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Biomedical subjects

W H Seto

Publications and source records attributed to W H Seto.

At least 37 records · Page 2Linked to original sources
PubMed1995

Staff compliance with infection control practices: application of behavioural sciences.

Microbiology and epidemiology have made significant contributions to the field of Infection Control. Most nosocomial infections which can be prevented are related to inappropriate patient care practices. However, it is extremely difficult to implement new infection control policies. To achieve staff compliance, infection control should learn from the behavioural sciences. Three related fields have been shown to be helpful in this respect: social psychology, consumer behaviour and organizational behaviour. Basic concepts from all three fields can be applied to the work of infection control for achieving staff compliance; the use of social power and the reasoned action model from the field of social psychology; the use of participatory decision-making from organizational behaviour; and the opinion leaders from consumer behaviour.

Behavioral Sciences↗
PubMed1995

Training the work force--models for effective education in infection control.

The education of hospital staff for infection control is really a form of adult education in which there are two important priorities: to teach what the student wants to know and to deliver knowledge that the student can use. Techniques developed in the industrial and commercial fields can be adapted to deal with these issues in the hospital. A 'total quality management' customer survey for infection control was conducted to identify services that are considered helpful by hospital staff and to identify topics that they want to know about. A 'task analysis' was carried out to determine the tasks performed by different categories of staff, because an education programme that focuses on tasks the staff performed, will be delivering knowledge that they can use. Finally, a scheme for identifying strategic areas for education, when a guideline is implemented, is described.

Adult↗
PubMed1992

An evaluation of inpatient consultations conducted by clinical microbiologists in a teaching hospital.

A systematic procedure for conducting consultations by clinical microbiologists requested by their clinical colleagues is described. The method was evaluated over a period of 17 months and involved sequential consultations related to 229 patients with known or probable infections. An attempt was made to elucidate the contributions of the clinical microbiologists in achieving a better understanding of the problems experienced in this particular setting and which in turn led to improved management of patients. It is hoped that this paper may provide a practical working framework for clinical microbiologists in the care of patients suffering from infection.

Adult↗
PubMed1992

An outbreak of Candida tropicalis peritonitis in patients on intermittent peritoneal dialysis.

An outbreak of Candida tropicalis peritonitis in intermittent peritoneal dialysis patients during a 6-week period is reported from a general hospital. Five patients were involved and there were three deaths. The strains recovered from affected patients were identical to those recovered from the water baths on the basis of biotyping, antimicrobial susceptibility pattern and chromosomal DNA fingerprints. No further cases were identified on subsequent surveillance after the prohibition of wet-warming of peritoneal dialysate in the hospital.

Candidiasis↗
PubMed1991

The use of routine wound swabs and Kardex review for the surveillance of surgical wound infections.

Prospective post-operative wound surveillance was carried out in two phases on 1285 patients. A total of 120 infections were documented. In phase I a review of routine swabs and Kardex was conducted in parallel with continuous surveillance. In this phase continuous surveillance detected 31/35 infections and routine swabs and Kardex methods picked up 28/35 infections. In phase 2 continuous surveillance was not carried out and routine swab and Kardex review detected 78/85 infections. Overall II infections were documented following discharge. Continuous surveillance is sensitive but laborious. The method described here would enable infection control nurses to visit patients in whom infections are more likely to occur, and still provide reliable and accurate rates of infections.

Hong Kong↗
PubMed1991

The enhancement of infection control in-service education by ward opinion leaders.

Opinion leaders are members within a social group with significant social influence over others. A guideline on urinary catheter care was introduced in three groups (A, B, and C) of two randomly allocated wards. Two opinion leaders per ward were identified by nurses in groups A and B with the use of a sociometric method. For education, in-service lectures for 30% of nurses and opinion leaders' tutorials for all nurses were used in group A; opinion leaders' tutorials alone in B, and lectures alone in C. Before and after the education program, the guideline's frequency of practice was assessed by surveying 30% of randomly selected nurses and by direct observation. Results of the survey were comparable for groups A and B and both groups were significantly higher (p less than 0.05) than C, suggesting that informational transmission by opinion leaders was superior to that by the lecture. However, practices by direct observation in group A were significantly better (p less than 0.05) than those in B, indicating that staff compliance is best achieved by using both opinion leaders and lectures. The lecture probably endorsed the opinion leaders' leadership, enhancing their ability to influence the staff.

