The Relationship between Hospital Infection Surveillance and Control Activities and Antibiotic Resistant Pathogen Rates

Objective: The purpose of the study was to examine the relationship of surveillance and control activities in Canadian hospitals with rates of nosocomial methicillin-resistant S. aureus (MRSA), C. difficile associated diarrhea (CDAD), and vancomycin-resistant Enterococcus (VRE). Methods: Surveys were sent to Infection Control programs in hospitals that participated in an earlier survey of infection control practices in Canadian acute care hospitals. Results: One hundred and twenty of 145 (82.8%) hospitals responded to the survey. The mean MRSA rate was 2.0 (SD 2.9) per 1,000 admissions, the mean CDAD rate was 3.8 (SD 4.3), and the mean VRE rate was 0.4 (SD 1.5). Multiple stepwise regression analysis found hospitals that reported infection rates by specific risk groups (r = - 0.27, p < 0.01) and that kept attendance records of infection control teaching activities (r = - 0.23, p < 0.01) were associated with lower MRSA rates. Multiple stepwise regression analysis found larger hospitals (r = 0.25, p < 0.01) and hospitals where infection control committees or staff had the direct authority to close a ward or unit to further admissions due to outbreaks (r = 0.22, p < 0.05) were associated with higher CDAD rates. Multiple logistic regression analysis found larger hospitals (OR = 1.6, CI 1.2 - 2.0, p = 0.003) and teaching hospitals (OR = 3.7, CI 1.2 - 11.8, p = 0.02) were associated with the presence of VRE. Hospitals were less likely to have VRE when infection control staff frequently contacted physicians and nurses for reports of new infections (OR = 0.5, CI 0.3 - 0.7, p = 0.02) and there were in-service programs for updating nursing and ancillary staff on current infection control practices (OR = 0.2, CI 0.1 - 0.7, p = 0.01). Conclusions: Surveillance and control activities were associated with MRSA and CDAD rates and the presence of VRE. Surveillance and control activities might be especially beneficial in large and teaching hospitals.

A Study of the Development of the Ability of the Archives Department of the Hudson's Bay Company to Carry Out Document Repairs

The objective of this thesis was to determine whether the establishment and operation of an archives services by the Hudson's Bay Company had an effect on the company's ability to carry out document repairs. Data collection methods included reviews of published material, archival records of the Hudson's Bay Company, and semi-structured interviews. The study found that the Hudson's Bay Company's commitment to operating a modern archives service in accordance with accepted archive administration practices had a substantial effect on its ability to carry out document repairs. The principled approach to repair, as practiced by the Public Record Office, was a major influence. A review of secondary sources placed this development squarely within the context of archival developments in 20th century England. Overall, the thesis findings add to the growing conversation about conservation history in England, in particular, archive conservation history as it occurred outside of the Public Record Office in the 20th century, by discussing how some methods of repair that were devised, adopted and extended by the Public Record Office in the 19th and 20th centuries were adopted and applied in the 20th century by a well-established business corporation.