Surface sampling within a pediatric ward—how multiple factors affect cleaning efficacy

BACKGROUND: The objectives of this study were to assess the number of organisms present on different surfaces within a clinical environment before and after cleaning took place, and to identify the impact of cleaning. The study involved extensive 2-week microbiological environmental monitoring of an entire ward before and after cleaning; the ward was located within a pediatric hematology-oncology ward comprised of a day unit and outpatient ward. METHODS: Tryptone soya agar contact plates were used to take a total of 1,160 surface samples before and after cleaning from 55 predetermined sites. Samples were taken from representative surfaces throughout the ward representing a variety of materials, surface heights, functions, and distances from patients, as well as both high-touch and infrequently touched surfaces. RESULTS: After surface cleaning was undertaken within the ward, there was a significant difference between the amount of colony-forming units (CFUs) recovered before and after cleaning (P < .0001). Cleaning produced an average CFU reduction of 68% throughout the ward environment. The corridor was the most contaminated area within the ward. There were differences in the CFUs among the various areas within the ward, which were cleaned with varying efficiency. The surface material, who interacted with the surface, levels of initial contamination, perceived risk, and perceived cleanability were all found to have a varying impact on the cleaning effectiveness. CONCLUSIONS: To the authors' current knowledge, this is the only study to assess cleaning within a pediatric ward by taking samples directly before and after cleaning. The standard of cleaning undertaken within the ward is open for discussion, and these data highlight the need for an improved cleaning intervention and can provide insight into the multitude of factors that must be considered when designing an effective training protocol

Enhanced propagation of motile bacteria on surfaces due to forward scattering

How motile bacteria move near a surface is a problem of fundamental biophysical interest and is key to the emergence of several phenomena of biological, ecological and medical relevance, including biofilm formation. Solid boundaries can strongly influence a cell's propulsion mechanism, thus leading many flagellated bacteria to describe long circular trajectories stably entrapped by the surface. Experimental studies on near-surface bacterial motility have, however, neglected the fact that real environments have typical microstructures varying on the scale of the cells' motion. Here, we show that micro-obstacles influence the propagation of peritrichously flagellated bacteria on a flat surface in a non-monotonic way. Instead of hindering it, an optimal, relatively low obstacle density can significantly enhance cells' propagation on surfaces due to individual forward-scattering events. This finding provides insight on the emerging dynamics of chiral active matter in complex environments and inspires possible routes to control microbial ecology in natural habitats

Does size matter? The impact of a small but targeted cleaning training intervention within a paediatric ward

Background: Cleaning is a critical tool for infection prevention and control, and is a key intervention for preventing healthcare associated infections (HCAIs) and controlling intermediate transmission routes between patient and environment. This study sought to identify potential areas of weakness in clinical surface cleaning, and assess the effectiveness of a staff group specific training intervention. Observations: One-hundred hours of audit observations in a paediatric cardiac intensive care unit (CICU) assessed surface cleaning technique of healthcare staff within bedspaces. Cleaning was assessed with a 5-component bundle, with each cleaning opportunity scored out of five. Training Intervention: Fifty hours of audit observations before and after a training intervention tested the efficacy of a staff group specific education intervention. The intervention was developed and implemented for 69% of nurses and 100% of cleaners. Results: One hundred and eighteen cleaning opportunities were observed before training, and scored an average of 2.4. One hundred and twenty-one cleaning opportunities were observed after training and scored an average 3.0. On average, before training, each cleaning opportunity by nurses and cleaners fulfilled 2.4 and 2.5, respectively, of the 5 bundle components. Following training, this improved to 3.3 and 2.9 respectively. There was a statistically significant improvement in bundle scores for nurses (P=.004) and cleaners (P=.0003). Conclusions: Surface wipe methods were inconsistent between all staff groups. The education based intervention resulted in a small improvement in most of the cleaning components. This study has identified how a small but targeted cleaning training intervention can have a significant (P= <.0001) impact on cleaning bundle compliance for both nurses and cleaners

Fracture mechanics of laser sintered cracked polyamide for a new method to induce cracks by additive manufacturing

This paper presents an experimental investigation on specimens manufactured by Selective Laser Sintering (SLS), with the purposes of giving designers advice when designing 3D printed parts, and laying the basis for a step forward in the field of fracture mechanics of 3D complex parts. The aim is to investigate the effect of building direction in Polyamide (PA) 3D printed samples and to assess whether a crack can be initiated directly from the sintering process for fracture mechanics study purposes. Six different configurations of Mode I Compact Tension (CT) specimens were manufactured and tested; the experiments were monitored by Digital Image Correlation (DIC) and fractured surfaces were analyzed using microscopy. Results showed that samples with better mechanical performance are those in which all the layers contain a portion of the crack. On the other hand, those with layers parallel to the crack plan offer a preferential pathway for the crack to propagate. DIC and fractography investigations showed that, under certain conditions, small-radius geometries, or too-close surfaces may glue depending on printer resolution. Experiments also showed that SLS is capable of printing specimens with internal cracks that can be used to study fracture mechanics of complex parts or parts with internal cracks

Effect of the Position in the Build Chamber on the Fatigue Strength of Additively Manufactured Maraging Steel MS1

The quality of additively produced parts and the achievable mechanical response may be affected by several factors, such as build orientation, heat treatment, or machining. A further rarely investigated factor is the position of the built part in the chamber with respect to inert gas flow. Previous studies have highlighted that the interaction between gas flow and laser track may induce an intense vaporization with consequent lack of fusion, particle entrainment, drop in density and denudation of the produced part, which is likely to detrimentally affect mechanical properties. This study addresses the effect of part position on the fatigue strength of heat-treated maraging steel MS1 produced by an EOSINT M280 machine in a nitrogen environment. Novelty arises from the lack of studies in this field, especially under fatigue. A factorial plan with subsequent statistical analysis highlighted that positioning the part upstream with respect to the gas flow leads to a slightly lower fatigue strength; however, no significant differences are observed. The failure mode, involving initiation from subsurface porosities of the same size, is also unaffected. Finally, a fatigue limit of 26% of the ultimate tensile strength is found, which is consistent with previous outcomes

Representations and geometrical properties of generalized inverses over fields

In this paper, as a generalization of Urquhart’s formulas, we present a full description of the sets of inner inverses and (B, C)-inverses over an arbitrary field. In addition, identifying the matrix vector space with an affine space, we analyze geometrical properties of the main generalized inverse sets. We prove that the set of inner inverses, and the set of (B, C)-inverses, form affine subspaces and we study their dimensions. Furthermore, under some hypotheses, we prove that the set of outer inverses is not an affine subspace but it is an affine algebraic variety. We also provide lower and upper bounds for the dimension of the outer inverse set.Agencia Estatal de InvestigaciónUniversidad de Alcal