Check List for Surgical and Medical Camps in Developing countries By Dr.T.V.Rao MD

Check List for Surgical and Medical Camps in Developing countreis

By Dr.T.V.Rao MD

To establish highly successful implementation processes of Surgical Safety Checklist, every health care provider including hospital managers, have to actively lead the processes, deliberately enrol to the work create an extensive multidisciplinary discussion and communication, arrange update trainings offer ongoing constructive feedbacks and conduct regular audits. In general, implementing Surgical Safety Checklists needs high level interaction among social, cultural, and operational reasons in the health system.

CHECK LIST:

The implementation of a checklist is intended to improve the outcome of surgical care and thus the quality of care in general. However, its introduction and sustainability is always a big challenge. Of course, the translation of a new concept into practice usually follows theory of diffusion and innovation— acquire knowledge, persuaded by utility, make a decision to adopt, determine usefulness, and then decide to continue using the innovation to full effect. In this observational study we have found, although the hospital reported 100 % utilization of the checklist in the operation room, a 40 % compliance with a varying degree of completeness of items (63.4 %). This is quite good that an instrument that is used 40 % of the time 3 years after what appears to have been a fairly basic introduction without significant reinforcement training.

How do you investigate a disease outbreak?

Outbreak investigations 10 steps, 10 pitfalls. Determine the existence of an outbreak → Confirm the diagnosis → Define a case → Search for cases → Generate hypothesis using descriptive findings → Test hypotheses with an analytical study → Draw conclusion.

Search for : How do you investigate a disease outbreak? What are the three key components of an outbreak investigation? Why is it important to investigate outbreaks? How many steps is an outbreak investigation? What are the 10 steps of outbreak investigation? Which of the following is the first step in an outbreak investigation? What are Standard Precautions?

Standard Precautions (or Universal Precautions) are work practices that are required for the basic level of Infection Control. They include: ? Good hygiene practices ? Frequent hand washing ? The appropriate use of gloves ? The use of other personal protective equipment, such as eye protection, masks, aprons, gowns and overalls ? The safe use and disposal of sharp instruments, such as needle and syringes ? The use of disposable equipment where applicable and available ? Correct cleaning, disinfection and sterilization of non-disposable equipment ? Safe collection, storage and disposal of waste ? The appropriate use of cleaning agents ? Protocols for preventing and managing occupational exposures to blood or body substances

Why do we need Standard Precautions?

Standard Precautions will help stop the spread of infections. Often you can’t tell who is infected with a disease, or the person may be infected but have not yet developed any signs or symptoms. Some diseases can take several months before people become sick but they can still be infectious. Therefore All body substances (except sweat and tears) of ALL people are considered to be potential sources of infection.

When should we use Standard Precautions?

For the treatment and care of ALL patients regardless of their infectious status. Outbreaks of disease— the occurrence of more cases than expected— occur frequently. Each day, health departments learn about cases or outbreaks that require investigation. While CDC recorded over 500 outbreaks of foodborne illness alone each year during the 1990s, recognized outbreaks of respiratory and other diseases are also common, and many more outbreaks may go undetected. So how are outbreaks uncovered? One way is to analyze surveillance data — reports of cases of communicable diseases that are routinely sent by laboratories and healthcare providers to health departments (see Lesson 5). Some health departments regularly review exposure information from individual case reports to look for common factors. For example, health department staff in Oregon uncovered an outbreak of E. coli O157:H7 in 1997 by noticing that three patients with the infection all had reported drinking raw milk.

Alternatively, outbreaks may be detected when health department staff conduct regular, timely analysis of surveillance data that reveals an increase in reported cases or an unusual clustering of cases by time and place. For example, by analyzing data from four different syndromic surveillance systems, health department staff in New York City noted a consistent increase in gastroenteritis in the days following a prolonged blackout in August 2003.) Investigation indicated that the increase in gastroenteritis was probably attributable to the consumption of meat that had spoiled during the power failure. Review of surveillance data to detect outbreaks is not limited to health departments.

