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Efficacy of covert closed-circuit television monitoring of the hand hygiene compliance of health care workers caring for patients infected with multidrug-resistant organisms in an intensive care unit

Livshiz-Riven, Ilana; Koyfman, Leonid; Nativ, Ronit; Danziger, Asaf; Shalman, Alexander; Frank, Dmitry; Shvarts, Boris; Azulay, Ofira; Ivanova, Evgeniya; Ziv-Baran, Tomer; Klein, Moti; Boyko, Matthew; Zlotnik, Alexander; Borer, Abraham; Brotfain, Evgeni
BACKGROUND:To compare covert closed-circuit television (CCTV) monitoring to standard overt observation in assessing the hand hygiene (HH) conduct of health care workers (HCWs) caring for patients infected with multidrug-resistant organisms (MDROs). This was a cross-sectional study in a general intensive care unit of a 1,000-bed university hospital. METHODS:Forty-six general intensive care unit HCWs (staff physicians, registered nurses, and auxiliary workers) caring for contact isolation MDRO-infected patients. The study incorporated the following 3 phases: phase 1, establishment of interrater reliability between 2 simultaneous observers using the overt observation method; phase 2, establishment of interrater reliability between 2 simultaneous observers using the CCTV method; and phase 3, simultaneous monitoring of HH by both methods to evaluate the suitability of CCTV as an alternative to direct observation of the HH conduct of HCWs caring for MDRO-infected patients. RESULTS:Overall, 1,104 opportunities to perform HH were documented during 49 observation sessions. The compliance rate observed by the overt method (37.3%) was significantly higher than that observed when only the covert method was used (26.5%). However, simultaneous overt-covert observations were found to have intraclass correlation coefficients of >0.85. CONCLUSIONS:Covert CCTV observation of HCW HH compliance appears to provide a truer and more realistic picture than overt observation, probably because of its ability to neutralize the Hawthorne effect of overt observation. The high intraclass correlation coefficients between covert observation and overt observation supports this conclusion.
PMID: 31676159
ISSN: 1527-3296
CID: 4184342

Septic arthritis of the hip joint due to Bacteroides fragilis in a paraplegic patient [Case Report]

Shalman, Anna; Acker, Asaf; Shalman, Alexander; Frank, Dmitry; Borer, Abraham; Koyfman, Leonid; Kotlovker, Vladimir; Saidel-Odes, Lisa; Gabay, Ohad; Klein, Moti; Brotfain, Evgeni
Septic arthritis of native joints is a potentially life-threatening disease. The most frequently isolated pathogens are Gram-positive cocci. Bacteroides fragilis is a rare pathogen in joint infections and is usually associated with immunocompromised and debilitated patients. Most cases of B. fragilis joint infection are related to skin or local perineal infections or are secondary to B. fragilis bacteraemia from another source, for example from the gastrointestinal tract. We present a clinical case of B. fragilis septic arthritis involving a native hip joint in a previously healthy paraplegic patient.
PMID: 32974505
ISSN: 2516-8290
CID: 4606012

Aesthetic Dentistry : A Clinically Structured Approach to Interdiscipl inary Treatment Planning

Chapter by: Calamia, John; Shalman, Alex; Poling, Rebecca
in: Clinical & Educational Scholarship Showcase by
[New York NY : NYU College of Dentistry. NYU Academy of Distinguished Educators], 2012
pp. 5-5
ISBN: n/a
CID: 350042