Nursing & Health
Permanent URI for this collectionhttps://research.avondale.edu.au/handle/123456789/457
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Item Cleaning Time and Motion: An Observational Study on the Time Required to Clean Shared Medical Equipment in Hospitals Effectively(Elsevier, 2024) Matterson, Georgia; Browne, Katrina; Tehan, Peta E.; Russo, Philip L.; Kiernan, Martin; Mitchell, Brett G.Background Despite the important role that cleaning plays in reducing the risk of healthcare-associated infections, no research has been undertaken to quantify the time required for effective cleaning and disinfection of different pieces of shared medical equipment commonly used in hospitals. This short report presents the results from a study that aimed to quantify the time required to clean common pieces of shared medical equipment effectively. Methods An observational time and motion study was conducted in a nursing simulation laboratory to determine the time required for effective cleaning and disinfection of 12 pieces of shared medical equipment commonly used in hospital. After training, the participants cleaned and disinfected equipment, with the time taken to clean recorded. Cleaning was deemed to be effective if ≥80% of ultraviolet fluorescent dots were removed during the cleaning process. Main results The time to clean equipment effectively ranged from 50 s [blood glucose testing kit; 95% confidence interval (CI) 0:40–1:00 (min:s)] to 3 min 53 s [medication trolley; 95% CI 3:36–4:11 (min:s)]. The intravenous stand was cleaned most effectively, with 100% of dots removed (N = 100 dots). In contrast, the bladder scanner was the most difficult to clean, with 12 attempts required to meet the 80% threshold for effective cleaning. Conclusion This study will inform staffing and training requirements to plan the cleaning and disinfection of shared medical equipment effectively. The findings can also be used for business cases, and in future cost-effectiveness evaluations of cleaning interventions that include shared medical equipment.Item Air Purifiers and Acute Respiratory Infections: A Randomised Clinical Trial(JAMA Network, 2024) Thottiyil Sultanmuhammed Abdul Khadar, Bismi; Sim, Jenny; McDonald, Vanessa M.; McDonagh, Julee; Clapham, Matthew; Mitchell, Brett G.Importance The effectiveness of in-room air purification for the reduction of acute respiratory infections (ARIs) in residential aged-care facilities (RACFs) is unknown. Objective To investigate the effectiveness of in-room air purifiers with high-efficiency particulate air (HEPA)–14 filters in reducing the incidence of ARIs among residents of RACFs. Design, Setting, and Participants This randomized clinical trial used a multicenter, double-blind, 2-period, 2-treatment crossover design for 6 months from April 7 to October 26, 2023, in 3 RACFs with a bed capacity of 50 to 100 in New South Wales, Australia. The purposive sampling approach included permanent residents in private rooms in the enrolled RACFs. Data collection was performed every 2 weeks and required no additional follow-up beyond the final data collection on October 31, 2023. Intervention An air purifier containing a HEPA-14 filter was placed in rooms of participants in the intervention group, and an air purifier without a HEPA-14 filter was placed in rooms of the control participants. The groups crossed over after 3 months. Main Outcomes and Measures The primary outcome was the incidence of ARIs, assessed with logistic mixed-model regression. Results Among 135 participants randomized (70 to the intervention-first group and 65 to the control-first group), 78 (57.8%) were female; mean (SD) age was 85.2 (8.6) years. In the intention-to-treat analysis, the use of air purifiers with HEPA-14 filters did not reduce ARIs compared with the control (OR, 0.57; 95% CI, 0.32-1.04; P = .07). Among the 104 participants who completed the entire study, the intervention reduced ARI incidence from 35.6% (37 participants) in the control group to 24.0% (25 participants) in the intervention group (OR, 0.53; 95% CI, 0.28-1.00; P = .048). Conclusions and Relevance In this clinical trial investigating use of air purifiers with HEPA-14 filters for reducing ARIs, no significant between-group difference was found in the intention-to-treat analysis. However, a significant reduction in ARIs was identified among participants who completed the entire study. These findings may help inform future large-scale studies of respiratory infectious diseases.Item Oral Care Practices and Hospital-acquired Pneumonia Prevention: A National Survey of Australian Nurses(Elsevier, 2024) Tehan, Peta E.; Browne, Katrina; Matterson, Georgia; Cheng, Allen C.; Dawson, Sonja; Graves, Nicholas; Johnson, Douglas; Kiernan, Martin; Madhuvu, Auxillia; Marshall, Caroline; McDonagh, Julee; Northcote, Maria; O'Connor, Jayne; Orr, Liz; Rawson, Helen; Russo, Philip; Sim, Jenny; Stewardson, Andrew