Compliance of Physicians with Standard Precautions of Handling Patients with Infectious Respiratory Disease

Background: Standard precautions (SPs) are the minimum infection prevention practices that aim to protect Health care workers (HCWs) including physicians and prevent them from transmitting the infections to their patients. Purpose: To assess the level of compliance of physicians with standard precautions of handling patients with infectious respiratory disease. Method: A cross sectional questionnaire-based study was conducted in two tertiary level hospitals named M Abdur Rahim Medical College and Hospital, Dinajpur, Bangladesh and Rajshahi Medical College and Hospital, Rajshahi, Bangladesh to assess the level of compliance of physicians with standard precautions. Purposive sampling technique was applied as per inclusion criteria and data was collected by face to face interview from 285 physicians. Statistical analysis of the results was done by SPSS and a p value less than 0.05 was considered as significant. Result: The study revealed that maximum physicians (76.5%) handling patients with infectious respiratory disease had a moderate level of compliance with standard precautions. 78.6% of the physicians had moderate level of awareness about standard precautions. Only 20.35% of the physicians had training on infection control. 94.4% of the respondents didn’t know the component of standard precaution and most of the physicians were not aware of the sequence of wearing and removing the different components of PPEs. Conclusion: The study result implies that with increased awareness, the compliance of the physicians with standard precautions increased. The main reasons of non-compliance with standard precautions were found to be lack of resources, lack of regular training and excess workload.

Impact of designed infection control educational program on nurses’knowledge and compliance with standard precautions at maternity hospitals

Objectives:This study aimed to assess the nurses’knowledge and compliance with infection control standard precautions and evaluate the impact of the designed infection control educational program on nurses’knowledge and compliance with standard precautions at the maternity hospital.Materials and Methods:A quasi‑experimental one‑group pretest‑posttest design was used on convenient sample of 60 nurses working at Obstetrics and Gynecological hospital in Cairo University Hospital,Kasr El Ainy,who received“designed infection control educational program”for 6 months.The data were collected through the questionnaire comprising demographics,knowledge,and compliance with standard precautions questionnaire.The nurses’knowledge and compliance score were compared before and after intervention.Results:The studied nurses had higher level of knowledge(85.3%)and compliance(92.8%)regarding infection control standard precautions after the educational program compared to before the program.The results revealed statistically significant difference between before and after the program regarding nurses’knowledge score(15.5±2.9 vs.17.1±1.6,P<0.001)and compliance score(58.5±13.2 vs.74.3±5.1,P<0.001).In addition,there was insignificant relation between nurses’knowledge and compliance with standard precautions both before(r=0.952,P=0.474)and after educational program(r=0.164,P=0.223).Conclusion:The nurses’level of knowledge and compliance regarding infection control standard precautions was significantly improved after the program.Therefore,it is recommended that periodical educational programs regarding the standard precautions of infection control are essential for nurses at maternity hospital.

Techniques and Precautions of Sod Culture in Citrus Orchards in Sichuan Province

Citrus is an important fruit in Sichuan,accounting for 52.6%fruit yield of the whole Sichuan Province.In recent years,citrus has expanded its original cultivation and planting area in Sichuan,and the planting area has continued to increase.In terms of citrus cultivation methods,the sod culture has become a hot spot.This paper focused on the benefits of sod culture in citrus orchards,the selection of grass species,and the cultivation techniques.It analyzed the problems that should be paid attention to in sod culture in citrus orchards,in order to provide a theoretical basis for production and cultivation of fruit farmers.

