Application of Ferrans and Powers Quality of Life Model to Improve Diabetes Health Outcomes: A Pilot Study.

The purpose of this pilot study was to evaluate the effectiveness of Ferrans and Powers Quality of Life Model as a guide to improve diabetes health outcomes. The success of the holistic and patient-centered diabetes pilot program indicates that nontraditional approaches to managing diabetes are effective.

Evaluation of the effect of cranberry juice on symptoms associated with a urinary tract infection.

The purpose of this research was to correlate daily consumption of cranberry juice and symptoms of a diagnosed UTI among 26 volunteer adult female patients.

Use of music in the treatment of insomnia: a pilot study.

The purpose of this pilot study was to evaluate the use of music to improve quality of sleep. Adults with insomnia listened to music at bedtime for 30 days. Measured by the Pittsburg Sleep Quality Index, results indicated that the use of music significantly increased sleep quality.

Bacterial contamination of healthcare workers' uniforms: a randomized controlled trial of antimicrobial scrubs.

BACKGROUND: Healthcare workers' (HCWs) uniforms become contaminated with bacteria during normal use, and this may contribute to hospital-acquired infections. Antimicrobial uniforms are currently marketed as a means of reducing this contamination. OBJECTIVE: To compare the extent of bacterial contamination of uniforms and skin when HCWs wear 1 of 2 antimicrobial scrubs or standard scrubs. DESIGN: Prospective, randomized, controlled trial. SETTING: University-affiliated, public safety net hospital PARTICIPANTS: Hospitalist physicians, nurse practitioners, physician assistants, housestaff, and nurses (total N = 105) working on internal medicine units. INTERVENTION: Subjects were randomized to wear standard scrubs or 1 of 2 antimicrobial scrubs. MEASUREMENTS: Bacterial colony counts in cultures taken from the HCWs' scrubs and wrists after an 8-hour workday. RESULTS: The median (interquartile range) total colony counts was 99 (66-182) for standard scrubs, 137 (84-289) for antimicrobial scrub type A, and 138 (62-274) for antimicrobial scrub type B (P = 0.36). Colony counts from participants' wrists were 16 (5-40) when they wore standard scrubs and 23 (4-42) and 15 (6-54) when they wore antimicrobial scrubs A and B, respectively (P = 0.92). Resistant organisms were cultured from 3 HCWs (4.3%) randomized to antimicrobial scrubs and none randomized to standard scrubs (P = 0.55). Six participants (5.7%) reported side effects to wearing scrubs, all of whom wore antimicrobial scrubs (P = 0.18). CONCLUSIONS: We found no evidence that either antimicrobial scrub product decreased bacterial contamination of HCWs' uniforms or skin after an 8-hour workday.

Staph ID/R: a rapid method for determining staphylococcus species identity and detecting the mecA gene directly from positive blood culture.

Rapid diagnosis of staphylococcal bacteremia directs appropriate antimicrobial therapy, leading to improved patient outcome. We describe herein a rapid test (<75 min) that can identify the major pathogenic strains of Staphylococcus to the species level as well as the presence or absence of the methicillin resistance determinant gene, mecA. The test, Staph ID/R, combines a rapid isothermal nucleic acid amplification method, helicase-dependent amplification (HDA), with a chip-based array that produces unambiguous visible results. The analytic sensitivity was 1 CFU per reaction for the mecA gene and was 1 to 250 CFU per reaction depending on the staphylococcal species present in the positive blood culture. Staph ID/R has excellent specificity as well, with no cross-reactivity observed. We validated the performance of Staph ID/R by testing 104 frozen clinical positive blood cultures and comparing the results with rpoB gene or 16S rRNA gene sequencing for species identity determinations and mecA gene PCR to confirm mecA gene results. Staph ID/R agreed with mecA gene PCR for all samples and agreed with rpoB/16S rRNA gene sequencing in all cases except for one sample that contained a mixture of two staphylococcal species, one of which Staph ID/R correctly identified, for an overall agreement of 99.0% (P < 0.01). Staph ID/R could potentially be used to positively affect patient management for Staphylococcus-mediated bacteremia.

Newly cleaned physician uniforms and infrequently washed white coats have similar rates of bacterial contamination after an 8-hour workday: a randomized controlled trial.

BACKGROUND: Governmental agencies in the United Kingdom and Scotland have recently instituted guidelines banning physicians' white coats and the wearing of long-sleeved garments to decrease nosocomial transmission of bacteria. OBJECTIVE: Our aim was to compare the degree of bacterial and methicillin-resistant Staphylococcus aureus contamination of physicians' white coats with that of newly laundered, standardized short-sleeved uniforms after an 8-hour workday and to determine the rate at which bacterial contamination of the uniform ensued. DESIGN: The design was a prospective, randomized controlled trial. SETTING: The setting was a university-affiliated public safety-net hospital. PARTICIPANTS: One hundred residents and hospitalists on an internal medicine service participated. INTERVENTION: Subjects wore either a physician's white coat or a newly laundered short-sleeved uniform. MEASUREMENTS: Bacterial colony count and the frequency with which methicillin-resistant Staphylococcus aureus was cultured from both garments over time were measured. RESULTS: No statistically significant differences were found in bacterial or methicillin-resistant Staphylococcus aureus contamination of physicians' white coats compared with newly laundered short-sleeved uniforms or in contamination of the skin at the wrists of physicians wearing either garment. Colony counts of newly laundered uniforms were essentially zero, but after 3 hours of wear they were nearly 50% of those counted at 8 hours. CONCLUSIONS: Bacterial contamination occurs within hours after donning newly laundered short-sleeved uniforms. After 8 hours of wear, no difference was observed in the degree of contamination of uniforms versus infrequently laundered white coats. Our data do not support discarding long-sleeved white coats for short-sleeved uniforms that are changed on a daily basis.

Development of a rapid diagnostic assay for methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative Staphylococcus.

We describe here a rapid assay for the detection of the tuf gene for the identification of Staphylococcus genus, the femB gene for the identification of Staphylococcus aureus species, and the mecA gene for the identification of methicillin resistance directly from BACTEC blood culture bottles showing Gram-positive cocci in clusters. The test, configured on a thin-film biosensor platform, allows for detection of genomic DNA from blood culture samples without the need for nucleic acid amplification. In an initial study to validate the technology, 107 consecutive positive blood cultures were tested on the thin-film biosensor, and the assay exhibited 100% concordance in comparison with standard microbiological methods for identifying methicillin-susceptible and methicillin-resistant S. aureus and for identifying methicillin-susceptible and methicillin-resistant coagulase-negative Staphylococcus. Results were obtained within 90 min directly from signal positive bottles with no instrumentation required.

Methicillin-resistant Staphylococcus aureus survival on hospital fomites.

We examined the duration of survival of 2 strains of methicillin-resistant Staphylococcus aureus (MRSA) on 3 types of hospital fomites. MRSA survived for 11 days on a plastic patient chart, more than 12 days on a laminated tabletop, and 9 days on a cloth curtain. Irregular surfaces may help harbor organisms in the environment. In addition to contact precautions, MRSA containment during an outbreak should include concurrent environmental decontamination.