Infection Disease & Health最新文献_第6页

Oral care practices and hospital-acquired pneumonia prevention: A national survey of Australian nurses 口腔护理实践与医院获得性肺炎预防：澳大利亚护士全国调查。

IF 2.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2024-05-08 DOI: 10.1016/j.idh.2024.04.006

Background

Hospital-acquired pneumonia (HAP) also known as non-ventilator associated pneumonia, is one of the most common infections acquired in hospitalised patients. Improving oral hygiene appears to reduce the incidence of HAP. This study aimed to describe current practices, barriers and facilitators, knowledge and educational preferences of registered nurses performing oral health care in the Australian hospital setting, with a focus on the prevention of HAP. We present this as a short research report.

Methods

We undertook a cross sectional online anonymous survey of Australian registered nurses. Participants were recruited via electronic distribution through existing professional networks and social media. The survey used was modified from an existing survey on oral care practice.

Results

The survey was completed by 179 participants. Hand hygiene was considered a very important strategy to prevent pneumonia (n = 90, 58%), while 45% (n = 71) felt that oral care was very important. The most highly reported barriers for providing oral care included: an uncooperative patient; inadequate staffing; and a lack of oral hygiene requisite. Patients' reminders, prompts and the provision of toothbrushes were common ways believed to help facilitate improvements in oral care.

Conclusion

Findings from this survey will be used in conjunction with consumer feedback, to help inform a planned multi-centre randomised trial, the Hospital Acquired Pneumonia PrEveNtion (HAPPEN) study, aimed at reducing the incidence of HAP. Findings may also be useful for informing studies and quality improvement initiatives aimed at improving oral care to reduce the incidence of HAP.

背景：医院获得性肺炎（HAP）又称非呼吸机相关肺炎，是住院病人最常见的感染之一。改善口腔卫生似乎可以降低 HAP 的发病率。本研究旨在描述在澳大利亚医院环境中从事口腔保健工作的注册护士的当前做法、障碍和促进因素、知识和教育偏好，重点是预防 HAP。我们将此作为一份简短的研究报告提交：我们对澳大利亚注册护士进行了一次横断面在线匿名调查。我们通过现有的专业网络和社交媒体以电子分发的方式招募参与者。所使用的调查表是根据现有的口腔护理实践调查表修改而成的：结果：179 名参与者完成了调查。手部卫生被认为是预防肺炎的一项非常重要的策略（n = 90，58%），而 45% 的参与者（n = 71）认为口腔护理非常重要。据报告，提供口腔护理的最大障碍包括：病人不合作；人手不足；缺乏口腔卫生必要条件。患者的提醒、提示和牙刷的提供被认为是有助于改善口腔护理的常见方法：本次调查的结果将与消费者的反馈意见结合起来，为计划中的多中心随机试验 "医院获得性肺炎预防（HAPPEN）研究 "提供信息，该研究旨在降低医院获得性肺炎的发病率。研究结果还有助于为旨在改善口腔护理以降低 HAP 发病率的研究和质量改进措施提供信息。

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引用次数: 0

N-95/P2 respirator compliance with fit testing recommendations and respirator satisfaction amongst hospital staff 医院员工对 N-95/P2 呼吸器是否符合密合度测试建议以及对呼吸器的满意度。

IF 2.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2024-05-03 DOI: 10.1016/j.idh.2024.04.001

Liam Hackett , Melanie (Meilun) Zhang , Matthew Casey , Joseph Miller , Jesse Smith , Caitlin Low , Emogene Aldridge , Patrick J. Owen , Paul Buntine

Background

Filtering Facepiece Respirators (FFRs) are an important and readily scalable infection control measure; however their effectiveness is ultimately determined by compliance. We aimed to examine staff compliance and satisfaction with wearing the N95/P2 FFRs assigned to them via the standardised fit testing protocol implemented in a single large healthcare network in Victoria, Australia.

Methods

In this cross-sectional survey, employees from five hospital campuses who participated in the health networks N95/P2 FFR fit testing process were invited in person to participate in the study. Data were analysed descriptively, after which chi-squared analysis was performed to determine differences between respirator types, gender, and age groups.

