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Biomedical subjects

S Chokloikaew

Publications and source records attributed to S Chokloikaew.

3 recordsLinked to original sources

Blood culture: comparison of outcomes between switch-needle and no-switch techniques.

BACKGROUND: Because blood culture is a common test at our institution, we hoped to save money and reduce the risk of needlestick injury by modifying our current technique for the preparation of culture specimens without increasing the risk of contamination. METHODS OBJECTIVE: To compare the contamination rates of blood culture specimens obtained by the conventional method of switching to another sterile needle before inoculation with those of specimens obtained by a method without switching. DESIGN: Cross-over study. SETTING: Department of Medicine of university hospital. PARTICIPANTS: Nursing personnel working in seven acute care medical wards in Siriraj Hospital, Bangkok, Thailand. INTERVENTIONS: From March to June 1991, participating nurses prepared blood culture specimens by means of both switch-needle and no-switch techniques in a cross-over study. All blood culture specimens were submitted to microbiology laboratory to determine the growth of microorganisms. MEASUREMENT: Growth in a culture was considered to be "true positive" or "contamination" by predetermined criteria. RESULTS: Total number of blood culture specimens was 1619; of these, 813 were prepared by switch-needle technique and 806 were prepared by no-switch technique. The contamination rates were 7.6% and 8.3% for switch-needle and no-switch techniques, respectively (p = 0.61). CONCLUSIONS: The switch-needle technique may not be necessary for obtaining blood culture specimens unless the needle is obviously contaminated. The no-switch technique for the preparation of blood culture specimens is more convenient and less expensive; it also poses less risk of needlestick injury.

Bacteriological Techniques

Does indication sheet reduce unnecessary urethral catheterization?

The study on the effect of indication sheet on the decision of doctors in ordering urethral catheterization was done in thirteen hospitals randomly selected from all regions of Thailand. 16,959 patients in medical and surgical wards were included between April and May 1989. The rates of urethral catheterization did not change by the influence of indication sheet. However, urethral catheterization without proper indications was reduced from 27.0 per cent in the control group to 14.3 per cent in the experiment group. The indication sheet was accepted in 96.5 per cent of the occasions when doctors prescribed urethral catheterization. The indication sheet changed the doctors' decision and hence reversed the order in 3 events (0.8%). It is concluded that indication sheet was well accepted by doctors and could reduce urethral catheterization without proper indications.

Hospitals

A national prevalence study on nosocomial infections 1988.

A National survey of N.I. in Thailand was done in April 1988. Twenty-three hospitals throughout the country were enrolled. Of the 6,805 patients studied, 52 per cent were males and 48 per cent were females. The prevalence rate of nosocomial infections was 11.7 per cent. The highest rate was found in the second biggest (regional) hospitals (18.8%). There were minor variations in the rates of infection in each age group. The infection rate was highest in intensive care units (35.1%) followed by orthopaedic (20.4%) and paediatric (15.7%) departments respectively. Urinary infections were the commonest (25.8%). Surgical wound infections ranked second (19.6%). Skin infections were as high as 11.8 per cent. P. aeruginosa were the commonest bacterial isolates (22%) followed by E. coli (18.1%) and Klebsiella species (14.0%). Antimicrobials were prescribed in 52 per cent of patients, and, in a large number, for prophylactic purposes. It is concluded that N.I. are the main health problems affecting more than 200,000 patients annually in Thailand. Urgent studies and interventions are clearly needed.

Adolescent