We have continued to monitor needlestick injuries, communicate findings to all personnel, and include needlestick prevention in educational programs. We contend that more convenient placement of needle disposal containers, communication of findings, and education do decrease needlestick injuries in healthcare workers.
Healthcare-associated infections (HAI) with Apergillus pose a serious threat to those most severely immune suppressed patients. Outbreaks of nosocomial aspergillosis have occurred mainly among neutropenic patients, but with several important exceptions. HAI due to aspergillosi has occurred in association with environmental disturbances including but not limited to: hospital construction, maintenance, demolition and renovation; contaminated fireproofing materials; air filters in hospital ventilation systems, and via contaminated carpeting. It behooves those in the practice of patient care to prevent these situations before they occur, as opposed to dealing with them once they happen. The framework of the six links in the infectious disease process will be used to examine healthcare-associated invasive aspergillosis: causative agent, portal of entry, susceptible host, portal of exit, reservoir and mode of transmission. Two particular interventions: the Protective Environment (PE), and the Infection Control Risk Assessment (ICRA), will be outlined. Building construction projects and the number of neutropenic patients are likely to continue to increase. Therefore, future directions need to focus on reducing the susceptibility of the susceptible host and reducing the exposure to Aspergillus from environmental sources. In addition, recently released guidelines with control measures aimed at reducing environmental exposure to Aspergillus need to be further studied.
This study provides insights into under-reporting musculoskeletal injuries in a major US government organization. The research indicates that current reporting procedures appear to be overtly cumbersome in time and effort. More flexible work assignments are needed to cover staff shortfalls owing to injuries. Health education on the detrimental long-term effects of ergonomic injuries and the need for prompt attention to injuries should prove useful in improving rates of reporting.
Home health care nurses are at risk of needle-sticks and blood exposures, yet few studies have been conducted related to such exposures in the home health care setting. This article describes a cross sectional prevalence pilot study of needle-sticks and blood exposures conducted among three home health care agencies in the San Francisco Bay area. Needlestick and blood exposure reports from 1993 to 1996 were submitted from three home health care agencies. The exposures were categorized using an existing categorization system and compiled into a composite report. A total of 52 exposures occurred; nurses sustained 92% of exposures. Twenty-three percent occurred before, during, or after needle disposal; 17% from manipulating intravenous/access ports; 15% from improper disposal; and 13.5% during or after blood draw. Needle safety devices need to be specifically designed for the unique home health care setting and for a standardized rate of calculating needlestick injuries in this setting.
ack injuries remain a significant cause of lost time and work injuries in the United States. The Bureau of Labor Statistics (BLS) reported 1.7 million nonfatal occupational injuries and illnesses involving lost time from work in 2000. Four of 10 injuries were strains or sprains, and most of these involved the back. Musculoskeletal disorders (MSDs) numbered more than 577,800 and continue to account for more than one of three total lost worktirne cases (U.S. Department of Labor, BLS, 2002). The occupational groups of nursing aides, orderlies, and' attendants sustained 44,700 and registered nurses 12,100 of the 577,800 total MSDs for 2000 (BLS, 2(02). Nurses have consistently been identified as one of the highest risk groups for sustaining occupational back injuries (Goldman, 2(00). Manual lifting and transfer activities are the job tasks most frequently associated with back injuries in nursing personnel (Caska, 1998; Leighton, 1995; Owen, 1992; Stobbe, 1988). Factors contributing to back injuries during lifting and transfer tasks might be organizational, environmental, or personal. Examples of organizational factors include time pressure to perform the task, lack of available lifting aids, and lack of personnel to assist with the lift. Environmental factors include space restrictions, inconvenient or inaccessible lifting equipment or transfer devices, and poor condition of such devices. The personal factor most often associated with back injury during lifting is history of previous back injury or recurrent back injury (Caska, 1998).
A questionnaire regarding tolerability and adherence was administered for 5 days to hospital employees who received azithromycin prophylaxis during a hospitalwide outbreak of a pertussis-like illness. Analysis of the 239 responses from those having received prophylactic azithromycin determined that it was well tolerated and accounted for a minimal loss of days worked; 81.5% were fully adherent with the regimen.
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