An, Hye-sun;Ko, Suhui;Bang, Ji Hwan;Park, Sang-Won
Infection and chemotherapy
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v.50
no.4
/
pp.319-327
/
2018
Background: Lancet-related needlestick injuries (NSIs) occur steadily in clinical practices. Safety-engineered devices (SEDs) can systematically reduce NSIs. However, the use of SEDs is not active and no study to guide the implementation of SEDs was known in South Korea. The lancet-related NSIs may be eliminated to zero incidence using a SED lancet with effective sharp injury protection and reuse prevention features. Materials and Methods: We implemented a SED lancet by replacing a conventional prick lancet in a tertiary hospital in a sequential approach. A spot test of the new SED was conducted for 1 month to check the acceptability in practice and a questionnaire survey was obtained from the healthcare workers (HCWs). A pilot implementation of the SED lancet in 2 wards was made for 1 year. Based on these preliminary interventions, a hospital-wide full implementation of the SED lancet was launched. The incidence of NSIs and cost expenditure before and after the intervention were compared. Results: There were 29 cases of conventional prick lancet-related NSIs for 3 years before the full implementation of SED lancet. The proportion of prick lancet-related NSIs among yearly all kinds of NSIs during two years before the pilot study was average 11.7% (22/188). Pre-interventional baseline incidence of all kinds of NSIs was 7.01 per 100 HCW-years. After the full implementation of SED lancet, the lancet-related NSIs became zero in the 2nd year (P = 0.001). The average direct cost of 18,393 US dollars (USD) per year from device and post-exposure medical care before the intervention rose to 20,701 USD in the 2nd year of the intervention. The incremental cost-effectiveness ratio was 210 USD per injury avoided. Conclusion: The implementation of a SED lancet could eliminate the lancet-related NSIs to zero incidence. The cost increase incurred by the use of SED lancet was tolerable.
Seo, Min-Jung;Kim, Chang-Soo;Ye, Soo-Young;Kim, Jung-Hoon
Journal of the Korean Society of Radiology
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v.10
no.5
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pp.351-358
/
2016
This study surveyed the health professionals in Busan with regard to their awareness of nosocomial infection control. According to the conclusion of this study, first, the level of awareness and performance of personal hygiene management, equipment sanitation management, and cleaning and environmental management increased as the level of education decreased. Also, when it comes to personal hand-washing, the level of awareness was higher among workers in primary, secondary and other medical institutions, where as the level of performance was higher among the group of medical practitioners. The differences were statistically significant at a significance level of .001. Medical practitioners also showed a higher level of awareness and performance of hospital sanitation management, which was statistically significant. Overall, as the level of awareness was lower than the level of performance, it seems that individuals need to thoroughly practice infection control, and realistic improvement measures need to be devised.
Purpose: This study was conducted to examine the effect of education on infection control for multidrug resistant organism (MDRO). Methods: One group pre-post time series design was used. Infection control education for MDRO infection was provided to nurses working in the Neonatal Intensive Care Unit (NICU). Knowledge and recognition were evaluated before and after education. Hand hygiene compliance, MDRO isolation rate and central line-associated bloodstream infection (CLABSI) rate were used as outcome variables. Data from 45 nurses was used for analysis. Results: General knowledge about MDRO increased (p=.011). Responses to questions about image of MDRO and MDRO management tended to change in a positive direction (p=.046). Hand hygiene compliance was 100% at pre-test, 79.5% during education period and 98.4% at post-education period. MDRO isolation rate was 6.83 per 1,000 patient days at pre-test, 10.24 during education period and 6.68 at post-education period. CLABSI rate was 3.76 per 1,000 central line days at pre-test, 6.84 during education period and 4.71 at post-education period. Conclusion: Findings indicate that the education program is effective in improving knowledge about MDRO in NICU nurses. However, more reliable indicators should be used to determine long-term effects.
