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Impact, barriers, and facilitators of blood culture diversion devices to reduce blood culture contamination and improve patient safety: a scoping review
No full textBlood culture contamination (BCC) is a frequent and costly challenge in clinical diagnostics. BCC leads to extended hospital stays, unnecessary antimicrobial therapy, diagnostic delays, and increased healthcare costs, sometimes exceeding $100,000 per case depending on the scope of analysis. It also contributes to environmental waste and reputational harm. Blood culture diversion (BCD), particularly via blood culture diversion devices (BCDDs), has emerged as a promising strategy to reduce BCC. BCDDs divert initial blood flow, likely contaminated with skin flora, thereby improving diagnostic accuracy. This scoping review analysed 23 studies, including randomised controlled trials and observational designs. BCD was an effective method to reduce the rate of BCC. BCDDs consistently outperformed open diversion methods in reducing BCC rates. However, findings on their impact on antimicrobial usage, hospital length of stay, and cost-effectiveness varied. Some studies reported significant cost savings and reduced vancomycin use, while others showed minimal change. Barriers to BCDD adoption include financial constraints, inconsistent definitions of BCC, and variable staff compliance. Enablers include positive user feedback, targeted training, and integration into national surveillance frameworks. Evidence gaps remain in comparative effectiveness, sustainability metrics, and behavioural factors influencing implementation. The review recommends broader adoption of BCDDs, particularly in high-risk settings, emphasising the need for local data to identify where implementation will be most effective. It also calls for standardised definitions, improved surveillance, and further research into broader clinical, economic, and environmental outcomes.</p
Afterlives of Urban Cosmopolitanism: Muslim Asia and its non-Muslim diasporas
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Strength and vulnerability: a qualitative study of mental health and unmitigated communion among female migrants in Southeast England
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Remote4all: voicing the lived experiences of disabled and/or neurodivergent remote workers
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Skin barrier-related genes in childhood atopic dermatitis, asthma, and allergy: a systematic review and meta-analysis
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NEUSIS: A compositional neuro-symbolic framework for autonomous perception, reasoning, and planning in complex UAV search missions
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Enhanced Theory of Change - Entrepreneurial Mentoring Intervention
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Mapping of subjective accounts into interpreted clusters (MOSAIC): topic modelling and LLM applied to stroboscopic phenomenology
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The interplay of knowledge distance, linguistic distance, and industry relatedness in foreign divestment
No full textThis paper extends our understanding of the link between foreign divestment and knowledge distance between the home and host countries. We consider how knowledge distance affects the MNEs decision to divest their foreign operations. We theorize and find evidence that, given the embedded nature of knowledge in a given context, MNEs aiming to source knowledge in a foreign country characterised by a high level of knowledge distance will be less likely to divest their operations in these countries. Elaborating on a firm's ability to leverage knowledge distance, we also consider how linguistic distance positively moderates the relationship between knowledge distance and foreign divestment. Results from a comprehensive panel of 1,718 foreign subsidiaries made by 255 manufacturing Finnish MNEs operating in 70 host countries reveal robust support for these arguments.</p