Influenza vaccine effectiveness against laboratory confirmed influenza in Greece during the 2013–2014 season: A test-negative study

BackgroundIn 2013–2014 Greece experienced a resurgence of severe influenza cases, coincidental with a shift to H1N1pdm09 predominance. We sought to estimate Vaccine Effectiveness (VE) for this season using available surveillance data from hospitals (including both inpatients and outpatients).MethodsSwab samples were sent by hospital physicians to one of three laboratories, covering the entire country, to be tested for influenza using RT-PCR. The test-negative design was employed, with patients testing positive serving as cases and those testing negative serving as controls. VE was estimated using logistic regression, adjusted for age group, sex, region and calendar time, with further adjustment for unknown vaccination status using inverse response propensity weights. Additional age group stratified estimates and subgroup estimates of VE against H1N1pdm09 and H3N2 were calculated.ResultsOut of 1310 patients with known vaccination status, 124 (9.5%) were vaccinated, and 543 patients (41.5%) tested positive for influenza. Adjusted VE was 34.5% (95% CI: 4.1–55.3%) against any influenza, and 56.7% (95% CI: 22.8–75.7%) against H1N1pdm09. VE estimates appeared to be higher for people aged 60 and older, while in those under 60 there was limited evidence of effectiveness. Isolated circulating strains were genetically close to the vaccine strain, with limited evidence of antigenic drift.ConclusionsThese results suggest a moderate protective effect of the 2013–2014 influenza vaccine, mainly against H1N1pdm09 and in people aged 60 and over. Vaccine coverage was very low in Greece, even among groups targeted for vaccination, and substantial efforts should be made to improve it. VE can and should be routinely monitored, and the results taken into account when deciding on influenza vaccine composition for next season.     

Key Characteristics of Rehabilitation Quality Improvement Publications: Scoping Review From 2010 to 2016

Objective

To characterize the peer-reviewed quality improvement (QI) literature in rehabilitation.

ICU物体表面的消毒效果监测

目的了解ICU医护人员手频繁接触物体表面的消毒质量,提高管理者对ICU物体表面消毒重要性的认识,为加强医院感染的预防与控制提供科学依据。方法 2013年3-8月对重症医学科、急诊和神经外科重症监护病房医务人员手频繁接触物体表面的消毒效果进行目标性监测,数据分析应用SPSS 19.0软件处理。结果共采集各类标本468份,合格393份,合格率84.0%,其中消毒后2h304份,合格249份,合格率81.9%;消毒后8h164份,合格144份,合格率87.8%,二者之间消毒效果差异无统计学意义;目标性病原菌监测结果显示,以多药耐药菌为主,共检出病原菌80株,检出率较高的病原菌为鲍氏不动杆菌39株、金黄色葡萄球菌29株,分别占48.8%、36.3%,其中泛耐药鲍氏不动杆菌34株、MRSA 28株,分别占87.2%、96.6%,肺炎克雷伯菌9株占11.2%。结论 ICU医护人员手频繁接触物体表面的日常清洁消毒质量有待提高,应强化医务人员手卫生管理,制定医务人员手频繁接触物体表面清洁与消毒的标准化操作规程,并加强规范的落实与监管。     

重症监护室护士慢性疲劳综合征与职业紧张的相关性

目的 调查重症监护室护士职业紧张现状与慢性疲劳综合征(CFS)发生率,并探讨其相关性.方法 选取2013年7月-2014年7月在荆州市10所综合性医院任职共235名ICU护士为研究对象,采用自制一般情况调查表、职业紧张量表(OSIR)和疲劳量表-14(FS-14)对其进行调查.结果 ICU护士职业紧张度最高发生在30～39岁年龄段,护龄在10～19 a、学历中专、常白夜班倒班、在编护士以及离婚和丧偶护士群体中,CFS的发生与年龄无关(P＞0.05);疲劳总分、躯体疲劳、脑力疲劳得分分别与职业任务、个体紧张反应得分呈正相关,与个体应变能力得分呈负相关,差异有统计学意义(P＜0.05).结论 ICU护士职业紧张情况较为严重,可通过缓解其职业紧张水平,从而降低患CFS的风险.     

