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Surgical site infections are a major issue for any hospital and the eradication of these events is the goal of hospitals and regulatory agencies. The Joint Commission completed a surveillance of the hospital and they gave specific advice regarding surgical site infection control and the results that they had gathered. This particular plan focuses on infection control because it a very critical area that can cause dire issues with patients and leave the hospital with both fiscal and reputational problems. To address the issues with infection control the Joint Commission guidelines state that
"Infection control includes the surveillance/identification, prevention and control of infections among patients/clients/residents/, employees, physicians, and other licensed independent practitioners, contract service workers, volunteers, students and visitors" (Joint Commission, 2010). This comprehensive view of infection control is an important consideration when developing a plan to ensure that all of the areas in the Joint Commission accreditation…
Centers for Disease Control (2010). FAQs (frequently asked questions) about "surgical site infections." Retrieved from http://www.cdc.gov /HAI/pdfs/ssi/SSI_tagged.pdf' target='_blank' REL='NOFOLLOW'>
The central theme that is discussed is the importance of matching the patient and therapy correctly in order to facilitate the best possibility of positive treatment and healing.
The article also provides an overview of mind - body therapy and the way that it relates to the mind's ability to aid the bodily functions in fighting diseases like cancer. There are various modes of this therapy, which can include methods such as meditation, music therapy, art therapy and other aspects under the domain of mind-body therapy. The article also emphasizes the acceptance of various alternative therapeutic strategies in the fight against cancer.
The importance of matching the right patient to the right therapy is underscored by references to the necessary procedures and assessments as required by the Association of Pediatric Oncology Nurses standards. Note is also made of the three central questions that should be asked when attempting to match…
Hadaway. L.C. (2206) Keeping Central Line Infection at Bay. Nursing 2006. Vol.
Ott M.J. (2006) Mind- Body therapies for the Pediatric Oncology patient:
Matching the Right Therapy With the Right patient. Journal of Pediatric Oncology Nursing. Vol. 23. no.5. p 254 -257
70% 36-38 0-0-5 Overall Rate
SIP 2a Subtotal
Cat-E) Invalid Cases
SIP 2b Data Prophylactic
Antibiotic selection for Aug-04 surgical patients
CAG Sep-04-100% 10-10 0-0-33 SIP 2b Subtotal
SIP 2c Prophylactic
Antibiotic selection for Aug-04
Sep-04 0-1 0-0-42 SIP 2c Subtotal
SIP 2d Prophylactic
Antibiotic selection for Aug-04 hip arthroplasty
Sep-04-100% 8-8 0-0-35 SIP 2d Subtotal
Cat-E) Invalid Cases SIP 2e
Data Data Prophylactic
Antibiotic selection for Aug-04 surgical patients
SIP 2e Subtotals
SIP 2f Prophylactic
Antibiotic selection for Aug-04 surgical patients
SIP 2f Subtotals
SIP 2h Prophylactic
Antibiotic selection for Aug-04 surgical patients
SIP 2h Subtotals
Cat-E) Invalid Cases Population Numerator Data SIP 3a…
Auerbach AD. (2001) Prevention of Site Infection. Critical Analysis of Patient Safety Practices,
Classen DC, Evans RS, Pestonik SL, Horn SD, Memlove RL, Burke JP. (1999) the timing of prophylactic administration of antibiotics and the risk of surgical wound infection.. Infect Control Hosp Epidemiol., 20(4); 247-78.
Delgado-Rodriguez, M. (1997). Nosocomial Infections in surgical patients; comparison of two measures of intrinsic patient risk. Infect Control Hosp Epidemiol., 19-23
Gysenna, IC. (1999). Preventing postoperative infection - current treatment recommendations. Drugs, 175-85.
HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey offers hospitals and other healthcare centered organizations and facilities the ability to assess how patients perceive the quality of care. While hospitals have implemented this kind of survey in the past, HCAHPS allows the data to be displayed publically and provides national data to allow for valid comparisons across hospitals nationally, regionally, and locally. This data display adds pressure to hospitals to improve their quality of care and increase their accountability. Quality improvement measures are what has resulted from the increase transparency. Such common quality measures hospitals look to highlight are:
Decrease eadmission rate
San Diego, California is where the selected home care agency is located. The California summary of HCAHPS survey results for July 2014 to June 2015 is 75, 78, 62, 69, 61, 70, 51, 85, 49, 68, 69, and 311, with…
Allegranzi, B., Gayet-Ageron, A., Damani, N., Bengaly, L., McLaws, M., & Moro, M. et al. (2013). Global implementation of WHO's multimodal strategy for improvement of hand hygiene: a quasi-experimental study. The Lancet Infectious Diseases, 13(10), 843-851. http://dx.doi.org/10.1016/s1473-3099 (13)70163-4
Bouldin, E., Andresen, E., Dunton, N., Simon, M., Waters, T., & Liu, M. et al. (2012). Falls Among Adult Patients Hospitalized in the United States. Journal Of Patient Safety, 1. http://dx.doi.org/10.1097/pts.0b013e3182699b64
Nakamura, M., Toomey, S., Zaslavsky, A., Berry, J., Lorch, S., & Jha, A. et al. (2014). Measuring Pediatric Hospital Readmission Rates to Drive Quality Improvement. Academic Pediatrics, 14(5), S39-S46. http://dx.doi.org/10.1016/j.acap.2014.06.012
Weber, R. & Moffatt-Bruce, S. (2014). Medication Reconciliation Error. Patient Safety, 115-127. http://dx.doi.org/10.1007/978-1-4614-7419-7_8
For this project, I elected to experience the leadership role in a clinical practice with a family nurse practitioner (FNP). Towards this end, my area of specialty will be infection prevention and control in a short-term and long-term rehabilitation facility.
The relevance of this clinical experience cannot be overstated when it comes to the further enhancement of my professional capabilities. As a matter of fact, I regard it a rite of passage as I seek to gather additional insight in my field of specialization for enhanced patient care in a clinical setting. Being fully aware of the diversity of the patient-care environment, I would want to be prepared to address various healthcare-related issues and concerns in an able and professional manner. This is more so the case given that the nursing field is very broad – effectively meaning that those in this noble profession ought to be prepared to function…
nurse in a hospital environment -- and other healthcare workers including a student conducting a capstone requirement -- must take great precautions when it comes to infectious diseases like influenza. Not only does the healthcare professional need to protect patients, the professional must take all available steps to be sure he or she is protected before serving others in the hospital.
This is a SOT analysis of a student nurse who is following (shadowing) a Registered Nurse working on a floor where there are infectious diseases. The analysis begins with the Strengths that the nurse must exhibit while at work on her floor; followed by the eaknesses that are apparent or expected; next are the Opportunities; followed by the Threats that the student nurse must learn about and relate to.
Being forewarned is being fore-armed for protection, and in the case of the infectious disease influenza, every fall doctors…
Centers for Disease Control and Prevention. (2012). Influenza. Retrieved November 15, 2014,
From http://www.cdc.gov .
National Foundation for Infectious Diseases. (2010). Influenza (Flu). Retrieved November
15, 2014, from http://www.nfid.org .
Failure to implement infection control precautions can lead to potential complications that include the spread of infection to otherwise healthy individuals within the ward or facility where the infection occurs and even out into the community through visitors who become infected (Banach, Bearman, Morgan & Munoz-Price, 2015). Thus, complications that arise from infection spreading may not be confined to the hospital or facility where they occur but can easily become an issue that impacts the outside world as well. Examples abound, whether they are influenza related, SARS-related, and so on. Communities can suffer significantly when even the simplest infection control precautions are not followed by nurses in health care facilities.
Another potential complication can be resource-related, as infection spreading can lead to a drain on resources as procedures are put in place to stem the spread and deal with contamination, quarantine and clean-up (Koutlakis-Barron & Hayden, 2016; Revolinski, Huang &…
If there are people, of whatever nationality, who will be found guilty of creating and scattering MD, will be subjected to penalties and/or punishment which will be imposed by the overall leader o the UN itself. More so, countries which will be proven allowing the research and development and eventual use of MD should also be asked to answer from the call of the UN.
The entire populace can also share their efforts to controlling the use of any form of MD, thereby preventing any possibility of massive deaths or environment destruction. People must voice out their concern. The people should be activist enough in letting their leaders know how they want the use of MD to be abolished. The media can play a detrimental role in airing and showing how the people, across all nations, are against any form of MD. Newspapers, magazines, TV programs, radio stations, are good…
Collins, Robin, 2005. A step in the right direction: the Global Partnership Against the Spread of Weapons and Materials of Mass Destruction. Ploughshares Monitor
Everett, R 2004. Introduction to Weapons of Mass Destruction - Radiological, Chemical and Biological. Langford Chichester: John Wiley & Sons
Kalyadin, Alexander 2003. A strategy for active Non-Proliferation of weapons of mass destruction. Publication: Military Thought
In the U.S healthcare environment, the clinical practice guidelines are the effective healthcare protocol to enhance patient’s safety as well as achieving evidence-based practice. The clinical guidelines provide recommendations to the best available practice to assist clinicians and other healthcare professionals to deliver best and quality care. More importantly, the clinical practice guidelines are designed to optimize patients’ care using the systematic assessment and evidence based review to assess pros and cons of the alternative care options. The guidelines serve as the strongest resources to assist the healthcare professionals to make clinical decisions as well as incorporating evidence gained through practice and scientific investigations into patient practice. Healthcare organizations develop the guidelines in form and policies, which are endorsed across the organization to create a platform that employees will follow and holding employees accountable to achieve a standard of care.