Results

Amongst the 258 staff members surveyed, 28% had either never or only sometimes worn an FFR to which they had been successfully fit tested, and 11% had experienced facial changes that potentially rendered their most recent fit test invalid. More than half (53%) of those surveyed had experienced side effects, the most common being skin irritation and pressure sores. A majority (87%) of staff felt that wearing an FFR had some impact on their ability to perform their duties. Pooled mean self-reported satisfaction ratings were highest for three-panel flat-fold and duckbill models.

Conclusion

28% of HCWs surveyed described not wearing N-95/P2 FFRs for which they had successfully been fit tested. Reasons for non-compliance remain unclear, but rates of side effects and interference with duties were high. Further research is required to determine and address potential causative factors and ascertain ongoing optimal organisation-level fit test strategies.

背景：过滤式面罩呼吸器（FFR）是一项重要且易于推广的感染控制措施，但其有效性最终取决于员工的依从性。我们的目的是调查员工对澳大利亚维多利亚州一个大型医疗保健网络实施的标准化密合度测试协议分配给他们的 N95/P2 FFR 佩戴的依从性和满意度：在这项横断面调查中，我们邀请了五家医院参与医疗网络 N95/P2 FFR 适合性测试程序的员工亲自参加研究。对数据进行描述性分析，然后进行卡方分析，以确定呼吸器类型、性别和年龄组之间的差异：在接受调查的 258 名工作人员中，有 28% 的人从未佩戴过或有时仅佩戴过已成功通过密合度测试的 FFR，有 11% 的人因面部变化而导致最近一次密合度测试无效。半数以上（53%）的受访者经历过副作用，最常见的是皮肤刺激和压疮。大多数员工（87%）认为佩戴 FFR 对他们履行职责的能力有一定影响。结论：在接受调查的医护人员中，有 28% 的人表示没有佩戴他们已成功通过密合度测试的 N-95/P2 FFR。不佩戴的原因尚不清楚，但副作用和干扰工作的比例很高。需要进一步开展研究，以确定和解决潜在的致病因素，并确定当前组织层面的最佳适合性测试策略。

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引用次数: 0

Key lessons from the establishment of a nurse-led infection prevention and control program for COVID-19 in an Australian hotel quarantine and isolation service 在澳大利亚一家酒店检疫和隔离服务机构建立以护士为主导的 COVID-19 感染预防和控制计划的主要经验。

IF 2.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2024-04-30 DOI: 10.1016/j.idh.2024.03.003

J. Petty , A. Peacock-Smith , E. Dawson , E. McSweeney , A. Ganesh , B. McEntee , R. Einboden

Background

A key aspect of Australia's response to the COVID-19 pandemic was to control transmission through legislated quarantine and isolation of overseas returning travellers and potentially infectious community members. In New South Wales, Special Health Accommodation (SHA) was rapidly established as a comprehensive health service for individuals that were at risk of having COVID-19, were confirmed to have COVID-19 or for those with complex health needs that were deemed inappropriate for management in Police managed Quarantine Hotels. SHA services were later expanded to care for community members who were COVID-19 positive and unable to effectively isolate, or contacts of individuals who were unable to quarantine effectively in their homes. SHA's unique nurse-led Infection Prevention and Control (IPC) program offers key lessons that may impact future programs.

Methods

A reflection on the experience of leading an Infection Prevention and Control program in SHA was undertaken. This was supported by a review of SHA admission, workforce and transmission data and data obtained from a cross-sectional questionnaire aimed to better understand the experiences of a novel population of health workers (HW) in a comprehensive health-led quarantine and isolation service.

Results

SHA program data demonstrates how its IPC program implementation prevented transmission of COVID-19 to SHA staff and patients. Responses from the questionnaire suggested staff felt safe and well-prepared through the IPC education they received. They also gained transferrable knowledge and skills, which they intend to use in future healthcare roles.

Conclusion

The SHA nurse-led IPC program offered successful quarantine and isolation for COVID-19 in non-purpose-built facilities. A review of IPC strategies and key lessons from the establishment of the SHA IPC program are of critical importance to planning and management of current and future pandemics.

