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Biomedical subjects

S Danchaivijitr

Publications and source records attributed to S Danchaivijitr.

At least 19 recordsLinked to original sources
PubMed1992

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↗
PubMed1992

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↗
PubMed1992

Comparison of costs for disposable and reusable syringes and needles in Siriraj Hospital.

The costs for disposable and re-usable syringes and needles were compared in Siriraj Hospital, in July 1988. Data were collected from all wards regarding number of items used or replaced. Labour costs for recycling re-usable items were estimated by close observation. The costs for disposable and re-usable syringes and needles were 498,039.50, 193,874.45, 69,410.00 and 27,366.95 baht respectively. It can be concluded that re-usable items cost only 36 per cent of disposable ones. It is evident that re-usable syringes and needles should be appropriate for hospitals in Thailand at present.

Disposable Equipment↗
PubMed1992

Pre-operative shaving and wound infection in appendectomy.

The study on the effects of shaving the skin on wound infections after appendectomy was done in 80 patients in 1988 in Siriraj Hospital. Patients were divided randomly into two groups, 40 patients each, a control and an experiment group. The control group had their skin shaved and the experiment group did not. Data showed no difference in: demography, preoperative admission time, interval between skin preparation and surgery, thickness of subcutaneous tissue, operating time, and suture materials. Shaving of the skin resulted in no alteration in bacteria found on the skin, on the walls of the wound before closing. Stitch abscesses were the only wound infection found in 3 patients in each group. It is concluded that skin shaving, though it did not increase wound infection rate, had no beneficial effect on wound infection in appendectomy.

Adolescent↗
PubMed1991

Hospital infection control in Thailand.

Nosocomial infection is a relatively new subject in Thailand. A group of interested medical personnel has been identified which has begun to work together. The nationwide prevalence study showed that nosocomial infection is a serious health problem that requires urgent intervention. Attempts have been made to develop proper control programmes. The main obstacles in practice are the lack of both support from administrators and cooperation from medical colleagues. These obstacles can be overcome in future by meetings, distribution of information, and education. Success in epidemic control and expenditure reduction should provide the evidence to convince administrators of the necessity of control of nosocomial infection.

Attitude of Health Personnel↗
PubMed1989

Bacterial contamination of re-usable and disposable syringes and needles.

Re-usable glass and disposable plastic syringes and needles were tested for their sterility. Ninety-one re-usable glass, 111 disposable plastic syringes, 105 re-usable and 91 disposable needles were determined for microbial contamination by direct method using soy-bean-casein digest and fluid thioglycolate media. The positive results were 2.2 per cent (2/91), 0.9 per cent (1/111), 2.9 per cent (3/105) and 3.3 per cent (3/91) for re-usable and disposable syringes and needles, respectively. It is concluded that there is no difference in the rates of contamination of re-usable and disposable items.

Bacteria↗
PubMed1989

Patients colonized by antibiotic resistant bacteria--a potential source of infections in the medical wards.

Bacterial colonization was studied in 12 non-infected female patients admitted into one medical ward, Siriraj hospital, Bangkok, from March to June 1988. Swabs were taken on the first day of admission, then every other day until discharge, from six sites; i.e. anterior nares, vault of axilla, hands, anterior chest, abdomen and toe web. The times and total number of swabbing were 52 and 312 respectively. All patients were colonized with bacteria. S. epidermidis was found in all patients. S. aureus was found in 9 patients, 48 times (15.4%). Methicillin-resistant S. aureus (M.R.S.A.) was identified in 4 patients on 10 occasions (3.2%). Gram-negative bacilli were isolated in 11 of 12 patients, and the number of positive samples was 60 (19.2%). All bacteria were highly resistant to the commonly used antimicrobials. The study failed to show that colonization increased with the duration of hospitalization. It is concluded that the majority of patients who had been colonized with pathogenic bacteria were important sources of infections in the medical ward.

Adolescent↗
PubMed1989

Comparison of effects of alcohol, chlorhexidine cream, and iodophore cream on venous catheter-associated infections.

The effects of alcohol, chlorhexidine cream and iodophor cream on the infectious complications associated with intravenous catheters were studied. One hundred and fifty patients were randomly allocated into each antiseptic group. Daily cleansing and disinfecting the cut down wounds were done with the above antiseptics. Minor surgical wound infections were found in one patient in the alcohol and iodophor group compared to five in the chlorhexidine group. Phlebitis complicated four patients, two in the iodophor group and one in each of the remaining groups. Only one patient in the chlorhexidine group had septicaemia due to A. antitratus. Thirty-four catheter tips (22.7%) yielded bacteria on culture. Incidence of positive tip cultures was significantly higher in the chlorhexidine group than in the other two. The rates of positive tip cultures correlated with duration of catheterization. It is concluded that alcohol is the antiseptic of choice for cut down wounds. Application of antiseptic cream to the wounds was less effective than alcohol and this practice should be discouraged.

Adolescent↗
PubMed1989

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↗