Clabsi Hospital is one of the best healthcare organizations…
One possible explanation for the differences observed in the studies could be that the strengths of the chlorhexidine solution were different. It could also be that over time more effective techniques have been developed in the application of the solution, as the results do appear to improve over time.
There are limitations to the methodology of the study which are centered on the use of secondary data for analysis. The use of secondary data allows a wider range of data to be gathered from across the U.S. than would be practical from primary data collection which is the reason for the choice in this study. However this puts the control of several variables beyond the researcher. The results of the techniques may have been affected by the application of different individuals, departments and hospitals, all of whom may vary techniques and other factors influencing the success of these techniques. The…
Adams, D., Quavum, M., Worthington, T., Lambert, P., & Elliott, T. (2005). Evaluation of a 2% chlorhexidine gluconate in 70% isopropyl alcohol skin disinfectant. Journal of Hospital Infections, 61 (4), 287-290.
Brungs, S., & Render, M. (2006). Using Evidence-Based Practice to Reduce Central line Infections. Clinical Journal of Oncology Nursing, 10 (6), 723-725.
CDC. (2002). Guidelines for Prevention of Intravascular Catheter-Related Infections. Morbidity and Mortality Weekly Report; Recommendations and Reports, 51 (RR-10), 1-34.
CDC Mission. (n.d.). Retrieved February 6, 2006, from CDC Web site: http://www.cdc.gov /about/mission.htm' target='_blank' REL='NOFOLLOW'>
Nurse burnout is a common occurrence. This can exacerbate an ongoing problem that is seen in hospitals, nosocomial infections. Nosocomial infections remain prevalent for patients with extended hospital stays like those in intensive care units. An infection that starts roughly 48 hours after admission, those in intensive care units (ICUs) experience a continued rate of infection leading to increase length of stay, mortality, and morbidity. The number of patients that develop a nosocomial infection are from 7 to 10% internationally (Dasgupta, Das, Hazra, & Chawan, 2015). As such, hospitals have decided to classify nosocomial infection sites based on clinical and biological criteria.
esearch has led to the discovery of several bacterial strains that involve the formation of nosocomial or hospital acquired infections. "The agents that are usually involved in hospital-acquired infections include Streptococcus spp., Acinetobacter spp., enterococci, Pseudomonas aeruginosa, coagulase-negative staphylococci, Staphylococcus aureus, Bacillus cereus, Legionella and Enterobacteriaceae family members,…
CDC. (n.d.). HAI Data and Statistics. Retrieved from https://www.cdc.gov/hai/surveillance/
Cheng, C., Bartram, T., Karimi, L., & Leggat, S. (2016). Transformational leadership and social identity as predictors of team climate, perceived quality of care, burnout and turnover intention among nurses. Personnel Review, 45(6), 1200-1216. doi:10.1108/pr-05-2015-0118
Cimiotti, J. P., Aiken, L. H., Sloane, D. M., & Wu, E. S. (2012). Nurse staffing, burnout, and health care -- associated infection. American Journal of Infection Control, 40(6), 486-490. doi:10.1016/j.ajic.2012.02.029
Dasgupta, S., Das, S., Hazra, A., & Chawan, N. (2015). Nosocomial infections in the intensive care unit: Incidence, risk factors, outcome and associated pathogens in a public tertiary teaching hospital of Eastern India. Indian Journal of Critical Care Medicine, 19(1), 14. doi:10.4103/0972-5229.148633
From the onset, it is important to note that nosocomial or healthcare-acquired infections (HAIs) happen to be rather common in our healthcare settings. In basic terms, nosocomial infections could be defined as the all those infections that are acquired or contracted within the healthcare environment. To be more specific, the World Health Organization – WHO (2020) defines the said infections as all those infections that “affect patients in a hospital or other health-care facility, and are not present or incubating at the time of admission.” Further, according to WHO (2020), this category of infections could also be inclusive of infections acquired by hospital staff in the course of executing their functions within a healthcare facility. This is the definition that will be adopted in this policy brief. As the Centers for Disease Control and Prevention – CDC (2018) observes, at least 1 out of a total of 31 hospitals…
Andersen, B.M. (2019). Prevention and Control of Infections in Hospitals: Practice and Theory. New York, NY: Springer.
Centers for Disease Control and Prevention – CDC (2018). HAI Data. Retrieved from https://www.cdc.gov/hai/data/index.html
Centers for Disease Control and Prevention – CDC (2020). States with HAI Reporting Mandates. Retrieved from https://www.cdc.gov/hai/state-based/required-to-report-hai-nhsn.html
Despotovic, A., Milosevic, B., Milosevic, I., Mitrovic, N., Cirkovic, A., Jovanovic, S. & Stevanovic, G. (2020). Hospital-acquired infections in the adult intensive care unit—Epidemiology, antimicrobial resistance patterns, and risk factors for acquisition and mortality. American Journal of Infection Control, 48(10), 1211-1215.
McIntosh, D.G. (2018). Healthcare-associated infections: potential for prevention through vaccination. The Adv Vaccines Immunother., 6(1), 19-27.
Stone, P.W., Pogorzelska-Maziarz, M., Reagan, J., Merrill, J.A., Sperber, B., Cairns, C. …Skillen, E. (2015). Impact of laws aimed at healthcare-associated infection reduction: a qualitative study. BMJ Qual Saf., 24(10), 637-644.
World Health Organization – WHO (2020). Health care-associated infections FACT SHEET. Retrieved from https://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdf?ua=1
The facility should strive to bring the SSI rate down below the expected level for the types of patients and surgeries that the facility has.
Plan of Action
In order to achieve better-than-average results in the SSI rates for our facility, there are a number of tactics that can be used. The first is that the culture of the organization needs to emphasize safety to a degree greater than the current degree. As of now, there is no particular focus on SSIs, and this contributes to a culture where there is little accountability with respect to the SSI rates, or to individual SSI cases. The organization must improve the accountability, so that staff members are specifically held accountable for the mistakes that they make that result in an SSI.
Beyond culture, there are specific things that the organization can do to promote an improved rate of SSI. The first is…
Anderson, D. (2009). Surgical site infections. Division of Infectious Diseases, Duke University Medical Center. Retrieved September 29, 2012 from http://www.hapmd.com/home/hapmdcom/public_html/wp-content/uploads/2009/03/cirugia/bibliografica-cx/20110504_articulo_2.pdf
Barie, P. & Eachempati, S. (2005). Surgical site infections. The Surgical Clinics of North America. Vol. 85 (6) 1115-35.
Harbarth, S., Samore, M., Lichtenberg, D. & Carmeli, Y. (2000). Prolonged antibiotic prophylaxis after cardiovascular surgery and its effect on surgical site infections and antimicrobial resistance. Circulation. Vol. 101 (2000) 2916-2921.
Lauwers, S. & de Smet, F. (1998). Surgical site infections. Acta Clin Belg. Vol 53 (5) 303-310.
hospitals is the spread of MSA (staphylococcus aureus). This pathogen remains a leading cause of hospital-acquired infection. Current 'typing' methods for the genome to identify the pathogen include "phage typing, multi-locus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE)" but these methods "have serious limitations when used to investigate the finer details of infection outbreaks" (Price et al. 2013: 14). This is why the use of whole genome sequencing that allows scientists to create distinctions up to a single nucleotide is useful. Whole genome sequences can be used to classify and characterize genetic differences in a far more refined fashion than previous methods "and additionally provides information about the genetic basis of phenotypic characteristics, including antibiotic susceptibility and virulence" (Price et al. 2013: 14). Local-level awareness of the history of disease transmission allows a more carefully matched protocol for treatment as well as improves tracking. "Combined with epidemiological data, such…
Blot, S.I. (2002 et al.). Outcome and attributable mortality in critically Ill patients with bacteremia involving methicillin-susceptible and methicillin-resistant Staphylococcus aureus. Archives of Internal Medicine, 162(19):2229-35.
Price, J.R. (2013) .Whole genome sequencing in the prevention and control of Staphylococcus aureus infection. Journal of Hospital Infection, 83: 14-21.
Human Immunodeficiency Virus (HIV)
Description of the communicable disease
Infection by the Human Immunodeficiency Virus (HIV) has become a global epidemic. It causes acquired immune deficiency syndrome (AIDS). The major causal sources of this communicable disease are through semen, blood, breast milk of infected mothers, and vaginal fluid. In addition, the virus can be found in sweat, saliva, and also tears; however, in the latter cases, generally not in sufficient amounts to cause spreading of the virus to another individual. The main common means of being infected with HIV are through having unprotected sex and through sharing of needles. HIV may be transferred through unprotected heterosexual or homosexual anal, vaginal, and perhaps oral sex. Even though the risk of infection is minimal with oral sex, there remains the same imperative to use protection such as a condom in the course of oral sex. Due to new treatments, the risk of…
Aids.gov. (2015). Global HIV / AIDS Organizations. Retrieved 19 May 2014 from: https://www.aids.gov/federal-resources/around-the-world/global-hiv-aids-organizations/
Body and Health Canada. (2015). HIV / AIDS. Retrieved 19 May 2014 from: http://bodyandhealth.canada.com/channel_condition_info_details.asp?channel_id=1020&relation_id=70907&disease_id=1&page_no=2
Cabieses Valdes, B.B. (2011). The living conditions and health status of international immigrants in Chile: Comparisons among international immigrants, and between them and the Chilean-born.
