MATERIALS AND METHODS
STUDY DESIGN
This was a comparative cross-sectional study that examined socioeconomic and diabetic related factors as exposure variables and Pseudomonas aeruginosa infection as an outcome variable. The study attempted to compare these variables in the patient’s attending different private laboratory for sugar and culture testing of Sankari and Edappadi, Salem district, TamilNadu, India and was conducted from June 2013 to September 2013.
SAMPLING TECHNIQUE AND SAMPLE SIZE
The data obtained by conducting interviews, examinations pus and blood sampling of respondents who have been determined (Questionnaire in Annexe- 1). The sample size of diabetic foot ulcer was 77 for the isolation of Pseudomonas aeruginosa from foot ulcer.
VARIABLES
1. Outcome (Dependent) variable- include occurrence of Pseudomonas aeruginosa from foot ulcer in diabetic patients at the time of the survey.
Explanatory (Independent) variable
1. Socioeconomic status- includes Age category, Gender, Literacy Status and Economic Status (Annual income)
2. Diabetic related factors include Duration of diabetes mellitus, Type of Treatment for diabetes mellitus at the time of the questionnaire, Random blood sugar at the time of the questionnaire, Associated disease along with a foot infection, History of previous amputation and Foot care maintenance.
DATA MANAGEMENT AND ANALYSES
The data entry was performed using IBM SPSSversion-20 and MedCalc version 3 statistical package. Frequencies and cross tabulations were used to check for missed values and variables. The strength of association between variables was determined using odds ratio, with 95% confidence.
COLLECTION OF SAMPLE
The foot ulcer samples were collected from patients who had diabetes a...
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...tion of the disc manufacture.
In this study 14 antibiotics were used. Each belongs to different groups. Some of the standard antibiotics are: Amikacin (10mcg), Amoxyclav (30 mcg), Ampicillin/Cloxacillin (10mcg), Cefdinir (5mcg), Cefixime (5mcg), Cefotaxime (30mcg), Ceftazidime(30mcg), Cefuroxime(30mcg), Cephalexin(30mcg), Cetriaxone(30mcg), Colistin(10mcg), Co-Trimoxazole(25mcg), Gentamycin (30mcg), Nalidixic acid(30mcg), Norflexin(10mcg), Roxythromycin (30mcg)and Streptomycin(10mcg). The essential oils were Eucalyptus oil, Lemongrass oil, Windergreen oil and Mint oil.
COMPOSITION OF MUELLER-HINTON AGAR
Beef infusion from : 300.0g
Acid hydrolysate of casein : 17.5g
Agar : 17.0g
Starch : 1.5g
The pH was adjusted to 7.3 ±0.2 at 25°C using 0.1 N hydrochloric acid (HCl) or 0.1 N sodium hydroxide (NaOH) solution
In 1987, a study described an asso¬ciation between P. aeruginosa isolates recovered from oral abscesses in two cancer patients and their recent exposure to contaminated (DUWL) water during dental treatment from separate DCUs in the same dental clinic. (11)
Bauer AW, Kirby WMM, Sherris JC, Turck M (1966) Antibiotic Susceptibility Testing by a Standardized Single Disk Method. Am J Clin Pathol. 45:493–496.
The treatment of PUs can be a complex process because of several interplaying factors such as co-morbidities, immobility, age, spinal bifida, and other factors. (Porter, M., & Kelly, J., 2014). From the time of the admission, a proper risk assessment (Braden Risk Scores) and proper skin assessment, documentations, and the treatment goals needs to be established by the nurse (Qaseem, Mir, Starkey, & Denberg, 2015). In the Atlanta VA Medical Center, I came to know from the Nurse Educator that if PU is developed because of malnourished, diabetics, older age, obese, and long-term hospital bedbound patients, they were referred to wound care specialists and nutritionists for quality treatment and dietary education. Proper hospital protocols for regular skin inspection and intervention should occur at the units if the patients are at risk for developing PUs. It is in the care of bedside nurse and the wound nurse to prevent the illness by doing regular assessment for timely interventions (Varga,
Diabetes is a metabolic disease, that causes a person to have high blood pressure. There are two kinds of diabetes, type 1 and type 2. Type 1 is the loss of insulin producing cells, leading to a deficiency of insulin. Type 2 diabetes is where the person is insulin resistant. Insulin is a peptide hormone, which causes cells to absorb the various glucose it requires. Type 2 diabetes is the most widespread endocrine disease worldwide. Metagenome wide associated study took on a study that was based on the determination of type 2 diabetes and relationship to gut microbial by using the deep shot gun sequencing of the gut microbial. The study consisted of 345 Chinese's individuals that were used to help find any relationships. 60000 type 2 diabetes associated markers were used and linked to type 2 diabetes. Gut microbes are living organisms that live in the gut and the digestive tract. Patients with type 2 diabetes were characterized by a moderate degree of gut microbial symbiosis. Symbiosis is a interaction between different microbial organisms, there are various types of symbiosis such as mutalistic, parasitic and communalistic. The abundance of butyrate producing bacteria as well as the opportunistic pathogens were determined as well. Enrichment of microbial functions due to sulphate reduction and oxidative stress resistance was found. Further studies were also performed with addition of individuals to the study. Gut microbial markers may be useful for classifying type 2 diabetes.
