No Abstract available.
Consensus* ; Infection Control*

No Abstract available
Cross Infection*

BACKGROUND: This study was designed to examine the effect of a hand washing improving program on the adherence of hand washing of health care workers in a surgical intensive care unit (SICU) and to test the hypothesis that improved hand washing adherence would help reduce nosocomial infection rates and MRSA colonization rates. METHODS: The study was conducted from March to December, 2001, at the SICU of a 2,200-bed university-affiliated hospital in Seoul. The hand washing improving program, developed by the investigator, a multi-fauceted program, was provided beginning August until October for medical personnel at the SICU. Hand washing adherence was monitored through direct observations for one hour everyday from mid-June through October. Nosocomial infections were monitored for the to month period from March to December. MRSA colonization rates were monitored during the four-month period from July to October by taking nares cultures from the patients who stayed at the SICU for three days or longer. RESULTS: Hand washing adherence rates increased from 33.5% at the pre-intervention to 58.4% at the post intervention period (p<.001). Nosocomial infection rates were 11.0 at the pre-intervention period and 11.6 per 1,000 patient-days at the post intervention period. When surgical site infections were excluded, the rates tended to decrease from 6.8 at the pre-intervention period to 6.0 per 1,000 patient-days at the nest-intervention period. MRSA colonization rates were 14.3% and 13.0% at the pre- and post-intervention period, respectively. But the differences were not statistically significant. The mean days from SICU admission to MRSA colonization were 2.9 in pre-intervention period and 6.5 at the post-intervention period. The differences between the pre- and post-intervention period were statistically significant (p=.001). CONCLUSION: The hand washing improving program was found to be effective in increasing the hand washing adherence of the healthcare workers at the SICU. In spite of the improved hand washing practices, however, nosocomial infection rates were found not changed significantly, although MRSA colonization by the patients, which is considered as a high risk factor for nosocomial infections, was delayed significantly. To demonstrate the causal relationship between hand washing and nosocomial infections, further studies are warranted with a larger number of patients during an extended study period.
Colon ; Cross Infection* ; Delivery of Health Care ; Hand Disinfection* ; Hand* ; Humans ; Critical Care* ; Methicillin-Resistant Staphylococcus aureus ; Research Personnel ; Risk Factors ; Seoul

No abstract available.
Biomarkers* ; Child* ; Hepatitis B* ; Hepatitis* ; Humans ; Prevalence*

No Abstract available.
Infection Control* ; Staphylococcus aureus* ; Staphylococcus*

BACKGROUND: The purpose of this study was to survey hygiene behavior of healthcare personnel according to the Hygiene Inventory 23 (HI23) and to use the results in education and research for promoting hygiene behaviors. METHODS: We sampled a total of 400 people with 50 from each job category. The sample was obtained through convenient sampling among 8,200 employees working at a tertiary-care hospital with 2,600 beds in Seoul. The HI23 consisted of 5 subscales and 8 questions on general hygiene, 3 on household hygiene, 3 on food-related hygiene, 5 on hand hygiene methods, and 4 on personal hygiene, resulting in a total of 23 questions. The researcher also added 14 questions on the general characteristics of the subjects. The self-administered questionnaires were distributed on October 2009 and analyzed blindly. RESULTS: The average total score for hygiene behavior was 3.04+/-0.44 (maximum of 4). In the subcategory of hygiene behavior, the mean score was 3.20+/-4.24 for general hygiene, 3.07+/-0.68 for household hygiene, 3.07+/-0.68 for food-related hygiene, 2.91+/-0.69 for hand hygiene methods, and 2.97+/-0.48 for personal hygiene. When factors affecting the level of hygiene behavior were identified through multivariate regression analysis, independent factors were found to be gender (female), job category (food-related job), experience in hand hygiene education, and experience in teaching hand hygiene or general hygiene. CONCLUSION: Programs and education adapted to the characteristics of each job category in hospitals are needed to promote hygiene behaviors such as general hygiene, hand hygiene methods, household hygiene, food-related hygiene, and personal hygiene.
Delivery of Health Care ; Family Characteristics ; Hand Disinfection ; Hand Hygiene ; Humans ; Hygiene ; Surveys and Questionnaires

For the detection of Helicobacter pylori infection, endoscopic biopsy related tests auch as urease test, culture, and histology with special staining of bacteria are most widely used standard methods and most accurate. (continue...)
Bacteria ; Biopsy ; Child* ; Diagnosis* ; Gastritis* ; Helicobacter pylori* ; Helicobacter* ; Humans ; Immunoglobulin G* ; Prevalence ; Urease

