Hospitals present complex challenges for controlling airborne infection due to their dense layouts and diverse range of activities. Factors such as bed occupancy, intensity of use, and mechanical ventilation can indirectly spread infection. New technologies using smart sensors show promise in detecting airborne infection but questions remain about their cost-effectiveness and optimal implementation. A holistic, interdisciplinary approach is needed to address the many interrelated factors contributing to infection spread.
Rw3 central manchester_univ_hosps_nhs_ft_hcai_inspection_report_20100113Terence Reeves
The Care Quality Commission conducted an enhanced inspection of Central Manchester University Hospitals NHS Foundation Trust. While they had no concerns with most measures, they found two areas needing improvement: the cleanliness of the patient environment on one ward, and the trust's arrangements and policies for decontaminating equipment were not always being followed. The CQC made a recommendation regarding cleanliness and a requirement for the trust to improve their decontamination arrangements and implement effective policies by March 1st.
The ability to understand the routes of infection, conduct epidemiology studies and to implement effective infection control procedures are crucial to hospital hygiene management.
Prolonged patient stays lead to increased morbidity and mortality rates in many cases.
Therefore, Healthcare-Associated Infections (HAI) represent a significant cost to hospitals and hinder patient care.
Advanced microbial strain typing, hospital hygiene and infection control solutions are improving the way hospitals deal with HAI.
Code of practice for clinical biochemistry chemical pathologistsVnhDng7
The document provides guidelines for clinical biochemists and clinical biochemistry services. It discusses management of services, staffing and workload, and safety. Key points include that clinical biochemists should take on management roles and ensure high quality services. Staffing levels should be adequate for workload. Safety is a joint responsibility and periodic inspections should be conducted. The guidelines are intended to help provide effective, reliable and safe pathology services.
1) The Ebola virus outbreak in the United States posed new challenges to the healthcare community as facilities had to treat their first cases.
2) The virus highlighted weaknesses in public health infrastructure and protocols for handling infectious diseases. Healthcare workers felt increased anxiety after two nurses in Dallas were infected while treating an Ebola patient.
3) In response, the CDC issued frequent guidance updates and healthcare facilities worked to strengthen protocols for safely treating potential Ebola patients and properly disposing of contaminated medical waste and equipment.
Surgical site infections can involve the skin, tissues below the skin, or implanted materials where surgery took place. To prevent such infections, doctors and nurses take several measures like cleaning hands and arms with antiseptics before surgery, wearing protective clothing during surgery, and cleaning the skin at the surgery site with special germ-killing soap. It is important for healthcare facilities to evaluate and ensure staff follow infection control policies, especially in outpatient areas like dressing change rooms, to prevent the spread of infections. Bacteriological culture testing of infected surgical sites helps identify causing organisms and guide appropriate antibiotic treatment, but samples must be properly collected by trained staff.
Hospital-acquired infections are a significant problem worldwide. They occur in healthcare facilities and affect patients through exposure to microorganisms. Reducing hospital-acquired infections requires coordinated efforts across many hospital departments and roles. Key steps include implementing infection control guidelines, ensuring proper sanitation and hygiene practices, monitoring multi-drug resistant bacteria, and providing training to healthcare workers.
Rw3 central manchester_univ_hosps_nhs_ft_hcai_inspection_report_20100113Terence Reeves
The Care Quality Commission conducted an enhanced inspection of Central Manchester University Hospitals NHS Foundation Trust. While they had no concerns with most measures, they found two areas needing improvement: the cleanliness of the patient environment on one ward, and the trust's arrangements and policies for decontaminating equipment were not always being followed. The CQC made a recommendation regarding cleanliness and a requirement for the trust to improve their decontamination arrangements and implement effective policies by March 1st.
The ability to understand the routes of infection, conduct epidemiology studies and to implement effective infection control procedures are crucial to hospital hygiene management.
Prolonged patient stays lead to increased morbidity and mortality rates in many cases.
Therefore, Healthcare-Associated Infections (HAI) represent a significant cost to hospitals and hinder patient care.
Advanced microbial strain typing, hospital hygiene and infection control solutions are improving the way hospitals deal with HAI.
Code of practice for clinical biochemistry chemical pathologistsVnhDng7
The document provides guidelines for clinical biochemists and clinical biochemistry services. It discusses management of services, staffing and workload, and safety. Key points include that clinical biochemists should take on management roles and ensure high quality services. Staffing levels should be adequate for workload. Safety is a joint responsibility and periodic inspections should be conducted. The guidelines are intended to help provide effective, reliable and safe pathology services.
1) The Ebola virus outbreak in the United States posed new challenges to the healthcare community as facilities had to treat their first cases.
2) The virus highlighted weaknesses in public health infrastructure and protocols for handling infectious diseases. Healthcare workers felt increased anxiety after two nurses in Dallas were infected while treating an Ebola patient.
3) In response, the CDC issued frequent guidance updates and healthcare facilities worked to strengthen protocols for safely treating potential Ebola patients and properly disposing of contaminated medical waste and equipment.
Surgical site infections can involve the skin, tissues below the skin, or implanted materials where surgery took place. To prevent such infections, doctors and nurses take several measures like cleaning hands and arms with antiseptics before surgery, wearing protective clothing during surgery, and cleaning the skin at the surgery site with special germ-killing soap. It is important for healthcare facilities to evaluate and ensure staff follow infection control policies, especially in outpatient areas like dressing change rooms, to prevent the spread of infections. Bacteriological culture testing of infected surgical sites helps identify causing organisms and guide appropriate antibiotic treatment, but samples must be properly collected by trained staff.
