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Hospital transfusion practice
Published in Jennifer Duguid, Lawrence Tim Goodnough, Michael J. Desmond, Transfusion Medicine in Practice, 2020
In a study from London47 in which 9220 patients were recruited, 5579 recipients of 21 913 units of blood were followed up for markers of infection. None were identified. The incidence of transfusion-transmitted HBV was 0 in 21 043 units (95% confidence interval (CI) for risk 0–1 in 5706 recipients); for HCV, it was 0 in 21 800 units (95% CI 0–1 in 5911 recipients); for HIV, it was 0 in 21 923 units (95% CI 0–1 in 5944 recipients), and for HTLV 0 in 21 902 units (95% CI 0–1 in 5939 recipients). At that time the UK services were not testing for HTLV. It is planned to introduce NAT testing for HTLV 1 and 11 during 2002, which would bring UK transfusion service practices in line with the current UK requirement for testing allogeneic stem cells, as well as other national transfusion services, even though it is also recognized that leukodepletion may well reduce the risk of transmitting HTLV. A considerable proportion of patients had pre-existing infections, and hospital-acquired infections may arise from other sources.
The roles of the midwife
Published in Helen Baston, Midwifery, 2020
Maternity services have a track record with regard to highlighting the importance of preventing the spread of infection (see Chapter 3). Hospital-acquired infections are a source of morbidity and mortality, contributing to extended hospital stays, consumption of health service resources and personal misery. Every effort should be made to ensure that the woman does not develop a life-threatening infection as a result of the care she receives and that she is not put at risk of contracting an infection from another patient, relative or member of staff.
“How do I look?”
Published in Alan Bleakley, Educating Doctors’ Senses Through the Medical Humanities, 2020
Hospital acquired infections are relatively common in the USA, carrying a large financial burden, and lead to readily preventable deaths. In 2009, the American Medical Association passed a proposal to follow the lead of the UK in phasing out white coats, but doctors objected so vociferously that the proposal was dropped. As noted above, the Gold Foundation that promotes humanism in medicine runs the ‘white coat ceremony’ to impress upon new medical students the importance of their vocation and the place of compassion and humility within it. Other countries such as India have also refused to follow the UK’s lead, guided more by symbolism than science, demonstrating just how potent impression management and self-display can be. Medical practice should be evidence-based but impression management refuses the available evidence. In the UK too, traditionalists manage to by-pass the new dress codes, men wearing bow ties, or tucking a tie in high up in the shirt. A claim is made that patients, especially the elderly, want a doctor to ‘look like a doctor’ (whatever that now means). However, some doctors see the need for identification with a multicultural mix of patients, for example dressing nattily but sporting dreadlocks (BMA 2018b).
Diagnostic performance of an in-house multiplex PCR assay and the retrospective surveillance of bacterial respiratory pathogens at a teaching hospital, Kelantan, Malaysia
Published in Pathogens and Global Health, 2023
Nik Mohd Noor Nik Zuraina, Suharni Mohamad, Habsah Hasan, Mohammed Dauda Goni, Siti Suraiya
Surveillance among the patient categories showed that 65% (n = 56) of inpatients, who were admitted in the wards, had a higher positive rate in comparison to those who were categorized as outpatients (35%, n = 30). Nonetheless, within the individual groups, the percentage of patients found positive for at least one pathogen were higher within the outpatients (51%) as compared to the inpatient group (43%). For the acquisition of pathogens, the patients were divided into community- and hospital-acquired, based on the patient categories, clinical diagnosis record and/or the length of hospital stay. All the outpatients, the hospitalized patients who were clinically diagnosed as CAP and those who underwent sputum collection in less than 48 h of admission were categorized as community-acquired. The hospital-acquired infections were recorded for those who were admitted for other than respiratory diseases and were sampled after three days of hospital stay. For these two groups, the positivity rate was higher among the patients with community-acquired infections (84%, n = 72) in contrast to the hospital-acquired group (16%, n = 14). When compared individually, the positive rate within community acquired respiratory infection (54%) was also found higher than the categorized group of hospital-acquired (26%). The association of infection acquisition means and pathogen positivity was found significant (p value = 0.001).
Rethinking risk communication in the hospital: infection prevention, risk perceptions, and lived experience
Published in Journal of Communication in Healthcare, 2022
Gabriela Capurro, Nisha Thampi
Hospital-acquired infections pose a serious threat to patients and hospital workers [9]. The risk of infection and the need to comply with IPAC measures – such as hand hygiene routines, putting patients in isolation, and using personal protective equipment (PPE) – are communicated in hospitals to workers, patients, and visitors. Everyone in the hospital is expected to rigorously adhere to these protocols, since it is understood that it only takes one person breaking the rules to put everybody at risk of infection. Furthermore, individuals are also expected to monitor the behaviour of others and remind them to comply with IPAC protocols [10]. These IPAC protocols and guidelines can, therefore, be conceptualized as risk communication [2], i.e. messages to raise awareness of the risk of infection; managing workers’ and visitor’s perceptions of their personal risk; changing individual behaviour to comply with IPAC guidelines; and involving staff and patients as stakeholders in the communication process. In the hospital, risk messages legitimate and normalize infection prevention behaviour, including IPAC protocols that can be monitored and enforced [11].
Salvage minimally invasive robotic and laparoscopic pyeloplasty in adults: a systematic review
Published in Arab Journal of Urology, 2022
Mai Elaarag, Hind Alashi, Maya Aldeeb, Ibrahim Khalil, Ahmad R. Al-Qudimat, Abdelhamed Mansour, Abdulla A Al-Ansari, Omar M. Aboumarzouk
Generally, a redo pyeloplasty is considered more challenging because of the scar tissue, fibrosis, and adhesions that occur due to a previous operation [6] especially, when the primary procedure is an open surgery [38]. This has significantly impacted the operative time in redo operations as well as complications are more likely. Atug et al. from the robotic group and Sundaram et al. from the laparoscopic group supports this by reporting a higher operative time in the redo group [32,39]. However, robotic and laparoscopic pyeloplasty has been associated with shorter hospital stays when compared to open surgery [11,24,37]. This is crucial because longer hospital stays tend to increase the risk of hospital-acquired infections. In addition, as stated earlier, with increased skills and experience, operative time may potentially shorten as well. This all adds up to the success of robotic and laparoscopic surgeries compared to open surgeries.