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Positive infection in a penile implant population
AJIC Volume
22, Number
Abstracts
2
INCIDENCE OF HEPATITIS C IN EMPLOYBES FOJaLOWING BXFQSURES TO BLOOD. L. Lemer-DurJava, RN, BSN, MSN.* Childma’s Hospital Medical Centm of Akron, Akron, OH. With tbe advent of thq OSHA blo”dbomc pathogen stand@ tkc Hospital elected to b~~hxie hqatitis C testing for all p~tbmts a”d employees with a” exp”smr to blood or bloody bcdy substances. Testing for Mtis C as part of the posl expos”re prc40~01 became .iffe&ve in June 1992. s&e that time, 110 employee-a”d Ii0 pad&s have brmtestedforHemlitisc. Thei”iti.al smeenim test for Ha&is C antibodv is bv Enzyme immunom~y @IA). Of the 220 wnples”se”t for test&, six weened &tivk for Hepatitis C antibody. AU positive wults were sent for confumPtory tzating by recombinvrt immunoblot assay (RIBA). Of dm five employee8 tested with RlBA, one w positive during confimmtwy RIBA testing. The patient i”volvuJ with this exposure was negative for hepatitis C antibodies. One patient also tested was positive by EIA a”d by RIBA. Wus the b&&me of infection is 0.9%. But the rate of smumnversion related tn expswe is zcm. The over all cost for testing exceeded $lO,ooO. With the low bxidmce of infection, the related testing costs, and lpck of any cross infection between patients and employees, hepatitis C twing af& exposures is of questionable value.
FQslTIvE INFBCTION IN A PBNILB IMPLANT POPULATION. RN: Crawford Me”wial Hospital, Va” Bure”, AR.
105
L. Thambrugh,
This study was initintcd to daerminc pmcedure s@fic pwopcmtive infection rata and possible risk pattems., Crawford Memorial Hospital is a 103 bed community hospital performing Xl0 penile implsnta annually. All &at charts indicated infwtl”“, revisia”, ox “lza”!ctim of the penile plwheeis WQC mviewd. Cater for D&ease c”“ko1 mid Prevatio” (CDC) defw&“s of -“lial i”fectio”S were used.
nosoumdal
‘ipenile
iqhnt
is P ptustMic dcvlce and any
meeting
CDCcriteriswacmnJi~anoamomiPlinfectionfornpaiodofoncyear. The smveilkmcz was collected on implants placed from Jmwuy 1990 to December 1992. lk nosacomial infection rate for this procedure in mu facility was 4.7% over the 36 month period reviewed. Tbbty-seven patie”ts met the criteria. Twenty-eight cases or 75.6% of the identified infections were “oted within the first 45 days pastoperatively. Four cases or 10.8% were identified in 45-90 days following implantatio” and 5 or 13.5% in the period greater than 90 days. All 5 of thase caes nwifeadng clinical infection r&r 90 days were medically complicated. 54% of the infections were following revision of a previously placed uninfected failed penile implant. Our pwtapuative infection rate WBS 4.7%. The stuiy de”lmshatcd that 75% Of these postopemtive infecticms will be manifested cliically within 45 days of impla”t or revision. The implnted pump mechvlism was most often implicated as the site of infection.
