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To sustainably improve cleaning of high-touch surfaces (HTSs) in acute-care hospitals using a multimodal approach to education, reduction of barriers to cleaning, and culture change for environmental services workers.
The study was conducted in 2 academic acute-care hospitals, 2 community hospitals, and an academic pediatric and women’s hospital.
Frontline environmental services workers.
A 5-module educational program, using principles of adult learning theory, was developed and presented to environmental services workers. Audience response system (ARS), videos, demonstrations, role playing, and graphics were used to illustrate concepts of and the rationale for infection prevention strategies. Topics included hand hygiene, isolation precautions, personal protective equipment (PPE), cleaning protocols, and strategies to overcome barriers. Program evaluation included ARS questions, written evaluations, and objective assessments of occupied patient room cleaning. Changes in hospital-onset C. difficile infection (CDI) and methicillin-resistant S. aureus (MRSA) bacteremia were evaluated.
On average, 357 environmental service workers participated in each module. Most (93%) rated the presentations as ‘excellent’ or ‘very good’ and agreed that they were useful (95%), reported that they were more comfortable donning/doffing PPE (91%) and performing hand hygiene (96%) and better understood the importance of disinfecting HTSs (96%) after the program. The frequency of cleaning individual HTSs in occupied rooms increased from 26% to 62% (P < .001) following the intervention. Improvement was sustained 1-year post intervention (P < .001). A significant decrease in CDI was associated with the program.
A novel program that addressed environmental services workers’ knowledge gaps, challenges, and barriers was well received and appeared to result in learning, behavior change, and sustained improvements in cleaning.
Barnyardgrass, large crabgrass, and Texas panicum were evaluated in field experiments over 3 yr to measure their duration of interference and density on grain sorghum yield. When grain yield data were converted to a percentage of the weed-free control, linear regression predicted a 3.6% yield loss for each week of weed interference regardless of year or grass species. Grain sorghum grown in a narrow (61-cm) row spacing was affected little by full-season interference; however, in wide (91-cm) rows, interference increased as grass density increased. Data from the wide-row spacing were described by linear regression following conversion of grain yield to percentages and weed density to log10. A separate nonlinear model also was derived which could predict the effect of weed density on grain sorghum yield.
Field experiments were conducted in the summers of 1988 and 1989 to evaluate sericea lespedeza control with POST herbicides. Triclopyr, picloram, 2,4-D, metsulfuron, dicamba, and selected herbicide mixtures were evaluated in 1988 and 1989. Clopyralid was evaluated in 1988 and fluroxypyr in 1989. Triclopyr at 0.56 and 1.12 kg ha–1 controlled sericea lespedeza both years. Fluroxypyr at 0.56 kg ha–1 also controlled sericea lespedeza. Control with picloram and metsulfuron was variable. Other treatments evaluated did not control sericea lespedeza.
The duration and intensity of unicorn-plant interference on lint yield of cotton were evaluated in the field. Random densities of 5.5 ± 1.1 unicorn-plant/m2 reduced lint yield by 41 kg/ha or about 5% for each week that unicorn-plant was present. Interference by 4, 8, and 12 weeds/10 m row decreased yield by 22, 49, and 56 kg/ha, respectively, for each week of weed interference. Each 1 kg/ha of unicorn-plant dry weight reduced lint yield by 0.26 kg/ha. Linear regression of weed dry weight could be used to predict cotton lint yield changes regardless of duration or intensity of weed interference.
Duration and density experiments were conducted in the field to measure horsenettle (Solanum carolinense L. # SOLCA) interference with Spanish and runner-type peanuts (Arachis hypogaea L. ‘Pronto’ and ‘Florunner′). Spanish peanut yield generally was higher with 6 to 8 weeks of weed-free maintenance. Horsenettle interference for 6 to 8 weeks did not decrease the yield of Spanish peanuts, and interference for 6 weeks did not decrease yields of runner peanuts. Weed-free maintenance for 2 or more weeks allowed increased runner peanut yield when compared to weedy plots. Linear regression predicted a 69 kg/ha Spanish peanut yield increase for each week of weed-free maintenance. Linear regression predicted a Spanish peanut yield reduction of 40 kg/ha for each week of weed interference in 1983, the only year in which the slopes of the regressions were statistically significant Curvilinear equations with the runner-type cultivar predicted an 81 kg/ha yield increase or 96 kg/ha decrease for each week of weed-free maintenance or weed interference, respectively. In 1 of 2 yr, Spanish peanut yield was reduced by horsenettle at a density of 32 plants/10 m of row.
A survey conducted to determine the distribution of red horned poppy in western Oklahoma identified infestations in 14 Oklahoma and 3 Texas counties. Soil pH from infested fields ranged from 7.0 to 8.5. Red horned poppy grew as an annual, germinating in fall, spring, or summer. Plants that emerged in the fall survived −25 C, flowered in April and produced mature seed in June. Plants that emerged in April, flowered in June and produced mature seed in July. Corolla color varied from red to yellow with time of anthesis.
Soil water from plots containing cotton, devil's-claw, cotton with devil's-claw, and bare soil was measured throughout the growing season using a neutron probe and related to weed interference with the crop. Volumetric water content throughout the soil profile to a depth of 180 cm did not differ among treatments before the 5th or 6th week after cotton emergence. Greater water depletion occurred early in the season in plots containing devil's-claw which corresponded to a period of rapid weed growth. In plots containing only cotton, the largest reduction in water content occurred later in the season during peak bloom and early boll formation. Soil water content at depths greater than 105 cm remained unchanged in all plots throughout the season. Interference from devil's-claw reduced cotton lint yield 96% in 1986 and 46% in 1987. Higher rainfall and reduced weed populations in 1987 reduced the impact of weed interference on cotton lint yield.
The effects of hogpotato interference on cotton and of the crop on the weed were measured under field conditions in four environments. Full-season interference from 105 ± 21 hogpotato plants/m2 reduced cotton plant height by 14 to 44%. Conversely, weed dry weight was reduced 54% through full-season interference from cotton. Lint yield reductions in cotton ranged from 31 to 98% following full-season weed interference. Interference during the first 7 weeks of crop growth reduced lint yield by approximately 40%; however, interference after 7 weeks of weed-free maintenance did not affect lint yield. Interference reduced boll size in 3 of 4 yr, lint percent in 2 of 4, and boll number in the only year it was measured. Cotton fiber length, uniformity index, and micronaire were reduced by full-season interference in 1 of 2 yr; however, fiber strength was not affected in either year. Significant use of soil water by hogpotato occurred at 120 cm and deeper in the soil while cotton used water primarily in the upper 75 cm.
Field experiments were conducted to evaluate the critical period for velvetleaf interference with cotton and to assess the reliability of using weed growth variables as predictors of cotton lint yield losses. An inverse linear relationship existed between velvetleaf dry weight and cotton lint yield. The relationship between the number of velvetleaf main-stem nodes or velvetleaf height with cotton lint yield was best described by quadratic regression equations. Weed dry weight appeared to be the most accurate predictor followed by weed height and by number of velvetleaf main-stem nodes. A nonlinear equation best described percent lint yield loss as a function of critical-period interference intervals.