Hand Hygiene Compliance in an Education and Research Hospital Intensive Care Units

Objective and Aim: Errors occurring during the provision of health services are medical errors. Hospital infections counted among these errors remain a serious health problem on the agenda. Hand hygiene is the most effective and cheapest way to prevent hospital infections, and it is also a method that can be easily applied by the healthcare worker. With hand hygiene compliance, it has been shown that one third of the hospital infections and even one third and half of the hospital infections occurring in intensive care are reduced. In this study, it was aimed to evaluate hand hygiene observation data retrospectively in intensive care units. Materials and Method: This study was carried out in Recep Tayyip Erdoğan University (RTEU) Training and Research Hospital Intensive Care Units (Internal Intensive Care, Surgical Intensive Care, Anesthesia Intensive Care, Cardiovascular Surgery Intensive Care, Coronary Intensive Care, Pediatric Intensive Care, Newborn Intensive Care) in 2016 and 2017. There were doctors, nurses and assistant health personnel among the healthcare professionals. Hand hygiene observation was made according to five basic indication rules. Results: In the Intensive Care Units (ICU), 255 health workers were evaluated in 2016 and 430 in 2017. The compliance rate in the ICU was evaluated as 86%. According to the five indication rules, the highest compliance was with 90-95% before aseptic procedures, after contamination with body fluids and after contact with the patient's environment. The least compliance was before contact with 60% of patients. According to professions, the compliance rate of physicians was 85%, nurses 95%, and assistant health personnel 90%. According to the units; The highest compliance was in the Surgical Intensive Care, Pediatrics and Neonatal Intensive Care Unit with 97%, and the least in the Anesthesia and Internal Medicine Intensive Care Units with 69% and 60% Discussion and Conclusion: Hand hygiene compliance; It is still below the desired levels, with regular training, evaluations and feedback. Hospital infections, especially for the prevention of intensive care infections, besides continuing education, rewarding practices will be more motivating for healthcare professionals here. It should develop and implement a feasible, acceptable, acceptable hand hygiene policy in hospitals.Keywords: Hand hygiene compliance, feedback, patient safety, intensive careDOI: 10.7176/JHMN/75-0

Central Sagittal Angle of the Sacrum as a New Risk Factor for Patients with Persistent Low Back Pain after Caesarean Section

Study DesignRetrospective.PurposeThis study investigated the possible association of persistent low back pain (LBP) with caesarean section (CS) under spinal anesthesia.Overview of LiteratureMany women suffer from LBP after CS, which is commonly performed under spinal anesthesia. However, this type of LBP is poorly understood, and there is poor consensus regarding increased risk after spinal anesthesia.MethodsWe examined two groups of patients who underwent cesarean delivery under spinal anesthesia. Group I included patients who presented to a neurosurgical clinic complaining of LBP for at least 6 months. Group II was a control group with patients without LBP. We analyzed clinical and sagittal angle parameters, including age, body mass index, parity, central sagittal angle of the sacrum (CSAS), and sacral slope (SS).ResultsFifty-three patients participated in this study: 23 (43.1%) in Group I and 30 (56.9%) in Group II. Non-parametric Mann–Whitney U-tests showed that age, parity, and CSAS significantly differed between the two groups at 6 months.ConclusionsAge, parity, and CSAS appear to be associated with increased risk for LBP after CS under spinal anesthesia. Future prospective studies on this subject may help validate our results

Unilateral Isolated Hypoglossal Nerve Palsy Caused by Gunshot Injury

WOS: 000427989400073PubMed: 29381638Cranial nerve palsies after gunshot injury are not uncommon. However, in the literature, only 1 patient with isolated hypoglossal nerve paralysis caused by gunshot has been published. the authors describe a 34-year-old man suffering from unilateral isolated hypoglossal nerve palsy caused by gunshot injury as a second reported patient. the bullet entered maxillary sinus, and caused condylar fracture, then ended up C1-2 interspace. the bullet was surgically removed by a posterior approach. It is important to pay attention to hypoglossal nerve injury when confronted with a gunshot wound. the authors recommend early and sufficient surgical decompression

Gender - didactics - interpretation : school Polish philology after performative turn

WOS: 000441502600010PubMed: 30005810Background and objectives: We compared the efficiency of the King Vision video laryngoscope and the Macintosh laryngoscope, when used by experienced anesthesiologists on adult patients with varying intubating conditions, in a prospective randomized controlled clinical trial. Methods: A total of 388 patients with an American Society of Anesthesiologists physical status of I or II, scheduled for general anesthesia with endotracheal intubation. Each patient was intubated with both laryngoscopes successively, in a randomized order. Intubation success rate, time to best glottic view, time to intubation, time to ventilation, Cormack-Lehane laryngoscopy grades, and complications related to the laryngoscopy and intubation were analyzed. Results and conclusions: First pass intubation success rates were similar for the King Vision and the Macintosh (96.6% vs. 94.3%, respectively, p > 0.05). King Vision resulted in a longer average time to glottic view (95% CI 0.5-1.4s, p < 0.001), and time to intubation (95% CI 3-4.6s, p< 0.001). the difference in time to intubation was similar when unsuccessful intubation attempts were excluded (95% CI 2.8-4.4s, p <0.001). Based on the modified Mallampati class at the preoperative visit, the King Vision improved the glottic view in significantly more patients (220 patients, 56.7%) compared with the Macintosh (180 patients, 46.4%) (p< 0.001). None of the patients had peripheral oxygen desaturation below 94%. Experienced anesthesiologists may obtain similar rates of first pass intubation success and airway trauma with both laryngoscopes. King Vision requires longer times to visualize the glottis and to intubate the trachea, but does not cause additional desaturation. (C) 2018 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda

Complication of Peribulbar Block: Brainstem Anaesthesia

WOS: 000410003200009PubMed: 28868171Peribulbar block is used to obtain anaesthesia and akinesia of the eye by injecting a local anaesthetic around the musclecone. A patient scheduled for cataract surgery received peribulbar block with 6 mL of 2% lidocaine hydrochloride. Following the injection, confusion, hypotension and dilatation of the contralateral pupil rapidly progressed to loss of consciousness and respiratory arrest. the patient was intubated and mechanically ventilated for 30 min. the patient regained her consciousness, was extubated and transferred to the intensive care unit for further follow-up. Although brainstem anaesthesia because of peribulbar block is very rare, this procedure should be performed with complete monitorisation and resuscitation equipment