The evidence supporting WHO recommendations on the promotion of hand hygiene: a critique
The purpose of this research was to examine the quality of the evidence relied upon by the World Health Organisation (WHO) in promoting hand hygiene with campaigns such as " Save Lives: Clean Your Hands " . (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 9, 2019 Category: Consumer Health News Source Type: news

Testing a novel audit and feedback method for hand hygiene compliance: A multicenter quality improvement study
In this study, the authors aimed (1) to compare HHC rates estimated using the standard audit method of overt observation by a known observer and a new audit method that employed a rapid ( (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 9, 2019 Category: Consumer Health News Source Type: news

Control of norovirus infection
The purpose of the review is to provide an update on control measures for norovirus (NoV), which is the most commonly implicated pathogen in acute gastroenteritis and outbreaks, causing major disruption in nurseries, schools, hospitals and care homes. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 9, 2019 Category: Consumer Health News Source Type: news

Control Strategies for Infection Prevention in Total Joint Arthroplasty.
Infection remains one of the most frequent and expensive complications after total joint arthroplasty. This paper reviews current strategies for preventing infection with total joint arthroplasty. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 9, 2019 Category: Consumer Health News Source Type: news

Monitoring healthcare associated infections and antimicrobial use at regional level through repeated point prevalence surveys: what can we learn.
Healthcare associated infections (HAIs) surveillance is an essential part of any infection prevention and control programme. Repeated point prevalence surveys (PPS) according to ECDC protocol have been implemented in all Friuli Venezia Giulia (FVG) region (Italy) acute hospitals to reduce and control HAIs. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 9, 2019 Category: Consumer Health News Source Type: news

Assessing antibiotic stewardship using the surgical site infection prevention bundle
Antibiotic prophylaxis is crucial in head and neck surgery to prevent infection from clean contaminated wounds. Scottish Intercollegiate Guidelines Network (SIGN) guidance, the gold standard of practice, recommends that administration of broad spectrum antibiotics is discontinued after 24 hours post-operation. A three-audit cycle quality improvement project was conducted to assess clinical practice against SIGN guidance at a large London teaching hospital. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 9, 2019 Category: Consumer Health News Source Type: news

Four Steps to Clean Hospitals: Look; Plan; Clean; and Dry
This literature review covers practical cleaning guidance in hospitals. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 9, 2019 Category: Consumer Health News Source Type: news

Resources for reducing SSIs
This collection of resources is aimed at the prevention of surgical site infection (SSI). (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 9, 2019 Category: Consumer Health News Source Type: news

Wiping out MRSA: effect of introducing a universal disinfection wipe in a large UK teaching hospital.
Contamination of the inanimate environment around patients constitutes an important reservoir of MRSA. This paper describes the effect of introducing a universal disinfection wipe in all wards on the rates of MRSA acquisitions and bacteraemias across a large UK teaching hospital. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 9, 2019 Category: Consumer Health News Source Type: news

Environmental contamination by bacteria in hospital washrooms
This journal article outlines how hand hygiene is a fundamental component of infection prevention, but few studies have examined whether hand-drying method affects the risk of dissemination of potential pathogens. This research aimed to perform a multi-centre, internal-crossover study comparing bacterial contamination levels in washrooms with hand-drying by either paper towels (PT) or jet air dryer (JAD; Dyson). (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 9, 2019 Category: Consumer Health News Source Type: news

Childhood cancer burden: a review of global estimates
This Review analyses 4 studies of the global cancer burden that included data for children and adolescents, with the aim that these data could help stakeholders to develop plans for national and institutional cancer programmes. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 9, 2019 Category: Consumer Health News Source Type: news

Best supportive care in advanced lung cancermore than a label?
Key messages from this viewpoint article include the fact that lack of consensus on what best supportive care is contributes to unwarranted variation in the quality of palliative care. A high integrity health system approach should reduce unwarranted variation in practice. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 9, 2019 Category: Consumer Health News Source Type: news

Overall Survival of Black and White Men With Metastatic Castration-Resistant Prostate Cancer Treated With Docetaxel
This review of data from 9 RCTs (n=8,820) found a longer median overall survival for black men vs white men (21.0 vs 21.2 months, multivariable HR 0.81, 95% CI 0.72-0.91). The mechanism for this difference was unknown. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 9, 2019 Category: Consumer Health News Source Type: news

Association of Corticosteroid Treatment With Outcomes in Adult Patients With Sepsis: A Systematic Review and Meta-analysis
This review of 37 RCTs (n=9,564) found that corticosteroid use was associated with reduced 28 day mortality (RR 0.90, 95% CI 0.82-0.88) vs placebo or standard supportive care. ICU mortality was also reduced (0.85, 0.77-0.94). (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 9, 2019 Category: Consumer Health News Source Type: news