Many hospital infection control practitioners review microbiologic isolates from patients by organism and ward each week to detect an increase in the number of, say, surgical wound infections or nosocomial (hospital-acquired) cases of Legionellosis. In the same way, staff at CDC regularly review laboratory patterns of organisms and are able to detect clusters of illness caused by the same organism, even if the victims are geographically scattered. Nonetheless, most outbreaks come to the attention of health authorities because an alert clinician is concerned enough to call the health department. Public, political, or legal concerns Public, political, or legal concerns can be the driving force behind the decision to conduct an investigation. A cluster of cancer cases in a neighborhood may prompt concerned residents to advocate for an investigation.

Sometimes the public is concerned that the disease cluster is the result of an environmental exposure such as toxic waste. Investigations of such clusters almost never identify a causal link between exposure and disease.(18,19) Nevertheless, many health departments have learned that they must be “responsibly responsive” to public concerns, even if they think that an epidemiologic link is unlikely.(7,8,20) Similarly, the public may fear that an outbreak is the result of an intentional criminal or bioterrorist act. The health department may be able to allay those fears by documenting that the outbreak was the result of an inadvertent or naturally occurring exposure.

Some investigations are conducted because they are required by law. For example, CDC’s National Institute for Occupational Safety and Health (NIOSH) is required to evaluate the risks to health and safety in a workplace if requested to do so by a union, three or more workers, or an employer.(21) Program considerations Many health departments run programs to control and prevent communicable diseases such as influenza, tuberculosis, vaccine-preventable diseases, and sexually transmitted diseases. An outbreak of a disease targeted by a public health program may reveal a weakness in that program and an opportunity to change or strengthen program efforts. Investigating the outbreak’s causes may identify populations that have been overlooked, failures in intervention strategies, or changes in the agent.

Using the outbreak to evaluate program effectiveness can help program directors improve future directions and strategies. Training Investigating an outbreak requires a combination of diplomacy, logical thinking, problem-solving ability, quantitative skills, epidemiologic know-how, and judgment. These skills improve with practice and experience. Thus, many investigative teams pair a seasoned epidemiologist with an epidemiologist-in-training. The latter gains valuable on-the-job training and experience while providing assistance in the investigation and control of the outbreak References CDC resources on outbreaks NIH to control the outbreaks of infections WHO worldwide resources to control outbreaks of infections.

Dr.T.V.Rao MD

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To establish highly successful implementation processes of Surgical Safety Checklist, every health care provider including hospital managers, have to actively lead the processes, deliberately enrol to the work create an extensive multidisciplinary discussion and communication, arrange update trainings offer ongoing constructive feedbacks and conduct regular audits. In general, implementing Surgical Safety Checklists needs high level interaction among social, cultural, and operational reasons in the health system.

CHECK LIST:

The implementation of a checklist is intended to improve the outcome of surgical care and thus the quality of care in general. However, its introduction and sustainability is always a big challenge. Of course, the translation of a new concept into practice usually follows theory of diffusion and innovation— acquire knowledge, persuaded by utility, make a decision to adopt, determine usefulness, and then decide to continue using the innovation to full effect. In this observational study we have found, although the hospital reported 100 % utilization of the checklist in the operation room, a 40 % compliance with a varying degree of completeness of items (63.4 %). This is quite good that an instrument that is used 40 % of the time 3 years after what appears to have been a fairly basic introduction without significant reinforcement training.

How do you investigate a disease outbreak?

Outbreak investigations 10 steps, 10 pitfalls. Determine the existence of an outbreak → Confirm the diagnosis → Define a case → Search for cases → Generate hypothesis using descriptive findings → Test hypotheses with an analytical study → Draw conclusion.

Search for : How do you investigate a disease outbreak? What are the three key components of an outbreak investigation? Why is it important to investigate outbreaks? How many steps is an outbreak investigation? What are the 10 steps of outbreak investigation? Which of the following is the first step in an outbreak investigation? What are Standard Precautions?

Standard Precautions (or Universal Precautions) are work practices that are required for the basic level of Infection Control. They include: ? Good hygiene practices ? Frequent hand washing ? The appropriate use of gloves ? The use of other personal protective equipment, such as eye protection, masks, aprons, gowns and overalls ? The safe use and disposal of sharp instruments, such as needle and syringes ? The use of disposable equipment where applicable and available ? Correct cleaning, disinfection and sterilization of non-disposable equipment ? Safe collection, storage and disposal of waste ? The appropriate use of cleaning agents ? Protocols for preventing and managing occupational exposures to blood or body substances

Why do we need Standard Precautions?