Hospital-acquired infections are a significant problem worldwide. They occur in healthcare facilities and affect patients through exposure to microorganisms. Reducing hospital-acquired infections requires coordinated efforts across many hospital departments and roles. Key steps include implementing infection control guidelines, ensuring proper sanitation and hygiene practices, monitoring multi-drug resistant bacteria, and providing training to healthcare workers.
The document provides instruction on properly citing sources in academic writing. It discusses when to use direct quotations, paraphrases, and summaries and how to format these citations. The document also explains how to incorporate short quotes into sentences and avoid "crouton quotes," which are short, isolated quotes that do not add meaning. It provides examples of citing both short quotes and longer block quotes using MLA style parenthetical citations and matching works cited entries.
The document outlines the agenda for the last day of class which includes signing up for conferences to discuss projects and receive graded papers, providing feedback on rough cuts of video projects by accessing shared documents and typing comments, and notes that the final exam will be on May 4th where all remaining projects and revisions are due and there will be snacks.
Global Research & Data Services has published market research reports on wines in over 50 countries. The reports provide essential market data including overall market value and volume, breakdown by product type, product pricing, and forecasts. They analyze indicators like macroeconomic conditions and ease of doing business. The reports are available for purchase individually by country for 490 EUR each or with a 15% discount for multiple reports. They offer decision-makers insights into wine market opportunities around the world.
This document discusses genetically modified organisms (GMOs) and their advantages. It lists numerous benefits of GMOs including higher crop yields, reduced need for pesticides, decreased costs for farmers, more nutritious foods, enhanced taste and quality of foods, increased resistance to diseases and hardiness of plants. GMOs are said to help feed a growing global population and reduce starvation. The document argues that GMOs are necessary to solve problems of food scarcity and human survival given the limited agricultural land and growing population worldwide. While it acknowledges some concerns about GMOs, the conclusion strongly advocates that GMOs are needed to address issues of hunger, poverty and sustainability.
This is a 3 sentence disclaimer for a dietary supplement product. It states that the product's claims have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease. The disclaimer also provides the copyright and date for Xyngular Corp.
Today's class agenda included selecting note-takers, checking a paper assignment, reviewing annotated bibliographies, and conducting peer review. The instructor discussed taking notes, studying effectively, completing a library quiz, and examples of peer review comments. Students were asked to compare a sample annotated bibliography to the assignment requirements. The class wrapped up with announcements about virtual work for the week and the instructor's availability.
This document asks readers to consider their image of libraries and what defines them, suggesting libraries are more than just books and vary in type from school libraries to university, business, and law libraries, as well as online only libraries. Readers are prompted to brainstorm and create an illustration of their image of a library, including what people, things, computers, and books they would include.
These market analyses give an overview of the actual situation, trends and future outlook of the markets for diesel generating sets in Australia, Africa and Americas.
The document discusses DGroups, a web-based platform that facilitates online knowledge networking among development professionals. It allows for the creation of email-based discussion lists and workspaces to support collaboration. DGroups aims to enable large-scale meaningful discourse and help people improve their lives through shared learning. With over 2,000 active communities and 151,000 members, DGroups provides a way for development organizations and professionals to communicate and exchange knowledge through email, which remains an important tool, especially in low-bandwidth environments.
This document contains a presentation on learning analytics. It lists the names of three presenters on learning analytics: Sven Charleer, Joris Klerkx, and Erik Duval. The rest of the document consists of references and citations related to learning analytics research.
The document describes using a peno3 server to store and transmit data through REST API and Socket.IO. REST API is used to store and retrieve non-volatile data through HTTP requests while Socket.IO enables live communication and sending volatile data between devices in real-time without saving to the server. Examples are provided for making requests to the REST API through HTTP and curl, and using Socket.IO to emit and receive events between clients.
Evaluating Architectural Changes to Alter Pathogen Dynamics in a Dialysis Uni...Subhajit Sahu
Highlighted notes while preparing for project on Computational Epidemics:
Evaluating Architectural Changes to Alter Pathogen Dynamics in a Dialysis Unit
Hankyu Jang, Alberto M. Segre, Samuel Justice, Daniel K. Sewell, Philip M. Polgreen, Sriram V. Pemmaraju
This paper presents a high-fidelity agent-based simulation of the spread of methicillin-resistant Staphylococcus aureus (MRSA), a serious hospital acquired infection, within the dialysis unit at the University of Iowa Hospitals and Clinics (UIHC). The simulation is based on ten days of fine-grained healthcare worker (HCW) movement and interaction data collected from a sensor mote instrumentation of the dialysis unit by our research group in the fall of 2013. The simulation layers a detailed model of MRSA pathogen transfer, die-off, shedding, and infection on top of agent interactions obtained from data. The specific question this paper focuses on is whether there are simple, inexpensive architectural or process changes one can make in the dialysis unit to reduce the spread of MRSA? We evaluate two architectural changes of the nurses’ station: (i) splitting the central nurses’ station into two smaller distinct nurses’ stations, and (ii) doubling the surface area of the nursing station. The first architectural change is modeled as a graph partitioning problem on a HCW contact network obtained from our HCW movement data. Somewhat counter-intuitively, our results suggest that the first architectural modification and the resulting reduction in HCW-HCW contacts has little to no effect on the spread of MRSA and may in fact lead to an increase in MRSA infection counts in some cases. In contrast, the second modification leads to a substantial reduction – between 12% and 22% for simulations with different parameters – in the number of patients infected by MRSA. These results suggest that the dynamics of an environmentally mediated infection such as MRSA may be quite different from that of infections whose spread is not substantially affected by the environment (e.g., respiratory infections or influenza).