背景：澳大利亚应对 COVID-19 大流行的一个重要方面是通过对海外归国旅行者和可能感染该病毒的社区成员进行法定检疫和隔离来控制传播。新南威尔士州迅速建立了特殊健康收容所（SHA），作为一项全面的健康服务，为可能感染 COVID-19、确诊感染 COVID-19 或有复杂健康需求且不适合在警方管理的隔离酒店居住的人员提供服务。后来，SHA 的服务范围扩大到护理 COVID-19 阳性且无法有效隔离的社区成员，或无法在家中进行有效隔离的个人的接触者。SHA 独特的由护士领导的感染预防与控制 (IPC) 计划提供了重要经验，可能会对未来的计划产生影响：方法：对 SHA 领导感染预防与控制项目的经验进行了反思。方法：对上海和睦家医院领导感染预防与控制项目的经验进行了反思，并回顾了上海和睦家医院的入院、劳动力和传播数据，以及通过横向问卷调查获得的数据，旨在更好地了解由卫生部门主导的综合检疫和隔离服务中卫生工作者（HW）这一新群体的经验：结果：上海和睦家医院的计划数据显示了其IPC计划的实施是如何防止COVID-19传播给上海和睦家医院的员工和患者的。问卷调查结果表明，通过IPC教育，员工感到安全并做好了充分准备。他们还获得了可迁移的知识和技能，并打算将其用于未来的医疗保健工作中：结论：由民政局护士主导的IPC项目成功地在非专用设施中对COVID-19进行了检疫和隔离。对IPC战略的回顾以及从建立SHA IPC计划中汲取的关键经验对当前和未来流行病的规划和管理至关重要。

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引用次数: 0

Daily COVID-19 employee attestations at a large quaternary hospital in Melbourne, Australia – Limitations and lessons learnt 澳大利亚墨尔本一家大型四级医院的每日 COVID-19 员工证明--局限性和经验教训。

IF 2.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2024-04-27 DOI: 10.1016/j.idh.2024.04.003

Vivian K.Y. Leung, Elizabeth Orr, Caroline Marshall

Background

As one of the many measures to limit the potentially infectious persons entering healthcare settings, the Victorian Department of Health (DH) introduced a daily attestation between 2020 and 2022. Upon entry to a health service, employees were required to confirm they were free from symptoms related to COVID-19 and did not have contact with a confirmed COVID-19 case in the previous 7–14 days.

Methods

We performed a retrospective analysis of employee attestations and SARS-CoV-2 tests performed between 1/6/2021 and 14/2/2022 at the main campus of the Royal Melbourne Hospital.

Results

We found the proportion of SARS-CoV-2 positive employees identified through workplace attestation was low (1.3%). Most SARS-CoV-2 positive employees analysed in this study (94%) were asymptomatic.

Discussion

Although the proportion of SARS-CoV-2 positive employees identified was low, attestations may have deterred unwell employees from presenting to work. Proactively monitoring employee attestations, such as measuring and reporting the number of symptomatic attestations, may make this a more useful tool.

背景：作为限制潜在感染者进入医疗机构的众多措施之一，维多利亚州卫生部（DH）在 2020 年至 2022 年期间引入了每日证明。在进入医疗服务机构时，员工必须确认自己没有出现与 COVID-19 相关的症状，并且在之前的 7-14 天内没有接触过 COVID-19 确诊病例：我们对 2021 年 6 月 1 日至 2022 年 2 月 14 日期间在墨尔本皇家医院主院进行的员工证明和 SARS-CoV-2 检测进行了回顾性分析：我们发现，通过工作场所证明发现的 SARS-CoV-2 阳性员工比例很低（1.3%）。本研究分析的大多数 SARS-CoV-2 阳性员工（94%）均无症状：讨论：虽然发现 SARS-CoV-2 阳性员工的比例较低，但证明可能会阻止身体不适的员工上班。主动监测员工的证明，如测量和报告无症状证明的数量，可能会使这一工具更加有用。

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引用次数: 0

Knowledge and attitudes of healthcare workers about influenza vaccination 医护人员对流感疫苗接种的认识和态度。

IF 2.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2024-04-27 DOI: 10.1016/j.idh.2024.04.005

Background

Influenza infection is a highly contagious viral disease. It may cause several nosocomial outbreaks. This study aimed to evaluate the knowledge and attitudes of healthcare workers (HCWs) about influenza vaccination and to identify factors associated with the uptake of influenza vaccination.

