Catheter-related bloodstream infection: burden of disease in a tertiary hospital

Background: Surveillance programmes have become the most effective tool for controlling catheter-related bloodstream infections (CRBSI). However, few studies have investigated programmes covering all hospital settings. Aim: To describe the results of a control and prevention programme for CRBSI based on compliance with recommendations for insertion and maintenance, using annual burden of disease in a tertiary level hospital. Methods: A CRBSI control and prevention programme involving all hospital settings was implemented. The programme consisted of CRBSI surveillance, direct observation of insertion and maintenance of catheters to determine performance, and education for healthcare workers. Findings: In total, 2043 short-term catheters were inserted in 1546 patients for 18,570 catheter-days, and 279 long-term catheters were inserted in 243 patients for 40,440 catheter-days. The annual incidence density was 5.98 (first semester 6.40, second semester 5.64) CRBSI per 1000 catheter-days for short-term catheters, and 0.57 (first semester 0.66, second semester 0.43) CRBSI per 1000 catheter-days for long-term catheters. One hundred and forty insertion procedures were observed, with an average insertion time of 13 (standard deviation 7) min. Compliance with recommendations was as follows: hand hygiene, 86.8%; use of alcoholic chlorhexidine solution for skin disinfection, 35.5%; use of mask, 93.4%; use of gloves, 98.7%; use of gown, 75.0%; use of sterile cloth, 93.8%; use of cap, 92.2%; bandage application, 62.7%; and use of aseptic technique, 89.5%. Forty-five maintenance procedures were observed, and compliance rates were as follows: hand hygiene, 42.1%; use of gloves, 78.1%; and port disinfection with alcoholic chlorhexidine solution, 32.5%. Conclusion: The CRBSI control and prevention programme implemented at the study hospital has decreased the rate of CRBSI, provided important information about the total burden of disease, and revealed possible ways to improve interventions in the future.

The Discursive double game of EMU reform: the clash of titans between French White Knight and German Iron Lady. Paper presented at the 9th Biennial Conference European Community Studies Association–Canada (ECSA-C), Ottawa, Ontario, April 27-28, 2012

From the Introduction. In the aftermath of the EU’s enlargement towards Central and Eastern Europe, many scholars and observers of European integration were proclaiming that the French-German “engine” of Europe had come to an end. The political legitimacy of French-German initiatives was contested by coalitions of smaller member states and the ‘new Europe’ was calling for new leadership dynamics. However, the experience of the Eurozone debt crisis provided dramatic evidence that no alternative to the Franco-German partnership has yet to emerge in the enlarged EU. In a time of existential crisis, Franco-German initiatives appear to have remained the basic dynamic of integration. However, unlike in the past, agreements on steps forward have proven to be particularly difficult. This is largely due to these countries’ contrasting political economic policy ideas, cultures, and practices....the paper analyses the ideational ‘frames’ of the two leaders while tracing their discursive interactions against changing background conditions since the European debt crisis was triggered by Greece in October 2009 until the last measures taken in 2012 before the French Presidential elections. The empirical analysis is based on a systematic corpus of press conferences and media interviews by Nicolas Sarkozy and Angela Merkel after European summits. It is complemented by a number of press interviews including some given by their respective Finance Ministers) and important speeches in that same period of time.

Growth and Euro Area Stability: The Double Dividend of a Deepened European Single Market for Services. Bertelsmann Stiftung Background Note 26 June 2015

The European Commission’s recent single market initiatives have a second important benefit beyond growth that is often overlooked: Deepening the Single Market for goods and services can also reduce imbalances in the euro area and limit its vulnerability to crises. A further integration of the Single Market thus provides a double dividend of growth and stability. This is the main issue addressed in this background note.

Double Portrait of Friedrich Wilhelm I and Louise Henriette

Gerrit van Honthorst and studio; 7 ft. 2 39/64 in.x 5 ft. 11 17/64 in.; oil on canvas

Some fundamentals in the study of nutrition : the cause of malnutrition and effects produced by malnutrition namely, disease : and elementary treatise prepared for use in the livestock feed industry /

Library's copy has author's autograph on cover slip.

Dulce domum, the burden of the song.

Poems.

The burden of the South, in verse; or, Poems on slavery,

Also appears in his Stanzas to Queen Victoria, 1866, p. 5-96.

The burden of neutrality : notes for onlookers in time of war /

Mode of access: Internet.

Seek and find; a double series of short studies of the Benedicite.

Publisher's catalog at end.

General regulations for working the absolute block telegraph on double lines of railway.

Mode of access: Internet.

Burden of heart disease and stroke in Illinois : mortality, morbidity and risk factors.

"February 2007"

Illinois arthritis data report : the burden of arthritis in Illinois in 2002 /

Updates the previous Data report which provided the burden of arthritis in Illinois during 2000. This report represents an analysis of arthritis-related data gathered primarily from the Illinois Dept. of Public Health's Behavioral Risk Factor Surveillance System (BRFSS) for 2002.

The burden of cardiovascular disease and obesity in the state of Illinois : [a report to the governor of Illinois and the Illinois General Assembly as required by S.J.R. 37]

"P.O. #301078"--Colophon.

The burden of diabetes in Illinois : medicaid, medicare, general population /

"Funding for this project was provided through a Cooperative Agreement (U32/CCU515667-04) with the Centers for Disease Control and Prevention/Division of Diabetes Translation"--P. i.