Evaluating Architectural Changes to Alter Pathogen Dynamics in a Dialysis Uni...Subhajit Sahu
This document presents a simulation study evaluating two architectural changes to reduce the spread of MRSA in a hospital dialysis unit. The simulation is based on real healthcare worker movement data collected from the unit. Splitting the central nursing station into two smaller stations had little effect on MRSA spread and slightly increased infections. Doubling the surface area of the nursing station substantially reduced MRSA infections, between 12-22%, by diluting pathogen loads. The results suggest the dynamics of environmentally-mediated infections like MRSA differ from other infections and reducing contacts may not help if it increases local pathogen concentrations.
The document provides instruction on properly citing sources in academic writing. It discusses when to use direct quotations, paraphrases, and summaries and how to format these citations. The document also explains how to incorporate short quotes into sentences and avoid "crouton quotes," which are short, isolated quotes that do not add meaning. It provides examples of citing both short quotes and longer block quotes using MLA style parenthetical citations and matching works cited entries.
The document outlines the agenda for the last day of class which includes signing up for conferences to discuss projects and receive graded papers, providing feedback on rough cuts of video projects by accessing shared documents and typing comments, and notes that the final exam will be on May 4th where all remaining projects and revisions are due and there will be snacks.
Global Research & Data Services has published market research reports on wines in over 50 countries. The reports provide essential market data including overall market value and volume, breakdown by product type, product pricing, and forecasts. They analyze indicators like macroeconomic conditions and ease of doing business. The reports are available for purchase individually by country for 490 EUR each or with a 15% discount for multiple reports. They offer decision-makers insights into wine market opportunities around the world.
This document discusses genetically modified organisms (GMOs) and their advantages. It lists numerous benefits of GMOs including higher crop yields, reduced need for pesticides, decreased costs for farmers, more nutritious foods, enhanced taste and quality of foods, increased resistance to diseases and hardiness of plants. GMOs are said to help feed a growing global population and reduce starvation. The document argues that GMOs are necessary to solve problems of food scarcity and human survival given the limited agricultural land and growing population worldwide. While it acknowledges some concerns about GMOs, the conclusion strongly advocates that GMOs are needed to address issues of hunger, poverty and sustainability.
This is a 3 sentence disclaimer for a dietary supplement product. It states that the product's claims have not been evaluated by the FDA and are not intended to diagnose, treat, cure, or prevent any disease. The disclaimer also provides the copyright and date for Xyngular Corp.
Today's class agenda included selecting note-takers, checking a paper assignment, reviewing annotated bibliographies, and conducting peer review. The instructor discussed taking notes, studying effectively, completing a library quiz, and examples of peer review comments. Students were asked to compare a sample annotated bibliography to the assignment requirements. The class wrapped up with announcements about virtual work for the week and the instructor's availability.
This document asks readers to consider their image of libraries and what defines them, suggesting libraries are more than just books and vary in type from school libraries to university, business, and law libraries, as well as online only libraries. Readers are prompted to brainstorm and create an illustration of their image of a library, including what people, things, computers, and books they would include.
These market analyses give an overview of the actual situation, trends and future outlook of the markets for diesel generating sets in Australia, Africa and Americas.
The document discusses DGroups, a web-based platform that facilitates online knowledge networking among development professionals. It allows for the creation of email-based discussion lists and workspaces to support collaboration. DGroups aims to enable large-scale meaningful discourse and help people improve their lives through shared learning. With over 2,000 active communities and 151,000 members, DGroups provides a way for development organizations and professionals to communicate and exchange knowledge through email, which remains an important tool, especially in low-bandwidth environments.
This document contains a presentation on learning analytics. It lists the names of three presenters on learning analytics: Sven Charleer, Joris Klerkx, and Erik Duval. The rest of the document consists of references and citations related to learning analytics research.
The document describes using a peno3 server to store and transmit data through REST API and Socket.IO. REST API is used to store and retrieve non-volatile data through HTTP requests while Socket.IO enables live communication and sending volatile data between devices in real-time without saving to the server. Examples are provided for making requests to the REST API through HTTP and curl, and using Socket.IO to emit and receive events between clients.
Evaluating Architectural Changes to Alter Pathogen Dynamics in a Dialysis Uni...Subhajit Sahu
Highlighted notes while preparing for project on Computational Epidemics:
Evaluating Architectural Changes to Alter Pathogen Dynamics in a Dialysis Unit
Hankyu Jang, Alberto M. Segre, Samuel Justice, Daniel K. Sewell, Philip M. Polgreen, Sriram V. Pemmaraju
This paper presents a high-fidelity agent-based simulation of the spread of methicillin-resistant Staphylococcus aureus (MRSA), a serious hospital acquired infection, within the dialysis unit at the University of Iowa Hospitals and Clinics (UIHC). The simulation is based on ten days of fine-grained healthcare worker (HCW) movement and interaction data collected from a sensor mote instrumentation of the dialysis unit by our research group in the fall of 2013. The simulation layers a detailed model of MRSA pathogen transfer, die-off, shedding, and infection on top of agent interactions obtained from data. The specific question this paper focuses on is whether there are simple, inexpensive architectural or process changes one can make in the dialysis unit to reduce the spread of MRSA? We evaluate two architectural changes of the nurses’ station: (i) splitting the central nurses’ station into two smaller distinct nurses’ stations, and (ii) doubling the surface area of the nursing station. The first architectural change is modeled as a graph partitioning problem on a HCW contact network obtained from our HCW movement data. Somewhat counter-intuitively, our results suggest that the first architectural modification and the resulting reduction in HCW-HCW contacts has little to no effect on the spread of MRSA and may in fact lead to an increase in MRSA infection counts in some cases. In contrast, the second modification leads to a substantial reduction – between 12% and 22% for simulations with different parameters – in the number of patients infected by MRSA. These results suggest that the dynamics of an environmentally mediated infection such as MRSA may be quite different from that of infections whose spread is not substantially affected by the environment (e.g., respiratory infections or influenza).
