Application of Deep Neural Network Factor Analysis Model in Operating Room Management Nursing Analysis of Postoperative Infection Nursing after Thoracic Surgery.

Thoracic surgery is the main surgical method for the treatment of respiratory diseases and lung diseases, but infections caused by improper care are prone to occur during the operation, which can induce pulmonary edema and lung injury and affect the effect of the operation and the subsequent recovery. Therefore, it is necessary to control the disease in time and adopt more scientific and comprehensive nursing measures. Based on the neural network algorithm, this paper constructs a neural network-based factor analysis model and applies the operating room management nursing to postoperative infection nursing after thoracic surgery and verifies the effect through the neural network model. The statistical parameters in this article mainly include the postoperative infection rate of thoracic surgery, patient satisfaction, postoperative rehabilitation effect, and complications. Through statistical analysis, it can be known that operating room management and nursing can play an important role in postoperative infection nursing after thoracic surgery, effectively reducing postoperative infection nursing after thoracic surgery, and improving the recovery effect of patients after infection.

Nurses' awareness on hospital acquired infection risks of the geriatric patients: A descriptive and cross-sectional study.

INTRODUCTION: The increasing number of persons > 65 years of age form a special population at risk for nosocomial and other health care-associated infections. Nosocomial infections are major problems in terms of morbidity and mortality as well as prolonged hospitalization and increased costs. The aim of the present study was determination of nurses' awareness of hospital-acquired infection risks of the geriatric patients. METHODOLOGY: This descriptive and cross-sectional study was conducted at a university hospital in North Cyprus. A total of 164 voluntary nurses composed the sample of the study. A questionnaire that was developed by the researchers based on the literature was used as data collection tool. After the ethical approval, data were collected using a questionnaire in September and October 2017 with self-completion method. The methods used to analyze the data include an analysis of descriptive statistic variables such as frequency and percentages for the categorical variables and the Pearson's Chi-square test for comparisons. RESULTS: Results of the study showed inadequate awareness among nurses on hospital-acquired infection risks of the geriatric patients. It was also determined that there were the statistically significant differences in term of education levels and experiences of nurses with different items on hospital-acquired infection risks of the geriatric patients. CONCLUSIONS: Based on the results of the study, implementations of comprehensive, systematic, and continuous educational programs to enhance awareness of the nurses on health care-associated infections was recommended.

Análise organizacional da central de materiais e esterilização pertinentes à alta rotatividade de equipes de enfermagem / Organizational analysis of the materials and sterilization center relating to the high rotativity of nursing teams

Introdução: Os elevados índices de infecções hospitalares impactavam os serviços prestados, consolidando a implantação da Central de Materiais e Esterilização (CME), conceituada como uma unidade de apoio aos serviços assistenciais e diagnósticos que realiza o processamento dos artigos médico-hospitalares. O quadro de funcionários era composto por profissionais não aptos para prestarem assistência direta, incitando a desvalorização da unidade. Com o desenvolvimento tecnológico recorrente, fez-se necessário um quadro de funcionários mais qualificado e interessado, porém o setor ainda encontra dificuldades na capacitação dos funcionários devido à alta rotatividade de pessoal. Objetivo: Identificar os principais fatores que contribuem para os elevados índices de rotatividade de funcionários na CME, avaliar mudanças na produtividade devido à perda de mão-de-obra constante, identificar as insatisfações da equipe e levantar o nível sociodemográfico dos profissionais. Metodologia: Estudo exploratório e descritivo, com abordagem quantitativa, realizado com as equipes de enfermagem atuantes na CME do Hospital Estadual de Bauru (HEB), embasando-se em um roteiro composto por perguntas abertas e fechadas. Resultados: Nota-se prevalência do gênero feminino, nível socioeconômico baixo, ambiente propício a riscos ocupacionais, predomínio de técnicos em enfermagem, contratações por preenchimento de vaga e remanejamento involuntário, presença inconstante de capacitações e treinamentos, permanência da desvalorização instituída, extenso ritmo de produção, além de despreparo e desinteresse dos profissionais, elementos que motivam a alta rotatividade na CME. Considerações Finais: O estudo salientou os principais elementos que influenciam na alta rotatividade, permitindo evidenciar a importância da implementação de capacitações e treinamentos recorrentes.

