Knowledge of intensive care nurses in selected care areas commonly guided by protocols

The purpose of this study was to determine the knowledge of nurses working in ICU with respect to pain management, glycaemic control and weaning from mechanical ventilation, care areas that are commonly guided by protocols. The effect of formal ICU training and years of ICU experience on this knowledge was elicited. A non-experimental, descriptive and contextual two-phase research design was used. The first phase of the study consisted of developing and validating a data collection instrument, using purposive sampling to select two groups of ICU nursing experts. The second phase of the study used the instrument developed in phase one to test the knowledge of nurses working in ICU. The knowledge of 136 ICU nurses (68 ICU trained and 68 non-ICU trained) from three (n=3) public sector and two (n=2) private sector hospitals in Gauteng was tested using the data collection instrument developed by the researcher and the two groups of ICU nursing experts. Knowledge of nurses, both ICU trained and non-ICU trained, working in the ICUs of three public and two private hospitals in Gauteng was found to be lacking in the three care areas tested in this study, namely pain management, glycaemic control and weaning from mechanical ventilation. The difference in knowledge between ICU trained and non-ICU trained nurses was statistically significant but relatively small. A weak correlation was found between level of knowledge and years of ICU experience. Recommendations to address this lack of knowledge of ICU nurses are given for clinical nursing practice, nursing management and nursing educators, as well as recommendations for further research in this area

Enhancing vaccine design strategies : applications for protein science, proteomics and adjuvants

Vaccines have saved millions of lives. Currently, and for infectious diseases in humans at least, sanitation and vaccination remain the most efficient and the most cost- effective prophylactic treatment available. Vaccination has led to the global eradiation of smallpox, the virtual eradication of polio and a reduction of over 95% in the incidence of diphtheria, tetanus, pertussis, measles, mumps and rubella. [1] Indeed, successful vaccine strategies have circumvented mortality caused by infectious diseases in developed countries and have thus increased our lifespan. [1] Today’s society in developed countries has a life expectancy of more than 80 years, and there is a higher proportion of elderly to young people. However, there remains a continued need for the development of new vaccines to offer protection for infections where we currently have no effective vaccine (infections such as malaria or human immunodeficiency virus) and have recurrent diseases (such as tuberculosis, respiratory syncytial virus, influenza A and B), plus newly emergent diseases, such as West Nile fever or Ebola. Vaccination is also increasingly recognised as an important strategy for food security, by providing protection to livestock against existing and emerging pathogens

Burnout among anaesthetists in South Africa

Background: Studies have been done to determine the level of burnout in anaesthesiology internationally, but not in South Africa.Method: The Maslach Burnout Inventory-Human Services Survey was used to assess the level of burnout. The primary objectives were to estimate the level of burnout among doctors working in the Department of Anaesthesiology at the University of the Witwatersrand (Wits doctors) and to estimate the level of burnout among private anaesthetist attending an anaesthetic symposium (Private doctors).Results: High levels of burnout were identified in 21.0% of Wits doctors. Higher burnout scores were noted in female doctors (p = 0.49), less years of anaesthetic experience (p = 0.37), doctors of younger age (p = 0.07), registrars (p = 0.22) and writing examinations within three months of completing the survey (p = 0.15), but none where statistically significant. High levels of burnout were identified in 8.1% of Private doctorsConclusion: High levels of burnout were identified, especially, among anaesthetists working in the academic hospitals affiliated to Wits.Keywords: anaesthetist, burnout, depersonalisation, emotional exhaustion, personal accomplishmen

Microbial contamination and labelling of self-prepared, multi-dose phenylephrine solutions used at a teaching hospital

Background: Common practice at Chris Hani Baragwanath Academic Hospital (CHBAH) is to use boluses from a self-prepared, multi-dose phenylephrine solution to treat spinal anaesthesia-induced hypotension in patients undergoing a Caesarean section. The aims of this study were to determine if there was microbial contamination of the solutions and to evaluate whether healthcare workers adhered to appropriate labelling and aspiration practices.Methods: A sample was collected and the labelling data were documented from the solutions found in the two obstetric theatres at CHBAH over a three-month period. The samples were sent to a laboratory for microbial investigation.Results: Microbial contamination was identified in 6.4% of samples collected. The name of the solution was indicated on 100% of the containers and the concentration of the solution was on 96.4%. The date the solution was prepared was indicated on 74.6% of containers and the time the solution was prepared was on 57.3%. Only 8.2% of healthcare workers who prepared the solution confirmed it by placing a signature on the container. Labelling data were written directly on 100% of the containers and a spikedevice was used in 64.5% of the containers.Conclusions: This study demonstrated microbial contamination of the solution and may indicate an infection hazard. Healthcare workers also did not adhere to appropriate labelling and aspiration practices. This is important for all patients from a patient safety perspective and the need to improve quality of care.Keywords: contamination, microbial, multi-dose, phenylephrine, self-prepared solution