Evaluating Architectural Changes to Alter Pathogen Dynamics in a Dialysis Uni...Subhajit Sahu
This document presents a simulation study evaluating two architectural changes to reduce the spread of MRSA in a hospital dialysis unit. The simulation is based on real healthcare worker movement data collected from the unit. Splitting the central nursing station into two smaller stations had little effect on MRSA spread and slightly increased infections. Doubling the surface area of the nursing station substantially reduced MRSA infections, between 12-22%, by diluting pathogen loads. The results suggest the dynamics of environmentally-mediated infections like MRSA differ from other infections and reducing contacts may not help if it increases local pathogen concentrations.
Seven steps to reduce the risk of infectious disease in hospitalsBassam Gomaa
Healthcare organizations face growing challenges related to infectious disease control. While frequent hand washing and the use of personal protective equipment are the leading weapons against infectious disease spread and hospital-acquired infections, the built environment, including the HVAC systems, also plays an important role. Strides in the development of smart building operation management platforms that easily and cost-effectively integrate with a facility’s existing systems can give healthcare providers a powerful tool with which to enhance the effectiveness of their overall infection control programs.
Healthcare Associated Infections (HAIs): Research NewsletterErin K. Peavey
In the US “One in 25 patients have a hospital-acquired
infection...Each day, over 205 deaths occur from HAIs...”
— Centers for Disease Control, 2011
An overview of this month’s article follows with bullet-points of the advantages and disadvantages of various environmental interventions in the prevention of Healthcare-Associated Infections (HAIs), often referred to as hospital-acquired infections. Paragraph summaries of Cleaning Strategies, Materials, Room Design and Hand-Hygiene are listed below. These provide broad themes and findings from the article. Reading the full article is always of benefit for a fuller understanding and is recommended. Click here to access the full article on the HERD Journal website.
Development of Predicative Management System for Tackling MRSA in British Hos...Ghasson Shabha
This document discusses the development of a predictive maintenance management system to tackle MRSA in British hospitals. It aims to assess integrating an MRSA predictive module into existing computer-aided facility management systems. This would monitor the spread of MRSA with a focus on hygiene protocols like cleaning. It also aims to generate an accessible online knowledge base for facilities managers to address infection control based on accumulated MRSA knowledge. Better understanding transmission mechanisms and a robust infection monitoring strategy across the healthcare facility lifecycle are needed. Future plans include an "intelligent safety by design" system and real-time predictive system monitoring air systems, along with an integrated online knowledge management system.
The document discusses decontamination of medical devices in the NHS. It outlines the importance of effective decontamination to reduce healthcare associated infections and minimize risks of disease transmission. It also examines current guidelines and challenges related to decontamination processes. Regulatory bodies are working to improve standards and ensure uniformity in decontamination practices across the NHS.
Contrary to their reputation as havens of healing, hospitals are home to invisible dangers known as germs that pose harm to patients and healthcare professionals alike. Hospital germ exposure has a wide range of risks, including the potential for infections, worse patient outcomes, and difficulties in preserving a secure medical environment. We examine the many aspects of hospital germ exposure in this thorough analysis, providing insight into the possible outcomes and risk-reduction tactics.
This document discusses infection control in surgical practice. It begins by outlining how surgical procedures expose patients to microorganisms and increase the risk of surgical site infections. Effective infection control requires an organized hospital-wide program to monitor infections, analyze data, implement corrective actions, and educate staff. Key aspects of infection control include proper hand hygiene, appropriate use of antibiotics, sterilization of surgical equipment, and classification of surgical wounds according to infection risk. Host factors like age, health status and operative factors like surgery duration influence infection risk. Strict adherence to infection control standards helps reduce surgical complications and healthcare costs.
Intensive care units experience high rates of infection due to patients having more comorbidities and invasive devices, with ventilator-associated pneumonia, central line-associated bloodstream infections, and catheter-associated urinary tract infections being common; infection control strategies like hand hygiene, isolation precautions, environmental cleaning, and surveillance are effective at reducing the transmission of multidrug-resistant pathogens in ICUs and improving patient outcomes. Surveillance of device-associated infection rates and antimicrobial resistance patterns is important for guiding infection control efforts and antimicrobial stewardship in the ICU.
This document discusses the importance of infection control and hygiene in operating theatres. It notes that surgical site infections are a major concern that increase morbidity, mortality and healthcare costs. The WHO Safe Surgery Checklist is highlighted as an important tool to reduce infections. Regular microbiological surveillance of operating theatre air is recommended to monitor bacterial counts and identify potential issues. Proper hand hygiene, environmental cleaning and maintaining appropriate air quality are essential practices to reduce infections arising from the operating theatre. Implementing checklists and collecting data on infections pre- and post-intervention can help assess effectiveness of patient safety measures in individual facilities.
