The Place of Nursing Theory in the Management of Post-Operative Infections in a Hospital Environment: Case of Cibitoke District Hospital

Introduction: Post-operative infections, such as surgical site infections (SSIs), are a significant concern in healthcare settings. Nurses play a crucial role in the prevention and management of these infections. The use of nursing theory could contribute to the prevention of SSIs. The aim of this study was to evaluate the role of nursing theory in the management of surgical site infections (SSIs) in a hospital environment. Method: A cross-sectional study was conducted using descriptive and analytical methods to assess the role of nursing theory in the management of Post-operative infections (POI) in a hospital setting in October 2023. The study population consisted of nurses working in the Surgery, Emergency, and Maternity units at Cibitoke District Hospital. A sample size of 71 nurses working full or part time in the Surgery were invited to participate in this study. A questionnaire was used to collect the data, and SPSS version 21.0 software was used for analysis. Results: The study found that nursing theory did not have any statistically significant place in the management of POI (p-value = 0.523). However, the results showed that experience was the only significant factor influencing the management of POI (p-value = 0.004). This is explained by the analysis of the net effects of the explanatory variable where we noticed that those who had more experience were more likely to manage post-operative infections. The participants’ knowledge regarding nursing theory in the management was poor as they scored less than 30% in all the variables used to measure their knowledge. Conclusion: The study revealed that nurses’ knowledge of nursing theories and their applications in the management of SSIs was poor. Continuing professional development, curriculum review, and in-service training were highly recommended.

Management Measures for Preventing Postoperative Incision Infections in General Surgery at Primary Hospitals

Objective:To analyze the management measures and effects of preventing postoperative incision infections in the general surgery department of primary hospitals.Methods:Forty-nine surgical patients with 11 healthcare workers who were admitted to the general surgery department of the primary hospital between August 2021 and August 2022 were selected as the routine group for routine incision infection management.Forty-nine surgical patients with 11 healthcare workers admitted to the same department between September 2022 and September 2023 were selected as the prevention group for prophylactic management of postoperative incision infections.The incision infection rate,knowledge,attitude,and practice(KAP)scores,and management satisfaction of the patients as well as the management skill scores of healthcare workers were compared between the two groups.Results:The rate of postoperative incision infection in the prevention group was lower than that in the routine group;after implementing management measures,patients in the prevention group had higher KAP scores than those in the routine group;patients in the prevention group were more satisfied with the management than those in the routine group;and healthcare workers in the prevention group had higher scores than those in the routine group,with P<0.05 for the comparison between the groups.Conclusion:The implementation of preventive management for general surgery patients in primary hospitals can reduce the incidence of postoperative incision infection and improve the KAP of patients,with higher management satisfaction.It can also enhance the management skills of healthcare workers,thus improving their overall management level.

BK viral infection: A review of management and treatment

BK viral infection remains to be a challenging post-transplant infection,which can result in kidney dysfunction.The mainstay approach to BK infection is reduction of immunosuppression.Alterations in immunosuppressive regimen with minimization of calcineurin inhibitors,use of mechanistic target of rapamycin inhibitors,and leflunomide have been attempted with variable outcomes.Over the past few years,investigators have explored potential therapeutic options for BK infection.Fluoroquinolone prophylaxis and treatment was found to have no benefit in kidney transplant recipients.The utility of cidofovir is limited by its nephrotoxicity.Intravenous immunoglobulin is becoming a popular option for treatment and prophylaxis for BK infection,as it increases the neutralizing antibody titers against the most common BK virus serotypes.Virus-specific T cell therapy is an emerging treatment option for BK viremia.In this review,we will explore management and therapeutic options for BK infection and recent evidence available in literature.

Severe acute pancreatitis complicated with intra-abdominal infection secondary to trauma:A case report

BACKGROUND Pancreatic trauma(PT)is rare among traumatic injuries and has a low incidence,but it can still lead to severe infectious complications,resulting in a high mortality rate.Acute pancreatitis(AP)is a common complication after PT,and when combined with organ dysfunction and sepsis,it will result in a poorer prognosis.CASE SUMMARY We report a 25-year-old patient with multiple organ injuries,including the pancreas,due to abdominal trauma,who developed necrotising pancreatitis secondary to emergency caesarean section,combined with intra-abdominal infection(IAI).The patient underwent performed percutaneous drainage,pancreatic necrotic tissue debridement,and abdominal infection foci debridement on the patient.CONCLUSION We report a case of severe AP and IAI secondary to trauma.This patient was managed by a combination of conservative treatment such as antibiotic therapy and fluid support with surgery,and a better outcome was obtained.