The Perceptions and Effects of Sleep Deprivation in a Department of Anesthesiology

Background and Objective Sleep deprivation has multiple pathophysiological, psychological and cognitive effects. The effects of sleep deprivation on anesthetists have been recognized both within and outside of the workplace. This study investigated the perceived effects of sleep deprivation on anesthetists. To document the longest time spent without sleep due to work schedule, to describe the perceptions of the effects of sleep deprivation and the degree of sleepiness and daytime fatigue symptoms using the Epworth Sleepiness Scale (ESS) and to describe measures taken by anesthetists to overcome sleepiness. Methods A prospective, contextual, descriptive research design was followed for the study. A convenience sample of anesthetists completed a questionnaire regarding perceptions and effects of sleep deprivation and the ESS. Data were descriptively analyzed. Results The mean [standard deviation (SD)] longest time spent without sleep due to work schedule was 31 (9.1) hours and all anesthetists felt that they had insufficient sleep due to work schedule, with 61 (57%) stating this occurred 1 to 2 nights per week. Effects of sleep deprivation included effects on academic development, feeling tired at work, difficulty in concentrating at work and feeling stressed or irritable. Dozing off in theatre both during a night call and a day shift at different frequencies were reported. Other effects on family and social life were described. The mean (SD) ESS score was 11.5 (4.4). Conclusions Anesthetists reported perceptions of inadequate sleep and the subsequent effects both at work and at home. Further research to determine the extent of sleep deprivation amongst anesthetists in South Africa is suggested

Designing liposomal adjuvants for the next generation of vaccines

Liposomes not only offer the ability to enhance drug delivery, but can effectively act as vaccine delivery systems and adjuvants. Their flexibility in size, charge, bilayer rigidity and composition allow for targeted antigen delivery via a range of administration routes. In the development of liposomal adjuvants, the type of immune response promoted has been linked to their physico-chemical characteristics, with the size and charge of the liposomal particles impacting on liposome biodistribution, exposure in the lymph nodes and recruitment of the innate immune system. The addition of immunostimulatory agents can further potentiate their immunogenic properties. Here, we outline the attributes that should be considered in the design and manufacture of liposomal adjuvants for the delivery of sub-unit and nucleic acid based vaccines

TBVAC2020 : advancing tuberculosis vaccines from discovery to clinical development

TBVAC2020 is a research project supported by the Horizon 2020 program of the European Commission (EC). It aims at the discovery and development of novel tuberculosis (TB) vaccines from preclinical research projects to early clinical assessment. The project builds on previous collaborations from 1998 onwards funded through the EC framework programs FP5, FP6, and FP7. It has succeeded in attracting new partners from outstanding laboratories from all over the world, now totaling 40 institutions. Next to the development of novel vaccines, TB biomarker development is also considered an important asset to facilitate rational vaccine selection and development. In addition, TBVAC2020 offers portfolio management that provides selection criteria for entry, gating, and priority settings of novel vaccines at an early developmental stage. The TBVAC2020 consortium coordinated by TBVI facilitates collaboration and early data sharing between partners with the common aim of working toward the development of an effective TB vaccine. Close links with funders and other consortia with shared interests further contribute to this goal

TBVAC2020: Advancing tuberculosis vaccines from discovery to clinical development

TBVAC2020 is a research project supported by the Horizon 2020 program of the European Commission (EC). It aims at the discovery and development of novel tuberculosis (TB) vaccines from preclinical research projects to early clinical assessment. The project builds on previous collaborations from 1998 onwards funded through the EC framework programs FP5, FP6, and FP7. It has succeeded in attracting new partners from outstanding laboratories from all over the world, now totaling 40 institutions. Next to the development of novel vaccines, TB biomarker development is also considered an important asset to facilitate rational vaccine selection and development. In addition, TBVAC2020 offers portfolio management that provides selection criteria for entry, gating, and priority settings of novel vaccines at an early developmental stage. The TBVAC2020 consortium coordinated by TBVI facilitates collaboration and early data sharing between partners with the common aim of working toward the development of an effective TB vaccine. Close links with funders and other consortia with shared interests further contribute to this goal