This study evaluated the effectiveness of using ultraviolet-C (UV-C) radiation for environmental disinfection in reducing healthcare-associated infections (HAIs) at a hospital in California. The study found that implementing a dedicated service model for facility-wide UV-C treatment significantly reduced the incidence of HAIs by 34.2% compared to the period before UV-C intervention. Regular UV-C treatments of patient rooms and high-touch surfaces maintained lower HAI rates and reduced the total number and incidence of HAIs by 28.8% compared to traditional cleaning methods alone. The results suggest that continuous, monitored UV-C disinfection of the hospital environment can decrease disease transmission and improve patient outcomes.
This document provides guidelines for basic infection control in a chemotherapeutic unit. It discusses several key principles:
1. Standard precautions including hand hygiene, personal protective equipment, patient placement, injection safety, medication handling, and cleaning/disinfection.
2. Transmission-based precautions like contact, droplet, and airborne precautions.
3. The importance of education and training staff on proper infection control practices.
4. Surveillance and reporting of hospital-acquired infections is necessary to monitor rates.
Prevention of healthcare-associated infections is paramount, as immunosuppressed cancer patients are highly vulnerable to infection.
White paper disinfection of mobile devicesPhilip Gulan
This white paper discusses using ultraviolet light (UV-C) to disinfect mobile devices in healthcare settings. Healthcare-associated infections affect millions of patients annually and can be spread through contaminated surfaces. Mobile devices are increasingly used in healthcare but can harbor bacteria. The ChargeMax charging cabinet uses UV-C light to automatically disinfect smartphones and tablets placed inside. An experiment showed bacteria was killed on devices exposed to UV-C light inside the cabinet, but survived on an unexposed control device. The paper concludes the ChargeMax is an effective and novel technology to reduce infection risks from contaminated mobile devices in healthcare facilities.
Sop shirl hooper_prevention of post-surgical mrsa in adults_8. 2010Shirl Hooper
This document discusses best practices for preventing post-surgical MRSA infections in adults. It identifies MRSA as a common cause of healthcare-associated infections that increase mortality, costs and hospital stays. The research problems examined are what practices best prevent post-surgical MRSA and the efficacy of MRSA screening prior to surgery. Strict adherence to hand hygiene and infection control measures by healthcare workers is key to preventing transmission. Surveillance screening and eradication of MRSA carriers may reduce postoperative infections.
HCS 410 Healthcare Organization and Administration HAIsMaria Jimenez
This literature review explores effective methods for reducing hospital-acquired infections. It discusses how hand hygiene is the most effective way to prevent the spread of infections, as health care workers can transmit diseases through direct contact with patients. The review also examines the history of efforts to control infections and identifies strategies like surveillance programs, staff training, and ensuring sufficient funding for prevention programs. Overall, the review aims to understand how hospitals can develop a culture of hand washing and hygiene to reduce the 100,000 patient deaths per year in the US due to hospital-acquired infections.
Disinfecting Mobile Devices for use in Healthcare SettingsPhilip Gulan
The use of mobile technology is expected to have a profound impact on how care is delivered, the quality of patient experience and the cost of healthcare in general. Therefore, the quantity of mobile devices being used in healthcare environments is expanding significantly every year. Use of smartphones and tablets in the healthcare settings is rapidly expanding and contributing to improved healthcare and reduced costs around the globe. But this introduction of new technology into clinically sensitive areas creates the risk of passing along bacterial contamination throughout a hospital.
The present study was aimed to design a simple model to test efficacy of germicidal Ultraviolet light (UV-C) used inside ChargeMax as a charging cabinet designed for smartphones and tablets and made by Cetrix Technologies.
This document discusses infection control in dialysis units. It provides background on the high rates of infection in dialysis patients, who are immunosuppressed and undergo frequent medical procedures and hospitalizations. The second leading cause of death in dialysis patients is infection. The document then outlines strategies recommended by the CDC and other experts to reduce infection rates, including surveillance and feedback, hand hygiene, chlorhexidine use, catheter care guidelines, and staff education. Standard precautions like environmental cleaning and proper use of personal protective equipment are also emphasized.
This document summarizes a presentation on improving the management of healthcare acquired infections. It discusses how facilities management plays an important role in infection control through the design, construction and maintenance of hospitals. It also addresses the role of knowledge management and performance management in coordinating infection prevention efforts across different departments. The presentation covers topics such as how facilities management services influence infection risks, the use of knowledge mapping to share information, and different approaches to measuring performance in healthcare organizations.
White paper 2020: G-CON's Transmissible Disease Defense UnitsBrittany Berryman
This white paper discusses the use of flexible, mobile biocontainment and test units to prevent the spread of transmissible diseases. Transmissible diseases are no longer scarce and geographically limited to a location, but are becoming a more frequent occurrence, spreading rapidly due to rising populations and modern travel capability. Additionally, infectious diseases are now thriving in regions previously unsuitable for spread due to unfavorable climate and environmental conditions. Both types of diseases, therefore, have become a real threat for the entire global population.
