This chapter addresses the fundamental nursing role and responsibility of preventing the risk of ... more This chapter addresses the fundamental nursing role and responsibility of preventing the risk of infection in all healthcare settings. Every nurse should possess the knowledge and skills to assess the risk of infection, to select and implement evidence-based strategies to prevention infection, and to review the effectiveness of these to inform any necessary changes in care. Healthcare-associated infection (HCAI) is the term used to describe an infection that arises as a result of some exposure to healthcare. Unlike the more traditional terms ‘hospital-acquired’ or ‘nosocomial’ infection, this updated term encompasses the range of settings in which healthcare is delivered and from which infections may arise. In recent years, much of the attention on HCAIs has focused on methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C. difficile), both of which are closely monitored in acute hospitals and in England as part of a programme of mandatory surveillance (Nati...
Hypothesis / aims of study Indwelling urinary catheters (IUCs) initially placed in hospital frequ... more Hypothesis / aims of study Indwelling urinary catheters (IUCs) initially placed in hospital frequently remain in place to become long-term catheters once the patient had been discharged, thus increasing the potential for intractable incontinence (1) . The continued overuse of IUCs in acute care has been well reported (2) . A large-scale continence audit in the UK observed that 26% of patients aged 65+ with urinary incontinence were given an IUC for containment purposes, compared with only 10% in care homes (3) . Current research aimed at reducing the use of IUCs in acute care focuses on removing IUCs already in situ rather than minimising initial use. This paper aims to progress from existing work to critically evaluate attempts to minimise the initial placement of IUCs by providing a systematic review of the evidence of the effectiveness of interventions to minimise the initial use of IUCs in adults in acute care.
Hypothesis/Aims of study Plain, uncoated PVC catheters for intermittent catheterisation (IC) have... more Hypothesis/Aims of study Plain, uncoated PVC catheters for intermittent catheterisation (IC) have the potential to be cleaned and re-used multiple times. Up until about 15 years ago this was standard practice in the UK – adults and children were taught to wash their catheters with soapy water and store them in a small container between uses. Regulatory changes around 2000 stopped re-use because catheter manufacturers were required to provide tested cleaning instructions or label their catheters ‘single-use’. Consequently, apart from a small number of metal catheters for women, single-use catheters became the only option for IC users. The UK’s almost exclusive use of single-use catheters is not the case in comparable countries (1) or in developing nations. In addition to the potential cost savings from catheter re-use, patients have reported advantages to both multi-use and single-use catheters (2). For example, being able to re-use a catheter reduces the fear of running out of suppl...
Background: Outbreaks of infectious diarrhoea and vomiting are a worldwide problem, with detrimen... more Background: Outbreaks of infectious diarrhoea and vomiting are a worldwide problem, with detrimental human and economic costs. In the United Kingdom, despite well-publicised guidelines and a plethora of recommended infection prevention and control strategies, hospital outbreaks are problematic - affecting patients and organisational operations. At present however, little is known about how hospital-based clinicians actually assess the infective status of patients with symptoms of diarrhoea and vomiting, whilst awaiting stool (faeces) microbiology results. Little is also known about the infection prevention and control measures that these clinicians employ in non-outbreak situations to prevent the spread of infection when infectious causes are suspected. These gaps in knowledge impede the ability of clinical leaders to appropriately support frontline staff in order to minimise incidences of avoidable outbreaks. This study therefore aimed to answer this question: How do clinicians in ...
ABSTRACTCatheter-associated urinary tract infections have serious consequences, both for patients... more ABSTRACTCatheter-associated urinary tract infections have serious consequences, both for patients and in impacting on healthcare resources. Much work has been carried out to develop an antimicrobial catheter. Although such developments have shown promise under laboratory conditions, none have demonstrated a clear advantage in clinical trials.Using a range of microbiological and advanced microscopy techniques, a detailed laboratory study comparing biofilm development on silicone, hydrogel latex and silver alloy coated hydrogel latex catheters was carried out. Biofilm development by Escherichia coli, Pseudomonas aeruginosa and Proteus mirabilis on three commercially available catheters was tracked over time. Samples were examined with episcopic differential interference contrast (EDIC) microscopy, culture analysis and staining techniques to quantify viable but non-culturable (VBNC) bacteria.Both qualitative and quantitative assessment found biofilms to develop rapidly on all three mat...
Archives of Disease in Childhood - Fetal and Neonatal Edition, 2019
We thank Pieter Degraeuwe for his letter and for highlighting the potential hidden risk of detect... more We thank Pieter Degraeuwe for his letter and for highlighting the potential hidden risk of detection bias.1 Our review focused specifically upon reducing central line-associated bloostream infections (CLABSIs) and while we accept that bloodstream infection for all forms of late-onset sepsis is a useful outcome measure, its use would have complicated the interpretation of results relating to reductions in CLABSI. 2 We agree that there are multiple challenges with using CLABSI as an outcome measure, including the variety of …
A key objective in the IPS research and development strategy is to increase research capability a... more A key objective in the IPS research and development strategy is to increase research capability and capacity among the Society’s membership. This article summarises the recent work of the IPS Research and Development Group. On the fiftieth anniversary of the appointment of the first infection control nurse the IPS are launching annual research awards to encourage research active practitioners to build and improve their research skills and make a significant contribution to evidence based practice in the specialty.
