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At least 19 recordsLinked to original sources
PubMed2005

Evaluation of the effectiveness of the Pastormaster method for disinfection of legionella in a hospital water distribution system.

The Pastormaster method consists of heating the water of hospital distribution systems at a specific point to a sufficient temperature for a minimum amount of time to eradicate legionella. The object of this study was to evaluate the effectiveness of the Pastormaster method for legionella disinfection in a hospital environment. A two-phase procedure was performed: hydraulic optimization of the water supply circuit, and implementation of the Pastormaster method. Water samples were taken at 10 representative points in the hospital hot-water system and cultured microbiologically. Other physical and chemical measurements were also determined. Implementation of the Pastormaster method and correction of the deficiencies identified during a hydraulic system audit confirmed the absence of legionella in the hospital water distribution system. The combination of implementation of the Pastormaster method and conduction of a hydraulic audit designed to identify and remedy any possible problems in water circulation is effective in minimizing the risk of legionella contamination in hospital water distribution systems.

Colony Count, Microbial↗
PubMed2001

Can simulation be used to reduce errors in health care delivery? The hospital drug distribution system.

OBJECTIVES: To construct a simulation model of the hospital drug distribution system, to evaluate the effects of different changes to the system on unavailability-related medication administration errors (U-MAEs), to test the most promising system in a controlled trial and to explore the model's validity. METHODS: A discrete-event simulation model of the drug distribution system was constructed, using data collected on a vascular surgery ward and a renal medicine ward as model inputs. The model's output was the U-MAE rate. The model was used to explore the effects on U-MAEs of different changes to the system. One of the changes predicted to reduce U-MAEs, a patients' own drugs scheme, was introduced on each study ward; U-MAE rates were measured using observations before and after its introduction and compared with those predicted by the model. RESULTS: The model predicted that the introduction of a patients' own drugs system would reduce unavailability-related errors on each ward; in practice, there was a slight decrease on the medical ward but an increase on the surgical ward. Reasons for these findings were explored and four contributing factors identified. Three of these related to failure to follow hospital procedures, the fourth to an issue for which no policy existed. If these factors had been taken into account, the error rates predicted by the model would have been similar to those observed. CONCLUSIONS: Simulation modelling is a potentially useful approach to the study of U-MAEs, although care must be taken to ensure that such models reflect actual practice rather than stated policy.

Computer Simulation↗
PubMed1992

Factors contributing to the contamination of hospital water distribution systems by legionellae.

To identify factors associated with the contamination of hospital water distribution systems by legionellae, 84 Quebec hospitals provided 3284 hot water specimens from 839 different sites. Concentrated samples were seeded on buffered charcoal yeast extract agar and a semi-selective medium. At least one water sample was contaminated by legionellae in 57 hospitals (67.9%). In 22 hospitals (26.2%), greater than 30% of samples were contaminated by these bacteria. In 9 (12.2%) of 74 hospitals, distilled water was colonized. The presence of at least one positive sample was found to be associated with localization and number of hospital beds (P = .02 for both). Heavy contamination was associated with large volume hot water tanks (P = .01), low water temperature at faucet (P = .03), and old water heaters (P = .06). Conditions required for the occurrence of nosocomial legionellosis may be present in numerous hospitals.

Cross Infection↗
PubMedDate not supplied

[Drug distribution systems in hospitals].

Any drug generally made and marketed by drug companies must respect the quality standards conferred by New Drug Approval regarding both safety and efficacy. Once prescribed by a doctor, inside a hospital, the drug, or more precisely the decision of its prescription will follow a complex circuit, involving numerous intermediates (human and technical) leading to drug dispensation and follow-up. Regulatory guidelines and rules harmonise and standardise this drug pathway in hospitals. Any weakness in this distribution system will be the source of nosocomial drug iatrogeny. The present review aims at describing the different steps and stages from the prescription to an individual patient to drug administration and follow-up. The evaluation of this system will be mentioned in the perspective of optimisation. The computerised system is essential allowing tracking of a drug, and providing help for decision-making (by confrontation with data bases) and a research tool (i.e, pharmacoepidemiology). Different experiences of assessment of the performance of such a drug distribution system inside hospitals will be presented, trying to check the quality reference: the right drug, the right patient, the right moment, in good conditions. The challenge is to optimise and secure all steps of the process. This goal needs assessment and quality control of the different phases, opening the discussion between hospital policy and regulatory and technical considerations.

Device Approval↗
PubMed1983

Protocols for unifying distributed systems in hospitals.