CDC. (2012). CDC Global Health Strategy 2012 -- 2015. Retrieved 19 May 2014 from: http://www.cdc.gov /globalhealth/strategy/pdf/CDC-GlobalHealthStrategy.pdf
It should be verified why things started off so great and then dipped very close to the lower control limit and stayed there for such a vast portion of the timeline. That being said, the fact that no values are outside of the lower control limit shows that the graph is at least somewhat accurate if not completely accurate, but it is worth of review nonetheless.
In short, control charts are fairly basic in nature but have a wide variety of different possible applications. Indeed, there are not a lot of detailed charts like this that can be applied to varying different types of applications such as manufacturing and hospital environments. However, this is indeed the case and the tools are effective if used right. Using the tool well involves knowing precisely why one or more values are outside of the control chart LCL and UCL and whether it…
Brito, Dayamin Martinez, Margarita Teresa Correa Vidal, and Roberto Oropesa Rodriguez. "Aplicacion De Las Cartas Simples De Control En El Laboratorio Antidoping. (Spanish)." Revista CENIC Ciencias Quimicas 38.2 (2007): 307-310. MedicLatina. Web. 1 May 2013.
Carey, Raymond G. Improving healthcare with control charts: basic and advanced SPC methods and case studies. Milwaukee, WI: ASQ Quality Press, 2003. Print.
Gus Dekker, et al. "Serial Plotting on Customised Fundal Height Charts Results in Doubling of the Antenatal Detection of Small for Gestational Age Fetuses in Nulliparous Women." Australian & New Zealand Journal of Obstetrics & Gynaecology 52.1 (2012): 78-82. Academic Search Premier. Web. 1 May 2013.
Yang Ming-Chin, et al. "The Use of Statistical Process Control (Risk-Adjusted CUSUM, Risk-Adjusted RSPRT & CRAM with Prediction Limits) for Monitoring the Outcomes of Out-of-Hospital Cardiac Arrest Patients Rescued by the EMS System." Journal of Evaluation in Clinical Practice 17.1 (2011): 71-77. Academic Search Premier. Web. 1 May 2013.
Due to their contact with different patients, it allows them to become carriers of the disease.
It is important to study the relevance of SARS to epidemiology because epidemiology can provide an amount of diverse and important information that can facilitate the process of controlling, if not totally preventing, its spread. y relating SARS to epidemiology, people can become aware of the whole story on SARS. Moreover, epidemiology can be a fundamental source in finding solutions to combat the disease. Thus, providing another measure in the management and control of its spread. For instance, in the outbreak cases of SARS in many places worldwide, the article indicated that epidemiology provided appropriate models in containing the disease.
Emerging Infections: What Have We Learned from SARS?
Retrieved on Nov. 12, 2004, from CDC.GOV.
Web site: http://www.cdc.gov/ncidod/EID/vol10no7/pdfs/04-0166.pdf
Emerging Infections: What Have We Learned from SARS?
Retrieved on Nov. 12, 2004, from CDC.GOV.
Web site: http://www.cdc.gov /ncidod/EID/vol10no7/pdfs/04-0166.pdf' target='_blank' REL='NOFOLLOW'>
Vitamin D in Controlling UTIs
In recent times, several experimental studies have been conducted in order to understand the impact of vitamin D on controlling Upper espiratory Tract Infections. This paper has selected by article "Effect of vitamin D3 supplementation on upper respiratory tract infections in healthy adults: the VIDAIS randomized controlled trial," a research study conducted by Murdoch et.al (2012). The goal of the article critique is to thoroughly analyze the article and to determine its validity and reliability. Furthermore, the critique would help in understanding the impact of Vitamin D on UTIs in healthy adults.
Experimental studies have reported that the relationship between serum 25-hydroxyvitamin D (25-OHD) and upper respiratory infections is inversely proportional. Murdoch et.al (2012) has reported that results of these experimental studies have been found to be inconclusive. The goal of Murdoch et.al (2012) was to study the impact of vitamin D on Upper respiratory…
Murdoch et.al (2012). Effect of vitamin D3 supplementation on upper respiratory tract infections in healthy adults: the VIDARIS randomized controlled trial.JAMA. 2012 Oct 3; 308(13):1333-9. doi: 10.1001/jama.2012.12505.
This can lead to social isolation, disapproval and prejudice, and shame and feelings of immorality (2008).
Arreola et al. (2009) state that LGBM are one of the groups that participate in some of the riskiest sexual behaviors among gay and bisexual men. This prevalence of risky behavior among gay and bisexual men is higher in instances where the men have been sexually abused as a child; it is even higher among LGBM (2009). Unprotected anal intercourse was significantly related to a history of childhood sexual abuse in a study conducted by Carballo-Dieguez and Dolezal (2005) (Morales 2009). In another study of adult men who sleep with men, there was a significantly higher portion of LGBM who reported sexual abuse before age 13 years (22%) than did non-Latino men who sleep with men (11%). Furthermore, studies have shown that childhood sexual abuse can significantly predict negative health outcomes including HIV /…
Arreola, S.G., Neilands, T.B., & Diaz, R. (2009). "Childhood sexual abuse and the sociocultural context of sexual risk among adult Latino gay and bisexual men." American journal of public health,2(99).
Brooks, R.A., Etzel, M.A., Hinojos, E., Henry, C.L., & Perez, M. (2005). "Preventing HIV
among Latino and African-American gay and bisexual men in a context of HIV-related stigma, discrimination, and homophobia: perspectives of providers. AIDS patient care
Healthcare Associated Infections: Critical Analysis
The prevention and control of healthcare associated infections is an issue that has attracted considerable attention across the globe given the increase of healthcare associated infections. Despite the development and use of several strategies and measures to lessen the burdens caused by healthcare associated infections, the practices of healthcare professionals are largely suboptimal while the infections persist. As a result, the prevention and control of these infections has attracted considerable concern, which has resulted in several studies on the practices and behaviors of healthcare practitioners. Carole Jackson, Karen Lowton and Peter Griffiths have conducted a research on nurses' prevention behaviors to control healthcare associated infections. The qualitative study utilizes vignettes created from nurses' reports of infection prevention behaviors and practices.
Healthcare associated infections can be described as infections that emerge from medical interventions like clinical or surgical processes or from contact with a…
Burns, N., & Grove, S. (2011). Understanding nursing research (5th ed.). Amsterdam, Netherlands: Elsevier.
Jackson, C. Lowton, K. & Griffiths, P. (2013, July). Infection Prevention As "A Show": A Qualitative Study of Nurses' Infection Prevention Behaviours. International Journal of Nursing Studies, 10(16).
"Prevention and Control of Healthcare-Associated Infections." (2011, November). Quality Improvement Guide. Retrieved from National Institute for Health and Clinical Excellence website: http://www.his.org.uk/files/9213/7483/8498/Prevention_and_control_of_healthcare-associated_infections_Quality_improvement_guide_NICE_Guidance_2011.pdf
"Qualitative Research Perspective." (n.d.). Chapter 4. Qualitative Research in Information Systems: Consideration of Selected Theories. Retrieved from Australian National University Press website: http://press.anu.edu.au/info_systems/mobile_devices/ch04s02.html
Behavioral risk for HIV infection among gay and bisexual men in the United States
According to reports published by the Centre for Disease Control and Prevention (CDC), they state that by the year 2004, more than nine hundred and forty thousand individuals in the United States of America had been diagnosed with AIDS, majority of who were gay men and African-Americans. This report including others have brought the issue of HIV infection in gay and bisexual men into sharp focus and more in particular the behavioral risks that the group exposes themselves to, which have contributed to the sharp increase in HIV infection amongst members of this group. This research intends to focus of this behavioral risk and preventive measures that have been established to prevent HIV infection in gay and bisexual men in the United States.
Another recent research conducted by Centre for Disease Control and Prevention…
Hockenbury, D., & Hockenbury, E., (2008), Psychology, Word publishers, pp 232-234
Kelly, J.A. (1992). HIV risk behavior reduction following intervention with key opinion leaders of population: An experimental analysis. American Journal of Public Health, 82, 1483 -- 1489.
Latkin, C.A., Sherman, S., & Knowlton, A. (2003). HIV prevention among drug users: Outcome of a network-oriented peer outreach intervention. Health Psychology, 22, 332 -- 339.
Wasserheit, J.N., & Aral, S.O., (1996), the dynamic topology of sexually transmitted disease epidemics: Implications for prevention strategies. The Journal of Infectious Diseases, 201 -- 213.
After 10 days, when pharyngeal infection becomes more acute, patients have an increased risk for myocarditis and peripheral neuritis. These can result in circulatory loss and loss of motor functions in the peripheral organs. Diphtherial infection should be immediately treated and even suspected cases should be treated on a prophylactic basis since the infection has a high mortality rate. Airway management is critical for patients presenting with respiratory complications. Intubation is essential in cases where the laryngeal membrane growth affects normal breathing process. Failure to secure airway passage is one of the main causes of death due to diphtheria. . [Allysia & Mark, 2009]
Firstline medication involves antibiotic treatment with penicillin or erythromycin to control bacterial growth and the use of antipyretics to control temperature. . Concurrent intravenous treatment with Diphtheria antitoxin is also critical to check the spread of the toxin and control further tissue damage. Patients manifesting respiratory…
1) Allysia M. Guy & Mark a Silverberg, (Oct 2009), 'Diphtheria', Accessed March 7th 2010, available at, http://emedicine.medscape.com/article/782051-overview
Case Study: Urinary Tract Infection
CHIEF COMPLAINT: Urination with a burning sensation, pelvic genital pain, frequent and urgent urination, urine which is colored for the past three days and dribbling urination.
