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Featured Articles
Reaching for the skies: Healthcare and cloud computing
Healthcare has traditionally been a late entrant in adopting new information technology innovation, and the Cloud is no exception. In terms of markets, the US has been a first mover in healthcare Cloud applications. The EU has spent a great deal of time and effort assessing its implications, above all on data privacy. Britain, however, may have taken the most significant steps to begin endorsing use of the Cloud in its healthcare system.
Cloud computing comprises platforms and applications (online operating systems, file and data sharing), as well as infrastructure (Web-based data storage and access). Service providers bill users on the basis of subscriptions or pay-as-you-go. The latter is a key incentive for growing interest in the Cloud, given that it allows businesses to reduce upfront investments and scale up on the basis of real requirements rather than anticipated ones. The Cloud
Ultrasound and the musculoskeletal system: swings and roundabouts
The use of ultrasound for diagnostic imaging has grown by leaps and bounds in recent years and is now the preferred approach for many applications, but according to experts the application with the biggest growth potential is imaging of the musculoskeletal system.
Major developments in the technology, which now provides a number of modes including grey scale, colour and power Doppler, spectral Doppler and elastography, allow accurate characterization of joint pathology; even the acquisition of dynamic, essentially isotropic 3D images is now possible. The biggest remaining challenge is reported to be the adequate training and monitoring of medical professionals to enable them to carry out this highly complex ultrasound application.
However, while patients ranging from young athletes with suspected torn tendons, muscles or ligaments to those suffering from chronic conditions such as rheumatoid arthritis or osteoporosis
The ?European Lung White Book? and respiratory intensive care
The European Respiratory Society (ERS) published their first White Lung Book a decade ago, to provide a comprehensive survey of respiratory health across Europe for the benefit of patients as well as medical personnel and policy makers. The book aimed to highlight the huge and underestimated burden of respiratory disease in the region. Since then political and economic upheavals as well as an expansion in medical research and development have necessitated a second edition of this invaluable book, which was published ahead of this year
Scientific literature: Hospital hygiene
The number of peer-reviewed papers covering the field of hospital hygiene is huge, to such an extent that it is frequently difficult for healthcare professionals to keep up with the literature. As a special service to our readers, International Hospital presents a few key literature abstracts from the clinical and scientific literature chosen by our editorial board as being particularly worthy of attention.
Hand Hygiene: State-of-the-Art Review With Emphasis on New Technologies and Mechanisms of Surveillance
Marra A, Edmond E. Current Infect. Disease Reports. 2012 Dec. 14:6: 585-591.
Hand hygiene (HH) is an important measure in infection prevention to decrease transmission of microbial pathogens; however, HH compliance by healthcare workers (HCWs) remains suboptimal. One of the principal recommendations of current guidelines is that waterless, alcohol-based hand rubs are the preferred method for HH in most situations, due to the superior efficacy of these agents in rapidly reducing bacterial counts on hands and their ease of use. Improving HH compliance is a good quality indicator for hospital patient safety programmes. Observers can follow HCWs to perform direct HH observations; however, HCWs may be prompted to clean their hands when observers are nearby, which does not represent real-world conditions. Moreover, having observers walk into patient rooms violates patient privacy and is time consuming. HH strategies using indirect metrics for surveillance (e.g., measuring the volume of HH products consumed) and the use of new technologies (e.g., electronic dispenser counters, radiofrequency, alcohol sensors, and video recording) will also be discussed.
Infection control practices among doctors and nurses in a tertiary care hospital
Jain M et al. Ann Trop Med Public Health 2012;5:29-33
Basic infection control measures in any healthcare setup can reduce the rates of healthcare-associated infections. A study to assess the knowledge and practice of 400 healthcare personnel regarding hospital infection control practices was performed. A structured questionnaire was distributed to the study group and collected the same day. Knowledge and practices of 329 nurses and 71 doctors regarding hand hygiene, standard precautions (SPs), hospital environmental cleaning and needle stick injury were collected and analysed. The results show that the study group had suboptimal knowledge regarding the SPs (55.3%) and risks associated with needle stick injuries (31.8%). The implementation of SPs was biased towards the HIV positive status of the patient. Only 57% of the doctors and nurses followed the maximal barrier precautions before a central venous catheter insertion. The study concludes that the lack of knowledge and practices regarding basic infection control protocols should be improved by way of educational intervention, in the form of formal training of the doctors and nurses and reinforcement of the same.
Is reprocessing after disuse a safety procedure for bronchoscopy? A cross-sectional study in a teaching hospital in Rome.
Marino M et al. Gastroenterol Nurs. 2012 Sep; 35(5): 324-30.
A bacteriological assessment was carried out of flexible bronchoscopes that were stored after a reprocessing procedure was performed to determine whether reprocessing removes microbiological contamination and whether the instruments could be used safely after extended storage without repeating the disinfection before bronchoscopy. The pre-reprocessing and post-reprocessing liquid sample that was taken from the stored instruments
Cardiovascular disease: the need for more R&D in Europe
Although cardiovascular disease, predominantly coronary heart disease (CHD) and stroke, is still the leading cause of mortality in Europe (around 47% of deaths), deaths from CHD have more than halved since the 1980s. There have been steady reductions in mortality from the disease in both genders and in most European countries, largely due to tests that allow timely diagnosis, as well as treatment with the new anti-thrombotic drugs. The major concern now, though, is that this steady reduction in mortality is beginning to plateau in many EU countries, particularly in younger people, and even more alarming is that an actual rise in mortality has recently been demonstrated in populations in Romanian, Greece and Lithuania. The danger is that such increases will be sustained and will begin to occur in other European countries, fuelled by the diabetes and obesity
Book review: Critical Care Ultrasound Manual
By Anthony McLean and Stephen Huang Churchill Livingstone, October 2012, 208 pp, e74
This is a concise step-by-step guide on the assessment of ultrasounds. Its aim is to train critical care physicians in applying Rapid Assessment by Cardiac Echo (RACE) and Focused Assessment with Sonography in Trauma (FAST) to sonography principles. The focus is on helping readers to obtain rapid practical information to assist management decisions. The user-friendly layout is further enhanced by explanatory diagrams and ultrasound images which help with the learning experience. Also included is a DVD showing video clips of procedures cross-referenced in the book assisting the reader in comprehending the content covered in the manual. Practical tips and cautions stand out in highlighted boxes. Multiple choice questions at the end of each chapter allow readers to analyse what they have learnt. The appendices provide a checklist to assist interpretation of transthoracic echocardiogram in a systematic way. A chapter on Doppler principles help those who wish to prepare the way for Doppler measurements.
ELSEVIERwww.elsevier.com
eHealth in Europe – a status check
The emerging European eHealth system depends on an asynchronous cocktail of technology development cycles, vendor push to adopt new products and solutions, as well as growing patient demands for less anonymous, personalized health intervention. Other factors making an impact are the often-significant divergences in hospital/healthcare cultures across EU Member States, coupled to significant differences in health and technology spending. This has been emphasized by new pressures on budgets and spending, after the end-2008 financial crisis.
The EU Commission has sought to bridge and buffer this array of cross-currents, while seeking to resolutely promote a common but effective eHealth agenda. It has sought to establish enabling rules and guidelines in order to level the playing field and provide transparent incentives for implementing eHealth projects, across the EU