ObjectivesTo elucidate the views of intermittent catheter (IC) users regarding urinary tract infe... more ObjectivesTo elucidate the views of intermittent catheter (IC) users regarding urinary tract infection (UTI) symptom presentation, terminology for describing signs and symptoms, the cause of UTI and management strategies.DesignQualitative study with semi-structured interviews. The transcribed text was analysed thematically.Setting12 general practitioner (GP) surgeries in Hampshire and Dorset, UK.ParticipantsA convenience sample of 30 IC users, aged over 18, using IC for at least 3 months who had at least one self-reported UTI since starting IC.ResultsParticipants reported a variety of signs and symptoms, such as urine cloudiness and smell, as indicators of UTI. The terms used often differed from those in the modified National Institute on Disability and Rehabilitation Research (NIDRR) symptom set. IC users had difficulty distinguishing possible UTI symptoms from those of their comorbidities. They expressed uncertainty about the cause of UTI, often attributing it to poor hygiene and ...
Studies have shown that people who require single room isolation while in hospital often feel lon... more Studies have shown that people who require single room isolation while in hospital often feel lonely, sad, worried, bored and in need of information. A literature review identified only 16 papers reporting on the child's experience of isolation. Findings indicate that children feel lonely, are scared of the personal protective equipment and feel bored. Patients' parents feel guilty, worried and under increased pressure to visit their children. It is also suggested that isolation may affect child development.
Hypothesis / aims of study In the UK, catheters for intermittent catheterisation (IC) are used on... more Hypothesis / aims of study In the UK, catheters for intermittent catheterisation (IC) are used once and discarded although not necessarily the case in other countries including Canada and Australia. Those who do reuse catheters (multi-use) typically wash them with soap and water, let them air dry and then store them in a convenient portable container. Concerns raised about urinary tract infection rates with multiple use catheters are not supported by a 2014 Cochrane review (1). If individuals do reuse their catheters, it is critical that they and clinicians are confident in the cleaning method. To date, no systematic evaluation has evaluated cleaning methods. Thus the purpose of this study was to: 1) Identify and test potential cleaning methods for plain uncoated catheters and 2) Conduct clinical testing with IC users in their own homes.
This chapter addresses the fundamental nursing role and responsibility of preventing the risk of ... more This chapter addresses the fundamental nursing role and responsibility of preventing the risk of infection in all healthcare settings. Every nurse should possess the knowledge and skills to assess the risk of infection, to select and implement evidence-based strategies to prevention infection, and to review the effectiveness of these to inform any necessary changes in care. Healthcare-associated infection (HCAI) is the term used to describe an infection that arises as a result of some exposure to healthcare. Unlike the more traditional terms ‘hospital-acquired’ or ‘nosocomial’ infection, this updated term encompasses the range of settings in which healthcare is delivered and from which infections may arise. In recent years, much of the attention on HCAIs has focused on methicillin-resistant Staphylococcus aureus (MRSA) and Clostridium difficile (C. difficile), both of which are closely monitored in acute hospitals and in England as part of a programme of mandatory surveillance (Nati...
Hypothesis / aims of study Indwelling urinary catheters (IUCs) initially placed in hospital frequ... more Hypothesis / aims of study Indwelling urinary catheters (IUCs) initially placed in hospital frequently remain in place to become long-term catheters once the patient had been discharged, thus increasing the potential for intractable incontinence (1) . The continued overuse of IUCs in acute care has been well reported (2) . A large-scale continence audit in the UK observed that 26% of patients aged 65+ with urinary incontinence were given an IUC for containment purposes, compared with only 10% in care homes (3) . Current research aimed at reducing the use of IUCs in acute care focuses on removing IUCs already in situ rather than minimising initial use. This paper aims to progress from existing work to critically evaluate attempts to minimise the initial placement of IUCs by providing a systematic review of the evidence of the effectiveness of interventions to minimise the initial use of IUCs in adults in acute care.
Hypothesis/Aims of study Plain, uncoated PVC catheters for intermittent catheterisation (IC) have... more Hypothesis/Aims of study Plain, uncoated PVC catheters for intermittent catheterisation (IC) have the potential to be cleaned and re-used multiple times. Up until about 15 years ago this was standard practice in the UK – adults and children were taught to wash their catheters with soapy water and store them in a small container between uses. Regulatory changes around 2000 stopped re-use because catheter manufacturers were required to provide tested cleaning instructions or label their catheters ‘single-use’. Consequently, apart from a small number of metal catheters for women, single-use catheters became the only option for IC users. The UK’s almost exclusive use of single-use catheters is not the case in comparable countries (1) or in developing nations. In addition to the potential cost savings from catheter re-use, patients have reported advantages to both multi-use and single-use catheters (2). For example, being able to re-use a catheter reduces the fear of running out of suppl...
