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Asepsis01:28

Asepsis

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The condition of being free from disease-causing living pathogens is asepsis. Aseptic techniques include a set of standard practices to achieve asepsis. An example is the regular environmental cleaning of all parts of the healthcare facility and hand hygiene at home before preparing or eating food. Medical and surgical asepsis in healthcare practice protects patients from harmful pathogens, minimizes the risk of contamination of susceptible sites, and reduces the risk of infection transmission.
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Hand hygiene01:23

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Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
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Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

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Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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Healthcare Associated Infections II: Preventive Measures01:22

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Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
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Standard Precaution01:26

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Standard precautions are the minimum infection control safeguards used while caring for all patients, irrespective of their disease condition. They help prevent the spread of common infectious microorganisms to healthcare workers, patients, and visitors in all healthcare settings.
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Subcutaneous Infection of Methicillin Resistant Staphylococcus Aureus MRSA
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Preoperative Staphylococcus aureus screening and eradication.

Ruben Scholten1, Gerjon Hannink2, Karin Willemsen3

  • 1Department of Orthopedic Surgery, Rijnstate Ziekenhuis, Arnhem, the Netherlands.

The Bone & Joint Journal
|September 30, 2020
PubMed
Summary
This summary is machine-generated.

Preoperative Staphylococcus aureus screening did not lower overall early prosthetic joint infection rates. However, it significantly reduced S. aureus-induced early PJI in hip and knee replacement patients.

Keywords:
ArthroplastyInfectionPreventionProsthetic joint infectionStaphylococcus aureusTotal hip arthroplastyTotal knee arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Infectious Disease Epidemiology
  • Public Health

Background:

  • Preoperative screening for Staphylococcus aureus nasal colonization is implemented to reduce surgical site infections.
  • Its effectiveness in preventing early prosthetic joint infections (PJI) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) remains debated.
  • This study evaluates the impact of a screening and eradication protocol on PJI incidence.

Purpose of the Study:

  • To assess the effect of preoperative Staphylococcus aureus screening and eradication on the overall incidence of early PJI.
  • To determine the impact on S. aureus-induced early PJI specifically.

Main Methods:

  • Retrospective review of 10,486 primary THA and TKA procedures from 2006 to 2018.
  • Comparison of early PJI incidence before and after the implementation of a S. aureus screening protocol in October 2010.
  • Statistical analysis using inverse probability weighting and logistic regression to account for confounding factors.

Main Results:

  • Analysis included 5,499 screened and 3,563 non-screened cases.
  • No significant reduction in overall early PJI was observed in the screened group (OR 0.78, p=0.173).
  • A significant decrease in S. aureus-induced early PJI was found in the screened group (OR 0.58, p=0.027).

Conclusions:

  • Preoperative S. aureus screening and eradication did not significantly reduce the overall incidence of early PJI after THA or TKA.
  • The protocol was effective in decreasing the incidence of S. aureus-induced early PJI.
  • Findings contribute to the ongoing discussion regarding the value of preoperative S. aureus screening protocols.