Research showing that the increase in age the higher the rate of diabetes type2, according to this article research in urban “In a selective urban sample, prevalence, rates of type 2 diabetes increased with age from 2.5% to 17.2% in men 35–75 years old.2 Similar tendencies are observed in most developed countries”( European Diabetes Nursing,2011). Older adult have some metabolic changes with diabetes type 2 that put them at higher risk for urinary incontinent, fall, cognitive issue and dementia.in addition elderly people with diabetes type 2 have high risk for admission to hospitals and nursing home. Elderly with diabetes type 2 has at least 5 or more medications that prescribed and patient may end up not taking the correct dosage of his medication either taking more or less, will increase the hospitalization rate. The role of nurse is crucial to improve the care for patient to provide better outcome. Education on diabetes in older adult is essential to provide teaching to reduce complication. Nurse will assess, monitor educated elderly on the proper use of insulin, medication, how to check blood sugar and diabetes foot care. They conducted researches from some of the nurses about the challenges that they faces with teaching the elderly about diabetes including “Misunderstandings about disease, treatments and poor health
...ended clinical practice standards for diabetic foot care to obtain positive patient outcomes. Further research should include a larger sample to determine regional trends and deficits and a study that concentrates on Type 1 diabetes should also be done to determine differences in interactions for this group. Research into diabetes and associated care is paramount to alleviating one of the quietest epidemics of modern times with 8.3 % of the population and 25.4% with pre-diabetes.
Secondary:Curtis, L. (2008). Prevention of hospital-acquired infections: review of non-pharmacological interventions. Journal of Hospital Infection, 69(3), 204-219. Revised 01/20
Healthcare-associated infections (HAIs) have been a persistent problem in the United States for decades. Yang et al. (2013) stated that “Nosocomial infections or healthcare-associated infections are defined as a localized or systemic condition resulting from an adverse reaction to the presence of an infectious agent or its toxin. There must be no evidence that the infection was present or incubating at the time of admission to the acute care setting” Also if infections occur within 48 hours of being discharged from the hospital or a healthcare setting, then it is considered as a healthcare-associated infection (Daud-Gallotti et al., 2012). Healthcare-associated infections can be easily prevented, however they are held accountable for hundreds of thousands of deaths for the past few decades. They have been known to increase rates of drawn-out hospital stays, cost, morbidity, mortality, and readmission to the hospital (Montoya & Mody, 2011). When antibiotic-resistant organisms (AROs) are involved with these types of infections, the rates are expanded even further and usually cause many more fatalities (Srigley, Lightfoot, Fernie, Gardam & Muller, 2013).
Healthcare-associated infections are a big issue in hospitals. They are the highest cause of morbidity and mortality rates in hospitalized patients. Due to increasing prevention methods, there has been a decrease in infections, but there is still a way to go. In detail, common infections are central line-associated bloodstream infections, catheter care urinary tract infections, surgical site infections and transmission of Clostridium difficile.
The Rural Diabetes Clinic (RDC) is in a rural community in Oklahoma and serves a population primarily of American Indian descent. The RDC currently does not meet the benchmark goals of the Clinical Quality Measures (CQM) – improvement activities for Hemoglobin A1c (HbA1c) levels in the diabetic patients, ages 18 to 75.
A long-term health condition can also be referred to as a ‘chronic illness’ and it can be used to define recurring conditions such as asthma, arthritis, and diabetes.
...s and measurement to decrease healthcare- associated infections. American Journal Of Infection Control, pp. S19-S25. doi:10.1016/j.ajic.2012.02.008.
...There are three types of diabetes that are referred to as type 1, type 2, and gestational diabetes. Some of the symptoms of diabetes are referred to as increased urine output, excessive thirst, weight loss, hunger, fatigue, skin problems, slow healing wounds, yeast infections, blurred vision and tingling or numbness in the feet or toes. There are both acute and chronic complications of diabetes. Some acute complications of diabetes are dangerously elevated blood sugar (hyperglycemia) or abnormally low blood sugar (hypoglycemia). Some chronic complications of diabetes include disease of the blood vessels (both small and large) that can damage the kidneys, feet, eyes, nerves and heart. Diabetes is an important factor in accelerating the hardening and narrowing of the arteries which leads to arthesclerosis, strokes, coronary heart disease and other large blood vessels.
Holmes, A., Castro-Sanchez, E., & Ahmad, R. (2015). Guidelines in infection prevention: Current challenges and limitations. British Journal Of Healthcare Management, 21(6), 275-277 3p.
Diabetic foot problems are a major health concern and are a common cause of hospitalization.