Application of PDCA in improving hand hygiene compliance and nosocomial infection quality in orthopedics

Objective:To explore the effect of the Plan-Do-Check-Action(PDCA)cycle on hand hygiene and nosocomial infection quality of or thopedic medical staff.Methods:The whole year of 2021 was selected to monitor the quality of hand hygiene and hospitalization.Follow-up monitoring and real-time recording during the period of morning shift and medical operation concentration time,and compare the compliance of hand hygiene before and after implementation,and evaluate the quality of nosocomial infection.Results:The hand hygiene compliance of doctors and nurses in stage P was 82%.The compliance of medical staff in stage D was 93%.The compliance of stage C was 94%and that of stage A was 95%.The quality score of hospital self-examination nosocomial infection was also significantly increased.Conclusions:The PDCA management cycle can effectively improve the compliance of hand hygiene and the nosocomial infection quality,which is wor thy of circulatory application in or thopedic nosocomial infection quality control,especially improving the quality of hand hygiene.

Management of bacterial and fungal infections in end stage liver disease and liver transplantation: Current options and future directions

Patients with liver cirrhosis are susceptible to infections due to various mechanisms, including abnormalities of humoral and cell-mediated immunity and occurrence of bacterial translocation from the intestine. Bacterial infections are common and represent a reason for progression to liver failure and increased mortality. Fungal infections, mainly caused by Candida spp., are often associated to delayed diagnosis and high mortality rates. High level of suspicion along with prompt diagnosis and treatment of infections are warranted. Bacterial and fungal infections negatively affect the outcomes of liver transplant candidates and recipients, causing disease progression among patients on the waiting list and increasing mortality, especially in the early posttransplant period. Abdominal, biliary tract, and bloodstream infections caused by Gram-negative bacteria [e.g., Enterobacteriaceae and Pseudomonas aeruginosa(P. aeruginosa)] and Staphylococcus spp. are commonly encountered in liver transplant recipients. Due to frequent exposure to broad-spectrum antibiotics, invasive procedures, and prolonged hospitalizations, these patients are especially at risk of developing infections caused by multidrug resistant bacteria. The increase in antimicrobial resistance hampers the choice of an adequate empiric therapy and warrants the knowledge of the local microbial epidemiology and the implementation of infection control measures. The main characteristics and the management of bacterial and fungal infections in patients with liver cirrhosis and liver transplant recipients are presented.

Analysis of the Influence of Operating Room Nursing Care Management on the Incidence Rate of Nosocomial Infection in Orthopedic Surgery Patients

Objective:To analysis the influence of operating room nursing care management on the incidence rate of nosocomial infection in orthopedic surgery patients.Methodology:Fifty six orthopedic surgery patients who admitted into the hospital between January to December 2018 were enrolled into this study and randomly divided into two groups,which were the control group(under general management)and the observation group(under the operating room nursing care management).Further,the incidence rate of nosocomial infections,the incidence rate of irregular nursing care phenomena,the satisfaction score of nursing care management,and the quality of life score were observed and recorded.Result:The incidence rate of nosocomial infection,the incidence rate of irregular nursing care management,the satisfaction score of nursing care management,and the quality of life score of the observation group were compared to that of the control group,and the result showed P<0.05,indicates the statistical significance between the data indicators.Conclusion:The use of operating room nursing care management in patients with orthopedic surgery has shown a significant effect.

Management strategy of prevention and control of nosocomial infection of COVID-19 in blood purification center

There are many patients in the blood purification center who need maintenance hemodialysis to maintain life. Those patients generally havelow resistance and are easily exposed to coronavirus because they go back and forth the hospital and residence three times a week andclosely contact with family, caregivers, community personnel, people in various means of transportation, medical staff, and other patientsvisiting hospital. Therefore, the blood purification center has become a high‑risk environment for the spread of COVID-19 infection. In viewof this, our center quickly responded to the formulation and implementation of infection prevention and control measures suitable for thecharacteristics of the blood purification center and continuous renal replacement therapy (CRRT) emergency plan for fever and suspectedpatients. According to these measures, we have a positive effect on preventing and controlling nosocomial infection in the blood purificationcenter.

