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Aims: The aim of this study was to investigate the correct use of gloves and alcohol-based products for hand hygiene and identify opportunities for hand hygiene replacement with gloves among healthcare professionals working in the Department of Anesthesia and Intensive Care of a tertiary care University Hospital. Background: Two centuries have passed since the discovery of Semmelweis that the “puerperal fever” was due to an infection transmitted by the hands. Currently the hand hygiene is still not well performed, rather it is often replaced by the improper use of gloves. Microbial transmission is estimated to occur in one-fifth of all contact cases. Objective: To investigate the correct use of gloves and alcohol-based products for hand hygiene and identify opportunities for hand hygiene replacement with gloves among healthcare professionals. Furthermore, to correlate the consumption data of the hydroalcoholic solution and the amount of antibiotics used for the treatment of hospital-acquired infections. Method: The study was conducted over six months period (from January to June 2018); during this period, 20 monitoring sessions were performed. The following indicators were evaluated: a) Non-adherence to hand hygiene with concomitant use of gloves; b) Adhesion to alcoholic friction of hands; c) Hand-washing adhesion. Instead, the consumption data, provided by the hospital ward itself, were used for the evaluation of d) The antibiotics used in the treatment of hospital-acquired infections; e) The hydro-alcoholic solution used by the healthcare professionals for hand hygiene. Results: The frequency of non-adherence to hand hygiene was very high at the beginning of the study, subsequently it decreased to about a half percent to that at the initial stage. The adhesion to alcoholic friction of hands increased during the study period. Otherwise, the hand-washing adhesion slightly reduced, especially in March probably due to the recruitment of new inadequately trained nursing staff. The trend of antibiotic consumption was similar to handwashing. The consumption of hydro-alcoholic solution was very low, however over time, it increased considerably until the end of the study. Conclusion: In light of the findings from this work, it is necessary to make the hospital staff increasingly aware of the correct practice of hand hygiene and to organize training and informative sessions to promote the health of the individual and the community.

Community and hospital acquired infections caused by drug resistant organisms especially the extended spectrum β-lactamase producers among members of the family Enterobacteriaceae have been on a global increase. Such infections could lead to an increased healthcare costs, morbidity and mortality. The Extended Spectrum β-lactamases are enzymes produced by some bacteria to inactivate group of β-lactam antibiotics such as penicillin and its derivatives as well as broad spectrum cephalosporins including monobactams. The enzymes have been the key source of multidrug resistance among many Gram-negative bacteria. Previous studies conducted on Extended Spectrum β-lactamase (ESβL) in Gombe Specialist Hospital focused more attention on the occurrence of the ESβL producing bacteria in clinical samples. This study aimed at phenotypic detection of ESβL producing bacteria from some selected contact surfaces in the same hospital for the first time to the best of our knowledge. One hundred and fifty (150) samples were collected from contact surfaces such as door handles, wheelchairs, ATM machines etc. using sterile swab sticks. The samples were cultured on nutrient and MacConkey agar plates to isolate bacterial contaminants. The bacterial isolates were identified using standard procedures. Gram negative isolates were screened for the potential ESβL producers using CLSI breakpoint and phenotypically confirmed using double disc synergy test (DDST). The results obtained confirmed high ESβL producers among E. coli with 20 (44.40%) followed by K. pneumoniae with 15 (33.30%) and then P. mirabilis having the least confirmed isolates. In conclusion, the ESβL producers detected from the contact surfaces suggest the adoption of more personal and environmental hygiene practices to limit the spread of drug resistant organisms and possible outbreak of nosocomial infections.

The solubilization of phosphates in the soil is one of the possible ways to increase the crop yield. Some rhizospheric microorganisms may mobilize the soluble phosphorous to the plants and therefore they may be used as biofertilizers. From the rhizospheric microorganisms, the bacteria are the most studied. Nevertheless, some fungal genera are well known as P solubilizers. The phosphate solubilizing filamentous fungi are more studied than the yeasts, mainly Penicillium and Aspergillus strains. The identification of strains of fungal isolates is more complex than in the case of bacteria because the taxonomy of fungi is based on morphological characteristics. Nevertheless, in the last years, the techniques based on molecular characteristics have changed the species concept in this group of eukaryotic microorganisms and they are very useful in the identification of the new isolates.