HISTORY OF PRESENT ILLNESS: A patient visits complaining about urination with a burning sensation, pelvic genital pain, frequent and urgent urination, urine which is colored for three days and dribbling urination. He is an African American who is 58 years old. However, he denies having fever.
This 58-year-old man describes his symptoms as having urination with a burning sensation, pelvic genital pain, frequent and urgent urination, urine which is colored for three days and dribbling urination. These symptoms show that he has a urinary tract infection commonly known as UTI. This infection has been often diagnosed in older adults. Most of the times, it has been diagnosed in residents with long-term care. This accounts for over a third…
Infections of the implantation area the mainly widespread of the dental implant complications. Implant infection is a state which is known as peri-implantitis which has a sign of swelling or inflammation of the tissues adjacent to the implantation area. Peri-implantitis is a type of periodontal disease that is able to result to inflammation, bone loss and failure in dental implant in any case it is not treated appropriately. A flame is part of a fire. Inflammation is a situation where a tissue gets swollen, red, and frequently hurts. About dental implants, it is an inflammation that can be caused by trauma or infection. Inflammation causes several special defensive cells to move to the inflamed area. Inflammation is capable of resulting to bone loss together with dental implants, where bone loss is a dangerous situation. The supporting bone holds the dental implant in the jaw.
Generally, the purpose of the…
Hayek (2005) Comparative study between the effects of photodynamic therapy and conventional therapy on microbial reduction in ligature-induced peri-implantitis in dogs. Journal of Periodontology 76, 1275 -- 1281.
Loe, H., Theilade, E. & Jensen, S.B. (1965) Experimental gingivitis in man. Journal of Periodontology 36, 177 -- 187.
Mombelli, A., Nyman, S.R. & Lang, N.P. (1994) Experimentally induced peri-implant mucositis. A clinical study in humans. Clinical Oral Implants Research 5, 254 -- 259.
Renvert, S., Roos-Jansa"ker, A.M., Lindahl, C., Renvert, H. & Persson, G.R. (2007) Infection at titanium implants with or without a clinical diagnosis of inflammation. Clinical Oral
Chlorhexidine to Prevent Ventilator-Associated Pneumonia
Ventilator-associated Pneumonia (VAP) is one of the most common infections acquired by patients who've utilized mechanical ventilation in health care facilities. This infection is a major concern because it leads to several deaths, extends hospital stay, and increases the costs of medical care services. The infections are commonly developed when pathogenic bacteria colonize the aero digestive tract. According to Babcock et al. (2004), the prevention of these infections has usually entailed preventing bacteria colonization and the subsequent aspiration of the contaminated secretions to the lower airways. Given the increased incidents of ventilator-association pneumonia, this paper proposes the use of chlorhexidine in preventing it. Chlorhexidine has proven effective in prevention of VAP as shown in baseline data. The implementation of this proposed procedure in patient care will entail various logistics based on approval from organizational leadership.
Methods for Obtaining Necessary Approval and Support
One of the…
Babcock, H., Zack, J.E., Garrison, T., Trovillion, E., Jones, M., Fraser, V.J., & Kollef, M.H. (2004). An educational Intervention to Reduce Ventilator-associated Pneumonia in an Integrated Health System. Chest, 125 (6), 2224-2231.
Hoshijima et al. (2013, December). Effects of Oral Hygiene Using Chlorhexidine on Preventing Ventilator-associated Pneumonia in Critical-care Settings: A Meta-analysis of Randomized Controlled Trials. Journal of Dental Sciences, 8(4), 348-357.
Keyt, H., Faverio, P. & Restrepo, M.I. (2014, June). Prevention of Ventilator-associated Pneumonia in the Intensive Care Unit: A Review of the Clinically Relevant Recent Advancements. Indian Journal of Medical Research, 139, 814-821.
Klompas M., Speck, K., Howell M.D., Greene, L.R., & Berenholtz, S.M. (2014). Reappraisal of Routine Oral Care with Chlorohexidine Gluconate for Patients Receiving Mechanical Ventilation: Systematic Review and Meta-analysis. JAMA Internal Medicine, 174 (5), 751-761.
Vancomycin should be given for at least 60 minutes. The initial dosage for pediatrics with renal impairment is not less than 15 mg/kg per day or 15 times the GF in mL/min. Premature infants should have longer dosing intervals. PO administration should be 40 mg/kg/day in 3-4 divided doses for 7-10 days. The maximum is 2,000 mg/day, which may be diluted in 1 oz of water or administered through an NG tube (PD).
Vancomycin is contraindicated to patients with hypersensitivity to vancomycin (Drug.com, 2012). Commercially prepared frozen Vancomycyn Hydrochloride injections in 5% dextrose may also be contraindicated to those with known allergic reaction to corn or corn products (Drug.com).
The patient should inform the doctor or pharmacist of all prescription and non-prescription or herbal products currently used (Medicine Net, 2012; Levinson, 2012). Aminoglycosides, amphotericin B, other antibiotics, and live bacterial vaccines are special mentions. If treatment requires…
Reference: PDR Network LLC.
Retrieved on April 20, 2012 from http://www.pdr.net/drugpages/concisemonograph.aspx?concise=688
The salmonella bacteria had been the twentieth century’s archetypical organism causing food poisoning, highly notorious for the 1988-89 crisis of salmonella in eggs. By that time, however, it had already been a topic of scientific and public health focus for more than a hundred years. Previously linked to animal foods, phage typing’s introduction during the 1940s started revealing the complex nature of its associations with its environment (Hardy, 2004).
The salmonella bacterium resides in living beings’ intestines. A majority of individuals contract salmonella infection after consuming feces-contaminated foods. Salmonella is an umbrella term referring to the cluster of bacteria giving rise to salmonellosis or salmonella infection within the intestinal tract. Different forms of salmonellosis include typhoid fever, enteric fever, food poisoning, and gastroenteritis. Salmonella poisoning has typically been associated with contaminated foods or water, particularly eggs, meat, and poultry. Disease symptoms, which typically manifest…
In conclusion, atkins draws an important link between teen childbearing and poverty, which takes this discussion past morals and values and moves it into socioeconomic territory. Half of all mothers currently on welfare assistance "were teenagers when they had their first child," atkins writes. Also, a) less than a third of teen mothers "ever finish high school"; b) the children born to teenage mothers "are twice as likely to raise their children in poverty"; c) the children of teen mothers "...are more likely to do poorly in school, more likely to drop out of school, and less likely to attend college"; and d) girls whose mothers were teenagers at the time of their birth are "...22% more likely to become mothers as teens themselves," thus completing the cycle and perpetuating the problem into future generations.
An article by Jennifer a. Hurley ("Promoting the Use of Birth Control Reduces Teen Pregnancy")…
Bakalar, Nicholas. "Adolescence: Abstinence-Only Programs Not found to Prevent HIV." The New York Times 14 August 2007: Retrieved Dec. 3, 2007, at http://www.nytimes.com .
Garrett, Robert T. "Texas teens lead nation in birth rate." The Dallas Morning News 5 November 2007: Retrieved Dec. 2, 2007, at http://www.dallasnews.com .
Green, Tanya L. "Parents Have the Right to Know when their Children Receive Family
Planning Services at School." Opposing Viewpoints: Students' rights. Greenhaven Press,
Apple Computer Founded in 1976 with a marketing model based on integration, aesthetics and design, never a low price leader, always an innovator. Mac Book Pro-replaced iBook and Power Book, designs based on size and power.
Segmentation -- middle-upper middle class individuals, small home and offices, larger businesses with design focus
Targeting -- turn the ordinary into something extraordinary, worry less about price and more about justification and lifestyle
Value proposition -- Focus on value and design to build, build through tribe mentality
Consumer Behavior -- Push the envelope and ease of use, be part of the innovative generation and first line of consumer
Buying decision process- consumer must be engaged; laptops are not whim purchases, but part of Apple tradition; MacBook seen as different than other brands, special and unique
Product eview -- Three separate designs of MacBook in use; 2006 original moved to 2008 MacBook…
7 Key Strategies That You Must Learn From Apple's Marketing. (2009). Retrieved from: http://blog.kissmetrics.com/7-strategies-apple-marketing/
Deidu, H. (February 27, 2012). The Value of the OS X Monopoly. Asymco. Retrieved from: http://www.asymco.com/2012/02/28/the-value-of-the-os-x-monopoly/
Linzmayer, O. (2004). Apple Confidential 2.0. San Francisco, CA: No Starch Press
Nguyen, V. (2009). MacBook Review. Slashgear. Retrieved from: http://www.slashgear.com/macbook-unibody-review-late-2009-2261568/
Management of Immunocompromised Patients
In beginning I writer specific nursing assignment. The Question: 2000 Words While clinical placement asked prepare a single room an admission. The patient requiring admission isolation room immunocompromised.
Immunocompromised patients usually require isolation in order to prevent them from becoming infected with infections from other patients which is known as protective isolation. For the immunocompromised patients, their immune system is unable to fight the infectious diseases. There are many diseases or conditions that lead to immunodeficiency in patients.
