47 research outputs found
A numerical scheme to simulate the distributed-order time 2D Benjamin Bona Mahony Burgers equation with fractional-order space
No full textIn this study, a new class of the Benjamin Bona Mahony Burgers equation is introduced, which considers the distributedorder in the time variable and fractional-order space in the Caputo form in the 2D case. The 2D-modified orthonormal normalized shifted Ultraspherical polynomials are derived from 1Dmodified orthonormal normalized shifted Ultraspherical polynomials and 2D-modified orthonormal normalized shifted Ultraspherical polynomials and the orthonormal normalized shifted Ultraspherical polynomials are applied to approximate of the space and time variables, respectively. Moreover, the convergence analysis of these basis functions is investigated. Due to the time variable being in the distributed-order mode and the space variable being in the fractional-order case, to apply the desired numerical algorithm for this type of equation, operational matrices of ordinary, fractional and distributed-order derivatives are computed. In the proposed method, once the unknown function is approximated using the mentioned polynomial, the matrix form of the residual function is derived and then a system of algebraic equations is adopted by applying the collocation approach. An approximate solution is extracted for the original problem by solving constructed equation system. Several examples are examined to demonstrate the accuracy and capability of the method
Rate of the incidence of hospital-acquired infections in Iran based on the data of the national nosocomial infections surveillance
No full textHospital-acquired infections (HAIs) lead to increased length of hospital stay, inappropriate use of broad-spectrum antibiotics and multiple antibiotic resistance. This study aimed to investigate the rate of HAIs in Iran. In this multi-centre study, the rate of HAIs was calculated based on the data collected through Iranian nosocomial infections surveillance for patients with HAIs, as well as through hospital statistics and information systems on hospital-related variables. Data were analysed using STATA software; in addition, ArcGIS was used for plotting the geographical distribution of HAIs by different provinces. The mean age of the 107 669 patients affected by HAIs was 52 ± 26.71 years. Just over half (51.55) of the patients were male. The overall rate of HAIs was 26.57 per 1000 patients and 7.41 per 1000 patient-days. The most common HAIs were urinary tract infections (26.83; 1.99 per 1000 patient-days), ventilator-associated events (20.28; 1.5 per 1000 patient-days), surgical-site infections (19.73; 1.45 per 1000 patient-days) and bloodstream infections (13.51; 1 per 1000 patient-days), respectively. The highest rate of HAIs was observed in intensive care units. Device, catheter and ventilator-associated infections accounted for 38.72, 18.79 and 16 of all HAIs, respectively. Based on the results, HAIs are common in intensive care units, and urinary tract infections and device-related infections are more prevalent in Iran. To reduce HAIs it is recommended to implement appropriate policies and interventions, train staff about the use of devices, and prepare and update protocols and guidelines for improving the quality of care. © 2020 The Author(s
Establishing Guidelines for Implementing Electronic Hand Hygiene Monitoring Systems
No full textHealthcare-associated infections (HAIs) in hospitals threaten patient safety and quality of care, which leads to increased healthcare costs. Despite national and state-level progress in hand hygiene compliance (HHC), the 2022 CDC annual report on HAIs highlighted ongoing concerns for standard infection ratios (SIRs) and called for improved HHC to reduce HAIs. Many hospitals use trained observers to collate HHC data; their audits are limited and often skewed by the Hawthorne Effect (HE) and observer bias, resulting in inaccurate HHC data. This project aimed to create guidelines for implementing electronic hand hygiene monitoring systems (EHHMSs) to help hospital inpatient units adopt EHHMSs.