NURSES’ PRACTICES AND POTENTIAL EXPOSURB TO BLOOD/BODY FLUIDS RBLATBD TO THE MANAGEMENT OF SIMULATED WOUND DRAINAGE SYSTEMS IN THB LABORATORY SETTING. M. Z&e, RN, DNSc; A. McArdle, RN, MSN, B. Goldrick, RN, PhD. Georgcmvn University Medical Center, Washington, DC. The rekasc of OSHA’s Blood Borne Pathogen standards has prompted a reexmnhmtio” of the work environment to ensure safe containment of blood and body fluids. The purposes of this research were: 1) To compare nursing management umcticea usina three. different wound dminafte systems in a simulated set&z and 2) To &.mnine the &k of contamination awci&d~with measwemmt and &iv&n of simulated wound drainage fluid. Systems compared were: Henmvac~, a bulb evacuator, and the Kendall TN-Closx?‘. Subjects were fit?y-zight volunteer, registexed nurse8 who had medical-surgical nursing ex~ce. Each post-qmative wound drainage system was filled with simulated wound drainage and connected t” a nm”“iki” i” an empty patient care room. Subjects were given the nmnufachmxs’ mcommenda!ions for dmbuge system “ma&ment and show” a sample of the d&age system. For each of the three trials, subjects were asked 10: a) choose appropriate personal protection equipment/use mmmended nnivers8.l precautions, b) -we drainage system fluid; c) reactivate the drainage system suction chamber, d) dispose of equipment/fluid and e) complete a satisfaction questionnaim. Subjects were observed by a an investigator during each simulation. Exposures were defined aa spilling, dripping and splashing of simulated drainage fluid “I rinse water anywhere in the patient -&mm or p&e”t b&mom. Fiftv-five DcIcent 155 . %j of nurses who enmtied bulb evacuator svstems and 45 % of ““rxes who en$ied Hemova?‘ systems had a” rrposure. There we no exposures with the Kendall Tru-t&sew system. Most nurses chose gloves for pzrscmal protection. Gowns and face shields were rarely used. The majority of exposurea were due to emptying fluid (27%) or emptying rinse water (29%) into the pa&at toilet. Twentythree percent (23%) of exposures occurred while pouring simulated fluid into a container at the bedside. The most commcm object exposed was the toilet seat (67%). The bed linen was exucsed 16% of the time. Nurse’s cloves were exwsed 6% of the trials. The use of a cl&d system or disposable, single-u& containers &eliminate rinsing should be considered.
PACElMAKBR SITE INFECTIONS AND ANTIBIOTIC TIMING AND ADMINISTRATION. V.A. Lewellm, MT, MPH, CIC.’ Kaiser FennsnmteMedical Cent”, Smt Die@, CA. ArUnwccdvemviexwastan&Uedtodeccrmine~i”c~oflnfcui”“for
Pama”atPs&mpber(PP)~h~mwwhDt~mbe”tti~t
clnstm dwi”g March and April 1993 (“=99). Rejated l”cidma of FT infeaion and JcpJiaRngedfrom0.13%~12.7%withmoptantaa~3%toS%. Themview covmed 27 months endii Mmrh 31.1992. Charts wue a”alyzed for surgical site i”fec&ms (SSIs) mtd data colkaed cm pm@lylactic a”tibll ti”lhlg ard ad”li”islmti0” intdlio”towgieplincision. SSIswm’edehcdandstmdif*d~theNNISRlsk Index.. w Mean length of time horn PP invrtion to cad of lnfectkm=4.3 nm”~;m”ge23daystolyear. DumticmofcrprPtion’t’was7Sminutcs. Pnwd”ref werrprfonncdbyphyrieiansA,B,C,&DwithmSSIrstcof6.1%. orpMis”uwexe S. au&, S. epid&dis, A. anitmtus and micromccur. Physician SQecific-m for ‘C’ and’D’wuemtstadslicaUvdmifiantIPiaha’sexact1. Themtefw~D’waahieher than the dcpmtmmt rate & i, 6.9% ;a 4.7%; a”d itirk 2, 14.3% vs. 9.4%].-No conqmtive data is pFaently available fa PPs ag&st which to uatdardize. I” 55.6% (55/99b mwhvlacdc rntibi”tia were -steal. Timinn of m~tibi”tic admi”istmtio” ii 71 i i39i55) of the pmadm was hlc#qrb. CorLdolll: v”ied ski” tlota wggested srmtbly of technique, wub plwocal and physlcim antibii ordming pnnana. Quality Improraneo tactivitiestoreducc ‘Quality Waste” in preop antibiotic administmtio” ad the PP SSI rate are in pmgress.