One is AIDS (acquired immunodeficiency syndrome). The pathophysiology of AIDS starts when the person's CD4+ T cell count begins to decrease as the disease kills these cells. This is HIV-induced cell lysis where the virus enters the CD4+ cells where it inserts its genetic information to the cell nucleus thus taking over the cell and replicating itself. The virus then mutates extremely rapidly thus making it more and…
Agusti, C., & Torres, A. (2009). Pulmonary Infection in the Immunocompromised Patient: Strategies for Management. New York: John Wiley & Sons.
Bodey, G.P. (2010). Managing Infections in the Immunocompromised Patient. Clinical Infectious Diseases, 40(Supplement 4), S239. doi: 10.1086/427328
Glauser, M.P., & Pizzo, P.A. (2009). Management of Infections in Immunocompromised Patients New York: Elsevier Health Sciences.
Hayden, R.T. (2008). Diagnostic Microbiology of the Immunocompromised Host. Washington, DC: ASM Press.
Caglar S; Yildiz S; Savaser S. (2010). Observation results of hand-washing by health-care workers in a neonatal intensive care unit. International Journal of Nursing Practice, 16(2), 132-137.
In this article the authors wanted to determine whether healthcare professionals were washing their hands and if they were doing so effectively. The researchers observed 344 incidents in which hand washing was warranted and found that nurses were 63% compliant and physicians were 53% compliant. However, when it came to making sure that the job was done thoroughly, physicians were able to do a better job than nurses at a 24% to 13% rate of success. Since hand washing has been proven to be the most effective and simplest method for preventing infection, it is imperative that healthcare professionals perform it as often as needed and thoroughly.
amos M.M., Schrader, ., Trujillo, ., Blea, M., & Greenberg, C. (2011). School nurse inspections improve…
Researchers are trying different techniques to increase the incidence of compliance with hand washing guidelines and in this study they used social pressure. Initially, compliance with hand washing regulations was deemed to be significantly below expected standard within the nursing staff. To hopefully combat this, researchers told the staff that they were going to weigh the soap dispenser bags to see if people were actually using them or not. The object of the study was to determine if this type of pressure would induce the staff into better compliance with hand washing regulations. The researchers found that this type of behavioral technique is very effective.
15. Parish, C. (2008). Patient campaigner calls for TV cameras to check hand-washing. Nursing Standard, 22(38), 6.
The author of the article looked at the compliance records of staff and whether patients and visitors used infection controls. The campaigner, Roger Goss, said that because MRSA and other similar healthcare-acquired infections were becoming more dangerous that staff and visitors needed to be monitored more closely to prevent spread. The man advocated that close-circuit televisions be used to determine compliance with regulations, and he encouraged staff to be fired and visitors not welcomed if they did not comply. The warning here to nurses is that people are watching whether they wash their hands properly, and they are ready to have them terminated if they do not.
Urinary tract infections (UTIs) are typically the most prevailing healthcare-associated infection (HAI) in acute care facilities in the U.S. The Centers for Disease Control and Prevention (CDC) has estimated that up to 150,000 hospital-onset, symptomatic catheter-associated UTIs (CAUTIs) occurred in 2013, resulting in as much as $161 million in excess direct medical costs (Kuntz, 2010, p. 319). Current research examines the reason for such a high occurrence of infection. oughly 75% of healthcare-associated UTIs are connected to improper use of indwelling urinary catheters, to which up to a quarter of hospitalized patients are exposed. Adult ICUs have the highest exposure rate for catheter use and reveal over 95% of UTIs related to catheter use.
In the last twenty years, various strategies have been implemented to aid in reducing the risk of CAUTI in healthcare settings. One of which includes identifying proper times to use catheters and proper care and insertion…
Deron, D.C., Edwards, J.R., Srinivasan, A., Fridkin, S.K., & Gould, C.V. (2011). Trends in Catheter-Associated Urinary Tract Infections in Adult Intensive Care Units -- United States, 1990 -- 2007. Infection Control and Hospital Epidemiology, 32(8), 748-756.
Flynn, M.B., Martins, S.A., Burns, S., Philbricks, D., & Rauen, C. (2013). Putting Evidence Into Nursing Practice: Four Traditional Practices Not Supported by the Evidence. Critical Care Nurse, 23(2), 37. Retrieved from http://www.aacn.org/wd/Cetests/media/C1322.pdf
Goeschel, C.A., Cosgrove, S.E., Romig, M., & Berenholtz, S.M. (2011). Prevention of Central Line -- Associated Bloodstream Infections: A Journey Toward Eliminating Preventable Harm. Current Infectious Disease Reports, 13(4), 343-349.
Kuntz, G. (2010). Guideline for Prevention of Catheter-Associated Urinary Tract Infections 2009. Infection Control and Hospital Epidemiology, 31(4), 319-326.
Evidence-Based Solution to educing Incidence
The goal of this assignment is to increase my ability to appraise and synthesize evidence to provide experience a logical argument in support of a proposal for practice change, and to provide experience in designing a detailed implementation and evaluation plan for my project. I need to discuss my project plan with you.
An evidence-based solution to reducing incidence of hospital acquired infections through indwelling medical devices
Hospital-acquired or nosocomial infections are the fourth leading cause of disease in developed countries. The increased insertion and implanting of prosthetic or indwelling medical devices is a leading cause of these infections since the introduction of a foreign body significantly reduces the body's immunity and decreases the number of bacteria needed to produce an infection. Prosthetic or indwelling medical devices such as urethral catheters, suprapublic catheter, nasogastric tubes, hemodialysis catheters, central venous catheters, and tracheostomy tubes are associated…
Chambless, J.D., Hunt, S.M., & Stewart, P.S. (2006). A three-dimensional computer model of four hypothetical mechanisms protecting biofilms from antimicrobials. Appl Environ Microbiol, 72(3), 2005-2013. doi: 10.1128/aem.72.3.2005-2013.2006
Chu, V.H., Crosslin, D.R., Friedman, J.Y., Reed, S.D., Cabell, C.H., Griffiths, R.I., . . . Fowler, V.G., Jr. (2005). Staphylococcus aureus bacteremia in patients with prosthetic devices: costs and outcomes. Am J. Med, 118(12), 1416. doi: 10.1016/j.amjmed.2005.06.011
Cookson, S.T., Ihrig, M., O'Mara, E.M., Denny, M., Volk, H., Banerjee, S.N., . . . Jarvis, W.R. (1998). Increased bloodstream infection rates in surgical patients associated with variation from recommended use and care following implementation of a needleless device. Infect Control Hosp Epidemiol, 19(1), 23-27.
Digiovine, B., Chenoweth, C., Watts, C., & Higgins, M. (1999). The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive care unit. Am J. Respir Crit Care Med, 160(3), 976-981. doi: 10.1164/ajrccm.160.3.9808145
air traffic has continued to increase and it now constitutes a considerable proportion of the travelling public. The amount of long-hour flights has increased significantly. Based on the International Civil Aviation authority, air traffic can be anticipated to double amid till 2020. Airline travel, especially over longer distances, makes air travelers vulnerable to numerous facets that will impact their health and well-being. Particularly, the speed with which influenza spreads and mutates, via transportation routes, is the reason why the influenza pandemic is considered to be a huge threat to the human population. Pandemic is a term, which is used for a virus or microbe when it spreads over a large area, in severe cases even the whole world and large number of people start getting affecting by it (CDC, 2009).
In the past 300 years, there have been ten significant influenza pandemics outbreaks that have taken place in this world.…
Airports Council International (2009) Airport preparedness guidelines for outbreaks of communicable disease. Available at: http://www.airports.org/aci/aci/file/ACI_Priorities/Health/Airport%20preparedness%20guidelines.pdf (Accessed: 28 November 2011)
Bouma, G.D. (2002) The research process. 4th edn. Melbourne: Oxford University Press.
Brigantic, R., Delp, W., Gadgil A., Kulesz, J., Lee, R., Malone, J.D. (2009) U.S. airport entry screening in response to pandemic influenza: Modeling and analysis. Available at: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B7578-4W2M6SG1&_user=10843&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000000150&_version=1&_urlVersion=0&_userid=10843&md5=44685b11dd53d74a8ef85a4f03e185f2 (Accessed: 28 November 2011)
Bush, George W. (2003a). Homeland security presidential directive -- 5: Management of domestic incidents. Available at: http://www.whitehouse.gov/news/releases/2003/02/20030228-9.html (Accessed: 28 November 2011)
As to catheter straps, if fastened too tightly they can act as tourniquets, cutting off the needed flow of blood and presenting. And at least theoretically, use of straps brings about a risk of increasing the complications such as "…deep vein thrombosis and pulmonary embolism" in those patients with "impaired lower extremity circulation" (Billington 504). Research presented in this article shows that the problem of infection due to poorly attached catheters can be reduced significantly through the use of a product called "Bard StatLock" -- which, the authors insist, is an effective stabilization device because it allows movement (through a swivel clip), because it is a "sterile latex-free, tug-resistant product" (Billington 504). An article in the journal RN, incidentally, states that treating "hemodialysis catheter-related bacteremia" can cost a hospital up to $45,000.
ashing "Bloody Hands": An article in the Australian Nursing Journal asserts, "…hand hygiene is the single most effective…
Aziz, a.M., Ashton, H., Pagett, a., Mathieson, K., Jones, S., & Mullin, B. (2009).
Sharps management in hospital: an audit of equipment, practice and awareness.
British Journal of Nursing, 18(2), 92-98.
Billington, a., Crane, C., Jownally, S., Kirkwood, L., & Roodhouse, a. (2008).