This document discusses the importance of disinfecting common surfaces like keyboards and mice to prevent the spread of infections in hospitals and schools. It notes that hospital acquired infections cost $30 billion per year to treat and that eliminating infections can save hospitals significant costs. The document also describes a study that found epidemic strains of C. difficile bacteria on 26% of desktop computer keyboards in a hospital, indicating keyboards can be a reservoir for bacteria transmission. It emphasizes that proper disinfection protocols, including washing keyboards and mice, are needed to reduce microorganisms and promote a healthy environment.
3. COMBATING AIRBORNE INFECTION
October 2016 Health Estate Journal 41
areas which are separately ventilated,
and securing a safe clinical environment
and appropriate provision of isolation
rooms and facilities. Hospital* and ward
speciality** have also been observed to
be relevant as much as building type.
Early indications based on the level of
infections recorded in General Acute
speciality hospitals in England over the
last five years is quite overwhelming. AE,
ICU, endoscopy, and internal wards, are
more susceptible to infection than others.
This remains to be tested.
Airborne infection
Most patients spend up to 90 per cent of
their time indoors. Much emphasis has
been placed in studies on the importance
of indoor air quality, and on the link
between the cleanliness of the air, its level
of ionisation, and the performance of
people working in the conditioned space
(MacRae, 2007, Mendell MJ, 2006, 2008).
Many different types of contaminants
and pollutants can be found in buildings,
including particulates (dust, pollen),
gaseous (Volatile Organic Compounds
(VOC) and odours), and microbiological
substances (mould, fungi, mildew,
bacteria, and viruses) (Kilcoyne, 2006;
http://tinyurl.com/hh2rq2g). These have
been identified in hospital environments.
Interestingly enough, such
contaminants and pollutants are often
considered be a component of hospital
dust, as they can easily circulate through
the air supply and return. The spread of
infection via medical equipment, and
appliances such as ventilators, peripheral
catheters, urinary catheters, mechanical
ventilators, parenteral nutrition, blood
pressure cuffs, and stethoscopes, among
many others, has also been highlighted in
the literature (Health Protection Agency,
2006; Health Infection Society, 2008).
Impact of reduced
natural ventilation
The situation has been exacerbated by
the need to conserve and optimise
energy efficiency and reduce carbon
emissions. This has essentially reduced
natural ventilation from fresh air, which is
currently at a level below the latest
requirement of Part F of the Building
Regulations, i.e. 12 l/person/sec to
achieve the recommended fresh air
requirements, as shown in Table 3.
Hospitals are becoming more airtight,
and warmer, to comply with parts F and L
Design Variables
(Extraneous & Independent Variables)
Descriptive Design Variables Independent Design Variables
Hospital Design Proximity of beds
Ward Design Sharing facilities
Bed Occupancy Number of beds
Hospital Speciality Technicality of clinical procedures
Mechanical Ventilation
Ward Speciality
of the Building Regulations; this has
compromised indoor air qualities
significantly, increasing the risk of
airborne infection in sensitive parts of
hospitals, such as Bone Marrow
Transplant, ICU, and AE areas. The
changes in energy efficiency regulations
require buildings to be ‘better sealed’ and
‘more airtight’. The new Part F Document
provisions have been designed to
ventilate buildings having air permeability
down to 3 m/h/m at 50 Pa, allowing
designers to plan to ‘worst case scenario’,
as the Building Regulations document
Part L allows air permeability up to
10 m/h/m. As hospitals are becoming
more airtight and warmer, they are more
likely to require air-conditioning systems
which will be energy-inefficient and costly
to run.
Indoor temperature
and relative humidity
Environmental conditions can affect the
survival and persistence of
microorganisms on indoor surfaces.
(Mendell MJ et al, 2006; 2008).
Controlling indoor temperature and
relative humidity (RH) to an acceptable
level minimises microbial growth, and
results in consistent thermal comfort in
the occupied space. RH is known to
influence microbial survival and growth
of mould, mildew, and bacteria inside
ductwork and ventilation diffusers,
leading to a high concentration of the
production of allergens, odour, and toxins
in the ambient environment. It has been
suggested that maintaining internal
relative humidity below 60% significantly
reduces the potential for microbial
growth in buildings (Kilcoyne, 2006).
The ability of some bacteria, e.g.
Mycobacterium tuberculosis (TB) to
persist in the indoor environment has
been clearly demonstrated (Skoog, 2006;
Cornet, et al, 2007. Fleischer, et al, 2006).
Interestingly, both Listeria and Salmonella
thrive on higher humidity levels. In theory,
the accepted limits for ventilation and air-
conditioning are 21˚C to 24˚C at 40% to
60% relative humidity; but in reality
Table 2: Extraneous and independent variables.
*‘Single speciality’ Trusts (lowest on
airborne infection – Trusts undertaking
orthopaedics, cancer therapy, or
children’s health services). ‘Specialist
Trusts’ (Trusts with specialist services
which receive patients referred from
other Trusts for these services). ‘General
acute’ Trusts (Trusts providing general
acute healthcare services – the highest
in terms of airborne infection). **Ward
speciality can be categorised into
medical, surgical, obstetrics and
gynaecology, critical care medicine,
among many other specialities.
(Hospital Infection Society and Infection
Control Nurses Association, 2007).
4. 42 Health Estate Journal October 2016
COMBATING AIRBORNE INFECTION
humidity levels can be much lower than
40% in many hospital wards (NHS, 1994).
Non-humid environments appear to be
optimal for bacteria to thrive in given
that the ‘comfort zone’ of 21˚C to
24 ˚C is well within the survival
temperature range of 18-37 ˚C. What
measures can be undertaken to reduce
the impact of indoor temperature and
relative humidity (RH) on the survival of
bacteria and viruses, and what improvements
can be made to ventilation systems to reduce
the spread of airborne infection?