Use of C-reactive protein to tailor antibiotic use: a systematic review and meta-analysis
This review of 15 studies found that use of CRP-based algorithms reduced antibiotic treatment in neonates (-1.45 days, p (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 9, 2019 Category: Consumer Health News Source Type: news

Breast Cancer Risk After Recent Childbirth: A Pooled Analysis of 15 Prospective Studies
This analysis concludes that compared with nulliparous women, parous women have an increased risk for breast cancer for more than 20 years after childbirth. Health care providers should consider recent childbirth a risk factor for breast cancer in young women. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 9, 2019 Category: Consumer Health News Source Type: news

The'No catheter No catheter associated urinary tract infection' programme
This case study outlines how a Nurse Consultant at Newcastle upon Tyne Hospitals NHS Foundation Trust led on the development and implementation of a programme of work to improve catheter care and reduce urinary tract infection rates. The programme has led to improved outcomes, experiences and use of resources by addressing unwarranted variation in practice. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 9, 2019 Category: Consumer Health News Source Type: news

Chief Medical Officer annual report 2018: better health within reach
This report concludes there are reasons to be optimistic but that greater effort to improve the health environment is required. It discusses health as the nation's primary asset, the health environment, using emerging technologies to improve health, and effective planning for future. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 7, 2019 Category: Consumer Health News Source Type: news

NIHR Signal: Repeat thyroid function tests for healthy older people are not needed
Commentary is provided of study which found older adults with normal thyroid function/subclinical thyroid dysfunction show notable long-term stability of thyroid hormone levels suggesting it is safe for GPs not to routinely retest unless they have risk factors/develop symptoms. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 7, 2019 Category: Consumer Health News Source Type: news

10 year olds in the UK have consumed 18 years' worth of sugar
PHE report that, based on average sugar consumption from the age of 2, children have already exceeded the maximum recommended sugar intake for an 18 year old. They have launched a new Change4life campaign today to support families to cut back on sugar. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 7, 2019 Category: Consumer Health News Source Type: news

The mental health impact of therapy dogs in prisons
This report presents the evaluation findings of a pilot scheme to introduce two therapy dogs to people with histories of self-harm in three prisons in England's North East. The pilot found that the therapy dogs had a calming influence on prisoners, helped increase coping skills and strategies, and provided a safe space for them to explore ways of expressing and processing emotions (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 3, 2019 Category: Consumer Health News Source Type: news

Understanding patient needs in switching from biologic to biosimilar medicines: final report of survey and focus group findings
This report raises concerns about patients'experiences of being switched onto biosimilar medicines from their existing biologics. It finds patients are not always receiving the support they need to understand any changes, or to monitor and manage side effects or other adverse consequences (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - January 3, 2019 Category: Consumer Health News Source Type: news

People leaving hospital after medical illness do not benefit from extended clot reducing treatment
Taking rivaroxaban after discharge from hospital does not significantly reduce the risk of venous thromboembolism, either blood clots in large veins or of dying from clots travelling to the lungs. This large multinational trial sought to find out whether using the anticoagulant rivaroxaban for 45 days after discharge was effective. Continued use offered a very small reduction in the risk of a venous thromboembolism, but also slightly increased the risk of major bleeding. Neither result reached statistical significance. The trial was terminated because of the lower than expected number of clots. (Source: Current Awareness S...
Source: Current Awareness Service for Health (CASH) - January 3, 2019 Category: Consumer Health News Source Type: news

Living with and beyond cancer
In this case study from Lincolnshire West CCG, nursing and care staff have been key players in a collaboration, leading and shaping the programme to improve cancer patients'care, support and experience. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Factors Underlying Racial Disparities in Sepsis Management
The authors of this journal article state that sepsis, a syndrome characterized by systemic inflammation during infection, continues to be one of the most common causes of patient mortality in hospitals across the United States. They say that while standardized treatment protocols have been implemented, a wide variability in clinical outcomes persists across racial groups. Specifically, black and Hispanic populations are frequently associated with higher rates of morbidity and mortality in sepsis compared to the white population. While this is often attributed to systemic bias against minority groups, a growing body of lit...
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Evaluating the discriminating capacity of cell death (apoptotic) biomarkers in sepsis
The authors of this journal article state that sepsis biomarker panels that provide diagnostic and prognostic discrimination in sepsis patients would be transformative to patient care. They assessed the mortality prediction and diagnostic discriminatory accuracy of two biomarkers reflective of cell death (apoptosis), circulating cell-free DNA (cfDNA), and nucleosomes. They say that to their knowledge, this is the first head-to-head comparison of cfDNA and nucleosomes in diagnosing sepsis and predicting sepsis-related mortality. Both cfDNA and nucleosome concentrations demonstrated a modest ability to distinguish sepsis sur...
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Hydrocortisone, Ascorbic Acid and Thiamine (HAT Therapy) for the Treatment of Sepsis. Focus on Ascorbic Acid
The authors of this journal article state that sepsis is a devastating disease that carries an enormous toll in terms of human suffering and lives lost. They say that over 100 novel pharmacologic agents that targeted specific molecules or pathways have failed to improve the outcome of sepsis. Preliminary data suggests that the combination of Hydrocortisone, Ascorbic Acid and Thiamine (HAT therapy) may reduce organ failure and mortality in patients with sepsis and septic shock. HAT therapy is based on the concept that a combination of readily available, safe and cheap agents, which target multiple components of the host's r...
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Severe sepsis 3-hour bundle compliance and mortality
Severe sepsis is a major cause of mortality among hospitalized patients. The authors of this journal article tracked severe sepsis 3-hour bundle compliance and mortality over time. Those patients with severe sepsis who received the entire bundle had improved in-hospital survivability over those patients who did not receive the bundle. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