Nursing Case Study
Managing a possible Case of Gastroenteritis: A Nursing Case Study
The effective delivery of optimal nursing care requires a comprehensive treatment plan that addresses both the patient's symptoms and the security of the immediate environment. This report presents a case study of appropriate evidence-based nursing practices in treating an elderly female patient presenting with abdominal discomfort in a residential care setting.
The client presents with new onset faecal incontinence, diarrhoea and increasing abdominal discomfort and cramps. These symptoms suggest a possible gastrointestinal disturbance (Crisp & Taylor, 2009) and present a number of possible diagnoses. While the client's nursing care plan indicates that she is normally continent, her confidential disclosure to the nurse suggests that her symptoms may be more prolonged. Another relevant client characteristic is her advanced age of 85 years.
The client's proximity to the dirty utility room in the aged care facility and the report…
1. Crisp J, Taylor C. (2010). Potter & Perry's fundaments of nursing (3rd ed.). Chatswood, N.S.W.: Elsevier, Australia.
2. Kirk MD, Hall GV, Veitch MGK, Becker N. (2010). Assessing the ?incidence of gastroenteritis among elderly people living in long-term care facilities. Journal of Hospital Infection, 76, 12.
3. Australian Government: Department of Health and Ageing. (2007). Retrieved from- http://www.health.gov.au/internet/main/publishing.nsf/content/icg-guidelinesindex.htm .
4. Andrew E, Simor MVD. (2010). Diagnosis, Management, and Prevention of Clostridium difficile Infection in Long-Term Care Facilities: A Review. The-Americans Geriatric Societ, 58(8), 1557-1593.
g., teachers of young children, day-care employees, and residents and staff in institutional settings).
Persons who live or work in environments in which varicella transmission can occur (e.g., college students, inmates and staff of correctional institutions, and military personnel).
Nonpregnant women of childbearing age. Vaccination of women who are not pregnant -- but who may become pregnant in the future -- will reduce the risk for VZV transmission to the fetus.
Interpretation of elative History:
18-month female with fever, diffuse rash
Prime demographic for varicella infection)
Child is irritable but alert
Good sign, since toxicity would be an issue with this child. A good level of consciousness is useful in assessing the level of illness but can change quickly in the pediatric population)
Her heart rate is 180 beats per minute
She is tachycardic, but most likely due to the fever and irritability. The child is not described as tachypneic)…
Hamment, JM. (1999) Respiratory viral infection predisposing for bacterial disease: a concise review. FEMS Immunology and Medical Microbiology [FEMS Immunol. Med. Microbiol.]; 26, 189-195. 1 Dec 1999.
Haiduven-Griffiths D, Fecko H. Varicella in hospital personnel: a challenge for the infection control practitioner. Am J. Infect Control 1987; 15:207-11.
California Career and Technical Education Standards (2564)
Industry Sector Health Science and Medical Technology (426)
Pathway D. Support Services (78)
Strand D1.0 Students understand the responsibilities of their roles and perform their tasks safely by using appropriate guidelines (51)
Standard D1.3 Know the process for evaluating compliance with corporate, legal, regulatory, and accreditation standards, ethics, and codes.
Standard Performance Objective: Given tasks in the dental office, student will demonstrate competency in performing their duties properly and safely within prescribed guidelines, referring to appropriate text in manuals as necessary.
Lesson Objective: At the end of the lesson the student will be able to prepare trays for several procedures, including routine dental exam, simple extraction, and treatment of caries with 100% accuracy within 30 minutes.
Equipment/Supplies: Instruments for dental procedures, including items for patient safety such as paper drape, clips, lead shield, rubber dam, and protective eyewear.
Comment: Savage and Walsh…
California Department of Education (2006). California career technical education model
curriculum standards: Grades seven through twelve. Sacramentao, CA: CDE Press.
DePaola, L.G. (2012). Infection control in the dental office. The Richmond Institute. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15641333
Savage, N.W., and Walsh, L.J. (1996). Integrating infection control into the dental curriculum. Australian Dental Journal 42(6), pp. 395-398.
Approaches in decision making
Decision-making forms a very significant component of success at work, at the same time it can be the cause of failure if the conditions are wrong and if those involved are not on the same page. Confusion with regard to decision-making can cause conflict to teams, supervisors, managers, and team leaders. There are various decision-making approaches that can be adopted depending on the situations, these include: consensus, majority vote, minority (subcommittee), expert, authority with discussion, and authority without discussion (Eisenfuhr, 2011). This will describe the 'consensus' and 'expert' approaches of decision-making with respect to the scenario selected.
In the consensus or group decision-making approach, the manager becomes part of the team and involves everyone who is willing and ready to contribute in the decision-making process. The fact that the word consensus is used does not signify that all those involved fully agree with whatever decision…
Bubnicki, Z. (2003). Analysis and decision making in uncertain systems. New York, NY:
Eisenfuhr, F. (2011). Decision making. New York, NY: Springer.
Bloodstream Infections in NICU
Bloodstream infections in the neonatal intensive-care unit (NICU) are a serious concern for parents and health care professionals. Exposure to bloodstream infections for most patients will caused delayed hospital stays and higher costs associated with hospital visit (Marschall et. al., 2008). There are many procedural changes that can be made at the hospital to decrease risk of bloodstream infections. ecommendations for decreasing bloodstream infections will be based on the practices of the Connecticut Children's Medical Center (CCMC), which is successful in decreasing bloodstream infections. In this paper I will discuss how to get the employees engaged in their work, how to receive buy-in for quality work, how this will reduce errors and increase the quality of work.
Engaging employees in their Work
It is important to train the employees on the recommended techniques for inserting a catheter since this is main cause of blood…
Buttes et. al. (2006). Drive down infection rates. Nursing Management. October.
Deaver, K. (2010). Preventing Infections in Hemodialysis Fistula and Graft Vascular Accesses. Nephrology Nursing Journal. 37 (5) 503-506
Marschall et. al. (2008). Strategies to prevent central line-associated bloodstream infections in acute care hospitals. Infection Control and Hospital Epidemiology. 29 (1) S22-30.
Globalization Case Study
The country I have selected to complete this assignment is the Sudan, which is part of Central Africa. Earlier this month there was a reported epidemic of cholera in Juba, which is part of the epublic of South Sudan (WHO, 2014). Cholera is a contagious disease which is extremely fatal and is caused by "ingestion of food or water contaminated with the bacterium Vibrio cholerae" (Thalo, 2014). Specifically, there was one confirmed death attributed to this disease as of May 18th, and over 30 suspected cases altogether.
Were I the lead nurse in a shelter working in this country in a situation in which people were rapidly filing in to seek assistance, the first thing I would do is gather my team of nurses and brief them on the nature of this disease and how it is contracted. I would inform them of the dire nature of…
Centers for Disease Control and Prevention. (2013). Cholera -- Vibrio cholerae infection. www.cdc.gov. Retrieved from http://www.cdc.gov /cholera/diagnosis.html' target='_blank' REL='NOFOLLOW'>
Epidemiological considerations anthracis originates in soil in a lot of regions of this world in which we live. Environmental aspects (for example plentiful precipitation subsequent to a phase of water dearth) might improve spore mass in soil, even though the precise impact of such features remains badly understood (Bell, Kozarsky, Stephens, 2002).
The organism by and large subsists in the endospore shape in environment; germination of spores exterior to an animal congregation might take place when the subsequent situations are encountered (Bell, Kozarsky, Stephens, 2002):
elative humidity >95%
Presence of sufficient nutrients
Temperature amid 8°C and 45°C
PH amid 5 and 9 (Bell, Kozarsky, Stephens, 2002)
Endospores are opposed to heat, drying, gamma radiation, ultraviolet light, and various antiseptics. Spores can continue in soil for decades, as exemplified by organic combat researches all through World War II on the Scottish island of Gruinard. All through 1943, as well as 1944,…
Bell, D.M., Kozarsky, P.E., Stephens, D.S. (2002). Clinical issues in the Prophylaxis, Diagnosis, and Treatment of Anthrax. Emerging Infectious Diseases, 8(2), 222-225.
Centers for Disease Control and Prevention. (2001). Anthrax Disease Information
Centers for Disease Control and Prevention. (2201). Notice to Readers: Considerations for Distinguishing Influenza-Like Illness from Inhalational Anthrax. Morbidity and Mortality Weekly Report, 50(44), 984-6.
Centers for Disease Control and Prevention. (2201). Notice to Readers: Update: Interim Recommendations for Ant microbial Prophylaxis for Children and Breastfeeding Mothers and Treatment of Children with Anthrax. Morbidity and Mortality Weekly Report, 50(45), 1014-6.
Green provides some clear guidelines to assist health education and promotion specialists in the identification and design of health promotion techniques for implementation in health promotion and disease prevention programs. Discuss how five of the guidelines presented by Dr. Green could assist you in the selection of an appropriate health promotion technique. Support your answer with appropriate examples.
The module gives really simple guidelines as to the how the process of health education promotion can work in today's world. Healthcare is a social industry and hence understanding the community structure and its needs is the primary concern. According to the directions given by Dr. Green, the following factors have to be considered before designing and implementing health promotion and disease prevention programs. Hence the process is structured by first identifying the needs of the community and then setting the goals (short-term and long-term) accordingly. Once this is done the following…
Adair, J.E. And Thomas, N. (2004). The Concise Adair on Teambuilding and Motivation. Thorogood. London.
