'Off the rails': hospital bed rail design, contamination, and the evaluation of their microbial ecology.

Microbial contamination of the near-patient environment is an acknowledged reservoir for nosocomial pathogens. The hospital bed and specifically bed rails have been shown to be frequently and heavily contaminated in observational and interventional studies. Whereas the complexity of bed rail design has evolved over the years, the microbial contamination of these surfaces has been incompletely evaluated.

A unified framework for developing effective hygiene procedures for hands, environmental surfaces and laundry in healthcare, domestic, food handling and other settings.

Hygiene procedures for hands, surfaces and fabrics are central to preventing spread of infection in settings including healthcare, food production, catering, agriculture, public settings, and home and everyday life. They are used in situations including hand hygiene, clinical procedures, decontamination of environmental surfaces, respiratory hygiene, food handling, laundry hygiene, toilet hygiene and so on. Although the principles are common to all, approaches currently used in different settings are inconsistent.

Evaluating a new paradigm for comparing surface disinfection in clinical practice.

Background: Despite an increasing understanding of the importance of near-patient surfaces in the transmission of healthcare-associated pathogens, there remains a need to define the relative clinical effectiveness of disinfection interventions.

Design: A serial 2-phase evaluation of the clinical effectiveness of 2 surface disinfectants.

Setting: A general acute care hospital.

Intensive care unit environmental cleaning: an evaluation in sixteen hospitals using a novel assessment tool.

Despite isolation precautions and enhanced hand hygiene product use, the transmission of healthcare-associated pathogens remains a major problem. Recent studies have confirmed that microbial contamination of the environment in intensive care units (ICUs) can lead to colonisation and infection of patients. Although environmental disinfectants have been used to minimise the spread of microbial pathogens, suboptimal cleaning may limit the effectiveness of such activities.

Parenteral antibiotic use in acute-care hospitals: A standardized analysis of fourteen institutions.

Despite increasing concerns regarding the need to optimize appropriate antibiotic use in hospitals, a standardized method for evaluating interinstitutional antibiotic use has not been developed. To address this issue, antibiotic use was analyzed by means of a uniform methodology among 14 acute-care hospitals. Data were standardized by use of a defined daily dose for each antibiotic while adjusting for patient volume by calculating use per 1000 patient-days.