Healthcare Professionals’ Adherence to Contact Precautions at a Maternal and Child Teaching Hospital

Background: Healthcare-associated infections affect hundreds of millions of patients worldwide. Children have greater susceptibility to healthcare-associated infections due to the immaturity of their immune system. Contact precautions aim to promote safety, protection and prevention of contamination. Thus, the objective of this study was to verify adherence to contact precaution measures, as well as compliance to the use of personal protective equipment. Methods: This cross-sectional observational study was carried out from July to October 2019 using a checklist to evaluate health professionals’ adherence to hand hygiene procedures and the use of gloves and surgical gowns when assisting children on contact precautions. Results: A total of 941 observations were carried out in a total of 300.532 hours. Hand hygiene was performed before and after contact with the patient in 58.84% and 75.09% of the cases, respectively and a surgical gown was used in 86.40% of the cases. The use of gloves was the variable most adhered to by professionals (87.57%). Intensive care unit professionals were the care workers who most complied with the regulation regarding hand hygiene after contact with the patient (p = 0.009) and the use of the surgical gown (p < 0.001). The correct hand hygiene technique was the recommendation with least adherence. Non-compliance to the hand hygiene technique was statistically significant among intensive care unit professionals (p = 0.002). Conclusions: Adherence to hand hygiene before contact with the patient and compliance with the hand hygiene technique were neglected by most professionals. However, there was good adherence to the use of surgical gloves and gowns, as well as high compliance to the techniques of removing these items. .

Health Facilities Readiness to Implement Standard Precautions for Infection Prevention and Control in Tanzania: Lesson Learnt from SARA Reports

Introduction: Standard Precautions are a set of measures applied in the care of all individuals/patients regardless of their infectious status aiming at preventing healthcare workers and patients from infections, preventing environmental contamination and spread of infections to the community. Many health facilities have not implemented them to an acceptable level. The purpose of the study is to report progress of improvement in health facilities readiness to implement standard precautions for infection prevention and control based on SARA reports. Methods: We generated mean scores of all standard precautions each year and calculated their standard deviations, variances and confidence intervals. One-way ANOVA was used to determine if the mean scores were equal. Finally, the trend of improvement in health facilities readiness to implement the standard precautions was generated. Results: A total of nine standard precautions were reported in SARA reports for 2012, 2017 and 2020. The mean scores of the standard precautions were 52.22% in 2012, 64.55% in 2017 and 69.66% in 2020. The overall trend showed an increase in health facilities readiness to implement standard precautions, although the mean scores were not statistically different (p-value 0.3217). Conclusion: SARA surveys conducted in Tanzania in 2012, 2017 and 2020 have shown an overall increase in health facilities readiness to implement standard precautions. Safe final waste disposal was being done in fewest facilities while single-use or auto-disable syringes were in most facilities that were sampled in all years. SARA surveys may be a useful way to evaluate Infection Prevention and Control adherence in health facilities.

Safely Using TCM Herbs： Adverse Reactions and Precautions

Although most people believe that herbal remedies are relatively safe to use, some are toxic or possess adverse reactions, especially when used incorrectly.Commonly used TCM herbs with known adverse reactions, as well as the most toxic herbs in the Pharmacopoeia of People’s Republic of China are listed as follows:

Assessment of a Precaution Index for Environmental Evaluation: An Example of Application to the Cow’s Milk Production

The paper presents a Precaution Index (P) developed to create an instrument to assess the potential risk related to the presence of pollution sources next to milk production farms. The methodology starts from the inventory and geo-referencing of all pollution sources in an area, with the help of the multi-criteria decision analysis. Results are represented in a map of P, which highlights which areas are most at risk and need monitoring, and which pollutants may be involved. This may help in the early identification of emerging hazards to food safety. P was calculated for the milk production in an Italian region. Results show that 97% of the area is in a condition of minimum precaution that would be needed in controlling the safety of dairy products.

Precautions before starting tofacitinib in persons with rheumatoid arthritis

Tofacitinib is an immunosuppressive and disease-modifying therapy in rheumatoid arthritis.It may result in many infections flaring up.It is important to take precautions of all kinds(cardiovascular,malignancy,infections etc.)before starting tofacitinib.In this article,we have highlighted important steps where we need to take precautions before starting tofacitinib.

