Should automated electronic hand hygiene monitoring systems be implemented in routine patient care? Systematic review and appraisal with Medical Research Council Framework for Complex Interventions

Manual hand-hygiene audit is time-consuming, labour-intensive and inaccurate. Automated hand-hygiene monitoring systems (AHHMSs) offer advantages (generation of standardized data, avoidance of the Hawthorne effect). World Health Organization Guidelines for Hand Hygiene published in 2009 suggest that AHHMSs are a possible alternative. The objective of this review was to assess the current state of the literature for AHHMSs and offer recommendations for use in real-world settings. This was a systematic literature review, and publications included were from the time that PubMed commenced until 19th November 2023. Forty-three publications met the criteria. Using the Medical Research Council's Framework for Developing and Evaluating Complex Interventions, two were categorized as intervention development studies. Thirty-nine were evaluations. Two described implementation in real-world settings. Most were small scale and short duration. AHHMSs in conjunction with additional intervention (visual or auditory cue, performance feedback) could increase hand hygiene compliance in the short term. Impact on infection rates was difficult to determine. In the few publications where costs and resources were considered, time devoted to improving hand hygiene compliance increased when an AHHMS was in use. Health workers' opinions about AHHMSs were mixed. In conclusion, at present too little is known about the longer-term advantages of AHHMSs to recommend uptake in routine patient care. Until more longer-term accounts of implementation (over 12 months) become available, efforts should be made to improve direct observation of hand hygiene compliance to improve its accuracy and credibility. The Medical Research Council Framework could be used to categorize other complex interventions involving use of technology to prevent infection to help establish readiness for implementation

Survey to explore understanding of the principles of aseptic technique: Qualitative content analysis with descriptive analysis of confidence and training

BACKGROUND: In many countries, aseptic procedures are undertaken by nurses in the general ward setting, but variation in practice has been reported, and evidence indicates that the principles underpinning aseptic technique are not well understood. METHODS: A survey was conducted, employing a brief, purpose-designed, self-reported questionnaire. RESULTS: The response rate was 72%. Of those responding, 65% of nurses described aseptic technique in terms of the procedure used to undertake it, and 46% understood the principles of asepsis. The related concepts of cleanliness and sterilization were frequently confused with one another. Additionally, 72% reported that they not had received training for at least 5 years; 92% were confident of their ability to apply aseptic technique; and 90% reported that they had not been reassessed since their initial training. Qualitative analysis confirmed a lack of clarity about the meaning of aseptic technique. CONCLUSION: Nurses' understanding of aseptic technique and the concepts of sterility and cleanliness is inadequate, a finding in line with results of previous studies. This knowledge gap potentially places patients at risk. Nurses' understanding of the principles of asepsis could be improved. Further studies should establish the generalizability of the study findings. Possible improvements include renewed emphasis during initial nurse education, greater opportunity for updating knowledge and skills post-qualification, and audit of practice

Parton energy loss limits and shadowing in Drell-Yan dimuon production

A precise measurement of the ratios of the Drell-Yan cross section per nucleon for an 800 GeV/c proton beam incident on Be, Fe and W targets is reported. The behavior of the Drell-Yan ratios at small target parton momentum fraction is well described by an existing fit to the shadowing observed in deep-inelastic scattering. The cross section ratios as a function of the incident parton momentum fraction set tight limits on the energy loss of quarks passing through a cold nucleus

Gluon distributions in nucleons and pions at a low resolution scale

In this paper we study the gluon distribution functions in nucleons and pions at a low resolution $Q^2$ scale. This is an important issue since parton densities at low $Q^2$ have always been taken as an external input which is adjusted through DGLAP evolution to fit the experimental data at higher scales. Here, in the framework of a model recently developed, it is shown that the hypothetical cloud of {\it neutral} pions surrounding nucleons and pions appears to be responsible for the characteristic valence-like gluon distributions needed at the inital low scale. As an additional result, we get the remarkable prediction that neutral and charged pions have different intrinsic sea flavor contents.Comment: final version to appear in Phys. Rev. D. Discussion on several points enlarge

Measurement of Angular Distributions of Drell-Yan Dimuons in p+pp + p Interactions at 800 GeV/c

We report a measurement of the angular distributions of Drell-Yan dimuons produced using an 800 GeV/c proton beam on a hydrogen target. The polar and azimuthal angular distribution parameters have been extracted over the kinematic range $4.5 < m_{\mu \mu} < 15$ GeV/c$^2$ (excluding the $\Upsilon$ resonance region), $0 < p_T < 4$ GeV/c, and $0 < x_F < 0.8$. The $p+p$ angular distributions are similar to those of $p+d$, and both data sets are compared with models which attribute the $\cos 2 \phi$ distribution either to the presence of the transverse-momentum-dependent Boer-Mulders structure function $h_1^\perp$ or to QCD effects. The data indicate the presence of both mechanisms. The validity of the Lam-Tung relation in $p+p$ Drell-Yan is also tested.Comment: 4 pages, 3 figure

dbar/ubar Asymmetry and the Origin of the Nucleon Sea

The Drell-Yan cross section ratios, $\sigma(p+d)/\sigma(p+p)$, measured in Fermilab E866, have led to the first determination of $\bar d(x) / \bar u(x)$, $\bar d(x) - \bar u(x)$, and the integral of $\bar d(x) - \bar u(x)$ for the proton over the range $0.02 \le x \le 0.345$. The E866 results are compared with predictions based on parton distribution functions and various theoretical models. The relationship between the E866 results and the NMC measurement of the Gottfried integral is discussed. The agreement between the E866 results and models employing virtual mesons indicates these non-perturbative processes play an important role in the origin of the $\bar d$, $\bar u$ asymmetry in the nucleon sea.Comment: 5 pages, 3 figures, ReVTe

Measurement of Angular Distributions of Drell-Yan Dimuons in p + d Interaction at 800 GeV/c

We report a measurement of the angular distributions of Drell-Yan dimuons produced using an 800 GeV/c proton beam on a deuterium target. The muon angular distributions in polar angle $\theta$ and azimuthal angle $\phi$ have been measured over the kinematic range $4.5 < m_{\mu \mu} < 15$ GeV/c$^2$, $0 < p_T < 4$ GeV/c, and $0 < x_F < 0.8$. No significant cos$2\phi$ dependence is found in these proton-induced Drell-Yan data, in contrast to the situation for pion-induced Drell-Yan. The data are compared with expectations from models which attribute the cos$2\phi$ distribution to a QCD vacuum effect or to the presence of the transverse-momentum-dependent Boer-Mulders structure function $h_1^\perp$. Constraints on the magnitude of the sea-quark $h_1^\perp$ structure functions are obtained.Comment: 4 pages, 3 figure