J.; Wallace, Janet; White, Nicole; Wilson, Rhonda; Mitchell, Brett G.Background Hospital-acquired pneumonia (HAP) also known as non-ventilator associated pneumonia, is one of the most common infections acquired in hospitalised patients. Improving oral hygiene appears to reduce the incidence of HAP. This study aimed to describe current practices, barriers and facilitators, knowledge and educational preferences of registered nurses performing oral health care in the Australian hospital setting, with a focus on the prevention of HAP. We present this as a short research report. Methods We undertook a cross sectional online anonymous survey of Australian registered nurses. Participants were recruited via electronic distribution through existing professional networks and social media. The survey used was modified from an existing survey on oral care practice. Results The survey was completed by 179 participants. Hand hygiene was considered a very important strategy to prevent pneumonia (n = 90, 58%), while 45% (n = 71) felt that oral care was very important. The most highly reported barriers for providing oral care included: an uncooperative patient; inadequate staffing; and a lack of oral hygiene requisite. Patients' reminders, prompts and the provision of toothbrushes were common ways believed to help facilitate improvements in oral care. Conclusion Findings from this survey will be used in conjunction with consumer feedback, to help inform a planned multi-centre randomised trial, the Hospital Acquired Pneumonia PrEveNtion (HAPPEN) study, aimed at reducing the incidence of HAP. Findings may also be useful for informing studies and quality improvement initiatives aimed at improving oral care to reduce the incidence of HAP.Item Which Trial do we Need? Gown and Glove use Versus Standard Precautions for Patients Colonized or Infected with methicillin-resistant Staphylococcus aureus or vancomycin-resistant Enterococcus(Elsevier, 2024-08) Browning, Sarah; White, Nicole M.; Raby, Edward; Davis, Joshua S.; Mitchell, Brett G.Background Gown and glove use as a component of ‘contact precautions’ was first recommended by the United States Healthcare Infection Control Practices Advisory Committee in 1996 and remains widely adhered to today. Despite a lack of randomized trial evidence in support of this practice, donning of gowns and gloves upon entry to the patient area (room or cubicle) continues to be ‘strongly recommended’ when the patient is infected or colonized with pathogens of epidemiological importanceItem Infection Prevention and Control Programme Priorities for Sustainable Health and Environmental Systems(Springer Nature, 2024-02-01) Saravanos, Gemma L.; Islam, Md Saiful; Huang, Yuanfei; Basseal, Jocelyne M.; Seale, Holly; Mitchell, Brett G.; Sheel, MeruInfection prevention and control (IPC) programmes reduce infection risk for patients, health workers, and the community. They are fundamental to achieving resilient, responsive, and sustainable health systems that align with the Sustainable Development Goals. Paradoxically, IPC programmes contribute to environmental harm, and this must be addressed alongside longstanding programme priorities.Item Patient Perspectives of Healthcare Associated Infection(Australasian College for Infection Prevention and Control, 2022) Mitchell, Brett G.; Northcote, Maria; Rickett, Carolyn; Russo, Phil; Amin, Maham; De Souza, Fiona; Pearce, Kirsty; Sim, Jenny; Curryer, CassieItem Healthcare-associated Infections in Australia : Principles and Practice of Infection Prevention and Control.(Elsevier, 2024) Mitchell, Brett G.; Shaban, Ramon Z.; Russo, Philip L.; MacBeth, DeboroughItem A Point Prevalence Study of Healthcare Associated Urinary Tract Infections in Australian Acute and Aged Care Faciltiies(2016-11-01) Gardner, Anne; Bennett, Noleen; Beckingham, Wendy; Fasugba, Oyebola; Mitchell, Brett G.Most healthcare-associated urinary tract infections (HAUTIs) including catheter associated urinary tract infections (CAUTIs) are potentially preventable through implementation of effective strategies. To provide the foundation for a national point prevalence study of HAUTIs including CAUTIs, a three phase project was developed. This study reports the findings of Phase II which aimed to (1) pilot an online process including online database for conducting point prevalence survey of HAUTIs and CAUTIs and (2) determine the point prevalence of HAUTIs and CAUTIs in acute and aged care facilities
Item Protocol for a Randomised Clinical Trial Investigating the Clinical Effectiveness and Cost Benefit of a Lifestyle Intervention Targeting Type 2 Diabetes Mellitus(2017-09-01) Morton, Darren; Mitchell, Brett G.; Cloete, LindaItem Antimicrobial Resistance Among Urinary Tract Infection Isolates of Escheria Coli in an Australian Population-Based Sample(2014-08-01) Mitchell, Brett G.; Mnatzaganian, George; Gardner, Anne; Fasugba, Oyebola