| 1. |
- Björling, Gunilla, Docent, et al.
(författare)
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Tracheostomy inner cannula care : a randomized crossover study of two decontamination procedures
- 2007
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Ingår i: American Journal of Infection Control. - : Elsevier BV. - 0196-6553 .- 1527-3296. ; 35:9, s. 600-5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Today several methods for decontaminating inner cannulae exist. These methods are not based on scientific data, but often on local clinical tradition. This study compares two different decontamination methods. The aim was to find a practical and safe decontamination method. It is a randomized, single-blinded, comparative crossover study. METHODS: Fifty outpatients with long-term tracheostomy with an inner cannula were consecutively included and randomly allocated to begin with one of two different treatment sequences: detergent and chlorhexidine-alcohol (A) or detergent (B). Samples for bacterial culture were taken before and after decontamination, and the number of bacteria colonies was counted. RESULTS: Before decontamination, the inner cannulae grew high numbers of bacteria, which were parts of the normal flora of the upper respiratory tract and did not differ significantly between the two sequences (AB; BA). The primary variable was the culture count value after chlorhexidine-alcohol/detergent (A) and detergent (B). The effects of both methods were larger than expected, and the results showed a nearly total elimination of organisms. The equivalence criterion, ratio of mean colony counts (A/B) >0.8, was met at a significance level of P<0.001. CONCLUSIONS: Cleaning the tracheostomy inner cannula with detergent and water is sufficient to achieve decontamination.
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| 2. |
- Bryce, Elizabeth, et al.
(författare)
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Impact of a mandated provincial hand hygiene program: Messages from the field.
- 2014
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Ingår i: American Journal of Infection Control. - : Elsevier BV. - 1527-3296 .- 0196-6553. ; 42:7, s. 708-712
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Tidskriftsartikel (refereegranskat)abstract
- The British Columbia Provincial Hand Hygiene Working Group was formed in September 2010 and tasked with the development and implementation of a provincial hand hygiene (HH) program for health care.
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| 3. |
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| 4. |
- Erichsen Andersson, Annette, 1966, et al.
(författare)
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Patients' experiences of acquiring a deep surgical site infection : An interview study
- 2010
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Ingår i: American Journal of Infection Control. - : Mosby, Inc.. - 0196-6553 .- 1527-3296. ; 38:9, s. 711-717
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Tidskriftsartikel (refereegranskat)abstract
- Background: The negative impact of surgical site infection (SSI) in terms of morbidity, mortality, additional costs, and length of stay (LOS) in the hospital is well described in the literature, as are risk factors and preventive measures. Given the lack of knowledge regarding patients’ experiences of SSI, the aim of the present study was to describe patients’ experiences of acquiring a deep SSI. Methods: Content analysis was used to analyze data obtained from 14 open interviews with participants diagnosed with a deep SSI. Results: Patients acquiring a deep SSI suffer significantly from pain, isolation, and insecurity. The SSI changes physical, emotional, social, and economic aspects of life in extremely negative ways, and these changes are often persistent. Conclusion: Health care professionals should focus on strategies to enable early diagnosis and treatment of SSIs. The unacceptable suffering related to the infection, medical treatment, and an insufficient patient-professional relationship should be addressed when planning individual care, because every effort is needed to support this group of patients and minimize their distress. All possible measures should be taken to avoid bacterial contamination of the surgical wound during and after surgery to prevent the development of SSI.
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| 5. |
- Erichsen Andersson, Annette, 1966, et al.
(författare)
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Traffic flow in the operating room : An explorative and descriptive study on air quality during orthopedic trauma implant surgery
- 2012
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Ingår i: American Journal of Infection Control. - : Elsevier. - 0196-6553 .- 1527-3296. ; 40:8, s. 750-755
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Tidskriftsartikel (refereegranskat)abstract
- Background:Understanding the protective potential of operating room (OR) ventilation under different conditions is crucial to optimizing the surgical environment. This study investigated the air quality, expressed as colony-forming units (CFU)/m³, during orthopedic trauma surgery in a displacementventilated OR; explored how traffic flow and the number of persons present in the OR affects the air contamination rate in the vicinity of surgical wounds; and identified reasons for door openings in the OR.Methods:Data collection, consisting of active air sampling and observations, was performed during 30 orthopedic procedures.Results:In 52 of the 91 air samples collected (57%), the CFU/m³ values exceeded the recommended level of <10 CFU/m³. In addition, the data showed a strongly positive correlation between the total CFU/m³ per operation and total traffic flow per operation (r=0.74;P=.001; n=24), after controlling for duration of surgery. A weaker, yet still positive correlation between CFU/m³ and the number of persons present in the OR (r=0.22;P=.04; n=82) was also found. Traffic flow, number of persons present, and duration of surgery explained 68% of the variance in total CFU/m³ (P=.001).Conclusions:Traffic flow has a strong negative impact on the OR environment. The results of this study support interventions aimed at preventing surgical site infections by reducing traffic flow in the OR.
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| 6. |
- Eriksson, Darek M., et al.
(författare)
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Organization information system : extending organizational cognition through intelligent artifacts
- 1996
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Ingår i: Cybernetics and systems. - : Informa UK Limited. - 0196-9722 .- 1087-6553. ; 27:3, s. 235-264
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Tidskriftsartikel (refereegranskat)abstract
- The question of investigation is, What can intelligent artifacts mean to a command system? By means of a theoretical synthesis of previous works, the present work starts with an epistemological discussion focused on systems thinking. With the organization in focus, an extrospective approach is taken in which a global discussion results in some implications for the organizational system design. This system is considered as a sociotechnological system; consequently, the nature of systems (i.e., complexity) and the nature of human beings (i.e., parts of the systems and who are to be served by the artifacts) are discussed. The result argues that intelligent artifacts can extend the intelligent behavior of organizations. Examples of computer system architecture and software architecture are given.
