Nursing & Health
Permanent URI for this collectionhttps://research.avondale.edu.au/handle/123456789/457
Browse
Search Results
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 Roles, Responsibilities and Scope of Practice: Describing the ‘State of Play’ for Infection Control Professionals in Australia and New Zealand(2015-03-01) Mitchell, Brett G.; Gardner, Anne; MacBeth, Deborough; Halton, Kate; Hall, LisaBackground: In the past decade the policy and practice context for infection control in Australia and New Zealand has changed, with infection control professionals (ICPs) now involved in the implementation of a large number of national strategies. Little is known about the current ICP workforce and what they do in their day-to-day positions. The aim of this study was to describe the ICP workforce in Australia and New Zealand with a focus on roles, responsibilities, and scope of practice.
Methods: A cross-sectional design using snowball recruitment was employed. ICPs completed an anonymous web-based survey with questions on demographics; qualifications held; level of experience; workplace characteristics; and roles and responsibilities. Chi-squared tests were used to determine if any factors were associated with how often activities were undertaken.
Results: A total of 300 ICPs from all Australian states and territories and New Zealand participated. Most ICPs were female (94%); 53% were aged over 50, and 93% were employed in registered nursing roles. Scope of practice was diverse: all ICPs indicated they undertook a large number and variety of activities as part of their roles. Some activities were undertaken on a less frequent basis by sole practitioners and ICPs in small teams.
Conclusion: This survey provides useful information on the current education, experience levels and scope of practice of ICPs in Australia and New Zealand. Work is now required to establish the best mechanisms to support and potentially streamline scope of practice, so that infection-control practice is optimised.
Item Preventing Healthcare Associated Infections: The Role of Surveillance(2015-02-04) Russo, Philip; Mitchell, Brett G.Surveillance of healthcare-associated infections is central to healthcare epidemiology and infection control programmes and a critical factor in the prevention of these infections. By definition, the term ‘infection prevention’ implies that healthcare-associated infections may be preventable. The purpose of surveillance is to provide quality data that can be used in an effective monitoring and alert system and to reduce the incidence of preventable healthcare-associated infections. This article examines the purpose of surveillance, explains key epidemiological terms, provides an overview of approaches to surveillance and discusses the importance of validation.
Item Australian Graduating Nurses’ Knowledge, Intentions and Beliefs on Infection Prevention and Control: A Cross-Sectional Study(2014-12-12) Matheson, Lucinda; Cloete, Linda; Wilson, Fiona; Wells, Anne; Say, Richard; Mitchell, Brett G.Background: In recent year, national bodies have been actively addressing the increasing concern on the spread of healthcare-associated infections (HAIs). The current study measures the knowledge, intentions and beliefs of third-year Australian nursing students on key infection prevention and control (IPC) concepts.
Methods: A cross-sectional study of final-year undergraduate nursing students from Schools of Nursing at six Australian universities was undertaken. Students were asked to participate in an anonymous survey. The survey explored knowledge of standard precautions and transmission based precautions. In addition intentions and beliefs towards IPC were explored.
Results: 349 students from six universities completed the study. 59.8% (95% CI 58.8–60.8%) of questions were answered correctly. Significantly more standard precaution questions were correctly answered than transmission-based precaution questions (p < 0.001). No association was found between self-reported compliance with IPC activities and gender or age. Certain infection control issues were correlated with the percentage of correctly answered transmission-based precaution questions. The participants were most likely to seek infection control information from an infection control professional.
Conclusion: Knowledge on transmission-based precautions was substandard. As transmission-based precautions are the foundation of IPC for serious organisms and infections, education institutions should reflect on the content and style of educational delivery on this topic.
Item Gender Differences in Effectiveness of the Complete Health Improvement Program (CHIP) Lifestyle Intervention: An Australasian Study(2014-12-05) Diehl, Hans; Chang, Esther; Mitchell, Brett G.; Rankin, Paul; Morton, Darren; Kent, LillianIssue addressed: Complete Health Improvement Program (CHIP) is a lifestyle modification program that promotes healthy diet, physical activity and stress management techniques. Among US CHIP participants, differences in gender responsiveness to improvements in chronic disease risk factors were demonstrated. This study examined gender differences in outcomes to the CHIP intervention in Australasia.
Methods: Changes in body weight, blood pressure (BP), blood lipid profile and fasting plasma glucose (FPG) were assessed in 925 participants (34.3% men, mean age = 56.0 ± 12.5 years; 65.7% women, mean age = 54.4 ± 13.5 years) 30 days after program commencement.
Results: Significant reductions (P < 0.001) in all biometrics measured were found for men and women but were greater among men for total (TC) and low-density lipoprotein cholesterol (LDL), triglycerides (TG), FPG, body mass index (BMI) and TC/high-density lipoprotein cholesterol (HDL) ratio. Participants with highest baseline classifications of BMI, systolic BP, blood lipids and FPG showed greatest reductions in 30 days.
Conclusions: CHIP more effectively reduced chronic disease risk factors among men than women. All participants, but particularly men, entering the program with the greatest risk achieved the largest reductions. Possible physiological or behavioural factors include food preferences, making commitments and differential support modes.
So what?: Developers of lifestyle intervention programs should consider gender differences in physiological and behavioural factors when planning interventions. In particular, developers should manage expectations of people entering lifestyle interventions to increase awareness that men tend to respond better than women. In addition, this is a call for further research to identify the underlying mechanisms responsible for the disproportionate responsiveness of males.
Item Prior Room Occupancy Increases Risk of Methicillin-Resistant Staphylococcus Aureus Acquisition(2014-12-01) Ferguson, John K.; Digney, Wilhelmine; Mitchell, Brett G.Background: In Australia, little is known about the risk of acquiring methicillin-resistant Staphylococcus aureus(MRSA) from prior room occupants. The aims of the study are to understand the risk ofMRSAacquisition from prior room occupants and to further extend the existing knowledge-base on the role of discharge cleaning in hospitals.
Methods: A non-concurrent cohort study was undertaken in five wards at a 250-bed general hospital in Tasmania, Australia. All admitted patients were screened for MRSA. Weekly screenings for all patients who remained in hospital were undertaken. New MRSA acquisitions were identified. The exposed group were patients whose immediate prior room occupant had MRSA, while the unexposed prior room occupant did not have MRSA.
Results: 6228 patients were at risk of acquiringMRSA,with 237 newMRSAacquisitions equating to an acquisition rate of 3.8% for each at-risk patient admission. The unadjusted odds ratio for acquiring MRSA when the prior room occupant had MRSA was 2.9 (95% CI 2.2–3.9). Using logistic regression, exposure to a prior occupant harbouring MRSA remained a significant predictor of subsequent acquisition, after controlling for variables, OR 2.7 (95% CI 2.0–3.6).
Conclusion: Admission to a room previously occupied by a person with MRSA increased the odds of acquisition for the subsequent patient, independent of other risk factors. It demonstrates the necessity of having effective discharge cleaning practices in place. We believe increased attention to discharge room cleaning in hospitals is required and the reconsideration of additional recommendations for discharge cleaning.