Nitrile versus Latex for Glove Juice Sampling.

The objective of this study was to explore the utility of nitrile gloves as a replacement for latex surgical gloves in recovering bacteria from the hands. Two types of nitrile gloves were compared to latex gloves using the parallel streak method. Streaks of Klebsiella pneumoniae and Staphylococcus aureus were made on tryptic soy agar plates, and the zones of inhibition were measured around pieces of glove material placed on the plates. Latex gloves produced a mean zone of inhibition of 0.28 mm, compared to 0.002 mm for nitrile gloves (p<.001). While the parallel streak method is not intended as a quantitative estimate of antimicrobial properties, these results suggest that nitrile may be a viable alternative to latex in glove juice sampling methods, since nitrile avoids the risk of latex exposure.

Hand hygiene compliance and associated factors among health care providers in Gondar University Hospital, Gondar, North West Ethiopia.

BACKGROUND: Health care associated infections are more predominant in developing countries where Hand hygiene compliance is associated with so many factors. However, these factors have not been studied so far in the study area. This study sought to determine Hand hygiene compliance and associated factors among health care providers. METHODS: Institution based cross-sectional study was conducted from April to May, 2013 in Gondar University Hospital. Stratified sampling technique was used to select 405 health care providers. Standardized questionnaire and world health organization observational checklist was used to collect the data. Data was entered and analyzed by using SPSS version 20. Descriptive statistics and binary logistic regression model was used to summarize the result. RESULTS: A total of 405 study participants were interviewed and observed with a response rate of 96.4%. Good Hand hygiene compliance of healthcare providers was found to be 16.5%. Having knowledge about hand hygiene compliance, (AOR = 3.80, 95% CI 1.60, 8.97), getting training (AOR = 2.60, 95% Cl 1.21, 5.62), the presence of individual towel/tissue paper (AOR = 1.91, 95% CI 1.03, 3.56) presence of alcohol based hand rub for Hand hygiene compliance (AOR = 6.58, 95% CI 2.67, 16.22) and knew the presence of infection prevention committees (AOR = 2.6, 95% CI 1.23, 5.37) were significantly associated with hand hygiene compliance. CONCLUSIONS: Hand hygiene compliance among health care providers in Gondar University Hospital was found to be low. It is better to give training on Hand hygiene compliance and provide Alcohol based hand rub and individual towel or tissue paper for hand hygiene compliance.

Optimizing the protection of research participants and personnel in HIV-related research where TB is prevalent: practical solutions for improving infection control.

Tuberculosis (TB) is a leading cause of death among persons with HIV globally. HIV-related research in TB endemic areas raises some unique and important ethical issues in infection control related to protecting both research participants and personnel. To address such concerns, this article provides practical guidance to help research teams develop strategies to prevent TB transmission in studies involving persons with HIV in TB endemic settings.

A review of antibiotic use in food animals: perspective, policy, and potential.

Antibiotic use plays a major role in the emerging public health crisis of antibiotic resistance. Although the majority of antibiotic use occurs in agricultural settings, relatively little attention has been paid to how antibiotic use in farm animals contributes to the overall problem of antibiotic resistance. The aim of this review is to summarize literature on the role of antibiotics in the development of resistance and its risk to human health. We searched multiple databases to identify major lines of argument supporting the role of agricultural antibiotic use in the development of resistance and to summarize existing regulatory and policy documents. Several lines of reasoning support the conclusion that agricultural antibiotics are associated with resistance, yet most public policy is based on expert opinion and consensus. Finally, we propose strategies to address current gaps in knowledge.

Building interdisciplinary research models: a didactic course to prepare interdisciplinary scholars and faculty.

Many academicians assume that anyone can engage in interdisciplinary research, but it is clear that successful interdisciplinary efforts require mastery of specific competencies that can be learned and improved. This paper describes the development and implementation of a course designed for Master's, pre- and postdoctoral students and research faculty on models of interdisciplinary research skills, based on a set of core competencies. Major challenges included working through institutional structures that made it difficult to offer cross-school courses, and interpersonal challenges among a diverse group of students from a number of disciplines. Although universities may be poised for interdisciplinary research, strategies for faculty preparation and support are lacking. Institutions embracing the concept of team and interdisciplinary science must focus not only on the structural barriers and facilitators, but also on direct support to faculty. The didactic course described in this paper is one approach to enhance interdisciplinary research skills of scholars-in-training and faculty, and we recommend that similar efforts be widely implemented.

Antibiotic identification, use, and self-medication for respiratory illnesses among urban Latinos.

PURPOSE: The purpose of this study was to describe the extent to which antibiotic and nonantibiotic medications commonly used for upper respiratory infections (URIs) were correctly identified by a sample of urban dwelling Latinas and the association of medication identification with antibiotic use and self-medication. DATA SOURCES: One hundred women completed an interview and were asked to identify whether a list of 39 medications (17 antibiotics, 22 nonantibiotics) were antibiotics or not, whether anyone in the household had used the medication, their ages, and the source of the medication. RESULTS: Overall, participants correctly identified 62% of nonantibiotics and 34% of antibiotics. Seventy three (73%) women in the study reported antibiotic use by at least one member of the household in the past year. Among users, self-medication was reported in 67.2% of antibiotics for adults, but in only 2.4% of children. There was no difference in antibiotic recognition between those who self-medicated and those who did not, but antibiotic self-medication was associated with a significantly lower recognition of nonantibiotics (p= .01). IMPLICATIONS FOR PRACTICE: Measures to improve antibiotic utilization should address self-medication and consider the cultural and social context in which antibiotic use occurs.

Swab type, moistening, and preenrichment for Staphylococcus aureus on environmental surfaces.

We compared five swabs, dry or premoistened and with or without preenrichment, to detect surface contamination with Staphylococcus aureus. Sensitivities varied based on swab type, as follows: 71.9% and 75% for rayon, 71.2% for cotton, 81.3% for polyester, and 53.2% for calcium alginate. Preenrichment improved sensitivity (80%, versus 61.3% for direct-plated specimens), as did premoistening (83.4%, versus 57.5% for dry swabs). All of the premoistened, preenriched swabs were positive.

CMS changes in reimbursement for HAIs: setting a research agenda.

BACKGROUND: The Centers for Medicare and Medicaid Services (CMS) promulgated regulations commencing October 1, 2008, which deny payment for selected conditions occurring during the hospital stay and are not present on admission. Three of the 10 hospital-acquired conditions covered by the new CMS policy involve healthcare-associated infections, which are a common, expensive, and often preventable cause of inpatient morbidity and mortality. OBJECTIVE: To outline a research agenda on the impact of CMS's payment policy on the healthcare system and the prevention of healthcare-associated infections. METHODS: An invitational day-long conference was convened in April 2009. Including the planning committee and speakers there were 41 conference participants who were national experts and senior researchers. RESULTS: Building upon a behavioral model and organizational theory and management research a conceptual framework was applied to organize the wide range of issues that arose. A broad array of research topics was identified. Thirty-two research agenda items were organized in the areas of incentives, environmental factors, organizational factors, clinical outcomes, staff outcomes, and financial outcomes. Methodological challenges are also discussed. CONCLUSIONS: This policy is a first significant step to move output-based inpatient funding to outcome-based funding, and this agenda is applicable to all hospital-acquired conditions. Studies beginning soon will have the best hope of capturing data for the years preceding the policy change, a key element in non-experimental research. The CMS payment policy offers an excellent opportunity to understand and influence the use of financial incentives for improving patient safety.