Incidence and Predictors of Nonventilator Hospital-Acquired Pneumonia in a Community Hospital.

BACKGROUND: Nonventilator hospital-acquired pneumonia (NV-HAP) is a common hospital-acquired condition that is amenable to basic nursing care interventions. PURPOSE: The purpose of this study was to determine the incidence of NV-HAP in a California community hospital and to identify the patient and nursing care factors including missed nursing care associated with its development. METHODS: A retrospective study identified possible NV-HAP cases with ICD-10 (International Classification of Diseases, Tenth Revision) codes and then validated cases using Centers for Disease Control and Prevention confirmatory criteria. RESULTS: The incidence of NV-HAP in our hospital was 0.64 cases per 1000 patient-days. Patient factors most strongly associated with NV-HAP were age (each year of increased age was associated with a 4% increased likelihood of developing NV-HAP) (OR = 1.04-1.07) and the presence of underlying disease, which reduced odds of developing NV-HAP by 36% (OR = 0.36; 95% CI, 0.12-0.98). Head-of-bed elevation reduced by 26% the odds of developing NV-HAP (OR = 0.26; 95% CI, 0.07-0.08). CONCLUSIONS: NV-HAP can be predicted and potentially prevented. Paradoxically, the presence of underlying disease was not positively associated with the development of NV-HAP in this study.

Evaluation of antimicrobial effectiveness and dentine mechanical properties after use of chemical and natural auxiliary irrigants.

OBJECTIVE: To evaluate the effect of GSE, NaOCl, CHX and QMix as an antimicrobial agents against Enterococcus faecalis and their influence on flexural and ultimate tensile strength of root canal dentine. METHODS: Root canals were divided into five groups (n=10) according to the substances used: 2.5% NaOCl, 2% CHX, 6.5% GSE, Qmix and control group (distilled water) (DW). Final irrigation was done with 17% EDTA in all groups, except when DW was used. The number of colony-forming units was used to evaluate the antimicrobial activity. Dentine beams were used to assess the flexural strength after treatment with substances as described before (n=10). The UTS was evaluated after the treatment of root dentine hourglass shape sections with the same substances (n=30). RESULTS: The lowest bacteria contamination was observed for CHX and GSE, while NaOCl and QMix showed an intermediate antimicrobial activity (p>0.05). NaOCl and QMix significantly reduced the mechanical properties of dentine (flexural strength and UTS) (p<0.05) and no statistical difference was found among CHX, GSE and DW (p>0.05). CONCLUSION: CHX and GSE were more effective than NaOCl and QMix against E. faecalis. Furthermore, they did not harm dentine mechanical properties as observed for NaOCl and QMix. CLINICAL SIGNIFICANCE: The use of GSE can be recommended for endodontic procedures since it has good antimicrobial activity and does not interfere in the mechanical properties of dentine; similarly to CHX.