Methods

We conducted a cross-sectional study over 5 months between November 2021 and March 2022. Data was collected using an anonymous self-administered questionnaire. We included all HCWs at Taher Sfar University Hospital who were willing to participate in the study.

Results

A total of 395 HCWs were included. They were mainly women (78.7%) with an average age of 27 years. The medical personnel was the largest group (67.8%). Most respondents considered the vaccination to be optional and knew that it should be renewed every year, but 97.5% of them judged the efficacy of the vaccine to be low. The influenza vaccination uptake was only 20.2%. The main reasons for accepting vaccination were to protect patients and families. However, misconceptions about the severity and the risk of influenza and the belief that barrier measures were sufficient to prevent infection were the main causes of avoiding vaccination. The factors associated with adherence to vaccination were being a medical professional, old age, longer professional experience, and considering vaccination to be mandatory for HCWs.

Conclusion

Our study showed a low adherence to influenza vaccination with misconceptions about vaccine efficacy and safety. More efforts are needed to improve the knowledge of HCW about the vaccine and boost the adherence rates.

背景：流感是一种传染性极强的病毒性疾病。它可能会引起多起院内爆发。本研究旨在评估医护人员（HCWs）对流感疫苗接种的认识和态度，并确定与流感疫苗接种率相关的因素：我们在2021年11月至2022年3月期间进行了为期5个月的横断面研究。研究采用匿名自填问卷的方式收集数据。我们将塔赫尔斯法尔大学医院所有愿意参与研究的医护人员都纳入了研究范围：共有 395 名医护人员参与了研究。她们主要是女性（78.7%），平均年龄为 27 岁。医务人员是最大的群体（67.8%）。大多数受访者认为接种疫苗是可选的，并知道每年都应重新接种，但 97.5%的受访者认为疫苗的效力较低。流感疫苗接种率仅为 20.2%。接受疫苗接种的主要原因是为了保护病人和家属。然而，对流感严重性和风险的误解，以及认为屏障措施足以预防感染是避免接种疫苗的主要原因。与坚持接种疫苗有关的因素包括：作为医务人员、年龄较大、专业经验较长，以及认为接种疫苗是医务工作者的义务：我们的研究表明，流感疫苗接种的依从性较低，且对疫苗的有效性和安全性存在误解。需要进一步努力提高医务工作者对疫苗的认识，提高接种率。

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引用次数: 0

Attitudes to cross infection, nebuliser hygiene and antimicrobial resistance in people with cystic fibrosis: Results of an international survey 囊性纤维化患者对交叉感染、雾化器卫生和抗菌药耐药性的态度：一项国际调查的结果。

IF 2.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2024-04-21 DOI: 10.1016/j.idh.2024.04.002

Background

Respiratory infection is a major cause of disease severity in people with cystic fibrosis (PwCF). This project aimed to establish the CF community's opinion regarding cross infection (CI), nebuliser hygiene, antimicrobial resistance, personal impact of microbiological findings and the role of the microbiology laboratory.

Methods

A questionnaire was completed anonymously (n = 280; PwCF (n = 128), parents (n = 123); friends/family/carers/charity personnel (n = 29)) from 13 countries. Readability scores (Flesch Reading Ease (FRE), Flesch Kincaid Grade Level (FKGL)) were determined for CI/IP&C information from six national CF charities and 21 scientific abstracts.