To review patients' and healthcare professionals' perceptions of patient involvement in promoting hand hygiene compliance in the hospital setting. Initiatives continue to emphasise the importance of involving patients in their safety at the point of care. A patient-centred care approach aimed to empower patients to become active members of the healthcare team. However, understanding the perceptions of patients and healthcare professionals of patient involvement in promoting hand hygiene compliance among healthcare professionals has yet to be fully explored. Integrative literature review. A five-stage review process informed by Whittemore and Knafl's methodology was conducted. MEDLINE and CINAHL were searched for papers published between January 2009-July 2017. Data were extracted manually, organised using NVivo 11 and analysed using thematic analysis. From an identified 240 papers, 19 papers were included in this review. Thematic analysis revealed two main themes with three related subthemes. Patients were willing to remind healthcare professionals (especially nurses) to wash their hands, healthcare professionals perception towards patients' involvement varied from one study to another. However, an overall positive attitude towards patient involvement was related to how patients asked and how healthcare professionals responded to being asked. There is limited evidence regarding patients' actual intention to ask healthcare professionals to wash their hands, and some evidence that patients are reluctant to do so. Further research is required to understand this area thoroughly, including which situations patients would feel more empowered to speak up. Simple messages promoting patient involvement may lead to complex reactions in both patients and healthcare professionals. It is unclear, yet how patients and staff react to such messages in clinical practice. There is a need for a deeper understanding of how they can work together to support harm free care.

BackgroundThere is a rapid uptake of mobile-enabled technologies in lower- and upper-middle–income countries because of its portability, ability to reduce mobility, and facilitation of communication. However, there is limited empirical evidence on the usefulness of mobile health (mHealth) information and communication technologies (ICTs) to address constraints associated with the work activities of health care professionals at points of care in hospital settings.ObjectiveThis study aims to explore opportunities for integrating mHealth ICTs into the work activities of health care professionals at points of care in clinical settings of hospitals in Sub-Saharan Africa. Thus, the research question is, “How can mHealth ICTs be integrated into the work activities of health care professionals at points of care in hospital settings?”MethodsA qualitative approach was adopted to understand the work activities and points at which mHealth ICTs could be integrated to support health care professionals. The techniques of inquiry were semistructured interviews and co-design activities. These techniques were used to ensure the participation of frontline end users and determine how mHealth ICTs could be integrated into the point of care in hospital settings. Purposive and snowball sampling techniques were used to select tertiary hospitals and participants for this study from South Africa and Nigeria. A total of 19 participants, including physicians, nurses, and hospital managers, were engaged in the study. Ethical clearance was granted by the University research committee and the respective hospitals. The data collected were sorted and interpreted using thematic analysis and Activity Analysis and Development model.ResultsThe findings show that mHealth ICTs are suitable at points where health care professionals consult with patients in the hospital clinics, remote communication is needed, and management of referrals and report writing are required. It was inferred that mHealth ICTs could be negatively disruptive, and some participants perceived the use of mobile devices while engaging with patients as unprofessional. These findings were informed by the outcomes of the interplay between human attributes and technology capabilities during the transformation of the motives of work activity into the intended goal, which is enhanced service delivery.ConclusionsThe opportunities to integrate mHealth ICTs into clinical settings depend on the inefficiencies of interaction moments experienced by health care professionals at points of care during patient consultation, remote communication, referrals, and report writing. Thus, the timeliness of mHealth ICTs to address constraints experienced by health care professionals during work activities should take into consideration the type of work activity and the contextual factors that may result in contradictions in relation to technology features. This study contributes toward the design of mHealth ICTs by industry vendors and its usability evaluation for the work activity outcomes of health care professionals.