22, Number
Abstracts
2
INCIDENCE OF HEPATITIS C IN EMPLOYBES FOJaLOWING BXFQSURES TO BLOOD. L. Lemer-DurJava, RN, BSN, MSN.* Childma’s Hospital Medical Centm of Akron, Akron, OH. With tbe advent of thq OSHA blo”dbomc pathogen stand@ tkc Hospital elected to b~~hxie hqatitis C testing for all p~tbmts a”d employees with a” exp”smr to blood or bloody bcdy substances. Testing for Mtis C as part of the posl expos”re prc40~01 became .iffe&ve in June 1992. s&e that time, 110 employee-a”d Ii0 pad&s have brmtestedforHemlitisc. Thei”iti.al smeenim test for Ha&is C antibodv is bv Enzyme immunom~y @IA). Of the 220 wnples”se”t for test&, six weened &tivk for Hepatitis C antibody. AU positive wults were sent for confumPtory tzating by recombinvrt immunoblot assay (RIBA). Of dm five employee8 tested with RlBA, one w positive during confimmtwy RIBA testing. The patient i”volvuJ with this exposure was negative for hepatitis C antibodies. One patient also tested was positive by EIA a”d by RIBA. Wus the b&&me of infection is 0.9%. But the rate of smumnversion related tn expswe is zcm. The over all cost for testing exceeded $lO,ooO. With the low bxidmce of infection, the related testing costs, and lpck of any cross infection between patients and employees, hepatitis C twing af& exposures is of questionable value.
FQslTIvE INFBCTION IN A PBNILB IMPLANT POPULATION. RN: Crawford Me”wial Hospital, Va” Bure”, AR.
105
L. Thambrugh,
This study was initintcd to daerminc pmcedure s@fic pwopcmtive infection rata and possible risk pattems., Crawford Memorial Hospital is a 103 bed community hospital performing Xl0 penile implsnta annually. All &at charts indicated infwtl”“, revisia”, ox “lza”!ctim of the penile plwheeis WQC mviewd. Cater for D&ease c”“ko1 mid Prevatio” (CDC) defw&“s of -“lial i”fectio”S were used.
nosoumdal
‘ipenile
iqhnt
is P ptustMic dcvlce and any
meeting
CDCcriteriswacmnJi~anoamomiPlinfectionfornpaiodofoncyear. The smveilkmcz was collected on implants placed from Jmwuy 1990 to December 1992. lk nosacomial infection rate for this procedure in mu facility was 4.7% over the 36 month period reviewed. Tbbty-seven patie”ts met the criteria. Twenty-eight cases or 75.6% of the identified infections were “oted within the first 45 days pastoperatively. Four cases or 10.8% were identified in 45-90 days following implantatio” and 5 or 13.5% in the period greater than 90 days. All 5 of thase caes nwifeadng clinical infection r&r 90 days were medically complicated. 54% of the infections were following revision of a previously placed uninfected failed penile implant. Our pwtapuative infection rate WBS 4.7%. The stuiy de”lmshatcd that 75% Of these postopemtive infecticms will be manifested cliically within 45 days of impla”t or revision. The implnted pump mechvlism was most often implicated as the site of infection.
