Surgical Site Infection (SSI) remains one of the most important problems in post operative complication, contributing approximately 38% of all cases. There is no doubt that SSIs substantially contribute to prolongation of hospital stay and increase costs. However, it has been difficult to establish the extent SSI contributes to attributable mortality. Research has found that the likelihood of death for patients with SSI is twice that for patients without Surgical Site Infection. This book gives a fresh look on the incidence of postoperative wound infections among the patients undergoing surgical procedure, risk factors that predispose to postoperative wound infections and characterize pathogens associated with Surgical Site Infections at a tertiary hospital in Africa. It brings with it the sense of infection control in health care setup, which forms a basis of antibiotic stewardship.
The main aim of this study to conduct surveillance program of surgical wound infections and to improve surgical practice by surgeons and otherhealthcare professionals. This study describes the results obtained in an epidemiological study of surgical wound infections through an active surveillance program lasting one year in surgical unit of a rural teaching hospital. It is a prospective observational study including patients of surgery ward of Rajah Muthaiah Medical College Hospital who have developed surgical wound infections during hospitalization. Among admissions in surgery ward, 300 cases were screened to have developed surgical wound infections. The most common microorganisms responsible for the infections observed were mainly gram negative and the most commonly isolated were Staphylococcus aureus and Escherichia coli Highest numbers of cases were observed after Wound debridement and Incision and Drainage operative procedures. Among wound Classes, dirty wounds have found to be highest . Superficial incision site infections were highest among other surgical sites. These nosocomial infection surveillance programs of nosocomial infections in rural setting are very rarely
Nosocomial infection (NI) is an infection acquired whilst staying, visiting or working in a hospital or healthcare facility. ? It is also defined as an infection acquired in hospital by a patient who was admitted for a reason other than that infection or an infection occurring in a patient in a hospital or other health care facility in whom the infection was not present or incubating at the time of admission. ? One of the risk factors for such infection is bacterial contamination of hospital wards indoor air by bacteria. In view of that, the microbiological quality of air can be considered as a mirror of the hygienic condition for hospital wards.
Wound infections are one of the most common hospital acquired infections and are an important cause of morbidity and mortality. Wound infection can be caused by different groups of microorganisms like Bacteria, Fungi and Protozoa. Most commonly aerobic microorganisms include Staphylococcus aureus, Coagulase Negative Staphylococci (CoNS), Enterococci, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumonia, Enterobacter, Acinetobacter etc. Common wound infections are Surgical site infections, Bite wound infections, Burn wound infections, Acute soft tissue infections, Diabetic foot ulcer infections, Leg and decubitus (pressure) ulcer infections. Surgical site infection rates in India to be between 4 to 30%. The control of wound infections has become more challenging due to widespread bacterial resistance to antibiotics and to a greater incidence of infections caused by methicillin-resistant Staphylococcus aureus and polymicrobic flora. The knowledge of the causative agents of wound infection has therefore proved to be helpful in the selection of empiric antimicrobial therapy and on infection control measures in health institutions.
The history of surgery is nearly as old as the human race. Control of wound infection has always been an essential part of any surgical procedure, and is still an important challenge in hospital operating rooms today. For patients undergoing surgery there is always a risk that they will develop some kind of postoperative complication. Over recent decades, the importance of airborne bacteria in the ORs has been a matter of interest and dispute. The number of viable airborne bacteria is highly correlated to risk of infection to the surgical patient. Almost 80-90% of bacterial contamination detected in an operative wound comes from the surrounding air. It was showen that both aerobic and anaerobic skin bacteria are dispersed into the air and survive sufficiently long to make an airborne route of wound infection. Transfer of bacteria from the patient's skin may also be likely to occur due to the surgical procedure, although this is a matter of continuing debate. Transport mechanisms of BCPs are much more important in infection-prone surgeries such as orthopaedic replacement, because bacterial species causing SSI belong to the normal skin flora.
Risk management has become a necessary activity in the administration of a hospital .The present study focused on assessment of some aspects of risk management in Main University Hospital in Alexandria (MUHA), including fire prevention and control measures , performance of hospital staff in providing some patient care activities and procedures which have the potential of risk of infection , knowledge of hospital staff regarding prevention of some occupational illnesses , training programs relevant to employees safety , and the role of relevant committees in implementation of risk management activities . The study was conducted in one general medical ward and one surgical ward in MUHA .Six checklists were designed to collect data about fire prevention and control measures and five patient care practices . Two questionnaires were prepared for interview with nurses , housekeepers and chairmen of safety related hospital committees namely : occupational health and safety committee , infection control committee and environment committee . The study revealed shortcoming of risk management in the MUHA .In spite of the presence of committee .