Study on Application Effect of 6S Management Mode in Infection Control Management of Fangcang Shelter Hospital of National Exhibition and Convention Center

Objective:In 2022,a pneumonia caused by novel coronavirus broke out in Shanghai.A large number of medical personnel were deployed nationwide to support the Fangcang Shelter Hospital of National Exhibition and Convention Center(Shanghai).Because the of the underdeveloped infrastructure and the disorganized layout process,the phenomenon of infection among medical personnel was rampant given the highly contagious nature of the Omicron variant.This paper discusses the effect of 6S management in infection control management of Fangcang Shelter Hospital of National Exhibition and Convention Center(Shanghai).Methods:A series of 6S management practices were carried out based on the evaluation of the control management of Fangcang Shelter Hospital of National Exhibition and Convention Center(Shanghai)during the anti-epidemic period,and the effect of the implementation of 6S management was studied based on the rapport among team members and the overall control system process,the management of wearing and stripping channels,the time of wearing protective articles and the psychological and emotional changes of the team members.Results:After the implementation of 6S management mode,the management of dressing room,epidemic prevention materials,and occupational protection awareness and infection control safety were significantly improved.More than 95.5%of the team members believed that improving the working environment in the shelter increased the confidence of victory in the fight against the epidemic,reduced the preparations before entering and leaving the cabin,improved the work efficiency and ensured occupational safety.It ensures the realization of the goal of“zero infection”and is set as a benchmark of control work of Fangcang Shelter Hospital of National Exhibition and Convention Center(Shanghai).Conclusion:The application of 6S management mode to the shelter infection control management can create and maintain a good working environment in the shelter,promote the implementation effect of various systems and processes of infection control,reduce the potential infection risk in the shelter and improve the efficiency of infection control management.

Therapeutic Aspects of Chronic Bone Infections and Management Challenges

This study aims to investigate various aspects of the treatment of chronic bone infections and the challenges in their management. The characterization of treatment of 73 patients with chronic bone infection was reported. The four management challenges including consultation delay, immune depression, extreme variety of clinical manifestations and non-use of CT or MRI were discussed in this study. We conducted a retrospective study at Aristide Le Dantec Hospital on 90 cases of chronic bone infection in 73 patients. The mean duration of symptoms before consultation was 36 months. More than half of the patients had a productive fistula at the first consultation. Sickle cell anemia was found in 6 patients. Multiple lesions were found in 10 patients;and long bones were affected in 90% of cases. The bacterial culture was positive in 93.15%. Staphylococcus aureus was the most isolated germ (68.35%). Seventy-two out of seventy-three patients were operated on. The procedure depended on anatomical and radiological lesions. Surgical treatment was associated with antibiotherapy which was firstly probabilistic and secondarily adapted to the results of bacterial culture. A favorable trend was found in 41 patients (56.16%). 32 cases of adverse effects were noted (43.83%), and 27 patients had recurrence after a favorable outcome. Several complications and sequelae were observed demonstrating the tenacity of these chronic infections.

Dynamic changes of cellular immune function and individualized adjustments of immunosup-pressant for the management of severe infection after liver transplantation

Objective To explore the dynamic changes of the cellular immune function in severe infection after liver transplantation,and to guide the individualized immunology adjustment. Methods 378 cases of liver transplantation were analyzed retrospectively. Seventy - four cases ( infection group) suffered serious infection,including 54 cases cured ( cure group) ,20 cases died (

Current scenario of traditional medicines in management of diabetic foot ulcers:A review

