<原著>学生実習におけるシーツ・寝衣交換に関する感染防護行為の教育効果について

院内感染を起こす病因菌の感染経路の中には, 体位変換や入浴介助のように直接接触が必要な患者ケア活動がなされるときに起こるものがある。これを防止するためには, 患者にケアを実施する可能性のある看護学生も院内感染に対する知識と技術を身につけることが重要と考えられる。そこで, 今回は急性期看護の実習中の看護学生に感染防護行為を指導し, その行為の実施状況を観察した後, 院内感染に対する看護学生の認識の変化を意識調査し, 指導の効果とあり方を検討した。感染防護行為の指導前である実習前半と指導後の実習後半を比較した結果, 看護学生は実習後半の方が, 高い割合で感染防護行為を行うことができていた。また, 院内感染に対する認識の変化の意識調査で看護学生が回答した記述内容から, 1)意識の高揚, 2)技術の向上, 3)知識の充実, 4)時間的な余裕, 5)器材の充実, が実習で感染防護行為を実施するための条件であることが分かった。It is of great importance to train nursing students in the knowledge and skills necessary to prevent nosocomial infections. The effectiveness of training on the prevention of the spread of infection for nursing students engaged in clinical training for acute care nursing was investigated. Observations on how the nursing students practicedinfection prevention after the training were made, and changes in their consciousness of nosocomial infections were then investigated with a survey. The measures the nursing students took to prevent the spread of infection in the first half of their clinical training were compared with the measures they took in the latter half of their clinical training after receiving special training in infection prevention. It was found that a higher proportion of students took preventive measures in the latter half of their training. It was also found from the answers the student nurses gave in the survey that the following conditions are needed in order to carry out preventive measures during clinical training : 1) raised awareness, 2) improved skills, 3) full knowledge, 4) enough time, and 5) enough equipment.国立情報学研究所で電子

Limited cross-border infections in patients newly diagnosed with HIV in Europe

Matti Ristola ja Jussi Sutinen kuuluvat työryhmään SPREAD ProgrammePeer reviewe

Transmission of HIV Drug Resistance and the Predicted Effect on Current First-line Regimens in Europe

M. Ristola on SPREAD Program -työryhmän jäsen.Background. Numerous studies have shown that baseline drug resistance patterns may influence the outcome of antiretroviral therapy. Therefore, guidelines recommend drug resistance testing to guide the choice of initial regimen. In addition to optimizing individual patient management, these baseline resistance data enable transmitted drug resistance (TDR) to be surveyed for public health purposes. The SPREAD program systematically collects data to gain insight into TDR occurring in Europe since 2001. Methods. Demographic, clinical, and virological data from 4140 antiretroviral-naive human immunodeficiency virus (HIV)-infected individuals from 26 countries who were newly diagnosed between 2008 and 2010 were analyzed. Evidence of TDR was defined using the WHO list for surveillance of drug resistance mutations. Prevalence of TDR was assessed over time by comparing the results to SPREAD data from 2002 to 2007. Baseline susceptibility to antiretroviral drugs was predicted using the Stanford HIVdb program version 7.0. Results. The overall prevalence of TDR did not change significantly over time and was 8.3% (95% confidence interval, 7.2%-9.5%) in 2008-2010. The most frequent indicators of TDR were nucleoside reverse transcriptase inhibitor (NRTI) mutations (4.5%), followed by nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.9%) and protease inhibitor mutations (2.0%). Baseline mutations were most predictive of reduced susceptibility to initial NNRTI-based regimens: 4.5% and 6.5% of patient isolates were predicted to have resistance to regimens containing efavirenz or rilpivirine, respectively, independent of current NRTI backbones. Conclusions. Although TDR was highest for NRTIs, the impact of baseline drug resistance patterns on susceptibility was largest for NNRTIs. The prevalence of TDR assessed by epidemiological surveys does not clearly indicate to what degree susceptibility to different drug classes is affected.Peer reviewe