Disposable Thermometers Research Articles

IMPACT OF ENHANCED DISCHARGE EDUCATION ABOUT SEPSIS ON 30-DAY SEPSIS READMISSIONS: QUALITY IMPROVEMENT PILOT PROGRAM AT A LARGE TERTIARY CARE CENTER

IMPACT OF ENHANCED DISCHARGE EDUCATION ABOUT SEPSIS ON 30-DAY SEPSIS READMISSIONS: QUALITY IMPROVEMENT PILOT PROGRAM AT A LARGE TERTIARY CARE CENTER

Infection prevention practices in the Netherlands: results from a National Survey

ObjectiveTo examine the extent to which acute care hospitals in the Netherlands have adopted recommended practices to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and Clostridioides difficile infection (CDI).MethodsBetween 18 July 2017 and 31 October 2017, we surveyed the infection prevention teams of all acute care hospitals in the Netherlands. The survey instrument was based on the ‘Translating Healthcare-Associated Infection Prevention Research into Practice’ (TRIP) questionnaire and adapted to the Dutch context. Descriptive statistics were used to examine the reported regular use of CAUTI, CLABSI, VAP, and CDI prevention practices as well as the hospital characteristics.ResultsOut of 72 eligible hospitals, 47 (65.3%) responded. Surveillance systems for monitoring CAUTI, CLABSI, VAP, and CDI were present in 17.8, 95.4, 26.2, and 77.3% of hospitals, respectively. Antimicrobial stewardship programs have been established in 91.5% of participating hospitals. For CAUTI, the majority of hospitals regularly used aseptic technique during catheter insertion (95%) and portable bladder ultrasound scanners (86.1%). Intermittent catheterization and catheter stop-orders were regularly used by 65.8 and 62.2% of hospitals. For CLABSI, all hospitals regularly used maximum sterile barrier precautions and chlorhexidine gluconate for insertion site antisepsis. Avoidance of the femoral site for central line insertions was regularly used by 65.9% of hospitals. Urinary catheters and central-lines impregnated with antibiotics or antiseptics were rarely used (≤ 5%). Selective decontamination strategies for preventing VAP were used in 84% of hospitals. With the exception of disposable thermometers (31.8%), all prevention practices to prevent CDI were regularly used by more than 80% of hospitals.ConclusionsMost Dutch hospitals report regular use of recommended practices for preventing CLABSI and CDI. Several specific practices to prevent CAUTI and VAP were less frequently used, however, providing an opportunity for improvement.

The Service Age of a Flexible Endoscope Has a Significant Impact of the Effectivness of Cleaning and Disinfection

BACKGROUND: During the year 2012, the organization had the second highest incidence rate of HO-C-Diff in New York State. Best practices were in place for prevention of C-Diff including hand hygiene, contact precautions, hospital-wide disposable thermometer use, prolonged isolation, and bleach cleaning. The facility invested in a UV disinfection system in June 2013 to be used as an addition to the bundle of C-Diff prevention measures. METHODS: A cross sectional design study was conducted that included all inpatients in a 370 licensed bed acute care hospital. The baseline period was 7/1/2012 e 6/30/2013 where all bundle components were in place to prevent C-Diff and a comparison timeframe of 7/1/2013 e 6/30/2014 where all bundle components were in place and the addition of a UV disinfection protocol to the terminal room cleaning process was implemented. An algorithm was used to guide the environmental services department in selecting priority rooms for UV usage. Rooms with C-Diff patients were a top

Does improving surface cleaning and disinfection reduce health care-associated infections?

Contaminated environmental surfaces provide an important potential source for transmission of health care-associated pathogens. In recent years, a variety of interventions have been shown to be effective in improving cleaning and disinfection of surfaces. This review examines the evidence that improving environmental disinfection can reduce health care-associated infections.

Commentary on Khorshid L, Eşer İ, Zaybak A and Yapucu Ü (2005) Comparing mercury‐in‐glass, tympanic and disposable thermometers in measuring body temperature in healthy young people. Journal of Clinical Nursing 14, 496–500

Commentary on Khorshid L, Eşer İ, Zaybak A and Yapucu Ü (2005) Comparing mercury‐in‐glass, tympanic and disposable thermometers in measuring body temperature in healthy young people. <i>Journal of Clinical Nursing</i> 14, 496–500

Comparing mercury‐in‐glass, tympanic and disposable thermometers in measuring body temperature in healthy young people

