Biomedical subjects

A V Durocher

Publications and source records attributed to A V Durocher.

5 recordsLinked to original sources

PubMed2001

Assessing excess nurse work load generated by multiresistant nosocomial bacteria in intensive care.

OBJECTIVE: To compare three methods for assessing the excess nurse work load related to recommended procedures for managing nosocomial infections (NI) due to multiresistant bacteria (MRB): two activity scores, the Omega score and the Projet de Recherche en Nursing (PRN) system, and a specific evaluation based on functional analysis of nursing procedures. SETTING: 10 beds in a medical intensive care unit (MICU). PATIENTS: Patients admitted from November 15, 1995, to June 15, 1996, were included and divided in two groups based on presence of MRB colonization or infection (MRB+ and MRB-groups). METHODS: Data were collected regarding length of stay (LOS) in days; Omega score for the entire stay; PRN score for the entire stay and per day; and time required to perform correctly four nursing procedures related to MRB NI, as evaluated specifically by the nursing staff, using a detailed functional analysis document that described all elementary nursing tasks in chronological order and all material needed to carry out those tasks. RESULTS: The LOS and total Omega and PRN scores were higher in the MRB+ group than in the MRB- group: LOS, 23 +/- 20.6 versus 12 +/- 15.3 days, (P<.001); Omega score, 164 +/- 103.4 versus 123 +/- 93.7 points (P<.001); PRN score, 3,606 +/- 3,187 versus 1,854 +/- 2,356 points (P<.001), respectively. The daily PRN score was also higher in MRB+ group (PRN, 160 +/- 25 vs 146 +/- 34 points in the MRB- group; P<.028). Four nursing procedures made necessary by MRB acquisition were identified: isolation precautions, with two levels according to whether the risk of contamination was mild-moderate or high; bathing the patient with antiseptic solution; bedpan management; and microbiological screening. The functional analysis indicated that the time needed to carry out these four procedures correctly was 245 minutes per patient per day, as compared to 85 minutes according to the PRN system. CONCLUSIONS: Our data confirm that MRB NIs are responsible for an increase in nurse work load, as estimated by LOS, Omega, and PRN scores. However, the daily excess nurse work load related directly to recommended procedures for managing MRB NIs in MICUs is underestimated by these activity scores, as compared to a specific functional analysis of nursing tasks. This may be of importance in evaluating potential links between nurse work load and MRB NIs and in determining the number of nurse hours needed to comply with infection control recommendations.

Cross Infection↗

PubMed1990

Respiratory and hemodynamic effects of halothane in status asthmaticus.

The respiratory and hemodynamic effects of halothane in patients with status asthmaticus who required mechanical ventilation was evaluated. Halothane was administered in 12 patients in a concentration of 1% for thirty minutes. Standard drug treatments and ventilator settings were not modified during halothane administration. The following data were collected before and after halothane administration: arterial blood gases, peak inspiratory pressure, VD/VT, pulmonary arterial pressure, right heart pressures and cardiac index (by means of the thermodilution method). After halothane treatment PaCO2 significantly decreased, arterial pH increased, peak inspiratory pressure decreased and VD/VT decreased significantly. Mean pulmonary arterial pressure and right heart pressures decreased and the cardiac index was unchanged. The heart rate significantly decreased and arrhythmias did not occur during halothane administration. The administration of halothane in patients with status asthmaticus requiring mechanical ventilation produces a rapid reduction in bronchospasm and barotraumatic injury and a rapid improvement in arterial blood gases, without any adverse hemodynamic effects.

Administration, Inhalation↗

PubMed1989

Influence of blood carbon dioxide pressure on growth index values in non-radiometric Bactec vials.

The influence of blood carbon dioxide pressure on growth index values yielded by the Bactec NR 660 system was evaluated. Growth index values of 1,175 Bactec blood culture vials collected from 293 patients were related to blood pCO2 and leukocyte concentrations. Thirty-three blood cultures were considered false-positive. These were significantly more frequently encountered in hypercapnia patients (5.4%) than in hypocapnia patients (1.7%) or normal patients (2.5%). There was no relationship between the growth index values and leukocyte concentrations.

Bacteria↗

PubMed1988

Routine evaluation of BACTEC NR-16A and NR-17A media.

The purpose of this study was to determine whether the BACTEC NR-16A and NR-17A media were more effective than the BACTEC NR-6A and NR-7A media in recovering organisms from the blood of patients undergoing antimicrobial therapy. A total of 986 sets of four blood culture bottles were compared, giving 141, 174, 93, and 104 isolates with BACTEC NR-6A, NR-16A, NR-7A, and NR-17A, respectively. BACTEC NR-6A and NR-7A media recovered 234 isolates, whereas BACTEC NR-16A and NR-17A media recovered 278 isolates. The recovery rate of bacteria when aerobic resin media were used was better than that with conventional aerobic media (P less than 0.001). The mean detection times were 51.5 and 69.7 h with NR-16A and NR-6A, respectively (P less than 0.01), whereas they were 68.2 and 71.3 h with NR-17A and NR-7A, respectively (P greater than 0.05). The small number of anaerobes recovered precluded a statistical comparison of relative recovery for that group of organisms.

Aerobiosis↗

PubMed1987

Computerized colonization-surveillance based on antimicrobial susceptibility patterns.

In order to estimate the occurrence of hospital-acquired colonizations, a specific program based on antimicrobial susceptibility tests was developed for the early recognition of clusters of colonized patients. This program allowed: (a) estimation of the endemic level of nosocomial colonization every three days within an intensive care unit; (b) detection of outbreak of hospital-acquired infections; (c) distinction between primary and secondary infections according to the dates of admission and collection; (d) provision of the latest profiles of susceptibility to antimicrobials for the 5 pathogens studied (Staphylococcus aureus, S. epidermidis, Serratia spp., Pseudomonas spp., Acinetobacter spp.). This study reported the experience of a two-year trial in colonization surveillance.

Bacteriological Techniques↗