Data pertinent to any one hospital patient are often distributed across several independent heterogeneous computer systems serving different functional areas of the hospital. A global, integrated hospital information system can evolve from this situation if existing computer systems are linked by a local area network and the systems are modified to employ a set of protocols that enable information exchange. This paper provides a high-level description of the required protocol functions.

Computers↗
PubMed2002

Pathogenic molds (including Aspergillus species) in hospital water distribution systems: a 3-year prospective study and clinical implications for patients with hematologic malignancies.

The incidence of mold infections in patients with hematologic malignancies continues to increase despite the widespread use of air filtration systems, suggesting the presence of other hospital sources for these molds. Water sources are known to harbor pathogenic molds. We examined samples from water, water surfaces, air, and other environment sources from a bone marrow transplantation unit with optimal air precautions. Molds (Aspergillus species, others) were recovered in 70% of 398 water samples, in 22% of 1311 swabs from plumbing structures and environmental surfaces, and in 83% of 274 indoor air samples. Microscopic examination of the water plumbing lines revealed hyphal forms compatible with molds. Four findings suggest that indoor airborne molds were aerosolized from the water: (1) higher mean airborne concentrations of molds in bathrooms (16.1 colony-forming units [CFU]/m(3)) than in patient rooms (7 CFU/m(3)) and hallways (8.6 CFU/m(3); P =.00005); (2) a strong type and rank correlation between molds isolated from hospital water and those recovered from indoor hospital; (3) lack of seasonal correlation between the airborne mold concentration in outdoor and indoor air; and (4) molecular relatedness between a clinical strain and a water-related strain (previously reported). Hospital water distribution systems may serve as a potential indoor reservoir of Aspergillus and other molds leading to aerosolization of fungal spores and potential exposure for patients.

Air Microbiology↗
PubMed1996

Communication services for a distributed hospital information system.

Planning principles and development are described of a communication server which controls and performs all information exchange between distributed and heterogeneous applications in a hospital information system. The analysis is based on business process modeling. At present, the core of the server uses a commercial product (Cloverleaf). This allows to connect both old systems with no or few interface features and new systems with modern interface facilities (such as HL7). Prerequisites, functions, and configuration of the server software are described in detail. Experiences, advantages, and disadvantages are discussed.

Communication↗
PubMed1999

Hospital drug distribution systems in the UK and Germany--a study of medication errors.

The aim of this study was to compare the incidence of medication errors and the stages of the drug distribution system at which they occur in a United Kingdom (UK) hospital using the ward pharmacy system, a German hospital using the unit dose system and a German hospital using their traditional system. Medication errors were identified by observing the preparation and administration of regularly scheduled solid oral medication. In the UK hospital using the ward pharmacy system, the medication error rate was 8.0% (95% confidence interval 6.2-9.8%). The majority of these errors occurred at the stage of medication administration. In the hospital using the traditional German system, the error rate was 5.1% (4.4-5.8%). With the German unit dose system, the error rate was 2.4% (2.0-2.8%). In both German systems the errors were mainly attributable to the stage of transcription. It was noted that patient turnover was much higher in the wards using the ward pharmacy system and therefore the study sites may not be comparable. However, recommendations can be made in order to reduce the error rate associated with each system. Errors associated with the ward pharmacy system may be reduced if medication is stored in individual patient medicine cabinets and patients' own drugs used. Errors occurring with the traditional system and the unit dose system may be reduced if the original prescription is used for medication administration.

Data Collection↗
PubMed1994

Controlled evaluation of copper-silver ionization in eradicating Legionella pneumophila from a hospital water distribution system.

A controlled evaluation was made of the efficacy of copper-silver ionization in eradicating Legionella pneumophila from a hospital water supply. Copper-silver ionization units were installed on the hot water recirculation line of one building with water fixtures positive for Legionella species. Another building with the same water supply served as a control. Legionella species persisted within the system when copper and silver concentrations were < 0.3 and < 0.03 ppm, respectively. When copper and silver concentrations were > 0.4 and > 0.04 ppm, respectively, there was a significant decrease in Legionella species colonization, but the percentage of water fixtures positive for organisms was unchanged in the control building. When the ionization unit was inactivated, water fixtures continued to be free of Legionella species for 2 additional months. Copper-silver ionization can eradicate L. pneumophila in a water distribution system. The advantages of copper-silver ionization include relatively low cost, straightforward installation, easy maintenance, nontoxic by-products and the presence of a disinfecting residual.

Copper↗