6 results on '"Hota S"'
Search Results
2. Validation and implementation of group electronic hand hygiene monitoring across twenty-four critical care units.
- Author
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Leis JA, Obaidallah M, Williams V, Muller MP, Powis JE, Johnstone J, Hota S, Katz K, Payne M, Castellani L, Downing M, Mertz D, Ricciuto DR, Kiss A, and Cuthbertson BH
- Subjects
- Critical Care, Electronics, Guideline Adherence, Humans, Infection Control, Ontario, Cross Infection prevention & control, Hand Hygiene
- Abstract
Objectives: An accurate estimate of the average number of hand hygiene opportunities per patient hour (HHO rate) is required to implement group electronic hand hygiene monitoring systems (GEHHMSs). We sought to identify predictors of HHOs to validate and implement a GEHHMS across a network of critical care units., Design: Multicenter, observational study (10 hospitals) followed by quality improvement intervention involving 24 critical care units across 12 hospitals in Ontario, Canada., Methods: Critical care patient beds were randomized to receive 1 hour of continuous direct observation to determine the HHO rate. A Poisson regression model determined unit-level predictors of HHOs. Estimates of average HHO rates across different types of critical care units were derived and used to implement and evaluate use of GEHHMS., Results: During 2,812 hours of observation, we identified 25,417 HHOs. There was significant variability in HHO rate across critical care units. Time of day, day of the week, unit acuity, patient acuity, patient population and use of transmission-based precautions were significantly associated with HHO rate. Using unit-specific estimates of average HHO rate, aggregate HH adherence was 30.0% (1,084,329 of 3,614,908) at baseline with GEHHMS and improved to 38.5% (740,660 of 1,921,656) within 2 months of continuous feedback to units ( P < .0001)., Conclusions: Unit-specific estimates based on known predictors of HHO rate enabled broad implementation of GEHHMS. Further longitudinal quality improvement efforts using this system are required to assess the impact of GEHHMS on both HH adherence and clinical outcomes within critically ill patient populations.
- Published
- 2022
- Full Text
- View/download PDF
3. Response to Alert on Possible Infections with Mycobacterium chimaera From Contaminated Heater-Cooler Devices in Hospitals Participating in the Canadian Nosocomial Infection Surveillance Program (CNISP).
- Author
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Mertz D, Macri J, Hota S, Amaratunga K, Davis I, Johnston L, Lee B, Pelude L, Science M, Smith S, and Wong A
- Subjects
- Canada epidemiology, Equipment and Supplies, Hospital microbiology, Equipment and Supplies, Hospital statistics & numerical data, Humans, Air Conditioning instrumentation, Cross Infection epidemiology, Cross Infection etiology, Cross Infection microbiology, Cross Infection prevention & control, Equipment Contamination prevention & control, Equipment Contamination statistics & numerical data, Infection Control methods, Infection Control organization & administration, Mycobacterium Infections, Nontuberculous epidemiology, Mycobacterium Infections, Nontuberculous etiology, Mycobacterium Infections, Nontuberculous microbiology, Mycobacterium Infections, Nontuberculous prevention & control, Nontuberculous Mycobacteria isolation & purification
- Abstract
Canadian hospitals were made aware of the risk of Mycobacterium chimaera infection associated with heater-cooler units (HCUs) through alerts issued by the US food and Drug Administration (FDA) and the US Centers for Disease Control and Prevention (CDC). In response, most hospitals conducted retrospective reviews for infections, informed exposed patients, and initiated a requirement for informed consent with HCU use. Infect Control Hosp Epidemiol 2018;39:482-484.
- Published
- 2018
- Full Text
- View/download PDF
4. Longitudinal Multicenter Analysis of Outcomes After Cessation of Control Measures for Vancomycin-Resistant Enterococci.
- Author
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Lemieux C, Gardam M, Evans G, John M, Suh KN, vanWalraven C, Vicencio E, Coulby C, Roth V, and Hota S
- Subjects
- Aged, Cross Infection prevention & control, Female, Hospitals, Humans, Infection Control methods, Longitudinal Studies, Male, Middle Aged, Ontario epidemiology, Vancomycin Resistance, Bacteremia mortality, Cross Infection mortality, Gram-Positive Bacterial Infections mortality, Vancomycin-Resistant Enterococci isolation & purification
- Abstract
OBJECTIVE To assess clinically relevant outcomes after complete cessation of control measures for vancomycin-resistant enterococci (VRE). DESIGN Quasi-experimental ecological study over 3.5 years. METHODS All VRE screening and isolation practices at 4 large academic hospitals in Ontario, Canada, were stopped on July 1, 2012. In total, 618 anonymized abstracted charts of patients with VRE-positive clinical isolates identified between July 1, 2010, and December 31, 2013, were reviewed to determine whether the case was a true VRE infection, a VRE colonization or contaminant, or a true VRE bacteremia. All deaths within 30 days of the last VRE infection were also reviewed to determine whether the death was fully or partially attributable to VRE. All-cause mortality was evaluated over the study period. Generalized estimating equation methods were used to cluster outcome rates within hospitals, and negative binomial models were created for each outcome. RESULTS The incidence rate ratio (IRR) for VRE infections was 0.59 and the associated P value was .34. For VRE bacteremias, the IRR was 0.54 and P=.38; for all-cause mortality the IRR was 0.70 and P=.66; and for VRE attributable death, the IRR was 0.35 and P=.49. VRE control measures were not significantly associated with any of the outcomes. Rates of all outcomes appeared to increase during the 18-month period after cessation of VRE control measures, but none reached statistical significance. CONCLUSION Clinically significant VRE outcomes remain rare. Cessation of all control measures for VRE had no significant attributable adverse clinical impact. Infect Control Hosp Epidemiol 2016;1-7.