NURSES’ PRACTICES AND POTENTIAL EXPOSURB TO BLOOD/BODY FLUIDS RBLATBD TO THE MANAGEMENT OF SIMULATED WOUND DRAINAGE SYSTEMS IN THB LABORATORY SETTING. M. Z&e, RN, DNSc; A. McArdle, RN, MSN, B. Goldrick, RN, PhD. Georgcmvn University Medical Center, Washington, DC. The rekasc of OSHA’s Blood Borne Pathogen standards has prompted a reexmnhmtio” of the work environment to ensure safe containment of blood and body fluids. The purposes of this research were: 1) To compare nursing management umcticea usina three. different wound dminafte systems in a simulated set&z and 2) To &.mnine the &k of contamination awci&d~with measwemmt and &iv&n of simulated wound drainage fluid. Systems compared were: Henmvac~, a bulb evacuator, and the Kendall TN-Closx?‘. Subjects were fit?y-zight volunteer, registexed nurse8 who had medical-surgical nursing ex~ce. Each post-qmative wound drainage system was filled with simulated wound drainage and connected t” a nm”“iki” i” an empty patient care room. Subjects were given the nmnufachmxs’ mcommenda!ions for dmbuge system “ma&ment and show” a sample of the d&age system. For each of the three trials, subjects were asked 10: a) choose appropriate personal protection equipment/use mmmended nnivers8.l precautions, b) -we drainage system fluid; c) reactivate the drainage system suction chamber, d) dispose of equipment/fluid and e) complete a satisfaction questionnaim. Subjects were observed by a an investigator during each simulation. Exposures were defined aa spilling, dripping and splashing of simulated drainage fluid “I rinse water anywhere in the patient -&mm or p&e”t b&mom. Fiftv-five DcIcent 155 . %j of nurses who enmtied bulb evacuator svstems and 45 % of ““rxes who en$ied Hemova?‘ systems had a” rrposure. There we no exposures with the Kendall Tru-t&sew system. Most nurses chose gloves for pzrscmal protection. Gowns and face shields were rarely used. The majority of exposurea were due to emptying fluid (27%) or emptying rinse water (29%) into the pa&at toilet. Twentythree percent (23%) of exposures occurred while pouring simulated fluid into a container at the bedside. The most commcm object exposed was the toilet seat (67%). The bed linen was exucsed 16% of the time. Nurse’s cloves were exwsed 6% of the trials. The use of a cl&d system or disposable, single-u& containers &eliminate rinsing should be considered.
PACElMAKBR SITE INFECTIONS AND ANTIBIOTIC TIMING AND ADMINISTRATION. V.A. Lewellm, MT, MPH, CIC.’ Kaiser FennsnmteMedical Cent”, Smt Die@, CA. ArUnwccdvemviexwastan&Uedtodeccrmine~i”c~oflnfcui”“for
Pama”atPs&mpber(PP)~h~mwwhDt~mbe”tti~t
clnstm dwi”g March and April 1993 (“=99). Rejated l”cidma of FT infeaion and JcpJiaRngedfrom0.13%~12.7%withmoptantaa~3%toS%. Themview covmed 27 months endii Mmrh 31.1992. Charts wue a”alyzed for surgical site i”fec&ms (SSIs) mtd data colkaed cm pm@lylactic a”tibll ti”lhlg ard ad”li”islmti0” intdlio”towgieplincision. SSIswm’edehcdandstmdif*d~theNNISRlsk Index.. w Mean length of time horn PP invrtion to cad of lnfectkm=4.3 nm”~;m”ge23daystolyear. DumticmofcrprPtion’t’was7Sminutcs. Pnwd”ref werrprfonncdbyphyrieiansA,B,C,&DwithmSSIrstcof6.1%. orpMis”uwexe S. au&, S. epid&dis, A. anitmtus and micromccur. Physician SQecific-m for ‘C’ and’D’wuemtstadslicaUvdmifiantIPiaha’sexact1. Themtefw~D’waahieher than the dcpmtmmt rate & i, 6.9% ;a 4.7%; a”d itirk 2, 14.3% vs. 9.4%].-No conqmtive data is pFaently available fa PPs ag&st which to uatdardize. I” 55.6% (55/99b mwhvlacdc rntibi”tia were -steal. Timinn of m~tibi”tic admi”istmtio” ii 71 i i39i55) of the pmadm was hlc#qrb. CorLdolll: v”ied ski” tlota wggested srmtbly of technique, wub plwocal and physlcim antibii ordming pnnana. Quality Improraneo tactivitiestoreducc ‘Quality Waste” in preop antibiotic administmtio” ad the PP SSI rate are in pmgress.