The role of packaging size on contamination rates during simulated presentation to a sterile field

Objective: The objective of this study was to assess the impact of package size on the contact between medical devices and non-sterile surfaces (i.e. the hands of the practitioner and the outside of the package) during aseptic presentation to a simulated sterile field. Rationale for this objective stems from the decades-long problem of hospital-acquired infections. This work approaches the problem from a unique perspective, namely packaging size. Design: Randomized complete block design with subsampling. Setting: Research study conducted at professional conferences for surgical technologists and nursing professionals. Participants: Ninety-seven healthcare providers, primarily surgical technologists and nurses. Methods: Participants were gloved and asked to present the contents of six pouches of three different sizes to a simulated sterile field. The exterior of pouches and gloves of participants were coated with a simulated contaminant prior to each opening trial. After presentation to the simulated sterile field, the presence of the contaminant on package contents was recorded as indicative of contact with non-sterile surfaces and analyzed in a binary fashion using a generalized linear mixed model. Results: Recruited subjects were 26–64 years of age (81 females, 16 males), with 2.5–44 years of professional experience. Results indicated a significant main effect of pouch size on contact rate of package contents (P = 0.0108), whereby larger pouches induced greater rates of contact than smaller pouches (estimates±SEM: 14.7±2.9% vs. 6.0±1.7%, respectively). Discussion and Conclusion: This study utilized novel methodologies which simulate contamination in aseptic presentation. Results of this work indicate that increased contamination rates are associated with larger pouches when compared to smaller pouches. The results add to a growing body of research which investigate packaging's role in serving as a pathway for product contamination during aseptic presentation. Future work should investigate other packaging design factors (e.g. material, rigidity, and closure systems) and their role in contamination

Involving patients in patient safety programmes: A scoping review and consensus procedure by the LINNEAUS collaboration on patient safety in primary care

This is the final version of the article. Available from Taylor & Francis via the DOI in this record.BACKGROUND: Patient involvement has only recently received attention as a potentially useful approach to patient safety in primary care. OBJECTIVE: To summarize work conducted on a scoping review of interventions focussing on patient involvement for patient safety; to develop consensus-based recommendations in this area. METHODS: Scoping review of the literature 2006-2011 about methods and effects of involving patients in patient safety in primary care identified evidence for previous experiences of patient involvement in patient safety. This information was fed back to an expert panel for the development of recommendations for healthcare professionals and policy makers. RESULTS: The scoping review identified only weak evidence in support of the effectiveness of patient involvement. Identified barriers included a number of patient factors but also the healthcare workers' attitudes, abilities and lack of training. The expert panel recommended the integration of patient safety in the educational curricula for healthcare professionals, and expected a commitment from professionals to act as first movers by inviting and encouraging the patients to take an active role. The panel proposed a checklist to be used by primary care clinicians at the point of care for promoting patient involvement. CONCLUSION: There is only weak evidence on the effectiveness of patient involvement in patient safety. The recommendations of the panel can inform future policy and practice on patient involvement in safety in primary care.The research leading to these results has received funding from the European Community's Seventh Framework Programme FP7/2008–2012 under grant agreement no. 223424

Regulation of the water status in three co-occurring phreatophytes at the southern fringe of the Taklamakan Desert

Aims We investigated the regulation of the water status in three predominant perennial C3 phreatophytes (Alhagi sparsifolia, Populus euphratica, Tamarix ramosissima) at typical sites of their occurrence at the Southern fringe of the hyperarid Taklamakan Desert (north-west China). Methods In the foreland of the river oasis of Qira (Cele), we determined meteorological variables, plant biomass production, plant water potentials (psi(l)) and the water flux through the plants. We calculated the hydraulic conductance on the flow path from the soil to the leaves (k(SL)) and tested the effects of k(SL) psi(L) and the leaf-to-air difference in the partial pressure of water vapour (Delta w) on stomatal regulation using regression analyses. Important Findings Despite high values of plant water potential at the point of turgor loss, all plants sustained psi(L) at levels that were high enough to Maintain transpiration throughout the growing season. In A. sparsitolia, stomatal resistance (r(s); related to leaf area or leaf mass) was most closely correlated with k(SL);. whereas in P. euphratica, similar to 70%, of the variation in r(s) was explained by Delta w. In T. ramosissima, leaf area-related r(s) was significantly correlated with psi(L) and k(SL). The regulation mechanisms are in accordance with the growth patterns and the Occurrence of the species in relation to their distance to the ground water