Introduction Communication is widely recognised to play a key role in patient care. The US Institute of Medicine’s 2002 report, ‘Crossing the Quality Chasm’, stated that ‘effective methods of communication, both among caregivers and between caregivers and patients, are critical to providing high-quality care’.(1) Interdisciplinary communication (IDC) can be challenging due to differences in training, education and roles between healthcare professions. Due to the nature of IDC, the majority of research on this subject has been qualitative, exploring the views of healthcare professionals on IPC. To date, however, the qualitative evidence on IDC has not been synthesised in a systematic manner. Therefore, a systematic review of the qualitative literature on healthcare providers’ experiences of interprofessional communication was conducted and registered with PROSPERO (registration number CRD42020177967). Aim The primary aim of this systematic review was to synthesise the qualitative evidence regarding healthcare providers’ perceptions of IDC in the hospital setting. A secondary aim was to identify the barriers and facilitators to IDC in the hospital setting. Methods Studies were eligible for inclusion in the review if they met the following criteria: 1) studies examining healthcare professionals’ experiences of IDC, 2) studies conducted in the hospital setting, and 3) studies conducted using qualitative research methods. Four databases (PubMed, CINAHL, Web of Science and Embase) were searched from inception until May 2020. Quality appraisal of the identified studies was conducted using the Critical Appraisal Skills Programme (CASP) tool for qualitative research. Data from the results sections of eligible studies were synthesised using thematic synthesis as described by Thomas and Harden.(2) Thematic synthesis consists of three stages: 1) line-by-line coding of all text relevant labelled ‘results’ or ‘findings’ in the included studies, 2) organisation of codes into descriptive themes that reflect the results of the included studies, and 3) development of descriptive themes into analytical themes that address the review question. Results Eighteen studies were identified as being eligible for inclusion in this review (Figure 1). Five descriptive themes emerged during thematic synthesis: 1) ‘Hierarchy’, 2) ‘Interprofessional Ethos’, 3) ‘Healthcare Environment’, 4) ‘Personal Factors’ and 5) ‘Methods of Communication’, which were developed into two analytical themes: ‘Barriers to IDC’ and ‘Facilitators to IDC’. Personal factors, such as strong interprofessional relationships, were found to facilitate IDC, while organisational factors, such as challenging and hierarchical working environments, were found to pose barriers to IPC. Conclusion We believe that this review makes a significant contribution to the literature. To our knowledge, it is the first study to synthesis the qualitative evidence on healthcare providers’ perceptions of IDC in hospitals. Maintaining an interprofessional ethos and building positive working relationships were identified as facilitators to IDC, while hierarchy and challenging working conditions were identified as barriers. A key finding is the significance that healthcare providers associate with personal aspects of IDC, such as mutual respect and understanding among healthcare professionals. Future research should involve the theory- and evidence-driven design of interventions to improve personal aspects of IDC, such as interprofessional education and engagement.

The aim of this study was to screen Streptomycetes isolates with antimicrobial and antiviral activity, in a search for new metabolites. The isolates were obtained from a composting process, and identified based on morphological characteristics and molecular biological methods. The antimicrobial activity was determined using the double-layer agar method against 53 test organisms (bacteria, yeasts, and filamentous fungi). All isolates were grown in submerged culture, in mineral salts-starch-casein (SC) broth and ISP2 media, and the filtrate cultures were used in the assays for antibacterial and antiviral activity. Bovine Herpes virus (BoHV-I) was used for the antiviral activity. The morphological and molecular characteristics confirmed that all 25 isolates belonged to the genus Streptomyces. In the assay for antimicrobial activity, 80% of the Streptomyces isolates were able to inhibit at least one of the test organisms. Of these, 80% were active against bacteria and 45% against fungi. Eight of the isolates showed a broad spectrum of inhibitory activity; of these, the isolate Streptomyces spp. 1S was able to inhibit 46 of the test organisms, and, most importantly, the 16 Gram-negative strains were inhibited. Of the 25 isolates, 44.4% of the isolates were able to grow and produce bioactive metabolites when grown in submerged culture. Four extracts showed a cytopathic effect in 10 CCID50 MDBK cell, even though no viricidal effect was observed. The results obtained with these isolates indicated good biotechnological potential of these Streptomyces strains.