Introduction:The high rates of hospital infections impacted the services provided, consolidating the implementation of the Sterilization and Materials Processing Center (CME), conceptualized as a support unit for care and diagnostic services that performs the processing of medical and hospital articles. The staff was composed of professionals unable to provide direct assistance, encouraging the devaluation of the unit. The recurrent technological development demanded more qualified and interested staff, but the sector still encounters difficulties training employees due to a high staff turnover. Objective: To identify the main factors contributing to the high rates of employee turnover in the CME, evaluate changes in productivity due to constant labor loss, identify team dissatisfaction, and raise the sociodemographic level of professionals. Methodology: Anexploratory and descriptive study with a quantitative approach was carried out with the nursing teams working in the CME of the Hospital Estadual de Bauru (HEB), based on a script composed of open and closed questions.Results:We note the prevalence of females, an unsatisfactory socioeconomic level, an environment conducive to occupational risks, a predominance of nursing technicians, hiring for filling vacancies and involuntary relocation, a fickle presence of training, permanence of the devaluation instituted, an extensive production, in addition to unpreparedness and lack of professionals as elements that increase the high rotation in the CME. Final Considerations:The study highlighted the main elements influencing high turnover, highlighting the importance of implementing recurrent training.

Uma mão lava a outra: relato de experiência de um projeto de extensão universitária

Trabalho apresentado na 1º ExpoSaúde. Trada da Infecção Hospitalar – IH onde corresponde a qualquer infecção adquirida após a internação do paciente e que se manifesta durante essa, ou mesmo após a alta, quando puder ser relacionada à internação ou aos procedimentos hospitalares realizados no paciente.

Lessons Learned From a Mental Health Hospital: Managing COVID-19.

Congregate settings such as psychiatric units have an increased risk of disease transmission because of the milieu setting and the inability to isolate patients. Interventions to prevent infection and cross-contamination are discussed including monitoring of patient temperatures, personal protective equipment, remote care, monitoring of human resources, and reinforcement of infection prevention strategies. We discuss the effectiveness of those interventions and the lessons learned, including implications for psychiatric clinical care, during future pandemics or a next wave of COVID-19.

Nurse Practitioner Led Emergency Clinic for Nosocomial Tuberculosis Exposure in a Level 3 NICU.

This article describes the nurse practitioner (NP) led management of a possible nosocomial exposure of tuberculosis (TB) in a level 3 NICU in Toronto, Canada. 26 babies, premature and term, were identified as being at risk and multiple emergency clinics were set up to diagnose possible infection, prescribe window prophylaxis, and monitor for adverse effects to the medication. The NICU NPs were chosen to organize, co-ordinate, and manage these emergency clinics because of their skills in leadership, diagnosing, therapeutic management, and client relationship building. The clinic was able to achieve 100 percent follow up with each at risk baby, from initial assessment through to completion of window prophylaxis with negative tuberculin skin test. Some insight in to the decision making surrounding possible TB outbreak management is provided, and special considerations around therapeutic management specific to this population are discussed. This incident demonstrates how nurse practitioners can be utilized to provide high quality care, across multiple clinical situations, to meet the needs of the health care system.

Intervention beamin prevention of local surgical infection

Introduction: Surgical site infections are frequent complications that affect patients undergoing surgery. These are preventable infections that constitute a loss of reputation for healthcare systems worldwide, with consequences for the patient in terms of morbidity, mortality, excessive length of stay, and additional costs to the system and the community. They aggravate their functional disability, increase the emotional stress of patients and families, leading to decreased quality of life.Nurses, as members of the multidisciplinary team, play a crucial role as promoters of adherence to the best practices for prevention and control of surgical site infection called "intervention bundle". Objective: Evaluate the adhesion of nurses to the intervention bundle in the prevention of Surgical Site Injury. Methods: Descriptive, cross-sectional, quantitative study. Sample of convenience, made up to 54 nurses. The data collection instrument was the checklist of the DGS of 2015. Results: The results revealed low adhesion in the presurgical bath with 2% chlorhexidine. Regarding trichotomy, it was avoided in about 59% of the cases. In the maintenance of capillary glycemia and normothermia, these were not met by 33% of professionals. Regarding adherence to surgical antibiotic prophylaxis, it was obeyed by 63% of the professionals, respecting the ideal timing of administration, 120 minutes before surgery. Conclusion: The implementation of programs of continuing education, accountability and awareness of the management bodies for the implementation of a safety culture are substantial in the prevention of surgical site disruption

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Linezolid versus vancomycin cost in the treatment of staphylococcal pneumonia.

