and measure the microbiological impact on surface contamination. METHODS: We conducted a prospective observational cross-over study in a ten-bed critical care unit in one rural Australian hospital. Selected high-touch sites were screened using dipslides across three study phases: baseline; continuous DHP; and no DHP (control). Quantitative aerobic colony counts (ACC) were assessed against a benchmark standard of ACC >2.5 cfu/cm2 to indicate hygiene failure. RESULTS: There were low levels of microbial contamination in the unit for baseline; DHP; and no DHP phases: 2.2% (95% CI 0.7-5.4%) vs 7.7% (95% CI 4.3-13.0%) vs 6% (95% CI 3.2-10.4%) hygiene failures, respectively. Significant reduction in ACCs did not occur when the DHP was operating compared with baseline and control phases. CONCLUSION: Further work is needed to determine whether continuous DHP technology has a role in decontamination for healthcare settings.

Nine years experience with chemically dependent physicians: the New Jersey experience.

Few studies have been able to retroactively evaluate the effectiveness of treating chemically dependent physicians. This paper provides an overview of the Physicians' Health Program of the Medical Society of New Jersey; details the current status of physicians treated for chemical dependency from 1982 to 1990; lists the perceived reasons for successful recovery; and identifies the needs for the future.

Rorschach from quality: a comparison of the Exner and Beck systems.

The Beck and Exner systems of assigning Rorschach form quality were compared, There are some inherent differences in the form quality tables of these two Rorschach systematizers. The Beck system is more extensive and seems slightly biased toward-or "poor" form quality in comparison to the Exner system. When the Rorschach records of psychiatric patients were scored for form quality, the Beck system yielded a significantly lower Extended F+% than the Exner system. This effect is probably related to the inherent differences in the respective form quality tables which resulted from the different procedures used in deriving these listings of form quality.