[http://www.who.int/water_sanitation_health/medicalwaste/148to158.pdf]
A. Hand washing
· Wash hands after touching blood, secretions, excretions and contaminated items, whether or not gloves are worn. · Wash hands immediately after gloves are removed, between patient contacts.
· Use a plain soap for routine hand washing.
· Use an antimicrobial agent for specific circumstances.
B. Gloves
Wear gloves when touching blood, body fluids, secretions, excretions, and contaminated items.
Put on clean gloves just before touching mucous membranes and non-intact skin.
C. Mask, eye protection, face shield
Wear a mask and eye protection or a face shield during procedures and patientcare activities that are likely to generate splashes or sprays of blood, body fluids, secretions, and excretions.
D. Gown
Wear a gown during procedures and patient-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions.
E. Patient-care equipment
Ensure that reusable equipment is not used for the care of another patient until it has been cleaned and reprocessed appropriately.
F. Environmental control
Ensure that the hospital has adequate procedures for the routine care, cleaning, and disinfection of environmental surfaces.
G. Linen
Handle used linen, soiled with blood, body fluids, secretions, and excretions in a manner that prevents skin and mucous membrane exposures, and that avoids transfer of microorganisms to other patients and environments.
H. Occupational health and bloodborne pathogens
· Take care to prevent injuries when using needles, scalpels, and other sharp instruments or devices.
· Use ventilation devices as an alternative to mouth-to-mouth resuscitation methods.
I. Place of care of the patient
Place a patient who contaminates the environment or who does not assist in maintaining appropriate hygiene in an isolated (or separate) room.
Showing posts with label organisations/hospitals. Show all posts
Showing posts with label organisations/hospitals. Show all posts
12/02/2009
Essentials of the standard precautions to be used in the care of all patients
Hospital infection rates in England out of control
Zosia Kmietowicz/ London [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1117592]
The NHS in England could save an estimated £150m ($240m) and many hundreds of lives by tightening hygiene rules in hospitals and investing in infection control, according to the spending watchdog the National Audit Office. The money could then be ploughed back into patient care.
At least 100000 cases of hospital acquired infections occur each year in England, with an estimated 5000 deaths, all of which cost the NHS in the region of £1bn annually, states the report.
Better education of staff on the spread of infection, improved surveillance of patients who have had major surgery, and the involvement of senior clinicians and management in the control of infection could reduce this burden by 15%Sir John Bourn, head of the National Audit Office, told parliament.
At any one time 9%of patients in hospital are being treated for an infection they acquired there. Yet one in five trusts do not have an infection control programme, 40%are dissatisfied with their isolation facilities, and 60%have no defined budget.
Despite guidance from the Department of Health that chief executives should take overall responsibility for ensuring effective infection control, there is little evidence of their involvement. More than half were not aware of the resources spent on hospital acquired infection or the number of cases, says the report.
“Hospital infections are a huge problem for the NHS,” said Sir John. “They prolong patients' stay in hospital and, in worst cases, cause permanent disability and even death. By implementing the [National Audit Office's] recommendations, the NHS could make real improvements in the quality of care for patients and free up significant additional resources,” he added.
Among other recommendations, he said that hospitals should join the nosocomial infection national surveillance scheme, which collects statistics on infection rates to allow local comparisons to be made.
More research on appropriate staffing levels is also warranted. In some areas a single infection control nurse is expected to cover over 1000 beds—a number described by the report as “unacceptably high.”
Moreover, despite a recommendation by the Royal College of Pathologists that the ratio of infection control doctors to beds should be 1:1000, only 46 trusts out of the 219 studied by the report reached that standard.
David Davis MP, chairman of the Public Accounts Committee, commented: “There is clear evidence that in many cases investing more in infection control—for example, by funding more infection control nurses—would save both cash and lives. There would also be a dramatic improvement in the quality of care for many other patients.”
The Management and Control of Hospital Acquired Infection in Acute NHS Trusts in England is available through the National Audit Office's home page (www.nao.gov.uk).
The NHS in England could save an estimated £150m ($240m) and many hundreds of lives by tightening hygiene rules in hospitals and investing in infection control, according to the spending watchdog the National Audit Office. The money could then be ploughed back into patient care.