Methicillin resistant Staphylococcus aureus (MRSA) is one of the most common nosocomial pathogens. Many hospitals are facing the problems which they have to use expensive antibiotics and suffer from long term hospital study of patients due to MRSA. This study is to survey MRSA nasal colonization of patients and doctors, and to investigate the mode of transmission of MRSA by pulsed field gel electrophoresis (PFGE) and then use these data to prevent further spread of cross infection and reduce nosocomial infection. Subjects of this study were 201 patients with MRSA infection at an university hospital in Busan from Sept. 1997 to Aug. 1998. Bacterial genotypes of MRSA strains isolated from nares and wound of patients (14 cases) and nares of doctors (8 cases) were analyzed by PFGE. Nasal cultures of 20 I patients for detecting nasal colonization of MRSA were performed and incidence rate of nasal colonization was 40% (80/201). Among 201 patients MRSA were acquired from hospital in 140 (70%) patients and were acquired from community 61 (30%) patients. Among 14 pairs of MRSA from colonized or infected sites and anterior nares, DNA patterns of 10 pairs (71.4%) were equal. 86% (12/14) MRSA strains isolated from patients and 12.5% (1/8) MRSA strains isolated from doctors show same pattern. DNA patterns were changed in some doctors after nasal oint. Treatment. It could be inferred that the most sources of MRSA in hospital are the endemically existing MRSA. Therefore, we believe that it would be necessary to control MRSA nasal colonization of the patients and the related medical teams to reduce the medical cost and to improve the efficacy of medical cares.
Choe, Ji Hyeong;Baek, Jin Hee;Jo, Yun Hee;Cho, Yoon Sook
Journal of Clinical Nutrition
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v.10
no.2
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pp.31-37
/
2018
Recently, in Korea, the importance of preparation and use of injectable drugs has been emphasized due to successive fatal accidents caused by injection infections. Parenteral nutrition (PN) has also been identified as a cause of infection. Cases of infection due to PN have been reported not only in Korea, but also abroad, and contamination occurs mainly during the preparation of PN. Because sterile preparation and compounding of injections are very important for infection control and patient safety, this article reviews the major guidelines outlined thus far. The Korea Ministry of Food and Drug Safety in 2006 published guidelines and the KSHP (Korean Society of Health-System Pharmacists) recently issued guidelines for the aseptic preparation of injections. In addition, as US guidelines, the ASHP (American Society of Health-System Pharmacists) guidelines and United States Pharmacopeia (USP) <797> are also reviewed. The recent guidelines published by the KSHP have significance in that they were adopted in accordance with the domestic reality, even though they conform to foreign guidelines, and are expected to be guidelines for hospital pharmacists performing aseptic preparation work. In addition, the Korea Ministry of Health and Welfare is considering appropriate guidelines for the safe management of medications, training staff for infection prevention and strengthening staff capacity. Furthermore, the gradual expansion of aseptic compounding facilities and human resources, as well as the provision of adequate medical costs are also considered. Based on the establishment and standardization of injectable drugs compounding guidelines for Korean hospitals, it is believed that if human resources and facilities are supported and medical charges are improved, it will be possible to expect the safer preparation and use of injections.
Journal of Korean Academy of Fundamentals of Nursing
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v.23
no.2
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pp.161-171
/
2016
Purpose: This study was conducted to investigate factors influencing influenza infection control compliance in nurses, including knowledge about, and awareness of infection control. Methods: The study participants were 168 nurses who worked at a hospital in J Province. Data were collected by self-reported questionnaires in April 2015. Collected data were analyzed using SPSS/WIN 20.0 program. Results: Mean score for knowledge about droplet precaution was 12.16 out of 16.00. Mean score for awareness about droplet precautions was 3.49 out of 4.00, and mean score for droplet precaution compliance was 3.33 out of 4.00. There was a positive correlation among knowledge, awareness and compliance (p<.001). Awareness, knowledge and experience of seasonal influenza education were the significant factors affecting the level of compliance (37.8%). Conclusion: Study results indicate that an educational program focusing on strategies to change nurses' awareness would be effective in improving infection control of respiratory virus and droplet precaution compliance in hospitals.