OBJECTIVE: Staphylococcusaureus is involved in around 20% of nosocomial pneumonia cases. Vancomycin used to be the reference antibiotic in this indication, but new molecules have been commercialized, such as linezolid. Previous studies comparing vancomycin and linezolid were based on models. Comparing their real costs from a hospital perspective was needed. METHODS: We performed a bicentric retrospective analysis with a cost-minimization analysis. The hospital antibiotic acquisition costs were used, as well as the laboratory test and administration costs from the health insurance cost scale. The cost of each hospital stay was evaluated using the national cost scale per diagnosis related group (DRG), and was then weighted by the stay duration. RESULTS: Fifty-eight patients were included. All bacteria identified in pulmonary samples were S. aureus. The cost of nursing care per stay with linezolid was €234.10 (SD=91.50) vs. €381.70 (SD=184.70) with vancomycin (P=0.0029). The cost of laboratory tests for linezolid was €172.30 (SD=128.90) per stay vs. €330.70 (SD=198.40) for vancomycin (P=0.0005). The acquisition cost of linezolid per stay was not different from vancomycin based on the price of the generic drug (€54.92 [SD=20.54] vs. €40.30 [SD=22.70]). After weighting by the duration of stay observed, the mean cost per hospital stay was €47,411.50 for linezolid and €57,694.0 for vancomycin (NSD). CONCLUSION: These results, in favor of linezolid, support other former pharmacoeconomic study based on models. The mean cost per hospitalization stay was not statistically different between the two study groups, but a trend in favor of linezolid is emerging.

All-Inclusive Central Line Dressing Kits: A Lean Approach.

A team of the frontline nursing staff was assembled to work on central line-associated bloodstream infections (CLABSIs). This team used Lean methodology to identify issues related to central line care and maintenance and then developed countermeasures to systematically eliminate these issues. Since supplies was noted as the number one concern, the team worked to create all-inclusive central line dressing kits. These kits created a standard for dressing changes, leading to a significant decrease in CLABSI rates at a level 1 trauma center.

Use of a Double Gloving Technique to Decrease Cross-Contamination by Anesthesia Providers.

The purpose of this project was to determine the impact of double gloving during the induction of general anesthesia on the incidence of cross-contamination by the anesthesia provider. In a representative sample of anesthesia providers, induction sequences were initially evaluated using the providers' standard technique (group 0). The same providers were reevaluated after being educated on the double gloving technique (group 1). One month later the providers were reevaluated to identify which ones continued the double gloving technique (group 2). For each sequence, all providers were asked to complete a general anesthesia induction following a standard sequence (n = 30). Every anesthesia workstation was cleaned before each induction using the same supplies, and a black light was used to iden-tify any contamination. The workstations included the anesthesia circuit/face mask, breathing bag, anesthesia machine (adjustable pressure-limiting valve/vaporizer), medication cart, intravenous (IV) stopcock, and IV fluid bag. Each group's workstation was evaluated before and after induction for foreign body changes. The 3 groups were compared using a related-samples Friedman test, which demonstrated that the double gloving technique significantly decreased contamination in most areas studied (P < .01). Use of a double gloving technique decreased cross-contamination by greater than 50%.

Nurses' knowledge, behaviour and compliance concerning hand hygiene in nursing homes: a cross-sectional mixed-methods study.