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| 7. |
- Granqvist, Karin, 1974, et al.
(författare)
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Learning to interact with new technology: Health care workers’ experiences of using a monitoring system for assessing hand hygiene – a grounded theory study
- 2022
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Ingår i: American Journal of Infection Control. - : Elsevier BV. - 0196-6553 .- 1527-3296. ; 50:6, s. 651-656
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Tidskriftsartikel (refereegranskat)abstract
- Background: Recently, innovative technologies for hand hygiene (HH) monitoring have been developed to improve HH adherence in health care. This study explored health care workers’ experiences of using an electronic monitoring system to assess HH adherence. Methods: An electronic monitoring system with digital feedback was installed on a surgical ward and interviews with health care workers using the system (n = 17) were conducted. The data were analyzed according to grounded theory by Strauss and Corbin. Results: Health care workers’ experiences were expressed in terms of having trust in the monitoring system, requesting system functionality and ease of use and becoming aware of one's own performance. This resulted in the core category of learning to interact with new technology, summarized as the main strategy when using an electronic monitoring system in clinical settings. The system with digital feedback improved the awareness of HH and individual feedback was preferable to group feedback. Conclusions: Being involved in using and managing a technical innovation for assessing HH adherence in health care is a process of formulating a strategy for learning to interact with new technology. The importance of inviting health care workers to participate in the co-design of technical innovations is crucial, as it creates both trust in the innovation per se and trust in the process of learning how to use it.
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| 8. |
- Hammarskjöld, Fredrik, et al.
(författare)
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Sustained low incidence of central venous catheter-related infections over six years in a Swedish hospital with an active central venous catheter team
- 2014
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Ingår i: American Journal of Infection Control. - : Elsevier. - 0196-6553 .- 1527-3296. ; 42:2, s. 122-128
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Tidskriftsartikel (refereegranskat)abstract
- Background: There are limited data on the long-term effects of implementing a central venous catheter (CVC) program for prevention of CVC infections. The aims of this study were to evaluate the incidence of CVC colonization, catheter-related infections (CRI), catheter-related bloodstream infections (CRBSI), and their risk factors over a 6-year period in a hospital with an active CVC team. Methods: We conducted a continuous prospective study aiming to include all CVCs used at our hospital during the years 2004 to 2009, evaluating colonization, CRI, CRBSI, and possible risk factors. Results: A total of 2,772 CVCs was used during the study period. Data on culture results and catheterization time were available for 2,045 CVCs used in 1,674 patients. The incidences of colonization, CRI, and CRBSI were 7.0, 2.2, and 0.6 per 1,000 CVC-days, respectively. Analysis of quarterly incidences revealed 1 occasion with increasing infection rates. Catheterization time was a risk factor for CRI but not for CRBSI. Other risk factors for CRI were hemodialysis and CVC use in the internal jugular vein compared with the subclavian vein. Hemodialysis was the only risk factor for CRBSI. Conclusion: We found that a CRI prevention program led by an active CVC team and adhered to by the entire staff at a county hospital is successful in keeping CVC infections at a low rate over a long period of time.
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| 9. |
- Hartung, Ronald, et al.
(författare)
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Knowledge representation for leadership stories
- 2007
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Ingår i: Cybernetics and systems. - : Taylor & Francis. - 0196-9722 .- 1087-6553. ; 38:5-6, s. 587-610
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Tidskriftsartikel (refereegranskat)abstract
- Leadership requires making decisions and implementing the results by influencing those being lead. The Personal Access to Leadership project, PAL, is constructing tools to assist leaders in creative ways and assisting the development of leaders. The tools are knowledge-based systems employing shallow understanding of the domain. The approaches used provide guidance, but do not generate solutions. One aspect that continues under exploration in PAL is the use of stories for training and guiding leaders. In order to make such support systems work, a representation is needed to enable locating useful stories related to the task of a leader. This article defines a model for story representation for the PAL tools, called the PAL tool IdeaLab. The IdeaLab is the tool to which stories are being added, as a help system to support and extend the user's thinking.
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| 10. |
- Håkansson, Anne, et al.
(författare)
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Using reengineering for knowledge-based systems
- 2007
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Ingår i: Cybernetics and systems. - : Informa UK Limited. - 0196-9722 .- 1087-6553. ; 38:8, s. 799-824
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Tidskriftsartikel (refereegranskat)abstract
- Reverse engineering, also called reengineering, is used to modify systems that have functioned for many years, but which can no longer accomplish their intended tasks and, therefore, need to be updated. Reverse engineering can support the modification and extension of the knowledge in an already existing system. However, this can be an intricate task for a large, complex and poorly documented knowledge-based system. The rules in the knowledge base must be gathered, analyzed and understood, but also checked for verification and validation. We introduce an approach that uses reverse engineering for the knowledge in knowledge-based systems. The knowledge is encapsulated in rules, facts and conclusions, and in the relationships between them. Reverse engineering also collects functionality and source code. The outcome of reverse engineering is a model of the knowledge base, the functionality and the source code connected to the rules. These models are presented in diagrams using a graphic representation similar to Unified Modeling Language and employing ontology. Ontology is applied on top of rules, facts and relationships. From the diagrams, test cases are generated during the reverse engineering process and adopted to verify and validate the system.
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