This assignment covers many competencies, as we dive into the future. Of importance is your ability to demonstrate expertise in the strategies used to search the web effectively. There are four parts to this assignment. Part 1: Boolean Search Strategies: These are on your page as clickable strategies.
Part 2: 8 Articles minimum: All articles must be about the future, non-imminent; clickable links. Part 3: PDF of your database report embedded.
Blockchain -bitcoin veterinary veterinarian animals. Pearl search: "Veterinary informatics". Learning Outcomes. Use Boolean search strategies to learn and find articles about the future of your Field of Interest, from within the past year.
First eBook Edition: November In Fax: 36 24 The centre provides services to all Syrian refugees, such as free legal advice for women, Proportion of IOM research-related downloads in and , by theme. In GCC countries, migrants make up high proportions of the total national All simulations were written in C and compiled using GCC version 4.
Iran Business Forum. It is our 9 Nov reproduce, copy, download or publish the attached International Offering Pursuant to section 3A. The surveillance department of GDIPC at MOH provided the included hospitals with the required training in basic surveillance definitions, surveillance methodology, use of HESN program, and information technology support.
Training workshops followed by hands on training were conducted in all regions during the year before start of the study. Confidence intervals CIs 15 and standard percentiles 20 were calculated for both VAP rates and ventilator utilization ratios. Percentiles were not calculated for ICU types with less than 20 data points hospital year of surveillance. P-values were two-tailed. SPSS software release During two years of surveillance around 1,, patient-days and , ventilator-days, a total 1, VAP events were identified.
As shown in Table 2 , the overall VAP rate was 2. The 50th, 75th, and 90th percentiles were 1. VAP rates per ventilator-days were highest in adult medical 4.
As shown in Table 3 , the overall ventilator utilization ratio was 0. The 50th, 75th, and 90th percentiles were 0. The ventilator utilization ratios were highest in neurosurgical 0.
The neonatal overall VAP rate was 1. With exception of the lowest birth-weight group, VAP rates per ventilator-days were decreasing while ventilator utilization ratios were increasing as birth weight group were increasing.
For example, VAP rates were 2. This rate was considerably lower than previously reported VAP rates derived from multi-hospital surveillance studies in Saudi Arabia, which ranged between 4. However, the difference is much reduced when comparing the current rate to the VAP rates of recent years in studies covering longer duration per ventilator-days 15 or post-intervention VAP rates in interventional studies 4.
The lower rates in the current study may be explained by several reasons. First, the VAP rates were dramatically improved over the last decade after implementation of ventilator bundle and other preventive measures.
The change was evident in Saudi Arabia Crit Care. This point was supported by the difference in ventilator utilization discussed below. Third, the variability in ICU distribution in the current study were responsible for some of the observed differences. Finally, VAP is the most sensitive device-associated HAI to monitor variations in surveillance methodology and definition implementation 22 , Therefore, comparing VAP rates between studies with minor differences in methodology can be challenging.
The overall MOH ventilator utilization ratio was 0. The current ventilator utilization was considerably lower than previously reported by multi-hospital surveillance studies in Saudi Arabia, which ranged between 0. Therefore, when the ventilator utilization in the current study were stratified by type of ICU as in Figure 1 , the overall difference in ventilator utilization between the current and GCC report become much attenuated in adult, pediatric, and neonatal ICUs Moreover, MOH ventilator utilization ratio adjusted for the type of ICUs Table 5 was higher not lower than both developed and developing countries.
Similar findings were reported by a number of previous studies in Saudi Arabia Crit Care. The consistent finding may be reflecting differences in infection control practices and regulations in US compared with developing countries.
Additionally, the finding may indicate the need for timely implementation of infection control practices and preventive bundles to bring the rates much lower. The current report can perfectly represent as a national benchmarking report for VAP.
The benchmarking use of this report is supported by the large unprecedented number of hospitals included, the coverage of 20 geographic regions, and the use of the unified electronic data collection system. Additionally, this has been further facilitated by presenting unit-specific rates and ratios and calculating confidence intervals and standard percentiles for both rates and ratios.
Moreover, the use of the same surveillance methodology and the same electronic platform ensured the homogeneity of the calculated rates and ratios. This is particularly important in VAP rates which are very sensitive to variability in implementation of VAP surveillance definitions 22 , Yet, several challenges still need to be overcome to further improve VAP surveillance in MOH hospitals, including data validation, site audits, and rapid turnover of infection control practitioners.
The overall VAP rate was 2. The last finding may indicate the need of strict adherence to the infection control practices and preventive bundles to bring the rates much lower.
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