Diabetic foot infections and diabetic foot ulcers(DFU)cause significant suffering and are often recurring.DFU have three important pathogenic factors,namely,microangiopathy causing local tissue anoxia,neuropathy making the foot prone to injuries from trivial trauma,and local tissue hyperglycaemia favouring infection and delaying the wound healing.DFU have been the leading cause for non-traumatic amputations of part or whole of the limb.Western medicines focus mainly on euglycaemia,antimicrobials,debridement and wound cover with grafts,and off-loading techniques.Advances in euglycaemic control,foot care and footwear,systemic antimicrobial therapy,and overall health care access and delivery,have resulted in an overall decrease in amputations.However,the process of wound care after adequate debridement remains a major cost burden globally,especially in developing nations.This process revolves around two basic concerns regarding control/eradication of local infection and promotion of faster healing in a chronic DFU without recurrence.Wound modulation with various dressings and techniques are often a costly affair.Some aspects of the topical therapy with modern/Western medicines are frequently not addressed.Cost of and compliance to these therapies are important as both the wounds and their treatment are“chronic.”Naturally occurring agents/medications from traditional medicine systems have been used frequently in different cultures and nations,though without adequate clinical base/relevance.Traditional Chinese medicine involves restoring yin-yang balance,regulating the‘chi’,and promoting local blood circulation.Traditional medicines from India have been emphasizing on‘naturally’available products to control wound infection and promote all the aspects of wound healing.There is one more group of chemicals which are not pharmaceutical agents but can create acidic milieu in the wound to satisfy the above-mentioned basic concerns.Various natural and plant derived products(e.g.,honey,aloe vera,oils,and calendula)and maggots are also used for wound healing purposes.We believe that patients with a chronic wound are so tired physically,emotionally,and financially that they usually accept native traditional medicine which has the same cultural base,belief,and faith.Many of these products have never been tested in accordance to“evidence-based medicine.”There are usually case reports and experience-based reports about these products.Recently,there have been some trials(in vitro and in vivo)to verify the claims of usage of traditional medicines in management of DFU.Such studies show that these natural products enhance the healing process by controlling infection,stimulating granulation tissue,antimicrobial action,promoting fibroblastic activity and collagen deposition,etc.In this review,we attempt to study and analyse the available literature on results of topical traditional medicines,which are usually advocated in the management of DFU.An integrated and‘holistic’approach of both modern and traditional medicine may be more acceptable to the patient,cost effective,and easy to administer and monitor.This may also nevertheless lead to further improvement in quality of life and decrease in the rates of amputations for DFU.

A Blockchain-Based Life-Cycle Environmental Management Framework for Hospitals in the COVID-19 Context

During the coronavirus disease 2019 (COVID-19) emergency, many hospitals were built or renovated around the world to meet the challenges posed by the rising number of infected cases. Environmental management in the hospital life cycle is vital in preventing nosocomial infection and includes many infection control procedures. In certain urgent situations, a hospital must be completed quickly, and work process approval and supervision must therefore be accelerated. Thus, many works cannot be checked in detail. This results in a lack of work liability control and increases the difficulty of ensuring the fulfillment of key infection prevention measures. This study investigates how blockchain technology can transform the work quality inspection workflow to assist in nosocomial infection control under a fast delivery requirement. A blockchain-based life-cycle environmental management framework is proposed to track the fulfillment of crucial infection control measures in the design, construction, and operation stages of hospitals. The proposed framework allows for work quality checking after the work is completed, when some work cannot be checked on time. Illustrative use cases are selected to demonstrate the capabilities of the developed solution. This study provides new insights into applying blockchain technology to address the challenge of environmental management brought by rapid delivery requirements.

New insights in diabetic foot infection

Foot ulcers are common in diabetic patients,have a cumulative lifetime incidence rate as high as 25%and frequently become infected.The spread of infection to soft tissue and bone is a major causal factor for lowerlimb amputation.For this reason,early diagnosis and appropriate treatment are essential,including treatment which is both local(of the foot)and systemic(metabolic),and this requires coordination by a multidisciplinary team.Optimal treatment also often involves extensive surgical debridement and management of the wound base,effective antibiotic therapy,consideration for revascularization and correction of metabolic abnormalities such as hyperglycemia.This article focuses on diagnosis and management of diabetic foot infections in the light of recently published data in order to help clinicians in identification,assessment and antibiotic therapy of diabetic foot infections.

Environmentally friendly polylysine gauze dressing for an innovative antimicrobial approach to infected wound management

Infections frequently occur after skin injuries,posing a significant challenge in current clinical care.Frequently changing dressings to minimize wound infections and adhesions results in large amounts of medical waste.Therefore,developing environmentally friendly multifunctional dressings has considerable application and translational significance.This study aimed to prepare a wound dressing with favorable antimicrobial properties and biosafety by grafting a natural antimicrobial peptide,polylysine,onto a traditional cotton textile dressing.The cotton textile dressing offers excellent moisture absorption and softness,while polylysine provides excellent biocompatibility,a broad antimicrobial spectrum,and high stability.Furthermore,both materials are natural and biodegradable,making them ideal for environmentally friendly wound dressings.

