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

BETTER PATIENT OUTCOMES AND EARLIER DIAGNOSIS OF BRAIN DEATH WITH TRANSCRANIAL AND CAROTID ARTERY DOPPLER ULTRASOUND

WOS: 000411688505179[No abstract available

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

Trends of primary glomerular disease in Turkey: TSN-GOLD registry report

Background Although several renal biopsy registry reports have been published worldwide, there are no data on primary glomerular disease trends in Turkey. Methods Three thousand eight-hundred fifty-eight native kidney biopsy records were assessed in the Turkish Society of Nephrology Primary Glomerulopathy Working Group (TSN-GOLD) Registry. Secondary disease and transplant biopsies were not recorded in the registry. These records were divided into four periods, before 2009, 2009 to 2013, 2013-2017, and 2017-current. Results A total of 3858 patients (43.6% female, 6.8% elderly) were examined. Nephrotic syndrome was the most common biopsy indication in all periods (58.6%, 53%, 44.1%, 51.6%, respectively). In the whole cohort, IgA nephropathy (IgAN) (25.7%) was the most common PGN with male predominance (62.7%), and IgAN frequency steadily increased through the periods (x 2 = 198, p 65 years), and there was no trend in this age group. An increasing trend was seen in the frequency of overweight patients (x 2 = 37, p < 0.0001). Although the biopsy rate performed with interventional radiology gradually increased, the mean glomeruli count in the samples did not change over the periods. Conclusions In Turkey, IgAN is the most common primary glomerulonephritis, and the frequency of this is increasing

Epidemiological features of primary glomerular disease in Turkey: a multicenter study by the Turkish Society of Nephrology Glomerular Diseases Working Group

Background The largest data on the epidemiology of primary glomerular diseases (PGDs) are obtained from the databases of countries or centers. Here, we present the extended results of the Primary Glomerular Diseases Study of the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD) Working Group. Methods Data of patients who underwent renal biopsy and received the diagnosis of PGD were recorded in the database prepared for the study. A total of 4399 patients from 47 centers were evaluated between May 2009 and May 2019. The data obtained at the time of kidney biopsy were analyzed. After the exclusion of patients without light microscopy and immunofluorescence microscopy findings, a total of 3875 patients were included in the study. Results The mean age was 41.5 +/- 14.9 years. 1690 patients were female (43.6\%) and 2185 (56.3\%) were male. Nephrotic syndrome was the most common biopsy indication (51.7\%). This was followed by asymptomatic urinary abnormalities (18.3\%) and nephritic syndrome (17.8\%). The most common PGD was IgA nephropathy (25.7\%) followed by membranous nephropathy (25.6\%) and focal segmental glomerulosclerosis (21.9\%). The mean total number of glomeruli per biopsy was 17 +/- 10. The mean baseline systolic blood pressure was 130 +/- 20 mmHg and diastolic blood pressure was 81 +/- 12 mmHg. The median proteinuria, serum creatinine, estimated GFR, and mean albumin values were 3300 (IQR: 1467-6307) mg/day, 1.0 (IQR: 0.7-1.6) mg/dL, 82.9 (IQR: 47.0-113.0) mL/min and 3.2 +/- 0.9 g/dL, respectively. Conclusions The distribution of PGDs in Turkey has become similar to that in other European countries. IgA nephropathy diagnosed via renal biopsy has become more prevalent compared to membranous nephropathy