The Artificial Intelligence Clinician learns optimal treatment strategies for sepsis in intensive care
The authors of this journal article state that sepsis is the third leading cause of death worldwide and the main cause of mortality in hospitals, but the best treatment strategy remains uncertain. In particular, evidence suggests that current practices in the administration of intravenous fluids and vasopressors are suboptimal and likely induce harm in a proportion of patients. To tackle this sequential decision-making problem, the authors developed a reinforcement learning agent, the Artificial Intelligence (AI) Clinician, which extracted implicit knowledge from an amount of patient data that exceeds by many-fold the life...
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Sepsis in the Burn Patient
Sepsis is the leading cause of death in burn patients. The authors of this journal article say that interventions are challenging owing to a lack of specific guidelines, and all burn types involve a risk for complications. They say that interventions should include care of the burn, medication administration, continuous monitoring for infection development, infection prevention measures, and (if necessary) treatment of sepsis. The article concludes that sepsis in burn patients is different from the unburned population. Efforts are needed to develop more accurate diagnostic strategies and guidelines to trigger rapid treatme...
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Prompt admission to intensive care is associated with improved survival in patients with severe sepsis and/or septic shock
This research article aims to investigate the association between time from hospital admission to intensive care unit (ICU) admission (door to ICU time) and hospital mortality in patients with sepsis. A shorter time from hospital door to ICU admission was shown to be independently associated with reduced hospital mortality in patients with severe sepsis and/or septic shock. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Hospital Costs Associated with Sepsis Compared with Other Medical Conditions.
The authors of this journal article say that sepsis is a condition that has become a main focus for health care organizations owing to the alarming cost of caring for patients, as well as the disturbing mortality rates, that accompany this condition. Health care organizations have implemented multiple strategies and best practices to improve the outcomes of patients with a diagnosis of sepsis. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Emerging Adjunctive Approach for the Treatment of Sepsis: Vitamin C and Thiamine.
The authors of this journal article say that evidence is emerging that parenteral administration of high-dose vitamin C and thiamine may be a beneficial adjuvant therapy of severe sepsis and septic shock. Despite modern practices in critical care medicine, sepsis and severe sepsis remain a leading cause of morbidity and mortality in the critical care unit. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Early Administration of Intravenous Fluids in Sepsis: Pros and Cons.
Fluid resuscitation in the management of patients with sepsis and severe sepsis has been considered the standard of care for almost 2 decades. The rationale for fluid resuscitation is related to improvement in cardiac output and organ perfusion. Recent research evidence challenges the use of fluid resuscitation in patients diagnosed with sepsis. Research is needed to determine the timing of fluid administration, as well as the volume and type of fluid to achieve positive patient outcomes. This journal article discusses the pros and cons of early fluid administration in the management of patients with sepsis. (Source: Curre...
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

The host response in critically ill sepsis patients on statin therapy : a prospective observational study
In conclusion, statin therapy is not associated with a modified host response in sepsis patients on admission to the ICU. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

The use of procalcitonin in the determination of severity of sepsis, patient outcomes and infection characteristics
The primary objective of this study was to determine the correlation between procalcitonin values and illness severity by evaluating the degree of end organ dysfunction using the Sequential Organ Failure Assessment score, length of stay and the severity of sepsis (sepsis alone vs. septic shock), The hypothesis that procalcitonin values would be higher in sicker patients was formulated before data collection began. Secondary outcomes studied in relation to procalcitonin levels included infection characteristics such as the site of infection, microbial agent and dialysis dependent CKD. Procalcitonin has a higher specificity ...
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Identification and treatment of paediatric sepsis: getting the balance right
This journal article says recent National Institute for Health and Care Excellence (NICE) guidance on sepsis defines clinical criteria to guide the management of a child presenting with suspected infection. In children with suspected infection, the authors say presence of a'high-risk'criterion should lead to intravenous access, parenteral antibiotic administration and consideration of intravenous fluid boluses, unless a senior decision-making doctor senior decision-making doctor (DMD; defined as a Specialist Trainee (ST) 4 paediatrician, or ST4 emergency physician for older children) makes an alternative diagnosis. They sa...
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