Results

Respondents (72.5%) indicated knowledge of laboratory aspects of CF microbiology was important, however implications of microbiological findings on personal health/well-being were of higher importance (p < 0.0001). Cross infection/infection prevention & control (CI/IP&C) was of highest importance (95.6% respondents) with 27.3% indicating they were not given adequate information, particularly in older respondents (50 y+) (p = 0.006) versus young adults (16-29 y) and respondents from the Middle East versus N. America (p = 0.022) and Europe (p = 0.045). Responses highlighted how CI/IP&C health literacy could be enhanced. Respondents (77.3%), particularly females (p < 0.0001), indicated they would increase the frequency of nebuliser disinfection following guidance on infection risks/best practice, therefore an educational video was prepared. CI/IP&C readability scores (mean ± sd) from CF charities (FRE 52.5 ± 10.8; FKGL 9.7 ± 2.3) were more readable (p < 0.0001) than scientific abstracts (FRE 13.3 ± 11.1; FKGL 16.9 ± 2.3), however not meeting the targets (FRE≥60 and FKGL≤8).

Conclusion

There is a requirement for further CI/IP&C evidence-based guidance, policies/guidelines, education awareness, best practice in the home environment and multi-modal communication, enabling the CF community to make informed choices on lifestyle behaviours.

背景呼吸道感染是导致囊性纤维化患者（PwCF）病情严重的主要原因。该项目旨在了解囊性纤维化患者群体对交叉感染 (CI)、雾化器卫生、抗菌素耐药性、微生物学发现对个人的影响以及微生物学实验室的作用的看法。方法来自 13 个国家的 280 名囊性纤维化患者（n = 128）、父母（n = 123）、朋友/家人/护理人员/慈善机构工作人员（n = 29）匿名填写了一份调查问卷。对来自 6 个国家 CF 慈善机构的 CI/IP&C 信息和 21 篇科学摘要进行了可读性评分（Flesch 阅读容易度 (FRE)、Flesch Kincaid 等级 (FKGL)）。结果受访者（72.5%）表示，CF 微生物学实验室方面的知识很重要，但微生物学研究结果对个人健康/福祉的影响更为重要（p < 0.0001）。交叉感染/感染预防与控制（CI/IP&C）的重要性最高（95.6% 的受访者），27.3% 的受访者表示他们没有获得足够的信息，尤其是在老年受访者（50 岁以上）（p = 0.006）与年轻人（16-29 岁）、中东受访者与北美受访者（p = 0.022）和欧洲受访者（p = 0.045）之间。答复强调了如何提高 CI/IP&C 健康素养。受访者（77.3%），尤其是女性（p <0.0001）表示，在获得感染风险/最佳实践指导后，她们会增加雾化器消毒的频率，因此我们准备了一段教育视频。与科学摘要（FRE 13.3 ± 11.1; FKGL 16.9 ± 2.3）相比，CF 慈善机构的 CI/IP&C 可读性评分（平均值 ± sd）（FRE 52.5 ± 10.8; FKGL 9.7 ± 2.3）更具可读性（p < 0.0001），但未达到目标（FRE≥60 和 FKGL≤8）。结论需要进一步制定以 CI/IP&C 为基础的循证指导、政策/指南、教育意识、家庭环境中的最佳实践和多模式交流，使 CF 社区能够在生活方式行为方面做出明智的选择。

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引用次数: 0

The increasing health burden of Legionella Pneumophila in NSW 军团菌对新南威尔士州健康造成的日益沉重的负担。

IF 2.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2024-04-11 DOI: 10.1016/j.idh.2024.03.004

Michael Staff , Adelaide Nyinawingeri

Background

Legionella pneumophila can cause severe respiratory disease and is notifiable in NSW. An analysis of notifications linked to hospitalisation and death data over the period 2010–2022 was conducted to determine the burden of disease and any association with the introduction of NSW regulatory changes in 2018.

Methods

Cases were retrospectively identified from the Notifiable Conditions Records for Epidemiology and Surveillance (NCRES). Data on related morbidity and mortality were obtained from linked data within the NSW Communicable Disease Register (CDR). The impact of the regulatory change was evaluated by analysing monthly count data using an interrupted time series analysis.

Results

A total of 928 cases were notified with 84% admitted to hospital. Annual adjusted notification and admission rates increased over the period from 4.40 to 7.92 cases and 3.72 to 7.20 admissions, per 1,000,000 population, respectively. The mean length of hospital stay (LOS) was 14 days with a median of 8 days (range 1–262 days). Time series analysis identified an underlying increasing time trend in cases notified per month with an IRR of 1.069 (95% ci 0.751–1.523) post 2018 regulatory implementation.