Agron P, Berends V, Ellis K, Gonzalez M. (2010). School wellness policies: perceptions, barriers, and needs among school leaders and wellness advocates. J Sch Health. 2010; 80: 527-535.
Eddy, J. Module 5. Policy Development as a Health Promotion Technique- Dr. James Eddy (59:40). Accessed from: mms://mediasrv1.ccs.ua.edu/CCS-AO2/HHE530/HHE530_Module5_D_combined.wmv
Fitzhugh, E. Module 5a. The Focus Group- Dr. Eugene Fitzhugh (1:00:14). Accessed from: mms://mediasrv1.ccs.ua.edu/CCS-AO2/HHE530/HHE530_Module5_A_combined.wmv
What are Bacteria and Viruses?
The most basic difference between bacteria and viruses is their size. Whereas both bacteria and viruses are too tiny to notice with the naked eye, most bacteria are about one micrometer in length and can be perceived with a good optical microscope. On the other hand, viruses are smaller than the wavelength of visible light, which suggests that they can only be perceived by using an electron microscope (Nursing Times, 2006). Infection, every so often the initial phase, takes place when bacteria, viruses or other microbes that cause disease enter the human body and start to multiply. Disease comes about and ensues when the cells in the human body are damaged, as a result of the infection, and signs and symptoms of a disease appear.
Bacterial and viral infections are contaminations caused by bacteria and viruses. Bacteria release poisons known as toxins into the…
ationalism Politics Impacts Public's View
Web Article eview
The principle best-practice strategy elucidated within Louis DePaola's article entitled "Infection control in the dental office" is for practitioners to adhere to sanitary and hygiene mandates as noted within a pair of documents produced by the Centers for Disease Control. The first document is the Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care (which was published in 2011), and the companion Infection Prevention Checklist for Outpatient Settings: Minimum Expectations for Safe Care. These documents have a number of specific measures for those working in dental offices to follow to reduce the incidence of healthcare associated infections (HAI).
In addition to denoting several of the key guidelines for practitioners to adhere to in order to ensure safety and reduce the rate of infection transmission, the author also reinforces several key facets of this literature that apply to dental office…
DePaola, L. (2012). "Infection control in the dental office." http://static.ow.ly/. Retrieved from http://static.ow.ly/docs/RICDE%20Infection%20Control%20in%20the%20Dental%20Office,%20Standards%20of%20Care%202012%20(CE%20Article%20PDF)_Mcl.pdf
It has also been suggested that low-level viral replication associated with SV may be a driver in chronic inflammation in some sufferers of chronic lung disease, although this is so far uncertain (Openshaw, 2005). It is estimated that infants who develop a wheeze as a result of SV contraction develop a recurring wheeze in around two thirds of all cases. It is also estimated that around half of these children will develop some form of asthma (Lehtinen et al., 2007). It is unclear why there are some who experience delayed onset of SV, although both immune 'imprinting' and viral persistence have been implicated (Openshaw and Tregoning, 2005).
The condition is diagnosed through rapid antigen-detection tests. It is difficult to diagnose SV in adults as the tests are insensitive in persons other than children, and practitioners rarely request tests for SV in adults. This means that it is difficult to…
Centers for Disease Control and Prevention (2005) Respiratory Syncytial Virus. National Center for Infectious Diseases: Respiratory and Enteric Viruses Branch. Retrieved on November 11, 2007, at http://www.cdc.gov /ncidod/dvrd/revb/respiratory/rsvfeat.htm' target='_blank' REL='NOFOLLOW'>
What are Bacteria and Viruses?
The most palpable variance between bacteria and viruses is their size. Whereas both bacteria and viruses are too tiny to notice with the naked eye, most bacteria are about one micrometer in length and can be perceived with a good optical microscope. On the other hand, viruses are smaller than the wavelength of visible light, which implies that they can be solely perceived by using an electron microscope (Nursing Times, 2006). Infection, every so often the initial phase, takes place when bacteria, viruses or other microbes that cause disease enter the human body and start to proliferate. Disease comes about and ensues when the cells in the human body are damaged, as a result of the infection, and signs and symptoms of a disease appear.
Bacterial and viral infections are contaminations caused by bacteria and viruses. Bacteria release toxins into the blood stream whereas…
Healthcare Disparity in Georgia
HIV infection continues to be a substantial trouble in Bibb County, Georgia. This illness substantially impacts lots of areas and Bibb County shares among the greatest HIV rates in America. One reason Bibb County deals with greater rates of infection is due to the high minority populace. Likewise, high levels of poverty and joblessness can make it tough for an individual to keep his/her health plan and access their primary-care service provider and acquire the required therapy for HIV. Social preconception likewise extends unfavorable mindsets of the community and can force the individual from looking for therapy or even testing for HIV.
The very best protection against HIV is enlightening the general public about the illness. outine testing for HIV is vital too. The first intervention would be to associate with a regional testing center and have the ability to check people as well as inform…
Centers for Disease Control and Prevention (CDC). (2008). HIV / AIDS among youth. Centers for Disease Control and Prevention. Retrieved July 24, 2011, from http://www.cdc.gov /hiv/resources/factsheets/PDF/youth.pdf' target='_blank' REL='NOFOLLOW'>
This key characteristics of community-based participatory research were shown to include the equitable involvement of all stakeholders, including community members, organizational representatives, and researchers in ways that allow all partners to contribute to the enhancement of community health initiatives. The seven major steps used in an outbreak investigation and the various components of TB prevention and control in the U.S. were outlined. An analysis concerning the greatest future challenges to tobacco cessation interventions showed that nicotine is highly addictive, but that these challenges can be mitigated through enhanced healthcare curricular offerings and various evidence-based strategies. The differences in eligibility criteria between Medicaid and Medicare were shown to relate to target group and that there would be a need for these programs throughout the 21st century. Finally, because oral diseases affect lower-income people more frequently, they are regarded as a neglected epidemic that can have profound adverse healthcare consequences if…
CDC tuberculosis guidelines. (2014). Centers for Disease Control. Retrieved April 25, 2014
from http://www.cdc.gov /tb/publications/guidelines/default.htm' target='_blank' REL='NOFOLLOW'>
These are questions dealing with attitude and are the most important questions when doing qualitative social science research to gauge relationships among events. In addition to construction questions about attitudes, it is important to have the questions drafted in the correct format (Nachmias, 2008).
The Quantitative methodologies will be the statistical tests designed for the overall model to incorporate the information provided through one, two or all of the Qualitative data analysis methodologies. The tests used to determine the relationship between these "qualitative" factors and increases in Infection rates, will be the Chi-Square, Student's T-Test, ANOVA (to test for variations among the data), the construction of a Linear Regression Model and the calculation of the Pearson Correlation Coefficient, otherwise known as "R-Squared" (Nachmias, 2008).
These tests will be utilized in conjunction with a predetermined level of significance, or alpha. Since these tests will all be measuring the means and relationships…
Barrett, R. & Randle, J. (2008). Hand hygiene practices: nursing students' perceptions. Journal of Clinical Nursing, 17(14), 1851-1857.
Beggs, C.; Noakes, C.; Shepherd, S.; Kerr, K.; Sleigh, P. & Banfield, K. (2006). The influence of nurse cohorting on hand hygiene effectiveness. American Journal of Infection Control, 34, 10, 621-626.
Larson, E.; Quiros, D. & Lin, S. (2007). Dissemination of the CDC's Hand Hygiene Guideline and impact on infection rates. American Journal of Infection Control, 35(10), 666-675.
Roberts, C.; Roberts, J. & Roberts, R.J. (2009). Investigation into the effect of an alcohol-based hand product on infection rate in a nursing home setting. Journal of Infection Prevention, 10(4), 138-142.
Methicillin-esistant Staphylococci (MSA), most common Healthcare Associated Infections
The PICOT question to be discussed is: For adult patients using catheters, does the use of sterilization practices reduce the future risk of health associated infections like MSA compared with standard procedure in one week?
The answer is yes.
The support given to answer the question will be based on peer-reviewed journals and scientific literature. A summary of the evidence will be availed in a chart plus a conclusion that summarizes evidence used will also be given.
Methicillin-resistant Staphylococcus aureus (MSA) bacteria is resistant to several antibiotics. A significant proportion of MSA infections in the community are on the skin. It results in alarming infections of the bloodstream, surgical site infections and pneumonia in health facilities. Studies have revealed that one person in every three individuals have staph in the nose - most of the time they don't show any illnesses (General…
General Information About MRSA in the Community. (n.d.). Retrieved February 21, 2015, from http://www.cdc.gov /mrsa/community/index.html' target='_blank' REL='NOFOLLOW'>
Pathogens and Diseases:
Pathogens are common characteristics of everyday environment as soil contains huge number of bacteria per cubic centimeter while air contains fungal spores. The existence of pathogens in everyday environment emanates from the fact that microorganisms are deposited through touching of various surfaces like tables. Pathogens can be described as disease-causing agents such as infectious microbes, and parasites. While the infectious microbes include viruses and bacteria, parasites include protozoa and fungi. Notably, microbes are only considered as pathogens if they cause harm or diseases since not all microbes are harmful (Koo, 2009). There are opportunistic pathogens, which are organisms that are normally part of the natural flora of the body. These organisms become harmful or pathogens after an invasion like the occurrence of an accidental injury or surgery.