Safely Using TCM Herbs: Adverse Reaction and Precautions (Continued)

Chan su (Venenum Bufonis,蟾酥)Its main active and toxic constituent is bufotoxin, which has a function similar to digitalis glycosides.Adverse reactions and toxicity: Chan su, althoughit is used in patent preparations, is traditionally known for its toxicity and is seldom used in decoctions. Toxicity is often due to over dosage of the patents, such as Liushenwan (六神丸) and Houzhengwan (喉症丸). After administration

Contamination Precautions for Chemicals Which May Be Used in Drinking Water Treatment

The present study aims to treat some aspects of environmental contamination under the focus of the principle of precaution, which is based on ideas and discussion about the concerns of society regarding ethics, the environment, water resources, the risk of contamination, and the uncertainties of technological applications in all areas of human knowledge. In the assessment of these scenarios it was decided to evaluate, under a critical view, the chemicals used in the treatment of drinking water, which could cause health problems, directly or indirectly, in the population. Some samples of commercial aluminium sulphate were analysed, concluding that there was a need for physical and chemical assessments to identify the origins of the raw materials used in its manufacturing process.

Challenges and Adherence to Standard Precautions for Prevention of Percutaneous Injuries and Exposure to Blood Borne Pathogens in Clinical Practice: A Review

Background: Standard Precautions (SP) was introduced by Centre for Disease Control to minimise the risks of disease transmission in the process of healthcare. Many factors are thought to influence the knowledge and the practice of these measures. Objective: To review challenges and adherence to SP for the prevention of percutaneous injuries and exposure to patients’ blood in clinical practice. Methods: The World Wide Web sites such as, Pub Med central, Google scholar were searched using key words such as percutaneous, needle stick injuries, standard precautions, adherence. Relevant articles were reviewed and included based on defined criteria. Results: The prevalence of needle stick injuries (NSI) varies among health care workers (HCWs) and across countries and is as high as 73% among some groups. The knowledge of SP varied among HCWs in different nations;however the practice of SP was noted to be lower than knowledge across most studies. Majority of HCWs in developing countries that sustained NSI failed to report the incident to appropriate authorities. Adherence to Standard Precautions is influenced by lack of proper training, poor supplies, low commitment of HCWs and health facility managers etc. Conclusion: Needle stick injuries and exposure to patients’ blood remain a risk for disease transmission among HCWs. Despite appreciable knowledge of standard precautions, the practice has remained low across the globe. Factors that had positive influence on practice of SP such as use of devices with safety features, adherence to infection control guideline, comfortable working environment, repeated and intense training etc. should be adopted and promoted.

Contact Precaution: Acceptance of Health Professionals to Teaching Hospital

The adoption by health professionals to the practice of patient isolation is a decision that reduces patients’ risks of occupational exposure to potentially contaminated biological material and prevents nosocomial infections. Verify the compliance of health professionals to the practices of contact precautions in patients colonized by microorganisms in a teaching hospital. This was a prospective observational cohort study in a special-sized hospital located in southeastern Brazil. The observation of health professionals in delivery of health care to patients with contact precaution was performed regarding hand hygiene, use of overcoat, glove, and mask. We carried out 1502 observations involving the following professional categories: nursing technicians and/or nursing assistants (n = 1028;68.4%), nurses (n = 200;13.3%), physical therapists (n = 185;12.3%), and physicians (n = 89;5.9%), totaling 971.8 hours. Regarding the level of compliance of professionals to contact precaution practices with hand hygiene after the procedures, the use of overcoats, gloves, and masks, all were statistically significant (p Klebsiella pneumoniae was the most positive pathogen identified in laboratory tests. This study provided the mapping of the compliance of health professionals to the practices of contact precautions in order to support a safer management of patient care reducing the risks of Healthcare-Associated Infections (HAI). This study also showed that health professionals are using practice management to deal with their behavior to protect their health.