Conclusion

L. pneumophila is posing an increasing burden of disease with an underlying upward trend in notification incidence despite the introduction of regulatory changes in 2018.

Implication for public health practice

This study demonstrates how linking notification, hospitalisation and death data can measure the health burden of a notifiable condition. Furthermore, time-series analysis using these data is able to identify underlying temporal trends and evaluate policy changes.

背景嗜肺军团菌可导致严重的呼吸道疾病，在新南威尔士州应予通报。我们对 2010-2022 年期间与住院和死亡数据相关联的通知进行了分析，以确定疾病负担以及与 2018 年新南威尔士州引入的监管变化之间的任何关联。相关发病率和死亡率数据来自新南威尔士州传染病登记册（CDR）中的链接数据。通过使用间断时间序列分析法对每月计数数据进行分析，评估了法规变更的影响。在此期间，调整后的年通报率和年入院率分别从每 100 万人口 4.40 例和 3.72 例增至 7.92 例和 7.20 例。平均住院时间（LOS）为 14 天，中位数为 8 天（范围为 1-262 天）。时间序列分析确定了每月通报病例的潜在增长时间趋势，2018 年法规实施后的内部收益率为 1.069（95% ci 0.751-1.523）.结论尽管 2018 年引入了法规变化，但嗜肺病毒造成的疾病负担不断增加，通报发病率呈潜在上升趋势.对公共卫生实践的启示本研究展示了如何将通报、住院和死亡数据联系起来衡量应通报病症的健康负担。此外，使用这些数据进行时间序列分析能够识别潜在的时间趋势并评估政策变化。

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引用次数: 0

Development of a rapid, multi-organisational, multi-modal assessment of a newly available disposable respirator 对新上市的一次性呼吸器进行多组织、多模式的快速评估。

IF 2.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2024-04-11 DOI: 10.1016/j.idh.2024.03.002

Irene Ng , Charles Bodas , Megan Roberts , Andrew Coe , Michelle Smith , Helen McCann , Daryl Lindsay Williams

Background

A rapid large-scale evaluation of a newly available duckbill style P2/N95 respirator, the Care Essentials (CE) MSK-003, was required to determine its suitability for deployment into the Victorian healthcare service. The aims of this study were to assess the feasibility of establishing a rapid, multi-organisational and multi-modal evaluation of the respirator, and to investigate whether this respirator would meet the needs of healthcare workers.

Methods

The evaluation was a collaboration among three healthcare organisations – two tertiary hospitals in metropolitan Melbourne and a rural-based hospital. Participants were healthcare workers undertaking their routine fit tests. They were required to complete quantitative fit testing and a usability assessment survey on the CE MSK-003 respirator. The a priori performance criteria were set as fit test pass rate of >70%, plus satisfactory subjective overall comfort and performance assessments, defined as a rating of adequate, good, or very good in >90% of the cohort.

Results

A total of 1070 participants completed the multi-modal assessment within a month. Seventy-eight percent of participants passed their quantitative fit test. Over 90% of survey respondents reported that the CE MSK-003 was adequate, good or very good in terms of its overall comfort and performance assessments.

Conclusion

We demonstrated that a multi-modal evaluation of a new respirator can be rapidly conducted with a high level of participation in a controlled, consistent manner across multiple organisations. The evaluation results of the CE MSK-003 respirator exceeded our predetermined (a priori) minimal criteria, making it suitable for broad distribution to healthcare organisations.

背景需要对新上市的鸭嘴式 P2/N95 呼吸器（Care Essentials (CE) MSK-003）进行快速大规模评估，以确定其是否适用于维多利亚州的医疗保健服务。本研究的目的是评估对该呼吸器进行快速、多组织和多模式评估的可行性，并调查该呼吸器是否能满足医护人员的需求。方法该评估由三家医疗机构（墨尔本市的两家三甲医院和一家农村医院）合作进行。参与者为进行常规密合度测试的医护人员。他们需要完成CE MSK-003呼吸器的密合度定量测试和可用性评估调查。先验性能标准设定为密合度测试合格率达到 70%，以及主观总体舒适度和性能评估达到满意，即 90% 的参与者的评级为 "足够"、"好 "或 "非常好"。结果共有 1070 名参与者在一个月内完成了多模式评估。78%的参与者通过了定量适应性测试。超过 90% 的调查对象表示 CE MSK-003 在整体舒适性和性能评估方面表现为足够好、好或非常好。结论我们证明，可以在多个组织中以受控、一致的方式快速对新型呼吸器进行多模式评估，而且参与度很高。CE MSK-003 呼吸器的评估结果超过了我们预先确定的（先验）最低标准，因此适合广泛分发给医疗机构。

