The risk of coronary thrombosis with cyclo-oxygenase-2 inhibitors does not vary with polymorphisms in two regions of the cyclo-oxygenase-2 gene.

Aims: To investigate whether polymorphisms of the cyclo-oxygenase-2 (COX-2) gene modify the adverse cardiovascular effects of COX-2 inhibitors.

Methods: A case control study was conducted in the Hunter Region of New South Wales, Australia. Cases (n= 460) were hospitalized with acute coronary syndrome (ACS).

Developing decontamination strategies and monitoring tools.

Decontamination within the healthcare setting plays a significant role in reducing the risk of healthcare-associated infections. This article will examine decontamination from hand hygiene to sterilization of instruments and discuss how hazard analysis at critical control points (HACCP) can be used to monitor and record practice, ensuring that consistent standards are based on recommended guidelines, the law and policies.

Skin care as a tool in the prevention of health care-associated infection.

Keeping skin healthy is particularly important for patients and all health-care personnel as any break in the skin can potentially harbour bacteria that may become a cross-infection risk to patients. When skin is damaged it is more difficult to remove microrganisms even when staff follow the recommended technique for hand washing (Royal College of Nursing, 2000). Broken skin on patients increases the risk of developing a healthcare-associated infection (HAI) as microorganisms can penetrate the surface of broken skin and cause anything from boils to bacteraemia.

Skin care: an essential component of hand hygiene and infection control.

Skin care is an important component of hand hygiene and also infection prevention education programmes relating to hand hygiene (Bissett, 2007a,b). Hand hygiene is the term commonly used to describe hand washing using plain soap or antiseptic soaps and hand rubbing using waterless antiseptic products or alcohol-based products. The importance of effective hand hygiene is well documented (Larson, 1997; Boyce et al, 2002; Horton and Parker, 2002) and can be achieved by following the six-step technique used for hand washing as illustrated by the Royal College of Nursing (2000).

ESBL-producing Enterobacteriaceae: controlling the spread of infection.

Extended spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae were first reported in Europe in the 1980s and have since become a worldwide problem. This has resulted in increased morbidity, mortality and cost in treating the infections they cause (Paterson et al, 2001; Bisson et al, 2002). In the UK the prevalence of ESBL rose from 5.

Compliance with guidelines on effective hand hygiene.

This article outlines in detail the processes involved in effective hand hygiene, as well as the responsibilities of nurses in relation to hand hygiene as a method of maintaining a safe environment for patients and staff. It also makes some recommendations to improve hand hygiene and reduce risk.

Reducing the risk of acquiring antimicrobial-resistant bacteria.

Antimicrobial-resistant organisms have become a major issue for all healthcare staff. The Government, media and public are now calling for action to be taken to minimize the risk of acquiring such an infection when admitted to any healthcare setting. Although it is impossible to completely remove the risk of acquiring infection, there are methods already available to healthcare staff and the public that would help to reduce the number of antimicrobial-resistant infections that occur.

Hand inspection cabinets as an aid to washing technique.

Aim: The study aimed to discover if self-assessment of handwashing techniques would help staff to improve practice.

Method: A rolling programme of self-assessment of handwashing technique was carried out over a period of three months using hand inspection cabinets (glow-and-tell boxes). A simple questionnaire was then used to establish opinions on the glow-and-tell box as an aid to self-assessment in handwashing technique.

Controlling the risk of MRSA infection: screening and isolating patients.

Methicillin-resistant Staphylococcus aureus (MRSA) continues to be a major cause for concern to health boards and trusts through the UK and the rest of the world. A review of literature sourced via Cinahl, Medline and Pubmed examines the discussions for and against screening patients for MRSA and isolating MRSA-positive patients as a means of managing MRSA within the hospital setting. The research evidence available on the ability of MRSA strains to spread within the healthcare setting and how this influences the opposing arguments is explored.

Does ingestion of cranberry juice reduce symptomatic urinary tract infections in older people in hospital? A double-blind, placebo-controlled trial.

Background: cranberry juice is often given to older people in hospital to prevent urinary tract infection (UTI), although there is little evidence to support its use.

Objective: to assess whether cranberry juice ingestion is effective in reducing UTIs in older people in hospital.

Design: randomised, placebo-controlled, double-blind trial.

Reducing the risk of catheter-related urinary tract infection.

It is estimated that 10-12 per cent of hospital patients and four per cent of patients in the community have a urinary catheter at any one time (Stamm, 1998). Urinary tract infections (UTIs) account for almost half of all health care-associated infection (HAI), and a significant number of these infections are related to the insertion of urinary catheters (Pratt et al, 2001). Recent research has estimated that a patient who has a catheter for 20 days is almost certain to develop a catheter-related UTI and that the cost of treatment of UTI is estimated as being 1,327 pounds sterling per patient (Roadhouse and Wellsted, 2004).

The control of urinary tract infection in hospitalised older people.

Urinary tract infection (UTI) can be symptomatic, asymptomatic, complicated or uncomplicated. A symptomatic UTI is identified by the presence of clinical symptoms that can be attributed to the presence of bacteria in the urinary tract. This may present as an acute uncomplicated UTI or an acute non-obstructive pyelonephritis (bacterial infection of the kidney).

Interpretation of terms used to describe handwashing activities.

A literature review on the use of alcohol-based handrubs highlighted many variations in the terms used to describe the activities related to effective hand hygiene. This suggests that an individual's interpretation of the terms used to describe hand-hygiene activities may lead to a variation in compliance with any protocol or guideline employing them. This article describes an audit that was undertaken to establish whether the definition of the terms handwashing, hygienic handwashing and hygienic handrub varied between grades of staff and disciplines who have direct contact with patients.

Can alcohol hand rubs increase compliance with hand hygiene?

A review of the literature indicates that alcohol hand rubs reduce microbial load, are less irritant to the skin of healthcare workers, and are more easily accessible than conventional methods of hand hygiene. The review also indicates that using alcohol hand rub increases compliance to hand hygiene guideline rates by 25%. This study examines whether making alcohol hand rubs readily available to healthcare workers will increase and maintain compliance with hand hygiene protocols and guidelines, thereby reducing nosocomial infection, or whether the methods of staff education on the use and benefits of products and other interventions need to be examined.