干预措施对ICU医院感染发病率的影响

目的 评价实施预防与控制干预措施对ICU医院感染发病率的影响。方法 采用前瞻性监测的方法 ,对本院2013年7月1日~2014年6月30日收住ICU的395例患者进行目标性监测。2014年1月开始实施预防与控制干预措施,将2013年7月1日~12月31日184例ICU患者目标性监测结果作为干预前,2014年1月1日~2014年6月30日211例ICU患者目标性监测结果作为干预后。比较干预前、后ICU医院感染发病率的变化。结果 干预前、后:ICU例次医院感染发病率由12.50%下降至6.16%,两者比较,差异具有统计学意义(χ2=4.77,P<0.05),调整例次感染发病率由3.75%下降至1.91%,次日感染发病率由19.67‰下降至12.54‰,呼吸机相关肺炎(VAP)感染发病率由12.18‰下降至8.25‰,血管导管相关血流感染(CRBSI)发病率由5.81‰下降至0‰,泌尿道插管相关泌尿道感染(CAUTI)发病率由3.48‰下降至3.12‰。结论 持续开展ICU医院感染目标性监测,有针对性的制定ICU医院感染预防与控制干预措施并实施,能有效的降低ICU医院感染发病率。     

预见性护理对预防ICU危重症患者导管相关性感染的效果分析

目的探析预见性护理对预防ICU危重症患者导管相关性感染的效果。方法选取2018年1月~2019年6月在ICU接受治疗的50例危重症患者进行研究,随机分为对照组与观察组。对照组给予常规护理,观察组给予预见性护理,对两组导管相关性感染发生率、置管时间、住院时间及护理满意度进行统计对比。结果观察组导管相关性感染发生率为4.00%,对照组为16.00%,观察组显著低于对照组(P<0.05)。观察组置管时间、住院时间均显著短于对照组(P<0.05)。观察组护理满意度为96.00%,对照组为80.00%,观察组显著高于对照组(P<0.05)。结论ICU危重症患者应用预见性护理后,可显著减少导管相关性感染的发生,加快患者康复,提高患者护理满意度。     

Understanding new nurses’ learning experiences in intensive care

ObjectivesRecruitment and retention of nurses in intensive care units (ICU) has been challenging over the last few years. Rising demand is now exacerbated by the ongoing Covid-19 pandemic. Transition to ICU from other clinical areas is stressful resulting in significant nurse retention issues. This study therefore aimed to illuminate and explore new nurses’ learning experiences in one large intensive care unit in the United Kingdom.Methodology/MethodsExploratory qualitative case study utilising two data collection methods: one to one interview with six new ICU nurses and focus groups with six senior/clinical education ICU nurses.SettingA large major trauma centre in London with over ninety ICU beds.FindingsFindings indicate that ICU is a challenging learning environment for new nurses due to the large number of skills which must be developed in a short period of time. Forming supportive social relationships proved important in helping new ICU nurses learn and adapt to this complex clinical environment. The high-risk culture of ICU makes it harder to learn particularly for internationally educated nurses. Frequently changing shift patterns also impacts learning.ConclusionSenior ICU nurses should be aware of the issues affecting new nurses and where possible alleviate the stress of working in this challenging environment. They should also consider individual circumstances whilst maintaining high quality education. Social support should be facilitated where possible and new nurses need to be aware of the realities of ICU work.     

Should Flexible Bronchoscopy be Routinely Performed in Aspiration Pneumonitis: Non Liquet

How to cite this article: Sehgal IS, Dhooria S, Agarwal R. Should Flexible Bronchoscopy be Routinely Performed in Aspiration Pneumonitis: Non Liquet. Indian J Crit Care Med 2021;25(2):113–114.     

Video Laryngoscopy-guided Nasal Intubation: One More Bullet in Our Rifle

How to cite this article: Cittadini A, Marsigli F, Sica A, Santonastaso DP, Russo E, Gamberini E, et al. Video Laryngoscopy-guided Nasal Intubation: One More Bullet in Our Rifle. Indian J Crit Care Med 2021;25(3):351.