At least 100000 cases of hospital acquired infections occur each year in England, with an estimated 5000 deaths, all of which cost the NHS in the region of £1bn annually, states the report.
Better education of staff on the spread of infection, improved surveillance of patients who have had major surgery, and the involvement of senior clinicians and management in the control of infection could reduce this burden by 15%Sir John Bourn, head of the National Audit Office, told parliament.
At any one time 9%of patients in hospital are being treated for an infection they acquired there. Yet one in five trusts do not have an infection control programme, 40%are dissatisfied with their isolation facilities, and 60%have no defined budget.
Despite guidance from the Department of Health that chief executives should take overall responsibility for ensuring effective infection control, there is little evidence of their involvement. More than half were not aware of the resources spent on hospital acquired infection or the number of cases, says the report.
“Hospital infections are a huge problem for the NHS,” said Sir John. “They prolong patients' stay in hospital and, in worst cases, cause permanent disability and even death. By implementing the [National Audit Office's] recommendations, the NHS could make real improvements in the quality of care for patients and free up significant additional resources,” he added.
Among other recommendations, he said that hospitals should join the nosocomial infection national surveillance scheme, which collects statistics on infection rates to allow local comparisons to be made.
More research on appropriate staffing levels is also warranted. In some areas a single infection control nurse is expected to cover over 1000 beds—a number described by the report as “unacceptably high.”
Moreover, despite a recommendation by the Royal College of Pathologists that the ratio of infection control doctors to beds should be 1:1000, only 46 trusts out of the 219 studied by the report reached that standard.
David Davis MP, chairman of the Public Accounts Committee, commented: “There is clear evidence that in many cases investing more in infection control—for example, by funding more infection control nurses—would save both cash and lives. There would also be a dramatic improvement in the quality of care for many other patients.”
The Management and Control of Hospital Acquired Infection in Acute NHS Trusts in England is available through the National Audit Office's home page (www.nao.gov.uk).
BMJ. 2000 February 26; 320(7234): 534.
PMCID: PMC1117592
Copyright © 2000, British Medical Journal
Hospital acquired infections
[http://www.privatehealth.co.uk/private-hospitals/hospital-infections-guide/]
Healthcare-associated infections (HAIs) are one of the most pressing issues facing our health services today. According to the Department of Health 1 in 10 patients acquires a HAI, and those who do contract an infection stay in hospital nearly three times longer than ordinary patients, placing tremendous financial pressure on the already strapped-for-cash health services.
The two hospital acquired infections, known as 'superbugs', posing a particularly serious threat to our hospital wards are MRSA and C. difficile. MRSA stands for methicillin-resistant staphylococcus aureus and is a form of bacteria from the Staphylococcus aureus (SA) family. If SA bacteria get into the body via cuts or wounds they can cause a boil or abscess and more seriously blood poisoning or a heart-valve infection. Clostridium difficile (C. difficile) is a bacterium from the Clostridium family causing diarrhoea and in more serious cases damage to the colon and intestines.
Many experts believe that the misuse of antibiotics has caused the drug-resistant SA infections to occur (if a course of treatment is not finished some of the bacteria can multiply and survive a range of antibiotics) and the high turnover of patients and high bed occupancy rates in our health services compound the problem. Indeed, the Health Protection Agency believes that reducing bed occupancy in NHS hospitals to 85%, or lower, is a crucial move to reduce the incidence of HAIs, but it is a Catch-22 situation as it is difficult to eliminate the superbugs with such a high volume of patients.
Healthcare-associated infections (HAIs) are one of the most pressing issues facing our health services today. According to the Department of Health 1 in 10 patients acquires a HAI, and those who do contract an infection stay in hospital nearly three times longer than ordinary patients, placing tremendous financial pressure on the already strapped-for-cash health services.
The two hospital acquired infections, known as 'superbugs', posing a particularly serious threat to our hospital wards are MRSA and C. difficile. MRSA stands for methicillin-resistant staphylococcus aureus and is a form of bacteria from the Staphylococcus aureus (SA) family. If SA bacteria get into the body via cuts or wounds they can cause a boil or abscess and more seriously blood poisoning or a heart-valve infection. Clostridium difficile (C. difficile) is a bacterium from the Clostridium family causing diarrhoea and in more serious cases damage to the colon and intestines.