- Published
- 2017
- Full Text
- View/download PDF
5. Personal Protective Equipment for Infectious Disease Preparedness: A Human Factors Evaluation.
- Author
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Herlihey TA, Gelmi S, Flewwelling CJ, Hall TN, Bañez C, Morita PP, Beverley P, Cafazzo JA, and Hota S
- Subjects
- Canada, Equipment Design, Guidelines as Topic, Humans, Safety, Communicable Disease Control methods, Health Personnel, Infectious Disease Transmission, Patient-to-Professional prevention & control, Personal Protective Equipment standards
- Abstract
OBJECTIVE To identify issues during donning and doffing of personal protective equipment (PPE) for infectious diseases and to inform PPE procurement criteria and design. DESIGN A mixed methods approach was used. Usability testing assessed the appropriateness, potential for errors, and ease of use of various combinations of PPE. A qualitative constructivist approach was used to analyze participant feedback. SETTING Four academic health sciences centers: 2 adult hospitals, 1 trauma center, and 1 pediatric hospital, in Toronto, Canada. PARTICIPANTS Participants (n=82) were representative of the potential users of PPE within Western healthcare institutions. RESULTS None of the tested combinations provided a complete solution for PPE. Environmental factors, such as anteroom layout, and the design of protocols and instructional material were also found to impact safety. The study identified the need to design PPE as a complete system, rather than mixing and matching components. CONCLUSIONS Healthcare institutions are encouraged to use human factors methods to identify risk and failure points with the usage of their selected PPE, and to modify on the basis of iterative evaluations with representative end users. Manufacturers of PPE should consider usability when designing the next generation of PPE. Infect Control Hosp Epidemiol 2016;37:1022-1028.
- Published
- 2016
- Full Text
- View/download PDF
6. Outbreak of multidrug-resistant Pseudomonas aeruginosa colonization and infection secondary to imperfect intensive care unit room design.
- Author
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Hota S, Hirji Z, Stockton K, Lemieux C, Dedier H, Wolfaardt G, and Gardam MA
- Subjects
- Adult, Aged, Aged, 80 and over, Biofilms growth & development, Cross Infection mortality, Cross Infection transmission, Equipment Contamination, Female, Humans, Hygiene, Male, Middle Aged, Phylogeny, Pseudomonas Infections microbiology, Pseudomonas Infections mortality, Pseudomonas Infections transmission, Pseudomonas aeruginosa genetics, Young Adult, Cross Infection epidemiology, Disease Outbreaks, Drug Resistance, Multiple, Bacterial, Hospital Design and Construction, Intensive Care Units, Patients' Rooms, Pseudomonas Infections epidemiology
- Abstract
Background: Pseudomonas aeruginosa has been increasingly recognized for its ability to cause significant hospital-associated outbreaks, particularly since the emergence of multidrug-resistant strains. Biofilm formation allows the pathogen to persist in environmental reservoirs. Thus, multiple hospital room design elements, including sink placement and design, can impact nosocomial transmission of P. aeruginosa and other pathogens., Methods: From December 2004 through March 2006, 36 patients exposed to the intensive care unit or transplant units of a tertiary care hospital were infected with a multidrug-resistant strain of P. aeruginosa. All phenotypically similar isolates were examined for genetic relatedness by means of pulsed-field gel electrophoresis. Clinical characteristics of the affected patients were collected, and a detailed epidemiological and environmental investigation of potential sources was carried out., Results: Seventeen of the infected patients died within 3 months; for 12 (71%) of these patients, infection with the outbreak organism contributed to or directly caused death. The source of the outbreak was traced to hand hygiene sink drains, where biofilms containing viable organisms were found. Testing by use of a commercial fluorescent marker demonstrated that when the sink was used for handwashing, drain contents splashed at least 1 meter from the sink. Various attempts were made to disinfect the drains, but it was only when the sinks were renovated to prevent splashing onto surrounding areas that the outbreak was terminated., Conclusion: This report highlights the importance of biofilms and of sink and patient room design in the propagation of an outbreak and suggests some strategies to reduce the risks associated with hospital sinks.
- Published
- 2009
- Full Text
- View/download PDF
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