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引用次数: 0

Capacity building to address antimicrobial resistance in remote Australia: The inaugural HOT NORTH Antimicrobial Academy 澳大利亚偏远地区应对抗菌药耐药性的能力建设：首届 HOT NORTH 抗菌学院。

IF 2.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2024-03-29 DOI: 10.1016/j.idh.2024.03.001

A.C. Bowen , B. Smith , K. Daveson , L. Eldridge , A. Hempenstall , T. Mylne , R. Szalkowski , K. Van Rooijen , L. Anderson , M. Stephens , S.Y.C. Tong , T. Yarwood

Background

Rates of antimicrobial resistance (AMR) for some pathogens in Australia are considerably higher in rural and remote compared to urban regions. The inaugural Hot North Antimicrobial Academy was a 9-month educational programme aimed to build workforce knowledge and capacity in antimicrobial use, audit, stewardship, surveillance and drug resistance in remote primary health care.

Methods

The Academy was advertised to Aboriginal and Torres Strait Islander, regional and remote healthcare workers. Participants were Aboriginal health practitioners, nurses, pharmacists and doctors from Queensland, Northern Territory, South Australia and Western Australia working in remote primary health care with a focus on Indigenous health. Due to COVID-19 restrictions, the Academy ran virtually from February–November 2021 using Microsoft Teams. The Academy was evaluated using surveys and yarning circles to assess impact and knowledge gain.

Results

Participants and faculty from across Australia attended 19 lectures and mentorship sessions. Eleven participants commenced and eight (73%) completed the Academy. The Academy raised participants awareness of AMR guidelines, governance and generating change; built confidence in advocacy; grew knowledge about drug resistant infections; and created a community of AMR champions in Indigenous health.

Conclusion

The evaluation confirmed the Academy met the needs of participants, provided opportunities to move stewardship from tertiary hospitals into Indigenous and remote clinics and developed skills in research, audit, stewardship and advocacy for all involved. All sessions were recorded for future use, with facilitation by the National Aboriginal Community Controlled Health Organisation (NACCHO) in future years.

背景：与城市地区相比，澳大利亚农村和偏远地区某些病原体的抗菌药耐药性（AMR）比率要高得多。首届 "热北抗菌学院"（Hot North Antimicrobial Academy）是一项为期 9 个月的教育计划，旨在培养偏远地区初级卫生保健人员在抗菌药物使用、审计、监管、监测和耐药性方面的知识和能力：该学院面向土著居民和托雷斯海峡岛民、地区和偏远地区的医疗保健工作者进行宣传。参加者是来自昆士兰州、北领地、南澳大利亚州和西澳大利亚州的原住民医疗从业人员、护士、药剂师和医生，他们主要从事偏远地区的初级医疗保健工作，重点关注原住民健康。由于 COVID-19 的限制，学院于 2021 年 2 月至 11 月期间使用 Microsoft Teams 虚拟运行。通过调查和学习圈对学院进行了评估，以评估其影响和知识收获：来自澳大利亚各地的学员和教师参加了 19 场讲座和辅导课程。11 名学员开始了学习，8 名学员（73%）完成了学习。学院提高了学员对 AMR 指南、管理和变革的认识；建立了宣传信心；增加了对耐药感染的了解；并创建了一个土著健康领域 AMR 倡导者社区：评估结果证实，学院满足了参与者的需求，提供了将管理从三级医院转移到土著和偏远地区诊所的机会，并培养了所有参与者在研究、审计、管理和宣传方面的技能。所有会议都进行了记录，供今后使用，全国土著社区控制健康组织（NACCHO）将在未来几年为会议提供便利。