Many experts believe that the misuse of antibiotics has caused the drug-resistant SA infections to occur (if a course of treatment is not finished some of the bacteria can multiply and survive a range of antibiotics) and the high turnover of patients and high bed occupancy rates in our health services compound the problem. Indeed, the Health Protection Agency believes that reducing bed occupancy in NHS hospitals to 85%, or lower, is a crucial move to reduce the incidence of HAIs, but it is a Catch-22 situation as it is difficult to eliminate the superbugs with such a high volume of patients.
The Right Environment for Premature Babies
It's a challenge for doctors who treat premature babies. How do you best recreate an environment closest to the womb for babies who should still be there?(...)
the whole article: http://www.sanfordhealth.org/Newsroom/VideoLibrary/VideoStories/TheRightEnvironmentforPrematureBabies/index.cfm
the whole article: http://www.sanfordhealth.org/Newsroom/VideoLibrary/VideoStories/TheRightEnvironmentforPrematureBabies/index.cfm
Environmental Sensitivity: Little Known Facts About Premature Baby
(...)Premature babies react more to changes in temperature, light, sound, scent and activity than full-term babies...
A premature baby who may only be recently out of the hospital does not need to be around a whole group of people. When a preemie has too much stimulus, he or she will basically shut down....
Preemies can also respond negatively to any extreme lighting.This includes not only harsh or too-bright lighting, but also to rooms that are too dark. Any pre-term infant that has spent time in a NICU also spent his or her days and nights with some kind of lighting. Hospital NICUs are never completely dark...
whole article: http://www.associatedcontent.com/article/202299/environmental_sensitivity_little_known.html?cat=5
A premature baby who may only be recently out of the hospital does not need to be around a whole group of people. When a preemie has too much stimulus, he or she will basically shut down....
Preemies can also respond negatively to any extreme lighting.This includes not only harsh or too-bright lighting, but also to rooms that are too dark. Any pre-term infant that has spent time in a NICU also spent his or her days and nights with some kind of lighting. Hospital NICUs are never completely dark...
whole article: http://www.associatedcontent.com/article/202299/environmental_sensitivity_little_known.html?cat=5
Costs of Preterm Birth
Prematurity can have a severe effect on newborns and their families. Additionally, premature birth in the U.S. puts a significant burden on the U.S. healthcare system. Employers are also affected by associated healthcare costs and reduced workplace productivity.http://www.fullterm.net/hcp/preterm_birth/costs.html
BAPM
British Association of Perinatal Medicine
(click on name to view website)
includes annual reports and publications that might be of interest
(click on name to view website)
includes annual reports and publications that might be of interest
10/02/2009
Premature babies put at risk by lack of intensive care facilities in hospital
Premature babies put at risk by lack of intensive care facilities in hospital
The Independent, Wednesday, 19 December 2007
The lives of England's most vulnerable babies are being put at risk by a critical shortage of intensive care cots and nurses, an inquiry has found.
http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/premature-babies-put-at-risk-by-lack-of-intensive-care-facilities-in-hospitals-765889.html
Staff shortages 'put premature babies at risk'
The Guardian, Wednesday 15 October 2008
It used the Freedom of Information Act to secure data from NHS trusts showing a shortfall of 1,700 neonatal nurses, leaving premature baby units unable to provide the recommended standard of care.
http://www.guardian.co.uk/society/2008/oct/15/children-health
The Independent, Wednesday, 19 December 2007
The lives of England's most vulnerable babies are being put at risk by a critical shortage of intensive care cots and nurses, an inquiry has found.
http://www.independent.co.uk/life-style/health-and-wellbeing/health-news/premature-babies-put-at-risk-by-lack-of-intensive-care-facilities-in-hospitals-765889.html
Staff shortages 'put premature babies at risk'
The Guardian, Wednesday 15 October 2008
It used the Freedom of Information Act to secure data from NHS trusts showing a shortfall of 1,700 neonatal nurses, leaving premature baby units unable to provide the recommended standard of care.