BACKGROUND: Effective hand hygiene is one of the most important measures for protecting nursing home residents from nosocomial infections. Infections with multi-resistant bacteria's, associated with healthcare, is a known problem. The nursing home setting differs from other healthcare environments in individual and organisational factors such as knowledge, behaviour, and attitude to improve hand hygiene and it is therefore difficult to research the influential factors to improve hand hygiene. Studies have shown that increasing knowledge, behaviour and attitudes could enhance hand hygiene compliance in nursing homes. Therefore, it may be important to examine individual and organisational factors that foster improvement of these factors in hand hygiene. We aim to explore these influences of individual and organisational factors of hand hygiene in nursing home staff, with a particular focus on the function of role modelling by nursing managers. METHODS: We conducted a mixed-methods study surveying 165 nurses and interviewing 27 nursing managers from nursing homes in Germany. RESULTS: Most nurses and nursing managers held the knowledge of effective hand hygiene procedures. Hygiene standards and equipment were all generally available but compliance to standards also depended upon availability in the immediate work area and role modelling. Despite a general awareness of the impact of leadership on staff behaviour, not all nursing managers fully appreciated the impact of their own consistent role modelling regarding hand hygiene behaviours. CONCLUSION: These results suggest that improving hand hygiene should focus on strategies that facilitate the provision of hand disinfectant materials in the immediate work area of nurses. In addition, nursing managers should be made aware of the impact of their role model function and they should implement this in daily practice.

Navel to Knees With Chlorhexidine Gluconate: Preventing Catheter-Associated Urinary Tract Infections.

Urinary tract infections are the most common type of health care-associated infection, and greater than 75% of them are attributed to an indwelling urinary catheter. A catheter-associated urinary infection may lead to a longer hospital length of stay by as many as 4 days. A new patient care standard requiring twice-daily chlorhexidine cleansing from umbilicus to knees was implemented on all patients of the pilot unit with a urinary catheter. This same technique was used after a patient with a urinary catheter had an incontinent bowel movement. The 9-month average catheter-associated urinary infection rate decreased from 3.06/1000 urinary catheter days to 0.46/1000 urinary catheter days after implementation of the new standard. The use of chlorhexidine for routine urinary catheter care and after bowel movements from umbilicus to knees for patients with urinary catheters may significantly decrease catheter-associated urinary tract infections when compared with the standard of care using soap and water. Standards for Quality Improvement Reporting Excellence guidelines were used in reporting these data.

Assessment of nursing students perceptions of their training hospital's infection prevention climate: A multi-university study in Saudi Arabia.

BACKGROUND: The risk of acquiring and spreading infection must be minimized in nursing students because they are exposed to healthcare-associated infections during clinical training. To achieve this goal, students should be knowledgeable and competent in infection control practice before proceeding to their training hospitals. OBJECTIVES: This study assessed the nursing students' perception of the infection prevention climate in training hospitals in Saudi Arabia. It also examined the predictors of the students' perceptions. DESIGN: A quantitative, cross-sectional design was used. METHODS: This investigation was part of a large study conducted in six Saudi universities. A total of 829 Saudi nursing students were included in this study. Data were collected using the Leading Culture of Quality in Infection Prevention scale and analyzed using descriptive and inferential statistics. Ethical approval was obtained from the King Saud University, and permission was given by the administration of each participating university. RESULTS: The overall perception of nursing students indicated a modest infection prevention climate. Prioritization of quality and improvement orientation was rated as the highest dimensions, whereas psychological safety and supportive environment were the lowest. The nursing students in University F had the poorest perceptions among the six universities. The predictors of nursing student perception of their training hospitals' infection prevention climates were the university where they studied, their age, and participation in infection prevention seminars. CONCLUSIONS: This article describes nursing students' perception of the infection prevention climate of their training hospitals in Saudi Arabia. Results may provide a unique theoretical underpinning on the perception and factors that effect an infection prevention climate. Thereby, previous knowledge and literature may be expanded. Results can be used as a guide in establishing clinical policies in efforts toward improving the infection prevention climate.

An Education-Based Text Messaging Program to Improve Nurses' Knowledge, Attitude, and Practice Related to Nosocomial Infections in Intensive Care Settings.