The author conducted a literature search in the Cumulative Index of Nursing and Allied Health Literature (CINAHL), Trip Medical Database, and the Agency for Healthcare Research and Quality (AHRQ) and found no guidelines for implementing EHHMSs. The author systematically reviewed the literature on EHHMSs and gathered stakeholders\u27 recommendations through a 5-point Likert scale survey. The literature review and stakeholder feedback indicated that EHHMSs could significantly improve HHC and reduce HAIs. Implementing EHHMSs in hospital inpatient units could enhance HHC, reduce HAIs, and improve patient safety. The guidelines provided a framework for hospitals to adopt EHHMSs effectively
Estimating the Clinical and Economic Impact of Introducing a New Antibacterial into Greek Clinical Practice for the Management of Hospital-Acquired Infections with Limited Treatment Options
No full textIntroduction: Hospital-acquired infections (HAIs) and growing antimicrobial resistance (AMR) represent a significant healthcare burden globally. Especially in Greece, HAIs with limited treatment options (LTO) pose a serious threat due to increased morbidity and mortality. This study aimed to estimate the clinical and economic value of introducing a new antibacterial for HAIs with LTO in Greece. Methods: A previously published and validated dynamic model of AMR was adapted to the Greek setting. The model estimated the clinical and economic outcomes of introducing a new antibacterial for the treatment of HAIs with LTO in Greece. The current treatment pathway was compared with introducing a new antibacterial to the treatment sequence. Outcomes were assessed from a third-party payer perspective, over a 10-year transmission period, with quality-adjusted life years (QALYs) and life years (LYs) gained considered over a lifetime horizon. Results: Over the next 10 years, HAIs with LTO in Greece account for approximately 1.4 million hospital bed days, hospitalisation costs of more than €320 million and a loss of approximately 403,000 LYs (319,000 QALYs). Introduction of the new antibacterial as first-line treatment provided the largest clinical and economic benefit, with savings of up to 93,000 bed days, approximately €21 million in hospitalisation costs and an additional 286,000 LYs (226,000 QALYs) in comparison to the current treatment strategy. The introduction of a new antibacterial was linked to a monetary benefit of €6.8 billion at a willingness to pay threshold of €30,000 over 10 years. Conclusion: This study highlights the considerable clinical and economic benefit of introducing a new antibacterial for HAIs with LTO in Greece. This analysis shows the additional benefit when a new antibacterial is introduced to treatment sequences. These findings can be used to inform decision makers to implement policies to ensure timely access to new antibacterial treatments in Greece. © 2022, The Author(s)
Connecting Dwellers to Building Performance and Weather Data through Sustainable Automation Systems
No full textThe paper presents a prototype for a Home Automation and Information Systems (HAIS) applied to an existing dwelling, the Florianopolis House, with the potential to address building performance and user behavior towards a more sustainable way of living. Home information and automation systems based on a great variety of sensors, associated with local weather stations and climate forecast databases can significantly impact the construction of more sustainable habits in home dwellers. Monitoring the weather variations, building\u92s performance and the impact each resident\u92s activity in energy and water consumption is a powerful tool for the dwellers\u92 awareness and can provide a significant impact on residents\u92 reconnection with the natural cycles. The development of the graphic interface is highlighted as a critical issue for the communication of building performance, weather data and actuators control
The use of an infographic visual reminder, staff education and feedback to increase hand washing compliance among hospital staff
No full textPurpose: Hand hygiene (HH) is the single most effective infection control measure in the prevention of hospital-acquired infections (HAIs). In the United States, approximately 15 million patients experience the ill effects of HAIs every year. This project aimed to increase awareness of HH practices as a means of increasing compliance rates using a before and after educational intervention, visual reminders, observation, and staff counseling.
Methods: This quality improvement project used an educational intervention about HH practices and assessed knowledge before and after followed by visual reminders and poster boards. Compliance records were used as the pre-intervention data with direct observation after. Differences in knowledge scores and compliance rates were measured.
Results: A total of 50 persons participated. More than half (56%) were registered nurses, 24% were licensed practical nurses, and 10% were physicians. Significant differences in the baseline and post-intervention knowledge of HH practices (Pre-intervention score=3.74 (0.49); post-intervention score=4.00 (0.00); p. value=<0.001). Compliance was low pre-intervention however compliance increased significantly afterwards from 33.3% to 87.8%.
Implications: A contributing factor to transmission of infection in a hospital setting is improper HH, which is ultimately a contributing factor in hospital costs and affecting patients’ quality of life. Healthcare institutions should invest in standardized HH training and provide feedback to staff on compliance rates. Economic and clinical benefits of education, visual reminders, and direct observation with counseling include reduced HAIs, drug resistance, hospital stay, and mortality of patients. Further research is needed to determine healthcare providers reluctance to washing their hands and understanding the strategies that work best to sustain high rates of HH compliance.D.N.P.Includes bibliographical reference
The national rate of intensive care units-acquired infections, one-year retrospective study in Iran