http://www.guardian.co.uk/society/2008/oct/15/children-health
Newborn senses
It should be noted that in the cases of sight and hearing, premature babies are more at risk for developing problems. Additionally, any injury to the brain will likely have some impact on the development of the senses. Premature babies should be checked for eye and hearing problems before they leave the NICU and at regular intervals following that. this artile describes the development of the five senses: sight, hearing, smell, touch and taste. click the link below:
09/02/2009
Smell of Vanilla Reduces Breathing Problems
http://faculty.washington.edu/chudler/preo.html
Dr. Luc Marlier and his co-workers at the CNRS tested 14 premature babies in the intensive care unit at the University Hospital in Strasbourg. The respiratory rate of each baby was monitored on three consecutive days:
January 28, 2005
Babies who are born prematurely often have breathing problems. In fact, approximately 80% of infants born after only 30 weeks of development have episodes of apnea, when they temporarily stop breathing. Doctors often treat these babies with drugs such as caffeine, theophylline and doxapram to prevent apnea. However, these drugs have significant side effects (for example, sleep problems, hyperactivity and gastrointestinal disorders) and do not work in all infants. Researchers at the National Center for Scientific Research (CNRS) in Strasbourg, France, have found that the smell of vanilla can reduce apnea in premature infants who do not respond to drug treatment.
Babies who are born prematurely often have breathing problems. In fact, approximately 80% of infants born after only 30 weeks of development have episodes of apnea, when they temporarily stop breathing. Doctors often treat these babies with drugs such as caffeine, theophylline and doxapram to prevent apnea. However, these drugs have significant side effects (for example, sleep problems, hyperactivity and gastrointestinal disorders) and do not work in all infants. Researchers at the National Center for Scientific Research (CNRS) in Strasbourg, France, have found that the smell of vanilla can reduce apnea in premature infants who do not respond to drug treatment.
Dr. Luc Marlier and his co-workers at the CNRS tested 14 premature babies in the intensive care unit at the University Hospital in Strasbourg. The respiratory rate of each baby was monitored on three consecutive days:Day 1 (baseline control): no treatment.
Day 2 (experimental condition): 15 drops of a vanillin solution was applied to the pillow of each infant. (Vanillin smells like vanilla.)
Day 3: (recovery control): no treatment.
The number of apnea episodes occurred significantly less often when the babies were exposed to the vanilla smell. The average number of apnea events was 34.7 on Day 1 (baseline control) and 33.2 on Day 3 (recovery control), but only 22.2 on Day 2 (when vanilla was placed on the pillows). The vanilla smell effectively reduced apnea in 12 of the 14 infants.
The scientists are not certain how the vanilla odor works to prevent apnea, but they offer two hypotheses:
Vanillin has direct or indirect effects on respiratory centers in the brain. Vanillin may reach the brain through the bloodstream after passing through the nasal mucosa or it may be carried into the brain by nerves in the olfactory system.
Vanillin helps infants adapt to stress.
So far, the researchers have tested vanillin only on infants with apnea who do not respond to drug treatment. Pleasant odors other than vanilla have not been tested. Nevertheless, because odor therapy is simple, inexpensive and without side effects, it appears to be a useful treatment for at least some premature infants with apnea.
The scientists are not certain how the vanilla odor works to prevent apnea, but they offer two hypotheses:
Vanillin has direct or indirect effects on respiratory centers in the brain. Vanillin may reach the brain through the bloodstream after passing through the nasal mucosa or it may be carried into the brain by nerves in the olfactory system.
Vanillin helps infants adapt to stress.
So far, the researchers have tested vanillin only on infants with apnea who do not respond to drug treatment. Pleasant odors other than vanilla have not been tested. Nevertheless, because odor therapy is simple, inexpensive and without side effects, it appears to be a useful treatment for at least some premature infants with apnea.
Common health problems in premature babies
http://www.prematurebabes.org/problems.html
-Breathing problems;
-Hypoglycaemia;
-Jaundice;
-Infection;
-Anaemia;
-Feed intolerance / enterocolitis;
-Eye problems;
-Intraventricular haemorrage;
-Patent ductus arteriosus.
-Breathing problems;
-Hypoglycaemia;
-Jaundice;
-Infection;
-Anaemia;
-Feed intolerance / enterocolitis;
-Eye problems;
-Intraventricular haemorrage;
-Patent ductus arteriosus.
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