Hospitals are the integral parts of complete healthcare system so it is very important to understand the functions & day to day operations of hospitals/ healthcare providers. The main aim of this book is to give the clear, practical & brief understanding of hospital departmental functions like: Out Patient Department, Patient Flow, Front Desk/Reception, In-Patient Department, Medical Laboratory, Waste Management, Kitchen/Dietary services, Housekeeping, CSSD/TSSD, Infection Control, Laundry Services, Medical Record Department,Gas Manifold Department, Radiology, Casualty/ Emergency ,ICU/ICCU, Rehabilitation Department, Store & Purchase Department, Operation Theater, Marketing Department, Human Resource & more. I am sure this Hospital Management Training Report book will help students, teachers & researchers from the Health & Hospital Management, Health Service Administration, Health Information Management etc to enable the understanding of Hospital functions.
This book tries to figure out and explain those factors associated with tuberculosis co-infection among HIV/AIDS patients taking anti retro-viral therapy. The study published in this book is conducted at Nekemte hospital, which is government owned hospital serving more than two million people in the Western part of Ethiopia. The hospital is one of few health institutions providing TB/HIV healthcare services in the country.
Biofilms are complex aggregates of microbes which attach to each other or to the surface and play a role in antibiotic resistance and persistence of infection. This research highlights that bacteria isolated from surface samples and equipments indicate poor hygienic condition in hospitals. Biofilm formation results in persistence of these organisms which contribute to Nosocomial infections. Contamination of water from swimming pools and domestic water indicates poor hygienic standards and ineffective chlorination. Biofilm of uropathogens and pus from wounds of diabetic patients, burn patient and surgical site infection result in prolonged infection, antibiotic resistance, delayed wound healing and extended hospitalization. Candida biofim also cause persistence of infection and helps the fungi to survive resulting in resistant infections. This book is useful for researchers, scientists, medical students, doctors and general public as it gives an insight about biofilms and its role in Nosocomial infection, transmission of infection through recreational water, domestic water and the role of biofilm in disease process and antibiotic resistance of organisms.
Nine patient safety solutions as recommended by W.H.O. were investigated at Sawai Mansingh Teaching Hospital, Jaipur (Rajasthan) India. It was found that hospital acquired infection and look alike, sound alike medication names were commonly problematic. Shortage of manpower, individual heavy work-load and compromising quality over quantity in providing health care at all levels by work force needed improvement . The training of these persons is needed on regular basis with the advancement of techniques and procedures. These and other details of the conducted study are reported herein on the basis of Nine Patient Safety Solutions as recommended by W.H.O.
Healthcare-associated infections (HCAI) are a major setback to any organization be it in Medicine or in Dentistry. Cross infection makes infection control practices important for health care personal’s to protect both patient as well as themselves. Hence, healthcare workers must know & implement standard infection control procedures & dispose biomedical waste properly for their own protection,for protecting patients & also to improve organization of work. Effective implementation of infection control procedures and adherence to standard precautions are challenging especially in resource-limited settings.
Periodontitis is a microbial disease affecting the supporting strctures of tooth, affecting the peoples of all gender and age groups. Local debridement of the bacteria and bacterial product from the site of infection and eliminating the microbes the systemic circulation is the key to successfully treat such disease. Systemic administration of antimicrobial agents produces less concentration of drug at the site of infection and on long term use, produces systemic toxicity and bacterial resistance. The introduction of local drug delivery in periodontics produces effective concentration of drug at the site of infection to treatment the disease and nullified those shortcomings. Therefore, nowadays local drug delivery is becoming more popular and demanding in treating patients with periodontal disease.
In oral and maxillofacial surgery, local anesthesia is used in exodontia, minor oral surgical procedures and in some major surgical procedures.Without vasoconstrictors local anesthetic agents can produce vasodilatation and increases rate of absorption of local anesthetics from injection site. Vasoconstrictors are added to local anesthesia to reduce bleeding from surgical site and to increase the duration of action of local anesthetics. Clonidine has been widely used, for a variety of purposes including withdrawing from long term abuse of drugs or alcohol, as well as to reduce perioperative stress in patients who are at risk of perioperative ischaemia. Clonidine has also proved to be a clinically useful adjunct in clinical anesthetic practice as well as in chronic pain therapy.
Medical waste management forms an essential part of the hospital service which involves technical, financial, managerial, administrative and logistic supports from national level. Hospital services deserve more attention since everybody wishes to see hospitals as ideal place for medical treatment having sanitation and hygienic activities. Bangladesh with its more than 150 million populations is overburdened with medical wastes. The result of the study has shown the variation of different variables used for the comparison among different category institutions and between government and non-government hospitals. No tertiary hospital and no government specialized hospital initiated medical waste management practices Non-government hospitals are managing waste better than government hospitals. Nosocomial infection rate is much higher in government hospitals than Non-government hospitals. Result indicates the lack of sufficient initiatives from government end for introducing medical waste management practices in Bangladesh. The rate of nosocomial infection in government hospitals should immediately be addressed for the sake of controlling spreading of infectious diseases.