Spread of Pathogens:
Since pathogens are common disease-causing agents, they spread in various ways to cause harm or illnesses. Some…
ABPI -- Bringing Medicines to Life (n.d.), How Pathogens Cause Disease, The Association of the British Pharmaceutical Industry, viewed 17 April 2012,
ABPI -- Bringing Medicines to Life (n.d.), Pathogens Cause Disease, The Association of the British Pharmaceutical Industry, viewed 17 April 2012,
Canadian Committee on Antibiotic Resistance (2007), Infection Prevention and Control Best
Practices, Canadian Committee on Antibiotic Resistance, viewed 17 April 2012,
Research Proposal for Catheter Associated Urinary Tract Infections
Catheter Associated Urinary Tract Infections (CAUTI) affects timely reimbursement and prolongs patient stays in the healthcare facility. Many hospitals strive for ways to reduce CAUTIs and take specific medical measures to aid patients in recovery from the same and avoid recurrence of the cases of CAUTIs. These deliberate measures ensure so they can have better patient outcomes and improve patient care. This also improves the reimbursement received from insurance providers.
The research seeks to investigate the effect of frequent CAUTI education, among the in-hospital patients with indwelling urinary catheter, conducted over six months.
Background and Significance of the Problem
It is common medical knowledge that urinary catheters have the potential to cause urinary tract infections, known as catheter-associated urinary tract infections (CAUTIs). Indwelling catheters are a part of many plans of care, specifically for emergent and critical care patients within…
For its versatility in eluding new antibiotics, it can be life-threatening. One of these "superbugs" is VRE, which is transmissible by direct hand contact or through surfaces and equipment by anyone, including the health care worker (Capriotti, 2007). VRE has recently spread to the community and the health care sector.
New antibiotics continue to be synthesized to cope with the rapid mutation of the VRE bacteria, but the organisms continue to overtake the drugs (Akins & Haase, 2005). A study conducted on a series of VRE outbreaks in Germany revealed that an estimate of 1 million Euros could be saved with adequate prevention and control of the infection. The use of newer antibiotics is not as cost-effective as prevention. These antibiotics have to be administered with precision and require complementary hygienic precautions on the part of the health care worker. The rising incidence of and serious threats posed by the…
Akins, R.L. And Haase, K.K. (2005). Gram-positive resistance: pathogens, implications and treatment options. Pharmacotherapy: Pharmacotherapy Publications. Retrieved on September 15, 2009 from http://www.medscape.com/viewarticle/507658
Capriotti, T. (2007). Resistant "Superbugs" create need for novel antibiotics.
Dermatology Nursing: Medscape. Retrieved on September 15, 2009 from http://www.medscape.com/viewarticle/554935
Department of Health (2006). Fact sheet. New York State Department. Retrieved on September 15, 2009 from http://www.health.stats.ny.us/diseases/communicable/v_r_e/docs/facts_sheet.pdf
Evidence-Based Practice Project
A literature review conducted by abie and Curtis (2006) aimed at establishing the effects of washing hands in reducing respiratory infections. The literature was obtained by searching CAB Abstracts, PubMed, Embase, Cochrane, and Web of Science library. The inclusion strategy for the review were any studies that reported having an impact of hand washing to reduce respiratory infections. All articles included in the review were published before June 2004. This was a quantitative systematic review, which made it an effective method of analyzing and evaluating the selected studies. After searching for the relevant articles, the researchers found 395 articles, but only 61 articles were selected after the researchers reviewed their abstracts (abie & Curtis, 2006). The review and selection process continued and the final review included only eight articles, which the researchers established were more relevant to their study. Having eliminated the articles that focused on children…
Loeb, M., McGeer, A., McArthur, M., Walter, S., & Simor, A.E. (1999). Risk factors for pneumonia and other lower respiratory tract infections in elderly residents of long-term care facilities. Archives of internal medicine, 159(17), 2058-2064.
Rabie, T., & Curtis, V. (2006). Handwashing and risk of respiratory infections: a quantitative systematic review. Tropical medicine & international health, 11(3), 258-267.
Smith, P.W., Bennett, G., Bradley, S., Drinka, P., Lautenbach, E., Marx, J., . . . Stevenson, K. (2008). SHEA/APIC Guideline: infection prevention and control in the long-term care facility. American journal of infection control, 36(7), 504.
Lyme Disease and Methicillin-Resistant Staphylococcus Aureus (MRSA)
This text will concern itself with Lyme disease and methicillin-resistant staphylococcus aureus (MRSA). In so doing, it will not only give the description and epidemiology of the concerns, but also the etiology and prevention strategies. Further, diagnosis as well as treatment options and prognosis will be highlighted.
1. Lyme Disease
Description and Etiology
Described as an illness that is often debilitating, Lyme disease, as the Centers for Disease Control and Prevention- CDC (2018) points out, “is caused by the bacterium Borrelia burgdorferi and is transmitted to humans through the bite of infected blacklegged ticks.” It is important to note that in addition to the bacterium Borrelia burgdorferi, blacklegged ticks are capable of transmitting what are commonly referred to as coinfections, i.e. a variety of other disease-causing parasites as well as viruses and bacteria. Those living in wooded areas have a high likelihood…
Some patients might feel as though they are not getting all of the attention they deserve if they are not shaved before surgery. Because patient comfort is a high priority, the attending nurse could explain in layman's terms the rational for the change, and the surgical site could be clipped if needed to put the patient at ease and full his expectations.
Mellinger and McCanless's article on evidence-based nursing offers guidance on cultivating awareness of the research literature relevant to the nursing field (2010). It highlights the importance of learning how to access the literature and interpret it in order to define performance standards and work procedures that reflect the best practices support by scientific findings. Mellinger and McCanless demonstrate how nurses can use the same means other health care professionals use to advance their work. The Consumer eports on Health article helps implementation of the change in procedure by…
Infection control; usual practices in surgical site preparation do not reduce infections. (2006,
May 30). Medical Devices & Surgical Technology Week, 253.
Mellinger, E., and McCanless, L. (2010). Evidence-based nursing practice in the perioperative setting: a Magnet journey to eliminate sacred cows. AORN Journal, 92, 572-578.
Preoperative hair removal and surgical site infection. (2006). Australian Journal of Nursing,
As standard procedure warranted in this case, her obstetrician injected her with varicella zoster specific immunoglobulin. The injection did occur too late, but this is a special case warranting attention and was a prophylactic to protect the baby. A few days later the N developed chickenpox anyway. The reasons why the vaccine did not take could have been the fact that the N had already been exposed, and the situation is referred to as "breakthrough varicella," (National Centre for Immunisation, 2009, p. 3). Breakthrough varicella is a mild form of the infection, and yet is still contagious. Varicella vaccine should not be given to the baby until it is twelve months of age, but it may not be necessary at all due to the potential in vitro exposure to the varicella zoster virus. Infants "should receive no specific treatment or vaccination after exposure to Varicella zoster virus (VZV) but…
Centers for Disease Control and Prevention (2014). Preventing varicella in health care settings. Retrieved online: http://www.cdc.gov /chickenpox/hcp/healthcare-setting.html' target='_blank' REL='NOFOLLOW'>
The Center for Disease Control (CDC) endorsed the policy of replacing peripheral intravenous catheters (PIVC) within 48 hours following insertion in order to prevent and decrease local catheter infections. The institution that this author is employed at also made a policy to establish such a procedure based on the CDC's actions. However, there is a large body of empirical research that indicates that the length of the time that the PIVC remains in a patient does not appear to be a major factor that results and infections and/or phlebitis. Thus, this policy of changing the PIVC with 48 hours may be unnecessary.
For instance Zarate, Mandleco, Wilshaw, and avert (2008) studied emergency room trauma patients who received a PIVC. The mean number of days before there were indications of phlebitis in these patients was 3.14 days with the range of 1 to 6 days. Phlebitis rates did not…
Lee, W.L., Chen, H.L., Tsai, T.Y., Lai, I.C., Chang, W.C., Huang, C.H., & Fang, C.T.
(2009). Risk factors for peripheral intravenous catheter infection in hospitalized patients:
A prospective study of 3165 patients. American Journal of Infection Control, 37, 683
Lee, W.L., Liao, S.F., Huang, C.H., & Fang, C.T. (2010). Soft tissue infections related to peripheral intravenous catheters in hospitalized patients: A case control study. Journal of Hospital Infection, 76, 124 -- 129.
Clinical Governance and Auditing
Throughout this paper, an attempt has been made to demonstrate an understanding of the procedure of Clinical Audit (CA). The focus of this CA is the high risk area of patient safety, and with regard to how this is linked to patient safety, hand hygiene has been selected. The findings and the recommendations that follow combined with the CA tool and the selection criteria will be outlined in form of a Clinical Audit. For the purposes of improving clinical practice, CAs forms an integral aspect of clinical governance. It is indeed notable that CAs encapsulates practice which through analysis can result to quality enhancement, particularly for the patients. Various definitions of the term which are invariably the same and which tend towards verbosity exist, but a terse and precise definition is given by Coffey (2009) who puts forth that a CA is a systematic evaluation of…
Hart T. (2013).Promoting hand hygiene in clinical practice. Nursing Times; 109: 38, 14-15.
Tollefson, J. (2011). Clinical skills for enrolled/division 2 nurses. South Melbourne, Vic, Cengage Learning.
Scott, H.R., Blyth, K.G., & Jones, J.B. (2009).Davidson's Foundations of Clinical Practice. London, Elsevier Health Sciences UK..
Wilson, J. (2006). Infection control in clinical practice. Edinburgh, Elsevier, Baillie're Tindall.