Cultura

The Importance of Infection Control Systems for all Health Specialties in Healthcare Facilities

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

Mastur Difallah Saeid Alzahrani, Tariq Ali Mohammed Al-Shamrani, Fahed Abdulkrim Mohammed Alfair, Hassan Ahmad Salam Alhuwiti, Majed Faisal Haris Alzaedi, Sami Abdulrahim Jahri

Abstract

Large differences in infection control adherence in various health specialties are one of the gaps in patient safety literature since most research on the topic has focused on individual professional groups but not comparatively within the same institutional setting. The objective of conducting this study was therefore to compare and analyze the compliance of nurses, physicians and environmental services staff in terms of infection control, and identify the impediments and facilitators of adherence in both groups. A cross-sectional mixed-design was used in a tertiary care hospital, which included 300 participants (100 participants in each specialty) using questionnaires that measured the compliance, and the perception of barriers and facilitators through a validated questionnaire. Qualitative depth was provided through semi-structured interviews on 36 people. One-way ANOVA found the significant differences in compliance scores between specialties (F(2,297) = 48.23, p< 0.001), with nurses showing the most adherence (mean=91.2, SD=6.5), then, physicians (mean=82.5, SD=9.1), and lastly, the lowest compliance scores were found in environmental services staff (mean=78.1, SD=10.4). The results of the multiple regression analysis have shown that barrier perception ( -0.41, p<0.001) and facilitator perception ( -0.35, p<0.001) were the toughest independent variables predicting compliance, whereas specialty membership still retained a significant one. The determination was found to be based on qualitative themes such as workload pressures, language barriers, and professional hierarchy. These results indicate that infection control involves multidisciplinary approaches to different barriers associated with each group of professionals, and the environmental services personnel should be prioritized that has been previously forgotten.

Keywords : Infection control; healthcare-associated infections; patient safety; health specialties; compliance.
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