Technological interventions: the need
for a holistic approach
There seems to be a multiplicity of
interrelated factors involved in the spread
of infection in clinical environments. Any
attempt to disentangle these factors
independently in order to measure their
impact on patient wellbeing will be
onerous, and almost entirely impossible
to achieve in practice. Past methods of
intervention were either preventative or
corrective. It appears that the methods
are highly fragmented, and expediently
applied on ad hoc basis, to meet the
immediate short-term agenda of clients
and their organisations. These methods
are largely based on insufficient and
anecdotal evidence, claims, and
observations, with a few exceptions.
Most preventative intervention methods
are prescriptive in their scope, and
ignore the role of the human factor as
a host in spreading infection. The impact
on susceptible patients appears to be
interwoven: one particular factor might
simultaneously act as a trigger for
another – which necessitates a new
modus operandi and a paradigm shift.
Cross-infection (Hard surfaces)
Cleaning
Methods of intervention vary in their
scope, efficacy, and effectiveness, in
tackling the spread of infection, and
include both preventative and corrective
approaches. The former were developed
primarily to inhibit the growth and
proliferation of bacteria by providing
long-term, hard-wearing surfaces, which
feature antibacterial properties. Among a
raft of products introduced into the UK
market and purported to be among the
most effective are Biocote, Addmaster,
and Dulux antibacterial paint. Greater
reliance on antibacterial and disinfectant
products on internal surfaces is a critical
factor in infection control. The efficacy of
these methods is determined by
accessibility of antibacterial agent/
additives at the coating/bacteria
interface; this is mainly based on slow
release of the agent to maintain an
effective concentration at and near the
surface of the material.
‘While hospitals have taken deep-
cleaning measures to eliminate superbugs
such as MRSA, there are fears staff may
have failed to carry out more basic routine
hygiene measures to control other
infections.’ (NICS, 2016).
Wearable sensors
Using wearable sensors to get real-time
data when it comes to monitoring
cleanliness, such as in washing hands, could
become ever more important.
A device and associated app will be able
to alert you when you experiencing an
asthma situation, as well as provide
journaling, treatment plans, displays, and
the tracking and information on the
treating of symptoms
(www.valedotherapy.com).
Other infection control strategies have
been devised to reduce infection by
improving procedural/managerial
measures to ensure that the safety and
wellbeing of patients is followed through.
There is a growing recognition that
implementation of new surveillance,
screening, and detection systems, may
prevent further spread of ABI (HSC
2000/002, 032).
The demands for emerging medical
technology conflict with the need to
control the spread of, and contain,
microorganisms which might lead to
cross-contamination. However, it was
observed that at a relative humidity, the
humidity level of the internal surface, and
the surface’s porosity, are conducive to
the growth and spread of infection.
Makison (2006) however found that
survival actually had more to do with
material type than RH.
Other management strategies
Other possible management strategies
for tackling the risk of airborne infection,
mainly within ducting in ventilation and
air-conditioning systems, include (i)
filtration, ii) deep cleaning via steaming,
and iii) a UVGI regime (Ryan et al, 2011).
Again the efficacy of these methods and
robustness is determined by accessibility
to the labyrinth of mechanical ducting,
the complexity of which has proven to be
problematic. A typical system includes air
filters, air cooling, chilled water systems,
de-humidifiers, humidifiers, ductwork,
dampers and diffusers, fire dampers, and
sound attenuators.
Steril Aire has created a ‘kill tunnel’
model (Spicer, 2016), which enables
effective use of UVC in normal HVAC
conditions for an acceptable kill rate in
commercial and NHS facilities, although
it will not be able to provide a log6
protection. How can this Steril Aire model
benefit from ubiquitous sensing using
smart sensor technology for early
detection and monitoring?
A combination of one or two methods
might be the answer, cost-permitting.
Cyclical duct cleaning is needed to
dislodge accumulation of dust, most of
which will comprise higher proportion of
organic compounds (OC), including hair
and skin flakes – the main nutrients for
microorganisms, and a major fire hazard.
Smart sensors
The authors would argue that digitised
smart sensors are critically important to
enable the assessment and quantification
of the effectiveness of any technological
intervention, and to mitigate any impact
it may have on the clinical environment
and a patient’s health. Suffice it to say
that sensors are becoming ubiquitous in
everyday life, generating data at an
unprecedented rate, and at a scale which
is self-perpetuating.
Models are essential tools to understand
processes, identify relationships, associations,
and causality, and formalise stakeholder
mental models. They can help to explain data,
as well as inform the deployment and
location of sensors, by identifying hotspots
and areas of interest where data collection
may achieve the best results.Figure 2: Smart sensors in action.
state change trends state
Data
Variationresponse
Information
factors interpretation values
Models
processes relationships
transformation
uncertainty context
Spatio-temporalintegration
calibration&validation
calibration&validation
positioning&planning
association causality
Action
Sensors observations
6. 44 Health Estate Journal October 2016
COMBATING AIRBORNE INFECTION
n Fleischer M et al. Microbiological
Control of Airborne Contamination in
Hospitals. Indoor and Built Environment
2006; 15 (1):53-56, SAGE Publications.
n Kunori T et al, (2002). Cost-
effectiveness of Different AIR BORNE
INFECTION Screening Methods.