Journal of Korean Academy of Fundamentals of Nursing
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v.15
no.4
/
pp.531-538
/
2008
Purpose: The purpose of this study was to identify factors influencing Vancomycin-resistant enterococcus infection control among nurses in intensive care units. Method: Data were collected from August 15 to October 14, 2007 from 188 nurses working in intensive care units. The nurses answered a 26 item-questionnaire, which included management of the cohort (14 items), hand washing (6 items) and management of the environment (6 items). Descriptive statistics, t or F test, ANOVA, and multiple regression analysis were used with SPSS PC+ 14.0 to analyze the data. Results: The participant's level of awareness of Vancomycin-resistant enterococcus infection control was 3.87; that of compliance was 3.74. Significant factors influencing the level of compliance with Vancomycin-resistant enterococcus infection control were'the level of the awareness' and 'the type of intensive care unit'. These two variables accounted for 21.0% of variance for compliance with the Vancomycin-resistant enterococcus infection control among the participants. Conclusion: In order to develop a strategy to increase the compliance with Vancomycin-resistant enterococcus infection control, it is necessary to be concerned about 'the level of the awareness', 'the type of intensive care unit;', and 'experiences of caring for patients with Vancomycin-resistant enterococcus'.
Background: Students in the department of dental hygiene are exposed to injections and sharp instruments during clinical practice. Therefore, it is necessary to develop measures for a safe practice environment. This study aimed to investigate dental stabbing accidents caused by dental instruments during clinical practice among students in the department of dental hygiene and suggest appropriate preventative measures. Methods: This study was conducted from May 1 to June 30, 2016, with students in the department of dental hygiene located at several universities in Seoul and Gyeonggi area. The study included 339 participants. A frequency analysis was performed to determine the general characteristics of dental infection control. A cross-analysis was conducted to identify the relationship between dental infection control education, stabbing accident prevention education, and treatment after stabbing accidents with a dental instrument. Results: Among the participants, 81.1% received dental infection control education and 66.4% received stabbing accident prevention education. Only 50.9% received hepatitis B vaccinations. Conclusion: Dental infection control education and stabbing accident prevention education were shown to be effective in preventing dental instrument stabbing in students. However, post-accident processing, such as reporting to upper management and medical treatment after the accident, was insufficient. Therefore, it is necessary to present a treatment flowchart for dealing with stab accidents in clinical practice for students in the department of dental hygiene and strengthen education.
Park, Jinyoung;Lee, Jae-Yeol;Hwang, Dae-Seok;Kim, Yong-Deok;Shin, Sang-Hun;Kim, Uk-Kyu;Song, Jae-Min
Maxillofacial Plastic and Reconstructive Surgery
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v.41
/
pp.49.1-49.8
/
2019
Background: The purpose of this study was to review the clinical features of oromaxillofacial infections in patients presenting to a hospital emergency ward, to identify the key factors affecting the requirement for hospitalization, and the potential risk factors predisposing to a prolonged length of hospital stay. Methods: A retrospective medical record review of the 598 patients treated for oromaxillofacial infection from 2013 to 2017 at the oral and maxillofacial surgery department, Yangsan Pusan National University Hospital, was conducted. The following information was collected from each patient: sex, age, past medical history, site of infection, etiology, admission or outpatient care, level of C-reactive protein (mg/dL), fascial spaces involved, treatment method, and duration of hospitalization. Chi-squared tests were used to identify risk factors, which were further analyzed using multivariable logistic regression. Results: A total of 606 patients were eligible for inclusion in the study, of which eight were excluded due to having incomplete charts; thus, 598 patients were included: 55% were male, mean patient age was 47.1 ± 19.9 years, and 12.9% of patients were diabetic. Furthermore, 71.2% of patients had infection originating in the mandible; the most common tooth of origin was lower posterior, and 29.8% of patients were hospitalized. Risk factors for hospital admission were elderly patients with concurrent disease, elevated C-reactive protein level, and multiple-space infection in the oromaxillofacial area. The duration of hospitalization was correlated with both diabetes and age. Conclusions: The requirement for hospital admission is determined by the severity of the infection; even severe infections, once treated with appropriate surgery, have no relation to the length of hospital stay. The important risk factors for increased duration of hospitalization are diabetes mellitus and older age. The understanding of risk factors associated with a prolonged hospital stay during the treatment of oromaxillofacial infection will aid in treatment planning as well as highlight the importance of adequate diabetes control in patients at risk of such infection.
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