Comments on the article about the treatment of peripancreatic infection

We read with great interest the article by Tang et al published in issue 4 of World Journal of Gastroenterology 2010.The results of their study indicate that percutaneous catheter drainage in combination with choledochoscope-guided debridement is a simple,safe and reliable treatment procedure for peripancreatic infections secondary to severe acute pancreatitis.However,there are some points that need to be addressed,including data about the patients in the study and their clinical characteristics,data about infection and superinfection during the treatment and type of treatment of patients with acute necrotizing pancreatitis.

Steroids in Maxillofacial Space Infection: A Retrospective Cohort Study

Maxillofacial space infection (MSI) is one of the most common conditions encountered in oral and maxillofacial surgery clinics. Early recognition and proper management of MSI could prevent a life-threatening event. Objectives: To report a series of MSI managed with antibiotics, surgical intervention and exogenous steroids as an adjunct, highlighting functional improvement following steroid administration. Methods: A retrospective cohort study was carried out from December 2013 to September 2016, involving 30 patients (n = 30, 22 males, 8 females) diagnosed with MSI. All patients were initially managed with intravenous empirical antibiotics, analgesics and removal of potential source of infection. A course of 3 doses of IV Dexamethasone 8 mg at an interval of 8 hours was started during the first day of hospital admission. Results: This series reports 30 patients presenting with MSI, who received prompt antibiotics and 3 doses of steroids as inpatients. Significant clinical improvement was noted in the form of amelioration of pain, rapid reduction in edema, and improved trismus, shortening hospital stay to an average of 3.5 days, and omission of surgical intervention in 50% of our cases. No adverse effects or drug reaction was noted. Conclusion: In conclusion, the value of synergistic use of corticosteroids with antibiotics in management of MSI is significant. Despite these promising findings, there is scarce evidence in the literature to fully support the use of corticosteroids in abscess management. The role of corticosteroids in treatment of MSI should be explored further.

Effects of cooperative nursing and patient education on postoperative infection and self-efficacy in gastrointestinal tumors

BACKGROUND Gastrointestinal tumors have a high incidence rate.The application value of the cooperative nursing care system of medical care has received widespread attention in recent years.However,there are few studies on the value of the joint application of collaborative nursing care and self-efficacy education.AIM To explore the effect of cooperative nursing care management/self-efficacy education on postoperative infection and self-efficacy in gastrointestinal tumor surgery patients.METHODS A total of 102 patients with gastrointestinal tumors treated in our hospital from October 2018 to February 2020 were selected and divided into a conventional group(n=51)and a combined group(n=51)according to the nursing plan.The routine group adopted routine nursing,and the joint group adopted the medical care cooperative responsibility system nursing management combined with selfefficacy education.The self-efficacy scores,coping style scores,self-experience burden scores,and postoperative complication rates of the two groups before and after intervention were counted.RESULTS After intervention,the daily life behavior management,cognitive symptom management,and disease management scores of the two groups were higher than those before the intervention,and those of the combined group were higher than those of the conventional group(all P=0.000).After the intervention,the positive response scores of the two groups were higher than those before the intervention,the negative response scores were lower than those before the intervention,and the combined group was better than the conventional group(all P=0.000).After the intervention,the two groups’emotional,economic,and physical factor scores were lower than those before the intervention,and the combined group was lower than the conventional group(all P=0.000).The incidence of infection in the combined group(1.96%)was lower than that in the conventional group(15.69%)(P=0.036).CONCLUSION Cooperative nursing care management and self-efficacy education improved the physical and mental states of gastrointestinal cancer surgery patients,change the response to disease,and reduce the risk of postoperative infection.

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.

Role of an acidic environment in the treatment of diabetic foot infections:A review

Management of diabetic foot ulcers is the biggest challenge to the clinician,as conventional antibiotic therapies and local wound care have their own limitations.They are not effective for control of infections and promotion of healing because of cytotoxic effects.In view of cytotoxicity of routinely used topical antiseptic agents,this article focuses on the search of an ideal topical antiseptic agent that is safe and effective in controlling infectious agents and also in promoting the healing process.This review focuses on the use of various acids such as citric,acetic,hyaluronic,and hypochlorous acids as topical agents in diabetic foot infections.This article also focuses on the different roles of acids in the treatment of diabetic foot infections.