American journal of infection control
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Am J Infect Control · Mar 2005
Impact of an educational program and policy changes on decreasing catheter-associated bloodstream infections in a medical intensive care unit in Brazil.
Central venous catheter-associated bloodstream infections (CVC-BSI) are a frequent cause of morbidity and mortality in intensive care settings. Many strategies have been used to decrease the risk of CVC-BSI; however, few studies have explored the educational intervention as an approach to reduce the CVC-BSI rates. ⋯ A multiple approach included an educational strategy, targeted to specific problems observed during a careful evaluation of CVC care practices, and policy changes can decrease rates of CVC-BSI. However, despite the good results, our rates are still high, and reinforcement of CVC care practices will be continued.
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Am J Infect Control · Feb 2005
Occupational exposure to blood and risk of bloodborne virus infection among health care workers in rural north Indian health care settings.
Approximately 3 million health care workers (HCWs) experience percutaneous exposure to bloodborne viruses (BBVs) each year. This results in an estimated 16,000 hepatitis C, 66,000 hepatitis B, and 200 to 5000 human immunodeficiency virus (HIV) infections annually. More than 90% of these infections are occurring in low-income countries, and most are preventable. Several studies report the risks of occupational BBV infection for HCWs in high-income countries where a range of preventive interventions have been implemented. In contrast, the situation for HCWs in low-income countries is not well documented, and their health and safety remains a neglected issue. ⋯ The high level of occupational exposure to blood found among this group of rural north Indian HCWs highlights the urgent need for interventions to enhance their occupational safety to prevent unnecessary nosocomial transmission of BBVs.
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Am J Infect Control · Feb 2005
Evaluation of risk factors for mortality in intensive care units: a prospective study from a referral hospital in Turkey.
The aim of the clinical practice is to decrease the mortality rate in intensive care units. Determination of the risk factors for mortality may provide useful guidance for intensive care patients. This study sought to find mortality-related risk factors in intensive care units. ⋯ The most important risk factors of mortality were observed as nosocomial infection, older age, high APACHE II score, mechanical ventilation, enteral nutrition, tracheostomy, and use of steroids or chemotherapy.
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Am J Infect Control · Dec 2004
Prediction rules to identify patients with methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci upon hospital admission.
In 2003, the Society of Healthcare Epidemiology of America (SHEA) recommended surveillance cultures upon hospital admission for patients at high risk for carriage of vancomycin-resistant enterococci (VRE) and methicillin-resistant Staphylococcus aureus (MRSA). The aim of this study was to assess the validity of factors from past medical history in defining patients at high risk for subsequent positive cultures with VRE or MRSA upon hospital admission. ⋯ Patients with a previous hospital admission represent a high-risk population for positive culture for VRE and MRSA and may be a group of which active surveillance is indicated.