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引用次数: 0

Catheter-associated urinary tract infections in Africa: Systematic review and meta-analysis 非洲导尿管相关尿路感染：系统回顾和荟萃分析。

IF 2.7 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Infection Disease & Health

Pub Date : 2024-03-13 DOI: 10.1016/j.idh.2024.02.005

Zelalem Asmare , Mulat Erkihun , Wagaw Abebe , Agenagnew Ashagre , Tadesse Misganaw , Sefineh Fenta Feleke

Background

Catheter-associated urinary tract infections (CAUTIs) account for the majority of device-associated healthcare-acquired infections with significant morbidity and mortality worldwide. In developing countries with limited resources, the burden of CAUTI have substantial burden owing to the lack of well-organized infection prevention and control. Although there are studies in African countries, the magnitude of CAUTI is inconsistent. Therefore this systematic review and meta-analysis aimed to determine the pooled prevalence of CAUTI in Africa and identify the pathogens involved.

Methods

Systematic review of articles from different databases and search engines such as Medline/PubMed, Google Scholar, Science Direct, and African Journal online were systematically searched to identify potential studies. Data were extracted on Microsoft Excel spreadsheet and analyzed using STATA 17.0. The pooled prevalence of CAUTI was estimated using a random effects model, inverse of variance was used to assess statistical heterogeneity across studies. Egger's tests was performed to identify possible publication bias.

Results

This systematic review and meta-analysis incorporated twenty studies, revealing a pooled prevalence of CAUTI at 43.28%. Gram-negative bacteria were the leading cause of CAUTI accounts for 82.9%. Escherichia coli (45.06%) was the most frequent gram-negative bacterial isolate involved in CAUTI followed by Klebsiella spp (24.17%). Staphylococcus aureus was the predominant gram-positive bacterial isolate, accounting for 53.24% of gram-positive associated cases in CAUTI.

Conclusion and recommendations

In conclusion, the high prevalence of CAUTI in Africa underlines a pressing healthcare challenge. Addressing this issue requires a concerted effort, encompassing health education, infection prevention measures, resource allocation, and collaborative initiatives to enhance patient safety and mitigate the impact of CAUTI on healthcare systems in the region. As prolonged catheterization increases the risk of infection, catheters should only be used for proper indications and removed promptly when no longer needed.

背景：导尿管相关性尿路感染（CAUTIs）在与设备相关的医疗保健获得性感染中占大多数，在全球范围内具有显著的发病率和死亡率。在资源有限的发展中国家，由于缺乏有序的感染预防和控制措施，CAUTI 造成了沉重的负担。虽然在非洲国家也有研究，但 CAUTI 的严重程度并不一致。因此，本系统综述和荟萃分析旨在确定非洲 CAUTI 的总体流行率，并确定其中涉及的病原体：系统地检索了不同数据库和搜索引擎（如 Medline/PubMed、Google Scholar、Science Direct 和 African Journal online）中的文章，以确定潜在的研究。通过 Microsoft Excel 电子表格提取数据，并使用 STATA 17.0 进行分析。使用随机效应模型估算了CAUTI的汇总患病率，并使用方差反比来评估各研究之间的统计异质性。采用Egger检验来确定可能存在的发表偏倚：本系统综述和荟萃分析纳入了 20 项研究，结果显示 CAUTI 的总患病率为 43.28%。革兰氏阴性菌是导致 CAUTI 的主要原因，占 82.9%。大肠埃希菌（45.06%）是 CAUTI 中最常见的革兰氏阴性菌，其次是克雷伯菌（24.17%）。金黄色葡萄球菌是最主要的革兰氏阳性细菌分离物，占 CAUTI 革兰氏阳性相关病例的 53.24%：总之，CAUTI 在非洲的高发病率凸显了一个紧迫的医疗挑战。解决这一问题需要各方共同努力，包括健康教育、感染预防措施、资源分配和合作计划，以加强患者安全并减轻 CAUTI 对该地区医疗系统的影响。由于长期导管插入会增加感染风险，因此导管只能在适当的适应症下使用，并在不再需要时及时拔除。

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引用次数: 0