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Busan, South Korea

Watson J.A.,St Marys Medical Center
American Journal of Infection Control | Year: 2016

Background Good hand hygiene is the single most important strategy used to prevent health care–associated infections (HAIs); however, health care workers' (HCWs') hand hygiene compliance rates range between 25% and 51%. This study aims to determine if a multimodal strategy using the World Health Organization's (WHO's) My 5 Moments for Hand Hygiene methodology increases HCWs' compliance with handwashing and awareness of the importance of good hand hygiene in the prevention of HAIs. Methods A quasi-experimental, 1-group pre-post survey design was used to test awareness and knowledge. A simple interrupted time series methodology at baseline and 3 months was used to monitor hand hygiene compliance. Results Overall, HCWs' hand hygiene compliance increased from 51.3% to 98.6%, with an odds ratio of 71.10. The pre-post survey demonstrated HCWs were aware and knowledgeable of the importance of good hand hygiene. Eight postsurvey questions focusing on the strategies used to promote hand hygiene demonstrated statistical significance using a 1-sample t test, with P values ranging from .000-.024. Conclusion A multimodal approach using the WHO's My 5 Moments for Hand Hygiene does increase HCWs' hand hygiene compliance and awareness and knowledge of the importance of hand hygiene in the prevention of HAIs. Using this approach can produce a positive social change by reducing preventable disease and decreasing HAIs not only within a facility but also in the community. © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Source


In the setting of extraarticular deformities of the knee, total knee arthroplasty (TKA) is difficult, as anatomical abnormalities obstruct identification of alignment landmarks and may preclude the use of traditional instrumentation. The long-term clinical value of computer assistance for TKA is a point of ongoing controversy. Few reports describe the use of computer-assisted orthopedic surgery as a method to decrease alignment outliers in TKA with associated posttraumatic deformities. In this report, a 70-year-old woman who had a severe distal femoral deformity from a previous open fracture underwent computer-assisted TKA for osteoarthritis. The use of a computer-assisted navigation system achieved a high degree of accuracy relative to the desired target alignment and led to improved function in a patient in which standard instrumentation was not feasible. Copyright © 2011. Published by Elsevier Inc. Source


Wolf E.M.,Sportsmed Orthopaedic Group Inc. | Arianjam A.,St Marys Medical Center
Journal of Shoulder and Elbow Surgery | Year: 2014

Background: This paper presents the results of arthroscopic remplissage in the treatment of traumatic anterior shoulder instability in a difficult subgroup of patients with both glenoid bone loss and a significant Hill-Sachs lesion. Methods: From March 2002 through May 2010, 270 patients were treated surgically for anterior shoulder instability. Of the surgical procedures performed, 59 patients (21.9%) with anterior instability and Bigliani grade IIIA (glenoid deficiency <25%) were treated with this technique. The average age was 33 years (range, 17-67 years); there were 48 men and 11 women. The procedure consisted of an arthroscopic posterior capsulodesis and infraspinatus tenodesis that filled the Hill-Sachs lesion and a concomitant arthroscopic anterior Bankart repair. Forty-five patients (76%) were available for follow-up ranging from 2 to 10 years (average, 58 months). All patients were evaluated by use of the Rowe and Constant scores. Twenty-seven patients were also evaluated by use of the Western Ontario Shoulder Instability Index. Results: Of the 45 patients, 2 (4.4%) had recurrent instability after traumatic dislocations; one was due to a basketball injury, and the other was reinjured by wrestling. At final follow-up, the median and mean scores ± standard deviation were as follows: Rowe score, 95, 92 ± 12; Constant score, 95, 92 ± 10; and Western Ontario Shoulder Instability Index, 110, 224 ± 261. All patients, except the traumatic dislocations, had no reoperations or complications. Conclusion: This procedure provides an effective arthroscopic approach in those cases of anterior shoulder instability that present with the combination of glenoid bone loss (grade IIIA) and a Hill-Sachs lesion. © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Source


Long T.E.,Marshall University | Williams J.T.,Marshall University | Williams J.T.,St Marys Medical Center
Expert Opinion on Investigational Drugs | Year: 2014

Introduction: Healthcare-associated infections caused by multi-drug resistant bacteria remain a major cause of worldwide mortality. With the recent approval of agents such as hetero-resistant cocci (i.e., ceftaroline, ceftobiprole, telavancin) for the treatment of Gram-positive infections by and drugs like fidaxomicin for treating Clostridium difficile, present-day research on antibacterials has largely shifted to developing interventions for diseases caused by Gram-negative bacilli. Cephalosporins have gained significant interest as antipseudomonals to be used in hospitals for treating device- and procedure-associated infections. With extended-spectrum activity against many enterobacterial pathogens, the introduction of new antipseudomonal cephalosporin-based treatments will mark a significant advancement in the management of hospital-borne diseases. © 2014 Informa UK. Source


Ho A.,National University of Singapore | Pinney S.J.,St Marys Medical Center | Bozic K.,University of California at San Francisco
Journal of Bone and Joint Surgery - American Volume | Year: 2015

Mrs. A is a pleasant seventy-seven-year-old widow with an increasingly symptomatic right knee that has markedly limited her activities in the past year. Mrs. A's daughter, who lives in town, urged her to seek treatment. History, physical examination, and radiographs confirmed the diagnosis of end-stage knee arthritis. Dr. Z, the orthopaedic surgeon, presented total knee arthroplasty as a potential treatment option and provided detailed information on the surgery and recovery. Mrs. A indicated that if Dr. Z thinks that total knee arthroplasty is a good idea, she would agree to have the surgery. She lives alone and goes grocery shopping once a week, but her pain makes such endeavors frustrating for her. Her daughter visits regularly, takes her to medical appointments, and helps her with medications. Mrs. A has returned for a preoperative visit with Dr. Z, and her total knee arthroplasty has been tentatively scheduled for the following month. At this visit, Mrs. A notes that she wants to drive to the adjacent state to visit her son two weeks after the surgery and is glad she will have "a new knee" for that visit. When asked more questions about her understanding of the total knee arthroplasty and postoperative instructions, Mrs. A says Dr. Z can just talk to her daughter when she comes to pick her up from the appointment. Copyright © 2015 by the Journal of Bone and Joint Surgery, Incorporated. Source

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