BACKGROUND: Direct observation of healthcare workers is commonly used in hospitals to investigate hand hygiene compliance. However, the hand hygiene compliance rate may increase due to the Hawthorne effect, which is the modification of behavior simply because subjects become aware that they are being observed. The objective of this study was to investigate the occurrence of the Hawthorne effect when directly observing hand hygiene compliance in intensive care unit (ICU) healthcare personnel. METHODS: A total of 87 staff members from the coronary care unit and cardiac surgery ICU of a general hospital in Seoul were included in this study: 24 residents and interns, 55 nurses, and 8 nursing assistants. Both covert and overt observations, where subjects were either unaware or aware of any direct observation, were performed on separate occasions. RESULTS: A total of 1,052 covert and 1,336 overt observations were documented over 30 and 34 occasions, respectively. Overall hand hygiene compliance was significantly higher with overt observation than with covert observation (1,041/1,336, 77.9% vs. 659/1,052, 62.6%, P<0.001). The Hawthorne effect was present in all professions and behaviors, with the exception of nursing assistants, and prior to touching a patient. CONCLUSION: Direct observation of hand hygiene compliance was associated with the Hawthorne effect when observations were made overtly and this was likely to contribute to an overestimation of compliance rate.
Compliance ; Coronary Care Units* ; Delivery of Health Care* ; Effect Modifier, Epidemiologic* ; Hand Hygiene* ; Health Personnel ; Hospitals, General ; Humans ; Intensive Care Units* ; Nursing ; Seoul ; Thoracic Surgery*

BACKGROUND: This study was aimed to assess the level of knowledge on the disinfection among nurses in the hospital. METHODS: Data was collected from the nurses who participated in an educational meeting of Korean Association of Infection Control Nurses for two days from July 7 to 8 in 2000. Seventy nurses (58.3%), among 120 participants. were answered to the 32 item questionnaire which was developed to test the level of knowledge in different types of disinfection. The correct answers for each item were computed and the rate of the total correct answer was dichotomized and compared at the level of 60% correct answer to identify the respondent's characteristics which affect the knowledge on the disinfection. RESULTS: The percent of the correct answer was 60.0% in total. 63.4% for the disinfectants general; 59.4% for the disinfection of skin: 57.6% for the disinfection of devices: 63.9% for the disinfection of endoscopies, and 55.1% for the disinfection of environments. The percent of correct answer was significantly higher among the nurses who participated in the educational programs on the disinfection previously (p=0.006), as well as the nurses who are at the infection control office or at the quality improvement department compared to other areas in the hospital (p=0.001). CONCLUSIONS: This study indicates that the level of knowledge about the disinfection was low with only 63% of the correct rate in total. We perceive that more educational programs and manuals on the use of disinfectants in a hospital setting is urgently required.
Disinfectants ; Disinfection* ; Infection Control ; Quality Improvement ; Surveys and Questionnaires ; Skin

Chronic idiopathic intestinal pseudo-obstruction syndrome is a clinical condition induced by an impaired function of intestinal motility. Although its clinical symptoms are those of intestinal obstruction, mechanical obstruction of the intestine cannot be found by vigorous studies, even by operative exploration. We have experienced nine cases of chronic idiopathic intestinal pseudo-obstruction syndrome. It will help in diagnosis and treatment of the pseudo-obstruction to present the patients with these syndromes. In all cases severely delayed intestinal transit times were noted in radiological gastrointestinal studies without evidence of mechanical obstruction. The most frequent tentative diagnoses were congenital megacolons. But all of the patients showed the presence of ganglion cells in the intestinal wall. Histological abnormalities of the muscle layer were found in three patients. We could not resolve the symptoms by the surgical decompression of the intestine (such as colostomy, ileostomy etc.). But the symptoms were improved after total colectomy in a patient whose main affected site was confined to the colon. The megacystis was the most frequent combined anomaly. All patients had been improved with NPO and total parenteral nutrition therapies were inevitable. The drugs which facilitate the intestinal activities such as cisapride could not resolve the symptoms of obstruction. Three patients were died with the complications of total parenteral nutrition, and four patients improved clinically. Early diagnosis and proper management will reduce the mortality and morbidity.
Child ; Cisapride ; Colectomy ; Colon ; Colostomy ; Decompression, Surgical ; Diagnosis ; Early Diagnosis ; Ganglion Cysts ; Gastrointestinal Motility ; Hirschsprung Disease ; Humans ; Ileostomy ; Intestinal Obstruction ; Intestinal Pseudo-Obstruction* ; Intestines ; Mortality ; Parenteral Nutrition, Total