Communication↗
PubMed1991

Infection of a shunt by Mycobacterium fortuitum: case report.

Mycobacterium fortuitum is a rare cause of central nervous system infection; however, shunt infection caused by this organism has not been reported. We report a case of shunt infection subsequent to insertion of a ventriculoatrial shunt for obstructive hydrocephalus caused by a cerebellar hematoma. The shunt infection was controlled by removal of the shunt and a combination of systemic and intraventricular administration of amikacin, and oral administration of ofloxacin. The case is discussed and the pertinent literature reviewed.

Anti-Bacterial Agents↗
PubMed1990

Streptococcus zooepidemicus (Lancefield group C) septicaemia in Hong Kong.

The clinical findings relating to 11 patients in Hong Kong (HK) and to 43 patients described elsewhere, all with Streptococcus zooepidemicus septicaemia, are reviewed. There was a particular association with cardiovascular disease (27%) with seven cases of endocarditis, three of abdominal aortic aneurysm and two of deep venous thrombosis. Associations not previously reported included two cases of pharyngitis and two patients with persistent post-operative fever. The overall mortality was 22%. Both human and porcine strains of S. zooepidemicus from HK did not hydrolyse aesculin in contrast to the aesculin-positive biotypes reported previously. HK strains also had very mucoid colonies and capsules of hyaluronic acid were seen in electron micrographs. Samples of chromosomal DNA, extracted by means of HindIII restriction endonuclease, of strains from human beings and pigs were identical. The MIC of penicillin for all strains was less than or equal to 0.03 mg/l but the MBC for all was greater than 32 mg/l. Penicillin alone is generally sufficient for cure but combination with an aminoglycoside may be indicated in seriously ill patients. In our locality, pigs were incriminated as a possible source of human infection whereas consumption of contaminated dairy products is important elsewhere.

Adult↗
PubMed1990

Evaluation of staff compliance with 'influencing' tactics in relation to infection control policy implementation.

The efficacy of 'influencing' tactics for inducing compliance to infection control policies was assessed in 20 Hong Kong hospitals. In phase 1, 45 infection control nurses (ICNs) were surveyed on the frequency of use of possible tactics. Twenty-three of the more frequently used tactics were selected for phase 2 in which a random sample of 881 nurses were questioned on whether they would willingly, reluctantly or not comply with these tactics. Based on factor analysis of the responses in phase 2, six dimensions of compliance were identified. These were, in their order of effectiveness in achieving compliance: professional-resources (providing specialized or expert help); professional-respect (esteeming others as fellow professionals); coalition (obtaining staff support), ingratiation (cultivating goodwill), hierarchical (exerting pressure derived from rank) and non-communicative (ignoring or disregarding other's point of view).

Attitude of Health Personnel↗
PubMed1990

A new semiquantitative culture method for early detection of surgical incisional wound infection.

A semiquantitative culture technique for early detection of surgical wound infection was done by rolling a segment of a plastic intravenous catheter across a blood agar plate after insertion into the most inflamed part of the wound on postoperative day 3. Patients were monitored daily for purulent discharge until healing. Of the 53 wounds studied, 44 (83%) had no growth or low-density superficial colonization on the blood agar (generally less than 15 colony-forming units and within the upper 1.5 cm of the catheter). None of these 44 wounds was subsequently infected; therefore, these colonies represented colonization. Of the 9 wounds (17%) that yielded greater than 15 colony-forming units and a diffuse subcutaneous pattern (colonies below the upper 1.5 cm of the catheter), all developed purulent discharge with a positive culture of the same organisms found by semiquantitative culture. This result differed significantly (P less than .01) from the 44 wounds without subsequent infection. This semiquantitative technique has the potential to distinguish infection from colonization and may be useful in diagnosing surgical wound infection.

Bacteria↗