Cultura

Compliance With Health Security Protocols Among Medical Staff In Intensive Care Units: A Comprehensive Analysis

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Amjad Fahad Alharbi, Mousa Eid Alharbi, Ahmed Eid Alharbi, Turki Hassan M. Alsaedi, Ahlam Fihan Alsaedi, Haifa Sami Alsayed, Lujain Fahad Alharbi, Abdulmohsin Mosifer Al-Otaibi
Faisal Ahmed M. Alghanmi, Fahad Abdullah Sumran Almutairi, Nasser Bkheet Alzahrani, Aedh Fatim Alharbi, Abdulmohssen Mansour Alzaher, Jawaher Matar Almutairi, Jana Ibrahim Alowais

Abstract

Healthcare-associated infections (HAIs) are a very important concern within intensive care units (ICUs) due to vulnerable patient groups' susceptibility to infection. Compliance of healthcare workers (HCWs) with health security protocols, including infection control measures (ICMs), is essential for combating HAI dissemination and ensuring patient safety. In this comprehensive review, existing evidence on HCWs' compliance with health security protocols within ICUs is critically analyzed, assessing different intervention efficacy aimed at maximizing such compliance. A critical assessment of existing intervention studies indicates that multi-modal intervention strategies, focusing on education, feedback, simulation, and doables, portray greater effectiveness (23.6%) in optimizing compliance than education-focused strategies (16.13%) altogether. HAIs in ICUs are found to be prevalent from 9% to 51.4% across the world, and developing regions register three to five times more prevalence of HAIs than ICUs in developing settings. Important determinants of compliance include shortages of supplies, absence of uniform guidelines, inadequate training, shortages of knowledge regarding infection, and overload levels within ICUs. In this article, existing evidence from different settings within healthcare is synthesized, assessing effective measures for augmenting medical personnel compliance rates with respect to health security protocols. The analyses emphasize specific requirements for comprehensive, contextually modified intervention strategy addressing multiple determinants simultaneously. To reduce HAIs, healthcare settings must target multi-modal intervention strategy complemented by institutional commitment, effective allocation, and monitoring processes within critical care settings.

Keywords : HAls, intensive care units, infection control practices, compliance, HCWs, multimodal strategies, patient safety, health security practices.
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty