Long-term antimicrobial effectiveness of a silver-impregnated foil on high-touch hospital surfaces in patient rooms

Society of Critical Care Medicine 2024 Guidelines on Adult ICU Design

RATIONALE

Advances in technology, infection control challenges-as with the COVID-19 pandemic-and evolutions in patient- and family-centered care highlight ideal aspects of ICU design and opportunities for enhancement.

OBJECTIVES

To provide evidence-based recommendations for clinicians, administrators, and healthcare architects to optimize design strategies in new or renovation projects.

PANEL DESIGN

A guidelines panel of 27 members with experience in ICU design met virtually from the panel's inception in 2019 to 2024. The panel represented clinical professionals, architects, engineers, and clinician methodologists with expertise in developing evidence-based clinical practice guidelines. A formal conflict of interest policy was followed throughout the guidelines-development process.

METHODS

Embase, Medline, CINAHL, Central, and Proquest were searched from database inception to September 2023. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to determine certainty in the evidence and to formulate recommendations, suggestions, and practice statements for each Population, Intervention, Control, and Outcomes (PICO) question based on quality of evidence and panel consensus. Recommendations were provided when evidence was actionable; suggestions, when evidence was equivocal; and practice statements when the benefits of the intervention appeared to outweigh the risks, but direct evidence to support the intervention did not exist.

RESULTS

The ICU Guidelines panel issued 17 recommendations based on 15 PICO questions relating to ICU architecture and design. The panel strongly recommends high-visibility ICU layouts, windows and natural lighting in all patient rooms to enhance sleep and recovery. The panel suggests integrated staff break/respite spaces, advanced infection prevention features, and flexible surge capacity. Because of insufficient evidence, the panel could not make a recommendation around in-room supplies, decentralized charting, and advanced heating, ventilation, and air conditioning systems.

CONCLUSIONS

This ICU design guidelines is intended to provide expert guidance for clinicians, administrators, and healthcare architects considering erecting a new ICU or revising an existing structure.

Prevention and control of hospital-acquired infections with multidrug-resistant organism: A review

Multidrug-resistant is defined as nonsusceptibility to at least 1 agent in 3 or more antimicrobial categories. Controlling the spread of drug-resistant organisms is a key step in the management of hospital-acquired infections (HAIs). To review the progress of research on the prevention and control of HAIs with multidrug-resistant organism (MDRO) in the past 5 years, and to provide reference for the development of comprehensive measures for the prevention and control of HAIs with MDRO. We conducted a search in the PUBMED database for studies related to MDRO and HAIs from 2018 to 2023, then integrated this data with information sourced from the U.S.A. The Centers for Disease Control and Prevention. Utilizing information technology to monitor and provide feedback on hand hygiene practices can enhance compliance. Environmental disinfection techniques such as ultraviolet or hydrogen peroxide demonstrate potential in reducing MDRO transmission. While some studies support that contact isolation measures for MDRO-infected or colonized patients can reduce HAIs, others do not confirm this outcome. Approaches for MDRO colonization among patients or physicians may mitigate MDRO transmission risk. Implementing clusterization interventions proves to enhance efficiency and cost-effectiveness in preventing and controlling MDRO. Early screening for pathogen species emerges as a valuable strategy aiding in antimicrobial use control. Combined with evidence from the literature, implementing clusterization interventions that include measures such as monitoring and feedback on hand hygiene and improved environmental disinfection techniques can help prevent and control HAIs with MDRO. However, further clinical studies are needed to validate the optimal clusterization intervention.

The Effect of the Addition of Copper Particles in High-Density Recycled Polyethylene Matrices by Extrusion

In this study, the effect of the recycling process and copper particle incorporation on virgin and recycled pellet HDPE were investigated by thermo-chemical analysis, mechanical characterization, and antibacterial analysis. Copper particles were added to pellet HDPE, virgin and recycled, using a tabletop single screw extruder. Some copper particles, called copper nano-particles (Cu-NPs), had a spherical morphology and an average particle size near 20 nm. The others had a cubic morphology and an average particle size close to 300 nm, labeled copper nano-cubes (Cu-NCs). The thermo-chemical analysis revealed that the degree of crystallization was not influenced by the recycling process: 55.38 % for virgin HDPE and 56.01% for recycled HDPE. The degree of crystallization decreased with the addition of the copper particles. Possibly due to a modification in the structure, packaging organization, and crystalline ordering, the recycled HDPE reached a degree of crystallization close to 44.78% with 0.5 wt.% copper nano-particles and close to 36.57% for the recycled HDPE modified with 0.7 wt.% Cu-NCs. Tensile tests revealed a slight reduction in the tensile strength related to the recycling process, being close to 26 MPa for the virgin HDPE and 15.99 MPa for the recycled HDPE, which was improved by adding copper particles, which were near 25.39 MPa for 0.7 wt.% copper nano-cubes. Antibacterial analysis showed a reduction in the viability of E. coli in virgin HDPE samples, which was close to 8% for HDPE containing copper nano-particles and lower than 2% for HDPE having copper nano-cubes. In contrast, the recycled HDPE revealed viability close to 95% for HDPE with copper nano-particles and nearly 50% for HDPE with copper nano-cubes. The viability of S. aureus for HDPE was lower than containing copper nano-particles and copper nano-cubes, which increased dramatically close to 80% for recycled HDPE with copper nano-particles 80% and 75% with copper nano-cubes.