Midwives and Nurses Compliance with Standard Precautions in Palestinian Hospitals

Midwives and nurses should use the standard precautions as the basic level of infection control precautions when delivering care to all patients, regardless of their presumed infection status. Therefore midwifes and nurses should have sound knowledge and compliance with standard precaution. Aim of the study: The study aimed to assess the level of the compliance of standard precautions among the midwives and nurses in the Palestinian Hospitals. Method: A cross sectional study was conducted from May to June 2015 on 81 midwives and nurses from Palestinian hospitals. The data were collected from labor rooms and postpartum departments of Palestinian hospitals. Data were collected using pretested questionnaire on 81 midwives and nurses selected by convenience sample. Results: The current study showed that the average of standard precautions knowledge level and compliance are 74.6% and 83.8% respectively. There are an association between age, education, work experience, and compliance with standard precautions at p p < 0.05 (0.191). Conclusion: The midwives and nurses in the current study for both knowledge and compliance have high level regarding standard precautions. There is an association between age, education, work experience, and compliance with standard precautions. Recommendations: Knowledge of midwives and nurses should be updated;the importance of latest evidence-based practices of infection control in continuing education/training program should be emphasized;and training programs for newly midwives and nurses about standard precaution and at regular intervals should be provided.

Online Sourcing - Take Precautions

With trade of over $100 billion in 2009, the importance of China and Africa bilateral exchanges are growing daily. This blooming relationship increases the need of understanding the ways of doing business.This regular column will provide a practical insight of doing business in China, including tips and advice based on experience.

Fire Burning Characteristics, Attacking Techniques and Safety Precautions in Pinus pumila Scrubs

In China, Pinus pumila is mainly distributed in Daxing’anling, while those growing in the eastern Daxing’anling are primarily covered under the jurisdiction of Huzhong Forest Bureau. P. pumila is an evergreen shrub, 3-6 m high, and always grows vigorously. Its trunks creep along the ground, usually 10 m long or more. It is easily flammable because of the large amounts of resins and volatile oils in its body. Attacking forest fires is a dangerous work, especially in P. pumila scrubs. The fires in P. pumila scrubs are very different from those in other forest types, e.g. fierce combustion and heavy smoke. In this paper, the distribution characteristics of P. pumila scrubs were presented. Attacking techniques and safety precautions for attacking fires in P. pumila scrubs were also discussed.

埃索美拉唑钠预防咽喉肿瘤术后并发应激性溃疡出血的研究

我们对80例咽喉肿瘤术后患者分别采用埃索美拉唑和泮托拉唑进行应激性溃疡出血预防性治疗的对比研究。1资料与方法1.1一般资料。选择2011年2月～11月我科咽喉肿瘤患者80例,随机分为2组,治疗组40例,男36例,女4例,平均年龄57.2岁;对照组40例,男35例,女5例,平均年龄59.8岁。两组患者年龄、性别、病种、手术时间、吸烟史、饮酒史比较差异无明显差异。

Expert Recommendations for Tracheal Intubation in Critically Ill Patients with Noval Coronavirus Disease 2019

Coronavirus Disease 2019(COVID-19),caused by a novel coronavirus(SARS-Co V-2),is a highly contagious disease.It firstly appeared in Wuhan,Hubei province of China in December 2019.During the next two months,it moved rapidly throughout China.Most of the infected patients have mild symptoms including fever,fatigue and cough,but in severe cases,patients can progress rapidly and develop into acute respiratory distress syndrome,septic shock,metabolic acidosis and coagulopathy.The new coronavirus was reported to spread via droplets,contact and natural aerosols from human to human.Therefore,aerosol-producing procedures such as endotracheal intubation may put the anesthesiologists at high risk of nosocomial infections.In fact,SARSCo V-2 infection of anesthesiologists after endotracheal intubation for confirmed COVID-19 patients have been reported in hospitals in Wuhan.The expert panel of airway management in Chinese Society of Anaesthesiology has deliberated and drafted this recommendation,by which we hope to guide the performance of endotracheal intubation by frontline anesthesiologists and critical care physicians.During the airway management,enhanced droplet/airborne personal protective equitment(PPE)should be applied to the health care providers.A good airway assessment before airway intervention is of vital importance.For patients with normal airway,awake intubation should be avoided,and modified rapid sequence induction is strongly recommended.Sufficient muscle relaxant should be assured before intubation.For patients with difficult airway,good preparation of airway devices and detailed intubation plans should be made.

