Health Care–Associated Infections and the Radiology Department

Health care–associated infections (HCAIs) are a significant concern for both health care workers (HCWs) and patients. They are a major contributing factor of disease in industrialized countries, and are responsible for significant morbidity, mortality, and a direct annual financial loss of $6-7 billion in North America alone. They are an increasingly challenging health issue due to multidrug-resistant pathogens such as methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci among others, along with an increasing number of susceptible patients. Over the last three decades, the risk of HCAIs has increased in the radiology department (RD) in part because of an increased number of patients visiting the department and an increase in the utilization of imaging modalities. In this review, we will discuss how patients and staff can be exposed to HCAIs in the RD, including contaminated inanimate surfaces, radiology equipment, and associated medical devices. As the role of medical imaging has extended from primarily diagnosis to include more interventions, the implementation and development of standardized infection minimization protocols and infection control procedures are vital in the RD, particularly in interventional radiology. With globalisation and the rapid movement of people regionally, nationally, and globally, there is greater risk of exposure to contagious diseases such as Ebola, especially if infected patients are undiagnosed when they travel. For effective infection control, advanced training and education of HCWs in the RD is essential.The purpose of this article is to provide an overview of HCAIs as related to activities of the RD. We will discuss the following major topics including the variety of HCAIs commonly encountered, the role of the RD in HCAIs, transmission of infections to patients and HCWs in the RD, standard infection prevention measures, and the management of susceptible/infected patients in the RD. We shall also examine the role of, and the preparedness of, HCWs, including RD technologists and interventional radiologists, who may be exposed to undiagnosed, yet infected patients. We shall conclude with a brief discussion of the role of further research related to HCAIs.Learning ObjectivesAfter the completion of this review article, the readers will• Understand the exposure and role of radiology department in health care–associated infections,• Know the causes/modes/transmission of infections in radiology department,• Be conscious of standard disinfection protocols,• Be aware of current and future strategies required for the effective control of health care–associated infection in the radiology department.This is a CME article and provides the equivalent of 2 hours of continuing education that may be applied to your professional development credit system. A 10-question multiple-choice quiz follows this reading. Please note that no formalized credit (category A) is available from CAMRT.     

The “New” Field of Religion and Medicine

Meticulous diagnostic investigation is a primary therapeutic requisite in management of acute peptic ulcer. In general, current treatment conforms to past practices. Therapy must be highly individualized, and basic therapeutic principles must be followed. The authors state that combined aluminum hydroxide neutralizers, anticholinergic drugs and, possibly, tranquilizers are notable changes in ulcer treatment. They emphasize that exact management of early uncomplicated ulcer acts as a prophylaxis against intractability, recurrence, chronicity and complications.     

Preventing Outpatient Health Care–associated Infections

With the shift of care delivery from inpatient to outpatient settings, outpatient health care–associated infections are gaining attention, and experts are recommending that serious measures be taken to prevent them. By adhering to strict hand hygiene and facilitating the adoption and use of the Centers for Disease Control and Prevention’s “Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care,” nurse practitioners can help prevent these costly and potentially fatal infections.     

Medical Care and Health Needs—Present and Future

Two of three persons in this country see a physician at least once a year, yet more medical care is needed. Part of the problem is that patients generally think in terms of “health” while doctors are interested in “sickness.” Some patients, particularly those used to poverty, are not accustomed to maintaining health and preventing disease and do not seek medical care even when it is provided.     

Health service consumption and parent reported episodes of illness in children 0–3 years

Objective - To describe health service consumption and to find out whether a series of possible explanatory variables can help us to predict the number of contacts among children.

Design - A prospective study following a cohort of children during the first four years of life.

Setting - A municipality in southern Norway.

Participants - 183 children born in the community from October 1979 to and including December 1980.

Main outcome measure - Direct and indirect encounters with general practitioners (GPs) from the bills to the national insurance office, outpatient encounters and hospital admissions from the hospital files, and episodes of illness as reported in postal questionnaires to the parents. Results - Each child had on average 10.6 GP contacts (2.6 per year), and the frequency of contacts decreased as they grew. Telephone contacts were almost as frequent as consultations at the doctor's surgery, and the doctors made more home visits to the youngest children. Of the contacts, 4/5 took place in the day tune, but most of the home visits took place during the evening/night/weekend. Each child had 1.9 hospital contacts in 4 years, i.e. 0.3 admissions and 1.6 outpatient department contacts.

The parents reported an average of 11.5 episodes of illness during the period, more than twice as many in the first year as in the last year. Information about sex, duration of breast feeding, smoking in the family, family history of allergy, parents' education, whether in kindergarten, and presence of psychosocial problems cannot help in predicting health care consumption. Conclusion - The low number of contacts with GPs can partly be explained by the fact that the children also have contact with a well-baby clinic. In our study, a series of possible explanatory factors did not help us to predict the amount of health care consumption during the first four years of life.     

Reproductive Health and Coronavirus Disease 2019–Induced Economic Contracture: Lessons From the Great Recession

The coronavirus disease 2019 (COVID-19) pandemic has magnified disparities in care, including within reproductive health. There has been limited research on the implications of the financial calamity COVID-19 has precipitated on reproductive health, including restricted access to contraception and prenatal care, as well as adverse perinatal outcomes resulting from economic contracture. We therefore examined the Great Recession (the period of economic downturn from 2007–2009 also referred to as the 2008 recession) to discuss how the current financial difficulties may influence reproductive health now and in the years to come. The existing literature examining the impacts of economic downturn on reproductive health provides a resounding body of evidence supporting the need for state and federal investment in comprehensive reproductive health care. Policies directed at expanding access to programs such as Special Supplemental Nutrition Program for Women, Infants, and Children and Medicaid (WIC), extending Medicaid coverage to 12 months’ postpartum, continuing coverage for telehealth services, and lowering barriers to access through mobile care units would help mitigate anticipated effects of a recession on reproductive health.     

Academic–Practice Partnerships for Community Health Workforce Development

Despite increasing attention to academic–practice partnerships for health practice and workforce development, guidelines for how to implement such partnerships are few. The Kansas Public Health Workforce and Leadership Development (WALD) Center provides a successful example of such a partnership. The WALD Center implements public health education and training projects through a collaborative process of health needs identification, program conceptualization, research, and program evaluation. Such coordination allows for continuous practitioner-oriented program development and the sharing of a rural state's scarce resources between interconnected projects. The WALD Center's methods provide a model for academic–practice partnerships for community health practice and workforce development, even in environments with scarce health resources.