Journal of Hospital Infection 2002;
51: 189-200.
n Levetin E, Shaughnessy R, Rogers C.A,
Scheir R. (2001). Effectiveness of
Germicidal UV Radiation for reducing
Fungal Contamination within Air-
Handling Units. Applied
Environmental Microbiology 2001;
67 (8): 3712–3715.
n Makison, C, Swan, J. The Effect of
Humidity on the Survival of AIR
BORNE INFECTION on Hard Surfaces.
Indoor and Built Environment 2006;
15: (1): 85-91, SAGE Publications.
n McCulloch J. Infection Control:
Science, Management and Practice.
Whurr, London, 2000.
n Mendell M.J et al. Indicators of
Moisture and Ventilation System
Contamination in U.S. Office Buildings
as Risk Factors for Respiratory and
Mucous Membrane Symptoms:
Analyses of the EPA BASE Data.
Journal Occupational Environmental
Hygiene 2006; 3 (5): 225–233.
n Mendell, M.J, et al. Risk Factors in
Heating, Ventilating, and Air-
Conditioning Systems for Occupant
Symptoms in US office Buildings, the
US EPA BASE study, Indoor Air 2008;
18 (4) 301–316.
n Menzies D et al. Effect of Ultraviolet
Germicidal Lights Installed in Office
Ventilation Systems on Workers’
Health and Wellbeing: Double-blind
Multiple Crossover Trial, Lancet 362
(9398): 1785–1791.
n NHS Estate. Infection Control in the
Built Environment: Design and
Planning. HMSO, London, 2001.
n NHS Estate. HTM 2040, Control of
Legionellae in Healthcare Premises, 1993.
n Health Building Notes. HBN 4 -
Supplement 1.
n Health Protection Agency. Mandatory
Surveillance of Healthcare Associated
Infection Report 2006. Department of
Health, England.
n Hospital Infection Society and Infection
Control Nurses Association (2007). The
Third Prevalence Survey of Healthcare
Associated Infections in Acute
Hospitals in England (2006). Report for
the Department of Health, England.
n Lee LD, Spencer M. Understanding the
Role of Contaminated Air in Healthcare
Acquired Infections. Infection Control
Today webinar. http://tinyurl.com/
juygvfr
n McCulloch J. Infection Control:
Science, Management and Practice.
Whurr, London, 2000.
n McIntosh B.S, Seaton RAF, Jeffrey
P.Tools to Think with? Towards
Understanding the Use of Computer-
based Support Tools in Policy Relevant
Research. Environmental Modelling &
Software 2007: Vol 22 (5): 640–648.
n Reis S et al. Integrating Modelling and
Smart Sensors for Environmental and
About the authors
Ghasson Shabha
Ghasson Shabha is a
senior lecturer at the
Integrated Design
and Construction
Centre (IDC) at the
School of
Engineering and the
Built Environment,
BCU. An architect and technologist
by profession, with wide-ranging
experience in the design, construction,
and management, of buildings includ-
ing schools, offices, and commercial
buildings, he is currently involved in
developing research into assessing
and mitigating the risk of airborne
infection in critical healthcare facilities,
including by harnessing wireless
sensors embedded into mechanical
ventilation and air-conditioning
systems transmitting real-time data to
a remote web server. Based on trends,
the data will be fed into a Predictive
Infection Criticality Model (PICM),
which is currently being developed at
the IDC to assess the intensity and fre-
quency of colonisation and to identify
‘hotspots’ in healthcare areas to alert
hospital teams and Built Environment
managers in managing infection more
robustly.
Chris Conway
Chris Conway is
associate professor
and the acting head
of the Integrated
Design and
Construction Centre
(IDC) at the School
of Engineering and
the Built Environment, BCU. |He is a
technologist and a construction
manager by profession, with a wide-
ranging expertise in managing large
and complex construction projects.
Fully acquainted with the operational
management of buildings and the
organisations housed within them,
he is currently leading and pursuing
research on the applications of Smart
and Digital Construction in 21st century;
he is particularly focusing on the
applications of wireless sensor
technology as applied to robots and
drones, to optimise the construction
process and maximise efficiency.
Human Health. Environmental
Modelling & Software 2015: Volume 74:
238–246.
n Ryan RM, Wilding GE et al. Effect of
Enhanced Ultraviolet Germicidal
Irradiation in the Heating, Ventilation
and Air conditioning System on
ventilator-associated pneumonia in a
neonatal intensive care unit. Journal of
Prenatal 2011: Vol 31 (9): 607–614.
n Skoog J. Relative Air Humidity in
Hospital Wards – User Perception and
Technical Consequences. Indoor and
Built Environment 2006; 1:93-97.
SAGE Publications.
n Taylor S. Is There A Doctor In The
House? Engineered Systems, 6 August
2016. http://tinyurl.com/z5f5p8v
n Van Enk R. Modern Hospital Design
for Infection Control. Healthcare
Design, September 2006.
n Yi W, Chandra S et al. Effectiveness
of an Ultraviolet Germicidal Irradiation
System in Enhancing Cooling Coil
Energy Performance in a Hot and
Humid climate. Energy and Buildings
2016: 130: 321–329. Elsevier
n Wagenvoort, J et al. Better
Environmental Survival of Outbreak
versus Sporadic AIR BORNE
INFECTION Isolate, 2000.
n Walkers J et al. Hospital and
Community Infection and the Built
Environment-design and testing of
infection control rooms. Journal of
Hospital Infection June 2007; 43-49.