De-escalation of antimicrobial treatment for adults with sepsis, severe sepsis or septic shock
This review concludes that there is no adequate, direct evidence as to whether de-escalation of antimicrobial agents is effective and safe for adults with sepsis, severe sepsis or septic shock. The authors say this uncertainty warrants further research via RCTs and the authors are awaiting the results of an ongoing RCT testing the de-escalation of empirical antimicrobial therapy for severe sepsis. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Cancer Survivorship
This review from US perspective covers surveillance for recurrence and screening for second primary cancer, long-term and late effects of cancer treatment, health promotion, promotion of psychological well-being, special populations, and care coordination and communication. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Challenging the supremacy of intravenous antibiotics
This editorial notes that although the risks of IV administration are well described, a perception of greater potency and mythical qualities of IV antibiotics may prevent prompt switching to oral route. The authors say there is need to balance actual benefit of IV route against the known risks. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Association of a label of penicillin allergy with increased risk of MRSA and Clostridium difficile infection: DTB Select summary
This journal article gives summary and context to a matched cohort study, that found people with a documented allergy to penicillin have higher rates of MRSA and Clostridium difficile infection. This was influenced by increased use of alternatives to beta-lactam antibiotics. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

NICE Bites: Prostatitis
This publication provides a summary of key prescribing points taken from the NICE guidance NG110. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

How is the NHS performing? December 2018 quarterly monitoring report
This report finds that patients are waiting too long for care and NHS trusts and clinical commissioning groups remain under significant financial pressure. Half of NHS providers are forecasting a financial deficit. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Opening the door to change
This report on issues that contribute to Never Events found that although safety alerts are seen as an effective way to share guidance, the context in which they are landing creates challenges for trusts. It also finds that education and training could be significantly improved. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 28, 2018 Category: Consumer Health News Source Type: news

Modernising the Mental Health Act: a summary of the final report of the Independent Review of the Mental Health Act.
This briefing provides a summary of the final report which includes proposed changes to CTOs, the nearest relative provision, hospital manager hearings, the introduction of a statutory care and treatment plan and calls for a sustained focus on improving the inpatient ward environment (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 21, 2018 Category: Consumer Health News Source Type: news

Department of Health and Social Care accounts
The financial sustainability of health and social care is a serious and ongoing concern of the Committee. It finds the Department should provide an assessment of the impact of regional variations on patient care; urgent action needed on risks Brexit poses to recruitment and the supply of medical equipment; and the NHS 10-year plan must explain how the service will address the many challenges it faces. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 21, 2018 Category: Consumer Health News Source Type: news

Chronic obstructive pulmonary disease in over 16s diagnosis and management NICE guideline [NG115]
This guideline covers diagnosing and managing chronic obstructive pulmonary disease (COPD) in people aged 16 and older, which includes emphysema and chronic bronchitis. It aims to help people with COPD to receive a diagnosis earlier so that they can benefit from treatments to reduce symptoms, improve quality of life and keep them healthy for longer. It was published in December 2018. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 20, 2018 Category: Consumer Health News Source Type: news

Chronic obstructive pulmonary disease (acute exacerbation): antimicrobial prescribing NICE guideline [NG114]
This guideline sets out an antimicrobial prescribing strategy for acute exacerbationbs of chronic obstructive pulmonbary disease (COPD). It aims to optimise antibiotic use and reduce resistance. It was published in December 2018. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 20, 2018 Category: Consumer Health News Source Type: news

Updated BTS Adult Bronchiectasis Guideline 2018: a multidisciplinary approach to comprehensive care
This updated BTS Guideline covers who to investigate, what investigations should be carried out and provides a suggested stepped approach to disease management. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 20, 2018 Category: Consumer Health News Source Type: news

On the right course? A review of the quality of care provided to patients aged 24 years and under who were receiving systemic anti-cancer therapy and subsequently died or were admitted to critical care
This analysis of care delivered to children and young adults who either died or had an unexpected admission to critical care within 60 days of receiving systemic anti-cancer therapy (SACT) has shown a mixed picture of care received. (Source: Current Awareness Service for Health (CASH))
Source: Current Awareness Service for Health (CASH) - December 20, 2018 Category: Consumer Health News Source Type: news