RESUMEN
The article describes the relationship between a certified nurse-midwife and their supervising obstetrician. The article deals with the relationship of both parties and the requirement of a collaborative agreement in a majority of states. The legal responsibilities of both the certified nurse-midwife and obstetrician are discussed and how it impacts both providers. The key factor is the trust relationship between the parties involved and how this can lead to more diverse obstetrical care and access for patients in the United States.
Asunto(s)
Enfermeras Obstetrices , Obstetricia , Médicos , Embarazo , Humanos , Estados Unidos , Femenino , Obstetras , GinecólogosRESUMEN
BACKGROUND: It is generally agreed that contaminated hospital surfaces play a role in the transmission of hospital-acquired infections (HAIs). The ability of an antimicrobial agent, engineered at Emory University, to reduce bacterial bioburden on hospital surfaces was examined. A quantitative microbial risk assessment was also conducted to quantify the potential reduction of human health risks associated with application of this antimicrobial product. METHODS: A 1-arm, prospective observational study was conducted. High-frequency contact surfaces within 18 hospital patient rooms were sampled in between patient use. Negative binomial regression with repeated measures was used to examine log CFU/100 cm(2) reductions in total, gram-negative, and Staphylococcus aureus microorganisms. Standard risk assessment methods were used. RESULTS: Multivariate regression demonstrated significant reductions in gram-negative (P < .0001) and S aureus (P = .009) bacteria with increasing patient turnover. No reduction was observed in total bacteria (P = .93). Infection risks were reduced by 4 and 3 logs for gram-positive and gram-negative bacteria, respectively. These risk reductions, along with HAI survey studies, suggest that application of this antimicrobial product could prevent as many as 5%-10% of HAIs. CONCLUSIONS: This study was the first evaluation of a distinctive antimicrobial agent for hospital surface treatment. The findings provide support for the utility of an antimicrobial product in potentially reducing HAI transmission from contaminated environment surfaces.
Asunto(s)
Desinfectantes/farmacología , Microbiología Ambiental , Bacterias Gramnegativas/aislamiento & purificación , Staphylococcus aureus/aislamiento & purificación , Propiedades de Superficie , Recuento de Colonia Microbiana , Bacterias Gramnegativas/efectos de los fármacos , Hospitales , Humanos , Estudios Prospectivos , Medición de Riesgo , Staphylococcus aureus/efectos de los fármacosRESUMEN
One year after trees had been infused post-harvest with oxytetracycline (OTC) to remit symptoms of pear decline, pears were harvested and tasted. In four sessions, the panel of tasters discerned between pears from trees treated with OTC and pears from untreated diseased trees. In three of the sessions, the fruit from treated trees was preferred over fruit from untreated diseased trees.