BACKGROUND: Nosocomial infection (NI) is common in health care settings. Educational strategies such as mobile teaching methods for health care providers may help to resolve this problem. This pilot study assessed the influence of a text messaging program to improve intensive care unit nurses' knowledge, attitude, and practice related to NI prevention. METHOD: In this single-group experimental study, 32 nurses received an educational intervention via short text messages on their cell phones. Information on knowledge, attitude, and practice regarding NI prevention was collected using a standard scale. Preventive messages about NI were prepared and sent to participants during a 2-month trial. Results were assessed 2 weeks after the intervention, and data were analyzed by paired t test. RESULTS: Knowledge, attitude, and practice of participants increased by 17%, 3%, and 9%, respectively, from baseline to follow up. The average score on the knowledge dimension was lower than for other components. Knowledge components such as hand hygiene, work safety, and protective equipment increased to a lesser degree from pre- to posttest, compared with other aspects (p < .05 versus p < .001). CONCLUSION: An education-based program operating through short text messages may be a useful in-service training strategy for intensive care unit nurses. [J Contin Educ Nurs. 2019;50(5):211-217.].

The value of the infection prevention and control nurse led MRSA ward round.

Meticillin-resistant S. aureus (MRSA) is prevalent in most parts of the world. The study took place at Queen Elizabeth Hospital Birmingham (QEHB) a UK tertiary referral hospital. At QEHB innovative nurse led daily ward rounds for patients that acquire hospital acquired MRSA during their hospital stay are undertaken. The aim is to optimise care delivered for these patients whilst at QEHB, thereby reducing the risk of infection in patients with healthcare-acquired MRSA. A segmented Poisson regression model suggests that the MRSA bacteraemia rate was affected where an 88.94% reduction (p = 0.0561) in bacteraemias was seen by the introduction of these ward rounds. We describe a nurse led MRSA ward round which was associated with a lower rate of MRSA bacteraemias.

A simple and short microbiology practical improves undergraduate nursing students' awareness of bacterial traits and ability to avoid spreading infections.

BACKGROUND: Nurses are responsible for implementing appropriate measures to reduce hospital infections, especially with multidrug resistant bacteria, so nursing students should learn about microbiology. This helps them to understand bacterial dissemination and infectious disease control. Because of tight schedules, however, its teaching is limited in undergraduate nursing classes in Japan. We therefore tested whether a simple short practical session in a microbiology class could help to improve undergraduate nursing students' awareness of bacterial traits and how to prevent infections. METHODS: This study involved second-grade nursing students (n = 76). Two short practical sessions (a total of 3 h, across 2 days) were used to assess the effectiveness of washing or disinfection on hand bacteria in a 16-class microbiology course (total class time was 24 h, plus an exam). Hand bacteria were sampled on LB agar plates with orientation during the first half-day, and the plates examined for colonies with distinct color or morphological traits, and discussed, in the second session, a week later. Questionnaires before and after the exercise were used to assess changes in awareness of unseen bacteria inhabiting around us connecting bacterial traits and how to prevent infections. RESULTS: The results showed that the practical increased the nursing students' awareness of fomites (utensils) (p = 0.0115), fomites (contact-based) (p = 0.0016), habitats (body surface) (p = 0.0127), action facilitating hospital infection (p = 0.0166), and changes in physical condition caused by bacterial infections (p = 0.0136). There were no changes in word associations (p = 0.627) or habitats (inside body) (p = 0.308). Difficulty score, which is an element in questionnaire psychometric properties, tended to be close to the expected score through the practical, but not statistical significant. In addition, regardless of before or after practical, Cronbach α score, which is an indicator of the reliability among items of multi-choice questions, showed > 0.8, indicating validity of evaluation items. Thus, the student's awareness of unseen bacteria inhabiting around us was significantly increased as compared to those before practical in microbiology class. CONCLUSIONS: The simple short practical effectively improved nursing students' awareness of unseen bacteria inhabiting around us in microbiology course, useful for even tight teaching schedules.

Catheter-associated urinary tract infection: signs, diagnosis, prevention.

Catheter-associated urinary tract infection (CAUTI) is one of the most prevalent healthcare-associated infections (HAIs) in the UK and can have implications for both the patient and the health service. This article highlights those at risk, the signs and symptoms of CAUTI, diagnosis, methods of prevention and treatment. It highlights current guidance available to nurses to help ensure they are following the most recent recommendations for best practice.