The purpose of this research was to reduce rate of CRBSI at Bangkok Hospital by using 2002 CDC evidence-based guidelines as a preventive of CRBSI. 1 MATERIALS AND METHODS.A target surveillance on CRBSI was conducted in all 4 adult intensive care units at the Bangkok Hospital. The findings were compared with the CDC recommendations. Then we set up a multidisciplinary patient-care project team who applied the CDC guidelines in order to work towards the reduction and eventual prevention of CRBSI's in our hospital.RESULTS. The reduction of CRBSI incidence was observed to be sustainable after the new guidelines were implemented in October 2004. The rate of CRBSI incidence reduced gradually especially in the year of 2010. It approached to zero per 1000 catheter-day. CONCLUSION.Nowadays, all healthcare personnel must take responsibility for preventing nosocomial infection. We has demonstrated that our multidisciplinary team can reduce the infection rates sharply. Catheter Related Blood Stream Infection (CRBSI) is the third most common nosocomial infection. The infection results in higher antibiotic costs, prolonged hospitalization days and is even related to high morbidity and death. [2][3][4] The Centers for Disease Control and Prevention (CDC) of the United States of America has provided evidence-based guidelines for catheter care to reduce Blood Stream Infections (BSI). They refer to recommendations for hand hygiene, 5 maximal sterile personnel protection equipment (PPE), 6, 7 preferred antiseptics for skin preparation, 8, 9 catheter site dressing regimens, 10 the site chosen for catheter placement, 11, 12 etc. In 2004, our Infection Control Committee set up a project aimed at reducing CRBSI at Bangkok Hospital by using the aforementioned 2002 CDC evidence-based guidelines as a preventive of CRBSI. 1 Materials and MethodsCase Definitions for CRBSI including 1. Bacteremia/fungemia in a patient with an intravascular catheter, with at least one positive blood culture obtained from a peripheral vein and clinical manifestation of infections (such as fever, chills, and/or hypotension) but no apparent source for the BSI except for the catheter.
To measure the surgery outcome of patients at 6, 12 and 24 weeks using the Oswestry Disability Index and the Euro Quality of Life (EuroQol). MATERIALS AND METHODS. Ninty-three out of a total of 311 patients who underwent spinal surgery at Bangkok Hospital between August 2010 and June 2011 and had completed their 6 months follow up. RESULTS AND CONCLUSION. The study found that surgery did improve the functionality of patients who had back pain due to radiculopathy, lumbar spinal stenosis, and herniated nucleus pulposus. Measured by ODI and Quality of Life (QOL) methodology, the treatment outcomes showed significant improvement.
OBJECTIVE.To use the Oswestry Disability Index (ODI) and Euro Quality of Life (EuroQol) as pre-screening assessment tools to improve surgery outcomes for patients with spinal disorders. MATERIALS AND METHODS.Prior to surgical intervention, 223 (out of 311 lumbar spine) patients who were eventually treated with surgery at Bangkok Spine Academy between August 2010 and June 2011, filled out the above mentioned questionnaires pre-operatively. ODI and EuroQol were used to assess their mobility, activities, pain, anxiety etc., which could help better determine their spine disability together with their medical history and physical examination. RESULTS. Mobility:Pre-operative 157 (92.9%) had problems, 12 (7.1%) had no problems. Self-care: Pre-operative 97 (57.4%) had problems, 72 (42.6%) had no problems. Usual activities: Pre-operative 157 (92.9%) had problems, 12 (7.1%) had no problems.Pain/discomfort: Pre-operative 167 (98.82%) had problems, 2 (1.18%) had no problems. Anxiety/depression: Pre-operative 137 (81.07%) had problems, 32 (18.93%) had no problems. CONCLUSION.All patients who underwent surgery for the treatment of low back pain were found to be having significant disability and restrictions in their lives; using the pre-operative ODI and EuroQol measurements they could be categorized as having moderate to severe disability.
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