996 research outputs found
Recommended from our members
Interventions to improve hand hygiene compliance in patient care
Background
Health careâassociated infection is a major cause of morbidity and mortality. Hand hygiene is regarded as an effective preventive measure. This is an update of a previously published review.
Objectives
To assess the shortâ and longâterm success of strategies to improve compliance to recommendations for hand hygiene, and to determine whether an increase in hand hygiene compliance can reduce rates of health careâassociated infection.
Search methods
We conducted electronic searches of the Cochrane Register of Controlled Trials, PubMed, Embase, and CINAHL. We conducted the searches from November 2009 to October 2016.
Selection criteria
We included randomised trials, nonârandomised trials, controlled beforeâafter studies, and interrupted time series analyses (ITS) that evaluated any intervention to improve compliance with hand hygiene using soap and water or alcoholâbased hand rub (ABHR), or both.
Data collection and analysis
Two review authors independently screened citations for inclusion, extracted data, and assessed risks of bias for each included study. Metaâanalysis was not possible, as there was substantial heterogeneity across studies. We assessed the certainty of evidence using the GRADE approach and present the results narratively in a 'Summary of findings' table.
Main results
This review includes 26 studies: 14 randomised trials, two nonârandomised trials and 10 ITS studies. Most studies were conducted in hospitals or longâterm care facilities in different countries, and collected data from a variety of healthcare workers. Fourteen studies assessed the success of different combinations of strategies recommended by the World Health Organization (WHO) to improve hand hygiene compliance. Strategies consisted of the following: increasing the availability of ABHR, different types of education for staff, reminders (written and verbal), different types of performance feedback, administrative support, and staff involvement. Six studies assessed different types of performance feedback, two studies evaluated education, three studies evaluated cues such as signs or scent, and one study assessed placement of ABHR. Observed hand hygiene compliance was measured in all but three studies which reported product usage. Eight studies also reported either infection or colonisation rates. All studies had two or more sources of high or unclear risks of bias, most often associated with blinding or independence of the intervention.
Multimodal interventions that include some but not all strategies recommended in the WHO guidelines may slightly improve hand hygiene compliance (five studies; 56 centres) and may slightly reduce infection rates (three studies; 34 centres), low certainty of evidence for both outcomes.
Multimodal interventions that include all strategies recommended in the WHO guidelines may slightly reduce colonisation rates (one study; 167 centres; low certainty of evidence). It is unclear whether the intervention improves hand hygiene compliance (five studies; 184 centres) or reduces infection (two studies; 16 centres) because the certainty of this evidence is very low.
Multimodal interventions that contain all strategies recommended in the WHO guidelines plus additional strategies may slightly improve hand hygiene compliance (six studies; 15 centres; low certainty of evidence). It is unclear whether this intervention reduces infection rates (one study; one centre; very low certainty of evidence).
Performance feedback may improve hand hygiene compliance (six studies; 21 centres; low certainty of evidence). This intervention probably slightly reduces infection (one study; one centre) and colonisation rates (one study; one centre) based on moderate certainty of evidence.
Education may improve hand hygiene compliance (two studies; two centres), low certainty of evidence.
Cues such as signs or scent may slightly improve hand hygiene compliance (three studies; three centres), low certainty of evidence.
Placement of ABHR close to point of use probably slightly improves hand hygiene compliance (one study; one centre), moderate certainty of evidence.
Authors' conclusions
With the identified variability in certainty of evidence, interventions, and methods, there remains an urgent need to undertake methodologically robust research to explore the effectiveness of multimodal versus simpler interventions to increase hand hygiene compliance, and to identify which components of multimodal interventions or combinations of strategies are most effective in a particular context
Development of Protective Clothing against Nanoparticle Based on Electrospun Nanofibers
In this paper, the development of efficient protective clothing against nanoparticulate aerosols is presented. Nanofibrous mats of polyamide 6 (PA6) were deposited onto a nonwoven viscose substrate by electrospinning technique. The influence of electrospinning parameters, including solution concentration, viscosity, and conductivity, was studied for the production of nonwovens with controlled fiber diameter showing a size distribution ranging from 66 to 195ânm. By varying several process parameters, textiles with different thickness of the nanofiber layer and thus air permeability were obtained. A hot-press lamination process using a thermoplastic resin as glue was applied to improve the adhesion of the nanofiber layer onto the textile support. After 1500 cycles of repeated compression and torsion, the nanofiber layer was still firmly attached to the support, while mechanical damage is visible in some areas. The penetration of NaCl particles with diameter ranging from 15 to 300ânm through the electrospun textiles was found to be strongly dependent on nanofiber layer thickness. A really thin nanofiber coating provides up to 80% retention of 20ânm size particles and over 50% retention of 200ânm size nanoparticles. Increasing the thickness of the nanofiber mat, the filtration efficiency was increased to over 99% along the whole nanoparticle range. The results obtained highlight the potential of nanofibers in the development of efficient personal protective equipments against nanoparticles.The financial support of this work was provided by MICINN (Spanish Ministry of Science and Innovation) and ERDF
(European Regional Development Fund) (ref.: PSE-420000-2008â003), and ACC1ÂŽO (Catalan Business Competitiveness
Support Agency
Study of the performance and capability of the new ultra-fast 2 GSample/s FADC data acquisition system of the MAGIC telescope
In February 2007 the MAGIC Air Cherenkov Telescope for gamma-ray astronomy
was fully upgraded with an ultra fast 2 GSamples/s digitization system. Since
the Cherenkov light flashes are very short, a fast readout can minimize the
influence of the background from the light of the night sky. Also, the time
structure of the event is an additional parameter to reduce the background from
unwanted hadronic showers. An overview of the performance of the new system and
its impact on the sensitivity of the MAGIC instrument will be presented.Comment: Contribution to the 30th ICRC, Merida Mexico, July 2007 on behalf of
the MAGIC Collaboratio
Long term monitoring of bright TeV Blazars with the MAGIC telescope
The MAGIC telescope has performed long term monitoring observations of the
bright TeV Blazars Mrk421, Mrk501 and 1ES1959+650. Up to 40 observations, 30 to
60 minutes each have been performed for each source evenly distributed over the
observable period of the year. The sensitivity of MAGIC is sufficient to
establish a flux level of 25% of the Crab flux for each measurement. These
observations are well suited to trigger multiwavelength ToO observations and
the overall collected data allow an unbiased study of the flaring statistics of
the observed AGNs.Comment: 4 pages, 4 figures, to appear in the proceedings of the 30th
International Cosmic Ray Conference, Merida, July 200
Second large-scale Monte Carlo study for the Cherenkov Telescope Array
The Cherenkov Telescope Array (CTA) represents the next generation of ground
based instruments for Very High Energy gamma-ray astronomy. It is expected to
improve on the sensitivity of current instruments by an order of magnitude and
provide energy coverage from 20 GeV to more than 200 TeV. In order to achieve
these ambitious goals Monte Carlo (MC) simulations play a crucial role, guiding
the design of CTA. Here, results of the second large-scale MC production are
reported, providing a realistic estimation of feasible array candidates for
both Northern and Sourthern Hemisphere sites performance, placing CTA
capabilities into the context of the current generation of High Energy
-ray detectors.Comment: In Proceedings of the 34th International Cosmic Ray Conference
(ICRC2015), The Hague, The Netherlands. All CTA contributions at
arXiv:1508.0589
- âŠ