Filamentous fungi are common airborne contaminants in hospitals, posing significant risks to immunocompromised patients. This study assessed the diversity, seasonal distribution, and antifungal susceptibility of airborne filamentous fungi, with a focus on Aspergillus spp., in two inpatient wards of a tertiary hospital in southeastern Brazil. Air samples were collected seasonally from November 2022 to September 2023 using a six-stage Andersen sampler. Fungal isolates were identified based on macro- and micromorphological characteristics, and Aspergillus spp. were further characterised by β-tubulin gene sequencing. In vitro susceptibility to amphotericin B (AMB), itraconazole (ITR), voriconazole (VOR), posaconazole (POS), and anidulafungin (AFG) was evaluated following CLSI guidelines. A total of 583 filamentous fungi were isolated, with Penicillium, Cladosporium and Aspergillus as the most prevalent genera. Fungal concentrations were higher in humidified air and decreased after installation and maintenance of the air-conditioning system. Fourteen Aspergillus species were identified across eight sections, including emerging and cryptic taxa such as A. subramanianii, A. sclerotiorum and A. alboviridis. Resistance to ITR was detected in one isolate of A. fumigatus and one of A. flavus, while isolates from emerging species of the section Circumdati exhibited elevated MICs for AMB and triazoles. All isolates demonstrated low AFG MECs. The study highlights the importance of routine environmental surveillance and antifungal susceptibility testing in hospital settings. The detection of potentially resistant Aspergillus species in hospital air emphasises the need to enhance ventilation, monitoring, and diagnostic capabilities to mitigate the risks of healthcare-associated fungal infections.

Blue light (470nm) LED antimicrobial properties were studied alone against bacteria and with or without the food grade photosensitizer, erythrosine (ERY) against filamentous fungi. Leuconostoc mesenteroides (LM), Bacillus atrophaeus (BA) or Pseudomonas aeruginosa (PA) aliquots were exposed on nutrient agar plates to Array 1 (AR1, 0·2mWcm(-2)) or Array 2 (AR2, 80mWcm(-2)), which emitted impure or pure blue light (0-300Jcm(-2)), respectively. Inoculated control (room light only) plates were incubated (48h) and colonies enumerated. The antifungal properties of blue light combined with ERY (11·4 and 22·8μmoll(-1)) on Penicillium digitatum (PD) and Fusarium graminearum (FG) conidia were determined. Conidial controls consisted of: no light, room light-treated conidia and ERY plus room light. Light-treated (ERY+blue light) conidial samples were exposed only to AR2 (0-100Jcm(-2)), aliquots spread on potato dextrose agar plates, incubated (48h, 30°C) and colonies counted. Blue light alone significantly reduced bacterial and FG viability. Combined with ERY, it significantly reduced PD viability. Blue light is lethal to bacteria and filamentous fungi although effectiveness is dependent on light purity, energy levels and microbial genus. Light from two arrays of different blue LEDs significantly reduced bacterial (Leuconostoc mesenteroides, Bacillus atrophaeus and Pseudomonas aeruginosa) viabilities. Significant in vitro viability loss was observed for the filamentous fungi, Penicillium digitatum and Fusarium graminearum when exposed to pure blue light only plus a photosensitizer. F. graminearum viability was significantly reduced by blue light alone. Results suggest that (i) the amount of significant loss in bacterial viability observed for blue light that is pure or with traces of other wavelengths is genus dependent and (ii) depending on fungal genera, pure blue light is fungicidal with or without a photosensitizer.

