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A B Mulhall

Publications and source records attributed to A B Mulhall.

6 recordsLinked to original sources

Introduction of laboratory based ward liaison surveillance of hospital infection into six district general hospitals.

A previous study demonstrated that laboratory based ward liaison surveillance (LBWLS) of hospital infection was an effective and efficient method. The method involved the follow-up of positive microbiology reports by the review of patient records and liaison with ward nursing staff to consider whether any patients had infection. Here we report the introduction of LBWLS into six district general hospitals to determine whether it is feasible to use this method on an everyday basis. The time required for data collection was assessed and the method was compared with a reference method in one hospital to check its ability to detect infections. To assess reproducibility two infection control nurses (ICNs) performed LBWLS independently, but concurrently, for 5 weeks. The method could be used in all hospitals studied; however, the time for data collection ranged from 3.0 to 6.8 h/100 beds per week. In comparison with the reference method, LBWLS detected 15/41 (37%) of community acquired infections and 30/43 (70%) of hospital acquired infections. In the reproducibility assessment 72 patients were identified by both ICNs. There was agreement about the infected/non-infected status of 65 of these patients. The mean pair agreement and Kappa statistic were 0.88 and 0.72. Laboratory based ward liaison was readily used in all hospitals and was reproducible.

Adolescent↗

The provision of urethral catheters: an equipment audit.

Although medical and nursing audit is attaining a high profile in UK hospitals, the development of objective measures remains a challenge. The availability and storage or urinary catheters was recorded by a point prevalence survey in a District General Hospital. A "long-term" and "short-term" catheter were provided in all areas, but seven further brands of catheter were found. Female length catheters were rarely available. With some limited exceptions there were no written or verbal policies concerning selection of catheters in the wards. Excess numbers of catheters were stored by wards responsible for their own ordering. Damage of catheters during storage was noted. The survey provided a simple, rapid and inexpensive method of audit to rationalise and improve the provision of catheters. The implementation of a policy incorporating the selection, ordering, storage and use of such equipment will both optimise patient care and maximise efficient budgeting.

Catheters, Indwelling↗

Biofilms, bacteria and bladder catheters. A clinical study.

Biofilms were present on 16 of 33 urethral catheters examined. In 11 cases the catheter carried a different microbial flora from that of the bladder urine. The length of time the catheter was in situ did not influence biofilm formation, and all types of materials tested supported biofilm growth. Biofilms were seen on 2 of the 7 catheters where prophylactic antibiotics had been used.

Bacteria↗

Bacteriuria during indwelling urethral catheterization.

The incidence of bacteriuria and the risk factors related to its acquisition were determined in a prospective study of 220 hospitalized patients. Bacteriuria was recorded in 97/220 (44%) of patients, in 42 cases within 48 h (Group A) and in 55 cases more than 48 h (Group B) after catheterization. The results of a multivariate analysis of Group A demonstrated that the reason for catheterization, the use of antimicrobial chemotherapy and the medical specialty of care were the only variables of those assessed associated with the acquisition of bacteriuria. In a similar analysis of Group B the number of days the catheter was in situ and the use of antimicrobial chemotherapy were the only factors which achieved statistical significance.

Adolescent↗