published_or_final_version / Public Health / Master / Master of Public Health

Enteral feeding is commonly used in paedaitric patients. It helps to improve the digestive, absorptive, immunologic and nutrition status. However, poor handling in enteral feeding can lead to bacterial contaminations and severe consequences resulting in significant morbidity and mortality. At present, there are no definite guidelines on the handling of enteral feeding in local setting, therefore developing evidence based guideline on enteral feeding is critically important to eliminate inconsistent practices and prevent nosocomial infections related to enteral feeding. This dissertation is a translational nursing research that aims at developing evidence based guideline on enteral feeding in infants. The objectives of this thesis are to search for existing literatures on enteral feeding; perform a critical appraisal on the literatures; develop guideline on enteral feeding in infants; assess the implementation potential of the proposed guidelines, and develop the implementation and evaluation plans. The ultimate goal is to reduce the nosocomial infections in infants with enteral feeding in an acute hospital. A systemic search for relevant and valid evidence was performed using three electronic databases and nine relevant studies were retrieved. Critical appraisals on the nine studies were performed and the level of evidence for each study was graded according to the Scottish Intercollegiate Guidelines Network (SIGN). By synthesizing the data from nine studies, it is concluded that optimal hang time and proper hand hygiene appeared to have significant effect in reducing nosocomial infections related to enteral feeding. The implementation potential of the innovation was assessed in terms of the transferability, feasibility and cost benefit ratio. After assessing the implementation potential, it is found that the evidence is transferable and feasible to implement the proposed guideline in the target paeditaric setting. An evidence based guideline on enteral feeding in infants was developed. An implementation plan of the new guideline included a comprehensive communication plan with both administration and nurses and a pilot test were developed to ensure a smooth implementation and optimize the transferability and effectiveness of the evidence based guideline in the target population. A systematic evaluation plan on patient outcomes, health care provider outcomes and systemic outcomes was developed. The evidence based guideline on enteral feeding was expected to be implemented in the long run to reduce the risk of nosocomial infections in infants with enteral feeding. / published_or_final_version / Nursing Studies / Master / Master of Nursing

This research project investigated the impact of an action research intervention implemented to reducing surgical wound infection in one of the acute care hospitals in India. The study aimed to develop and implement a clinical practice improvement program in reducing surgical wound infection by improving the hand washing and wound dressing practices of nurses. The study also aimed to identify the important contributing factors to a model that predicts surgical wound infection. Pre-post evaluation measures were taken to compare the results of surgical wound infection rate before and after the implementation of the intervention. Surgical wounds of two thousand patients (one thousand before the intervention and another one thousand after) were assessed to determine the wound infection rate and severity of wound infection. The hand washing and wound dressing practices of forty nurses were observed. These same nurses were involved in the intervention using a participatory action research process. The results of the study suggest that there was a marked, significant reduction in the rate and severity of wound infection following the implementation of the intervention. By increasing the hand washing facilities in the ward, educating nurses on the importance of better hygiene, pre-operative shaving and post-operative wound care, the hand washing and wound dressing practices of nurses improved considerably. These improvements resulted in a reduction in the number and severity of patients' surgical wound infections. The study also examined the contribution of different factors to surgical wound infection in a Indian hospital. Significant predictive factors were the patients' age, longer pre-operative hospital stay, extended pre-operative shaving time before surgery, wound class, and co-morbidity of the patient. The identification of risk factors that contributed to increased surgical wound infection for example pre-operative skin preparation, pre-operative hospital stay of the patient would help in taking appropriate measures at the ward level and organisation as a whole. Nosocomial infections extends to an unnecessary lengthy hospital stay, additional treatment increased mortality and morbidity, and increased cost to the patients and the nation as a whole. This project proved that educational mentoring, data surveillance processes and involving the nurses in an action research process were effective in enabling participants to improve their clinical practice and thereby reduce the incidence of patients' surgical wound infections. Establishing infection control teams, ongoing surveillance and feedback to staff of nosocomial infection rates is an urgent need in all Indian hospitals. Organisational management, as a priority, need to provide funding and staff dedicated to undertaking this essential work. Health care professionals can no longer plead ignorance of a situation for which all have a moral and professional responsibility.

Thesis (M.A.)--Northern Kentucky University, 2007. / Made available through ProQuest. Publication number: AAT 1445115. ProQuest document ID: 1342744201. Includes bibliographical references (p. 35-36)

Thesis (M.S.)--University of Michigan, 1981. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M.S.)--University of Michigan, 1981. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M.S.)--University of Michigan, 1983. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M.S.)--University of Michigan, 1983. / eContent provider-neutral record in process. Description based on print version record.

Nosocomial infections represent for the health care providers serious economical and also health complications. The aim of this thesis is a comprehensive presentation of nosocomial infections. Second part focuses on a bacteria Clostridium difficile. This thesis analyzes epidemiological situation in a particular medical care facility together with the cost of therapy. The incidence of Clostridium difficile is, despite of the worldwide increasing trend, decreasing in the selected facility. Significant differences exist among individual departments in the amount of samples collected as well as in their rate of positivity for the bacteria presence. Data collected are applied to a German pharmacoeconomic model which compares vancomycin therapy with fidaxomicin therapy. On a group of 100 patients it was proved that more efficient is, despite of its higher price, treatment by fidaxomicin because it leads to a lower percentage of recurrences and morbidity and mortality decrease.

Magister Scientiae (Medical Bioscience) - MSc(MBS) / Introduction: Nosocomial infections are infections that occur 48 hours after receiving care for an unrelated condition in a clinic or a hospital environment, many of which are resistant to at least one of the drugs most commonly used to treat them. The dental clinical settings are reservoirs for the transmission of microbes through aerosols produced by routine dental procedures.