Standard Precautions will help stop the spread of infections. Often you can’t tell who is infected with a disease, or the person may be infected but have not yet developed any signs or symptoms. Some diseases can take several months before people become sick but they can still be infectious. Therefore All body substances (except sweat and tears) of ALL people are considered to be potential sources of infection.

When should we use Standard Precautions?

For the treatment and care of ALL patients regardless of their infectious status. Outbreaks of disease— the occurrence of more cases than expected— occur frequently. Each day, health departments learn about cases or outbreaks that require investigation. While CDC recorded over 500 outbreaks of foodborne illness alone each year during the 1990s, recognized outbreaks of respiratory and other diseases are also common, and many more outbreaks may go undetected. So how are outbreaks uncovered? One way is to analyze surveillance data — reports of cases of communicable diseases that are routinely sent by laboratories and healthcare providers to health departments (see Lesson 5). Some health departments regularly review exposure information from individual case reports to look for common factors. For example, health department staff in Oregon uncovered an outbreak of E. coli O157:H7 in 1997 by noticing that three patients with the infection all had reported drinking raw milk.

Alternatively, outbreaks may be detected when health department staff conduct regular, timely analysis of surveillance data that reveals an increase in reported cases or an unusual clustering of cases by time and place. For example, by analyzing data from four different syndromic surveillance systems, health department staff in New York City noted a consistent increase in gastroenteritis in the days following a prolonged blackout in August 2003.) Investigation indicated that the increase in gastroenteritis was probably attributable to the consumption of meat that had spoiled during the power failure. Review of surveillance data to detect outbreaks is not limited to health departments.

Many hospital infection control practitioners review microbiologic isolates from patients by organism and ward each week to detect an increase in the number of, say, surgical wound infections or nosocomial (hospital-acquired) cases of Legionellosis. In the same way, staff at CDC regularly review laboratory patterns of organisms and are able to detect clusters of illness caused by the same organism, even if the victims are geographically scattered. Nonetheless, most outbreaks come to the attention of health authorities because an alert clinician is concerned enough to call the health department. Public, political, or legal concerns Public, political, or legal concerns can be the driving force behind the decision to conduct an investigation. A cluster of cancer cases in a neighborhood may prompt concerned residents to advocate for an investigation.

Sometimes the public is concerned that the disease cluster is the result of an environmental exposure such as toxic waste. Investigations of such clusters almost never identify a causal link between exposure and disease.(18,19) Nevertheless, many health departments have learned that they must be “responsibly responsive” to public concerns, even if they think that an epidemiologic link is unlikely.(7,8,20) Similarly, the public may fear that an outbreak is the result of an intentional criminal or bioterrorist act. The health department may be able to allay those fears by documenting that the outbreak was the result of an inadvertent or naturally occurring exposure.

Some investigations are conducted because they are required by law. For example, CDC’s National Institute for Occupational Safety and Health (NIOSH) is required to evaluate the risks to health and safety in a workplace if requested to do so by a union, three or more workers, or an employer.(21) Program considerations Many health departments run programs to control and prevent communicable diseases such as influenza, tuberculosis, vaccine-preventable diseases, and sexually transmitted diseases. An outbreak of a disease targeted by a public health program may reveal a weakness in that program and an opportunity to change or strengthen program efforts. Investigating the outbreak’s causes may identify populations that have been overlooked, failures in intervention strategies, or changes in the agent.

Using the outbreak to evaluate program effectiveness can help program directors improve future directions and strategies. Training Investigating an outbreak requires a combination of diplomacy, logical thinking, problem-solving ability, quantitative skills, epidemiologic know-how, and judgment. These skills improve with practice and experience. Thus, many investigative teams pair a seasoned epidemiologist with an epidemiologist-in-training. The latter gains valuable on-the-job training and experience while providing assistance in the investigation and control of the outbreak References CDC resources on outbreaks NIH to control the outbreaks of infections WHO worldwide resources to control outbreaks of infections.

Dr.T.V.Rao MD

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Comment

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