Slope stability evaluation and monitoring of a landslide: a case study from NE Turkey

Landslides are quite common natural hazards in the eastern Black Sea region of NE Turkey.Following the heavy rainfall in the K?prülü(Rize)village settlement area,located in this region where the slope debris overlies the agglomerates,a failure occurred.Due to the developed tension cracks and deformations on the ground,houses,tea gardens,and roads were damaged completely.To figure out the causes and mechanism of the sliding and to suggest the precautions,a detailed geotechnical study was carried out.Along the five survey lines,twelve boreholes were drilled with a total depth of 300 meters.Also,the geophysical surveys on ten profiles were conducted and the inclinometer measurements were taken in five boreholes.Undisturbed and disturbed samples were collected and laboratory experiments were performed.Inclinometer measurements indicated that the sliding started in the slope debris and then spread to the agglomeratic bedrock.The slope stability was examined using the limit equilibrium(LE)and finite element(FEM)analysis methods.The results of the slope stability analyses showed that the failure mode is talus slide with composite shape and outputs coincide with the inclinometer monitoring results.Based on the collected data,it is determined that there will be unavoidable engineering problems if no precautions are taken.Because of the negative reasons which make the application of supporting methods meaningless in the study area,it is considered that transferring the residences to a safer place without risk of natural hazards will be economical and reliable.

Infection Prevention Strategy in Operating Room during Coronavirus Disease 2019(COVID-19)Outbreak

A novel coronavirus that emerged in late 2019 rapidly spread around the world.Most severe cases need endotracheal intubation and mechanical ventilation,and some mild cases may need emergent surgery under general anesthesia.The novel coronavirus was reported to transmit via droplets,contact and natural aerosols from human to human.Therefore,aerosol-producing procedures such as endotracheal intubation and airway suction may put the healthcare providers at high risk of nosocomial infection.Based on recently published articles,this review provides detailed feasible recommendations for primary anesthesiologists on infection prevention in operating room during COVID-19 outbreak.

Estimating the Impact of COVID-19 Pandemic on the Research Community in the Kingdom of Saudi Arabia

Ever since its outbreak inWuhan,COVID-19 has cloaked the entireworld in a pall of despondency and uncertainty.The present study describes the exploratory analysis of all COVID cases in Saudi Arabia.Besides,the study has executed the forecastingmodel for predicting the possible number of COVID-19 cases in Saudi Arabia till a defined period.Towards this intent,the study analyzed different age groups of patients(child,adult,elderly)who were affected by COVID-19.The analysis was done city-wise and also included the number of recoveries recorded in different cities.Furthermore,the study also discusses the impact of COVID-19 on the economy.For conducting the stated analysis,the authors have created a list of factors that are known to cause the spread of COVID-19.As an effective countermeasure to contain the spread of Coronavirus in Saudi Arabia,this study also proposes to identify the most effective Computer Science technique that can be used by healthcare professionals.For this,the study employs the Fuzzy-Analytic Hierarchy Process integrated with the Technique for Order Performance by Similar to Ideal Solution(F.AHP.TOPSIS).After prioritizing the various Computer Science techniques,the ranking order that was obtained for the different techniques/tools to contain COVID-19 was:A4>A1>A2>A5>A3.Since the Blockchain technique obtained the highest priority,the study recommends that it must be used extensively as an efficacious and accurate means to combat COVID-19.