To explore hospital healthcare professionals' knowledge and attitudes towards dementia care in China. Hospital healthcare professionals deliver most diagnosis and treatment for people with dementia in China. Literature shows that healthcare professionals' knowledge and attitudes are of great importance in providing optimum dementia care. However, there is limited research of healthcare professionals' dementia knowledge and attitudes within hospital contexts in China. A cross-sectional survey was conducted between April and December 2019. A self-report questionnaire composed of demographics and knowledge and attitude scales related to dementia was used for doctors and registered nurses working in settings where people with dementia are cared for in eleven public tertiary hospitals in Hebei Province, China. The STROBE checklist was adhered to in this study. In total, 603 healthcare professionals completed the study. The majority of respondents were registered nurses (71.3%). The overall mean knowledge score was 20.7 (SD=2.9) out of a maximum possible score of 30. The overall mean score for attitudes was 91.3 (SD=15.9) out of a maximum possible score of 140. Standard multiple linear regression analysis revealed that the highest level of education, the experience of searching for dementia-related information and willingness to receive dementia training or education were significant predictors of knowledge scores. The department, the experience of working with people with dementia, length of dementia care, interest in dementia care and training type were significant predictors of attitude scores. Deficits in the knowledge of dementia and a low level of positive attitude were identified among the healthcare professionals who work in hospital settings where people with dementia are cared for in China. Education and training in dementia care should be integrated into undergraduate nursing and medical programmes and provided for healthcare professionals after commencing employment.

This article presents a process evaluation of the implementation and refinement of a patient experience toolkit (PET) by action researchers in six hospital wards in the English National Health Service (NHS). An initial assumption that health care professionals (HCPs) would use PET to improve patient experience proved unrealistic due to staff and service pressures. However, the action researchers' facilitation of PET and their support during the implementation of quality improvement efforts filled in for HCPs' lack of time. The findings suggest that the PET can be a successful guide for skilled facilitators working with HCPs, although excessive staff pressures should be avoided. Toolkits designed for implementation by HCPs should, therefore, be used sparingly; a more appropriate target audience may be facilitators. Furthermore, while the potential of action research is confirmed by this evaluation, HCPs' time to engage in service improvement is found to moderate the success of this increasingly prominent methodology.

Healthcare professionals’ experiences during the initial stage of the COVID-19 pandemic in the intensive care unit: A qualitative study

Background: Sharp injuries (SIs) are wounds caused by sharp instruments accidentally puncturing the skin. Hence, the objective of this study was to assess magnitude of sharp injuries and associated factors among health care professionals in western “wollega” public Hospitals, west Ethiopia. Methods: Facility based cross- sectional study design was used in western “Wollega” zone public hospitals from February 10 to March 12, 2015. All health care professionals available during the study period were included in the study. Data were entered in to SPSS for windows version 16.0 for analysis. Multivariable logistic regression model was done to identify independent effects of each predictor. Result: The prevalence of sharp injuries among health care professionals in western wollega public hospitals is 56 (32.9%). The prevalence of sharp injuries was higher among diploma nurses (40.5%), followed by laboratory technicians and diploma midwifery respectively. The sharp injuries experienced in the last one year were related to recapping of needle (53.6%), 48.2% during suturing, and failure to adhere to Universal precautions (33.9%). The multivariate logistic regression analysis showed that the most important risk factor for sharp injuries were lack of training (Adjusted Odds Ratio=15.6), working experience 10 injection per day (Adjusted Odds Ratio=13), working more than 35 hours per week (Adjusted Odds Ratio=8.22), negative attitude (AOR=8.6), poor practice of universal precautions (Adjusted Odds Ratio=6.6), night shift work (Adjusted Odds Ratio=6.6) and recapping of needle most of the time (Adjusted Odds Ratio=9.9). Conclusion and recommendation: The prevalence of sharp injury in western wollega public hospitals is 56 (32.9%) within the last one year. Lack of training, hours worked per week, number of injection per day, work experience, poor practice, negative attitude, night shift work and recapping of needle were identified as risk factors for sharp injuries. Further prospective studies on large scale are recommended to determine the cause and effect relationship of factors affecting sharp injuries among HCPs in hospital setting.

Roles and competencies in the nutritional domain for the management of the metabolic diseases and in the hospital setting: A position paper of the Italian College of Academic Nutritionists, MED-49 (ICAN-49)