Background: Outbreaks of infectious diarrhoea and vomiting are a worldwide problem, with detrimen... more Background: Outbreaks of infectious diarrhoea and vomiting are a worldwide problem, with detrimental human and economic costs. In the United Kingdom, despite well-publicised guidelines and a plethora of recommended infection prevention and control strategies, hospital outbreaks are problematic - affecting patients and organisational operations. At present however, little is known about how hospital-based clinicians actually assess the infective status of patients with symptoms of diarrhoea and vomiting, whilst awaiting stool (faeces) microbiology results. Little is also known about the infection prevention and control measures that these clinicians employ in non-outbreak situations to prevent the spread of infection when infectious causes are suspected. These gaps in knowledge impede the ability of clinical leaders to appropriately support frontline staff in order to minimise incidences of avoidable outbreaks. This study therefore aimed to answer this question: How do clinicians in ...
ABSTRACTCatheter-associated urinary tract infections have serious consequences, both for patients... more ABSTRACTCatheter-associated urinary tract infections have serious consequences, both for patients and in impacting on healthcare resources. Much work has been carried out to develop an antimicrobial catheter. Although such developments have shown promise under laboratory conditions, none have demonstrated a clear advantage in clinical trials.Using a range of microbiological and advanced microscopy techniques, a detailed laboratory study comparing biofilm development on silicone, hydrogel latex and silver alloy coated hydrogel latex catheters was carried out. Biofilm development by Escherichia coli, Pseudomonas aeruginosa and Proteus mirabilis on three commercially available catheters was tracked over time. Samples were examined with episcopic differential interference contrast (EDIC) microscopy, culture analysis and staining techniques to quantify viable but non-culturable (VBNC) bacteria.Both qualitative and quantitative assessment found biofilms to develop rapidly on all three mat...
Archives of Disease in Childhood - Fetal and Neonatal Edition, 2019
We thank Pieter Degraeuwe for his letter and for highlighting the potential hidden risk of detect... more We thank Pieter Degraeuwe for his letter and for highlighting the potential hidden risk of detection bias.1 Our review focused specifically upon reducing central line-associated bloostream infections (CLABSIs) and while we accept that bloodstream infection for all forms of late-onset sepsis is a useful outcome measure, its use would have complicated the interpretation of results relating to reductions in CLABSI. 2 We agree that there are multiple challenges with using CLABSI as an outcome measure, including the variety of …
A key objective in the IPS research and development strategy is to increase research capability a... more A key objective in the IPS research and development strategy is to increase research capability and capacity among the Society’s membership. This article summarises the recent work of the IPS Research and Development Group. On the fiftieth anniversary of the appointment of the first infection control nurse the IPS are launching annual research awards to encourage research active practitioners to build and improve their research skills and make a significant contribution to evidence based practice in the specialty.
ObjectivesTo elucidate the views of intermittent catheter (IC) users regarding urinary tract infe... more ObjectivesTo elucidate the views of intermittent catheter (IC) users regarding urinary tract infection (UTI) symptom presentation, terminology for describing signs and symptoms, the cause of UTI and management strategies.DesignQualitative study with semi-structured interviews. The transcribed text was analysed thematically.Setting12 general practitioner (GP) surgeries in Hampshire and Dorset, UK.ParticipantsA convenience sample of 30 IC users, aged over 18, using IC for at least 3 months who had at least one self-reported UTI since starting IC.ResultsParticipants reported a variety of signs and symptoms, such as urine cloudiness and smell, as indicators of UTI. The terms used often differed from those in the modified National Institute on Disability and Rehabilitation Research (NIDRR) symptom set. IC users had difficulty distinguishing possible UTI symptoms from those of their comorbidities. They expressed uncertainty about the cause of UTI, often attributing it to poor hygiene and ...
Studies have shown that people who require single room isolation while in hospital often feel lon... more Studies have shown that people who require single room isolation while in hospital often feel lonely, sad, worried, bored and in need of information. A literature review identified only 16 papers reporting on the child's experience of isolation. Findings indicate that children feel lonely, are scared of the personal protective equipment and feel bored. Patients' parents feel guilty, worried and under increased pressure to visit their children. It is also suggested that isolation may affect child development.
Hypothesis / aims of study In the UK, catheters for intermittent catheterisation (IC) are used on... more Hypothesis / aims of study In the UK, catheters for intermittent catheterisation (IC) are used once and discarded although not necessarily the case in other countries including Canada and Australia. Those who do reuse catheters (multi-use) typically wash them with soap and water, let them air dry and then store them in a convenient portable container. Concerns raised about urinary tract infection rates with multiple use catheters are not supported by a 2014 Cochrane review (1). If individuals do reuse their catheters, it is critical that they and clinicians are confident in the cleaning method. To date, no systematic evaluation has evaluated cleaning methods. Thus the purpose of this study was to: 1) Identify and test potential cleaning methods for plain uncoated catheters and 2) Conduct clinical testing with IC users in their own homes.
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