No full textBackground: Hospital-acquired infections (HAIs) in intensive care units (ICUs) are among the avoidable morbidity and mortality causes. This study aimed at investigating the rate of ICU-acquired infections (ICU-AIs) in Iran. Methods: For the purpose of this multi-center study, the rate of ICU-AIs calculated based on the data collected through Iranian nosocomial infections surveillance system and hospital information system. The data expanded based on 12 months of the year (13,632 records in terms of �hospital-ward-month�), and then, the last observation carried forward method was used to replace the missing data. Results: The mean (standard deviation) age of 52,276 patients with HAIs in the ICUs was 47.37 (30.78) years. The overall rate of ICU-AIs was 96.61 per 1000 patients and 16.82 per 1000 patient-days in Iran�s hospitals. The three main HAIs in the general ICUs were ventilator-associated events (VAE), urinary tract infection (UTI), and pneumonia events & lower respiratory tract infection (PNEU & LRI) infections. The three main HAIs in the internal and surgical ICUs were VAE, UTI, and bloodstream infections/surgical site infections (BSI/SSI). The most prevalent HAIs were BSI, PNEU & LRI and eye, ear, nose, throat, or mouth (EENT) infections in the neonatal ICU and PNEU & LRI, VAE, and BSI in the PICU. Device, catheter, and ventilator-associated infections accounted for 60.96, 18.56, and 39.83 of ICU-AIs, respectively. The ventilator-associated infection rate was 26.29 per 1000 ventilator-days. Based on the Pabon Lasso model, the lowest rates of ICU-AIs (66.95 per 1000 patients and 15.19 patient-days) observed in zone III, the efficient area. Conclusions: HAIs are common in the internal ICU wards. In fact, VAE and ventilator-related infections are more prevalent in Iran. HAIs in the ICUs leads to an increased risk of ICU-related mortality. Therefore, to reduce ICU-AIs, the specific and trained personnel must be responsible for the use of the devices (catheter use and ventilators), avoid over use of catheterization when possible, and remove catheters earlier. © 2021, The Author(s)
Practicum piece on the Maine Civil Rights March & Rally, held Oct. 10 in Bango
No full textPracticum piece on the Maine Civil Rights March & Rally, held Oct. 10 in Bangor, which was a disappointment to the author in terms of public participation. Hais says she has lost her sense of idealism over the last three decades, and she believes the general public now accepts the violation of civil rights by silencing its outrage. U.S. representatives Tom Allen and John Baldacci endorsed the march, but Sens. Olympia Snow and Susan Collins, and Gov. Angus King did not
Mapping Human-Animal Interaction Studies: A Bibliometric Analysis
No full textLas figuras incluidas en este artículo se pueden ver en más detalle en los archivos de imagen depositados junto con el documento del artículo. El uso de todos estos documentos está sujeto a derechos de autor.The presence of nonhuman animals in our shared world affects most areas of human activity, both physically and conceptually. The study of human–animal interactions is thus considered a field of great interest, but also of great complexity. In recent decades, it has become manifest in multiple disciplines through many works, intersectionalities, approaches, and methodologies. Our main aim was to provide a useful reference for researchers and other professionals specialized in human–animal interaction studies (HAIS). For researchers from other areas of knowledge, we also aimed to serve as an approximation to the internal coherence and structure of HAIS, contributing to the incorporation of nonhuman animals into their research and advancing their moral consideration through the concept of agency. This paper presents an updated description of the multidisciplinary field of HAIS through a bibliometric study based on the co-occurrence of author keywords, topics, and trends. In this analysis, we found similarities in 60% of the terms used in human–animal studies (HAS) and critical animal studies (CAS), although numerous different terms also emerged. This degree of term co-occurrence was not found with anthrozoology (AZ), which shared only one line of research, related to companion animals, with HAS and which accounted for 13% of the terms used. It had only one common node with CAS.Peer reviewe
Postoperative antibiotic prophylaxis
No full textSurgical site infections (SSI’s) are the second most common adverse event occurring in hospitalized patients (Safe Care Campaign, 2016). Wound infections can cause major postoperative complications (i.e. longer hospital stays due to ineffective healing) (Lewis, 2014). Health care–associated infections (HAIs) are infections that are acquired from exposure to a microorganism in any health care is delivered setting (Lewis, 2014). Antibiotic prophylaxis before surgery may decrease the risk of bacterial infections post operatively (Lewis, 2014). Conclusion: antibiotic prophylaxis reduces the incidence of surgical site infections in post-op patients and should be used in all clean-contaminated procedures. Antibiotic prophylaxis should also be used in clean procedures where the risk for infection could have devastating consequences for the patient (Salkind & Rao, 2011). By using prophylactic antibiotics, we reduce the
incidence of infection which leads to a reduction in length of stay and overall hospital costs. As stated by American Family Physician, “adherence to the core
prevention measures may not reduce surgical site infections to the same degree as adherence to all of the measures,” indicating that further studies
must be conducted to determine which combination of infection control measures are the most effective in reducing infection. With all details considered, antibiotic prophylaxis does indeed have a positive correlation with reduced incidences of surgical site infections however, antibiotic therapy alone is not enough to compensate for poor infection control (Sinha, Van Assen, & Freidrich, 2014). To ensure safe and accurate practice, it is imperative that we understand and follow the specific parameters and guidelines pertaining to the antibiotic of choice such as: duration of prophylaxis, dosage, timing of
administration and adverse effects. As an adjunct to a timely antibiotic regime, we as nurses must also enforce additional infection control measures, such as hand hygiene and postoperative wound management, to further reduce the risk of primary infections in our post-surgical patients.Not peer reviewedStudent Research Day Poster (2017