The aim of this study was to determine whether a disposable thermometer was at least as accurate as a tympanic thermometer when compared with a mercury-in-glass thermometer and to investigate the waiting periods of mercury-in-glass thermometers. Although different methods of temperature measurement have been widely studied and described during the last decade, comparison between readings obtained when measuring body temperature using disposable, mercury-in-glass and tympanic thermometers is little documented and there is confusion about the waiting periods of mercury-in-glass thermometers. This research was descriptive and comparative. Temperature measurements included three sequential readings using first a tympanic thermometer in the left ear, then a disposable thermometer in the left axillary area and finally a mercury-in-glass thermometer in the right axillary area. All the temperatures were measured on the Celsius (degrees C) scale. To identify the stabilization periods of the mercury-in-glass thermometers, the temperature measurement was repeated until the reading stabilized. F-tests were used to compare readings of the mean temperatures. It was found that body temperature readings measured by tympanic thermometer were higher than axillary mercury-in-glass thermometer by 0.12 degrees C, body temperature readings measured by tympanic thermometer were higher than axillary disposable thermometer readings by 0.65 degrees C and body temperature readings measured by axillary mercury-in-glass thermometer were higher by 0.53 degrees C than readings measured by axillary disposable thermometer. It was found that readings measured by mercury-in-glass thermometer stabilized in the eighth minute. When assessing body temperature it is important to take the type of thermometer into consideration. In addition, axillary mercury-in-glass thermometers must be kept in place a minimum of eight minutes.

Management of an outbreak of Enterobacter cloacae in a neonatal unit using simple preventive measures

Enterobacter cloacae is becoming an increasingly important nosocomial pathogen. Outbreaks ofE. cloacae in intensive care units and burns units have been described frequently. In December 1999, a neonate with line sepsis was transferred from a university hospital to the neonatal unit of the Diakonessen Hospital. Blood culture yielded E. cloacae. An outbreak of E. cloacae was occurring in the university hospital at that time. In February 2000, a second neonate in our hospital developed line sepsis caused by E. cloacae. Direct measures taken included cohorting of infected children, disinfection of incubators, thermometers and wards, and screening patients. Of nine neonates, seven were colonized withE. cloacae . Despite these measures, the outbreak continued. Forty-one patients were screened; 15 were colonized. Environmental searches yielded E. cloacae in a sink and on two thermometers. Sixteen isolates were typed by arbitrarily primed PCR using four primers. All the patient isolates and the two isolates from thermometers were identical. The strain isolated from the sink was unrelated. Amplified fragment length polymorphism typing showed that the outbreak clone was identical to that in the university hospital. After the introduction of disposable thermometer covers, E. cloacae colonization slowly decreased.

DISPOSABLE THERMOMETER

DISPOSABLE THERMOMETER

The Effect of Timing of Initial Bath on Newborn’s Temperature

Objective:To determine the effect of the early timing of an initial bath on newborn temperature. Design:Random assignment to group, comparative study. Setting:Newborn nursery of a 20-bed obstetric unit in a regional hospital in the Midwest. Patients:80 healthy, full-term newborns.Interventions: 40 neonates were bathed at 1hour of age and 40 were bathed at hours of age. Main Outcome Measures:Axillary temperatures were measured before the admission bath and at 10, 20, and 60minutes after the bath with disposable thermometers; the maximum drop in temperature also was determined. Results:No significant differences were noted in axillary temperatures between the two groups before the bath or at 10, 20, or 60minutes after the bath. The groups did not differ significantly by gender, birth weight, length of bath in minutes, room temperature during bath, Apgar score at 5minutes, or gestational age. Conclusion:Healthy full-term newborns with an axillary temperature>36.8°C (98.2°F) can be bathed after 1hour of age when appropriate care is taken to support thermal stability.

A Randomized Crossover Study of Disposable Thermometers for Prevention of Clostridium difficile and Other Nosocomial Infections

A Randomized Crossover Study of Disposable Thermometers for Prevention of Clostridium difficile and Other Nosocomial Infections

Reduction in the incidence of Clostridium difficile-associated diarrhea in an acute care hospital and a skilled nursing facility following replacement of electronic thermometers with single-use disposables.

To determine if the spread of Clostridium difficile-associated diarrhea is related to the use of electronic thermometers in an acute hospital and a chronic healthcare facility. After finding that a significant percentage (20.8%) of electronic rectal thermometer handles were contaminated with C difficile, all electronic thermometers were replaced with disposables. A before/after trial was conducted to determine if the change to disposable thermometers would reduce the incidence of C difficile-associated diarrhea. The study took place in a 343-bed acute hospital and a 538-bed skilled nursing facility. All patients who underwent routine microbiological evaluation for nosocomially acquired diarrhea over a 1-year period were included in the study. Nosocomial diarrhea was defined as 3 or more loose stools per day for 2 consecutive days and/or abdominal findings such as pain, distension, and ileus occurring 3 or more days after admission. During the 6-month postintervention period, the incidence of C difficile-associated diarrhea was reduced from 2.71/1,000 patient days to 1.76/1,000 patient days in the acute hospital and from 0.41/1,000 patient days to 0.11/1,000 patient days in the skilled nursing facility. The protective effect of the intervention was statistically significant for both facilities. Replacement of electronic thermometers with single-use disposables significantly reduced the incidence of C difficile-associated diarrhea in both acute care and skilled nursing care facilities. Data suggest that the rectal route may be important in the transmission of C difficile in these settings.