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31 results

Page 1 of 2

  • Alcohol-based decontamination of gloved hands: A randomized controlled trial

  • Kerri A. Thom, Clare Rock, Gwen L. Robinson, Heather R.S. Reisinger, Jure Baloh, Emily Chasco, Yuanyuan Liang, Shanshan Li, Daniel J. Diekema, Loreen A. Herwaldt, J. Kristie Johnson, Anthony D. Harris, Eli N. Perencevich
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 45 / Issue 4 / April 2024
    Published online by Cambridge University Press:
    23 November 2023, pp. 467-473
    Print publication:
    April 2024
    • Article
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      • Open access
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  • Objective:

    The gold standard for hand hygiene (HH) while wearing gloves requires removing gloves, performing HH, and donning new gloves between WHO moments. The novel strategy of applying alcohol-based hand rub (ABHR) directly to gloved hands might be effective and efficient.

    Design:

    A mixed-method, multicenter, 3-arm, randomized trial.

    Setting:

    Adult and pediatric medical-surgical, intermediate, and intensive care units at 4 hospitals.

    Participants:

    Healthcare personnel (HCP).

    Interventions:

    HCP were randomized to 3 groups: ABHR applied directly to gloved hands, the current standard, or usual care.

    Methods:

    Gloved hands were sampled via direct imprint. Gold-standard and usual-care arms were compared with the ABHR intervention.

    Results:

    Bacteria were identified on gloved hands after 432 (67.4%) of 641 observations in the gold-standard arm versus 548 (82.8%) of 662 observations in the intervention arm (P < .01). HH required a mean of 14 seconds in the intervention and a mean of 28.7 seconds in the gold-standard arm (P < .01). Bacteria were identified on gloved hands after 133 (98.5%) of 135 observations in the usual-care arm versus 173 (76.6%) of 226 observations in the intervention arm (P < .01). Of 331 gloves tested 6 (1.8%) were found to have microperforations; all were identified in the intervention arm [6 (2.9%) of 205].

    Conclusions:

    Compared with usual care, contamination of gloved hands was significantly reduced by applying ABHR directly to gloved hands but statistically higher than the gold standard. Given time savings and microbiological benefit over usual care and lack of feasibility of adhering to the gold standard, the Centers for Disease Control and Prevention and the World Health Organization should consider advising HCP to decontaminate gloved hands with ABHR when HH moments arise during single-patient encounters.

    Trial Registration: NCT03445676.

Religious Liberty
  • Essays on First Amendment Law
  • Edited by Daniel N. Robinson, Richard N. Williams
  • Published online:
    05 September 2016
    Print publication:
    08 September 2016
  • The principal aim of the establishment and free exercise clauses of the First Amendment was to preclude congressional imposition of a national church. A balance was sought between states' rights and the rights of individuals to exercise their religious conscience. While the founding fathers were debating such issues, the potential for serious conflict was confined chiefly to variations among the dominant Christian sects. Today, issues of marriage, child bearing, cultural diversity, and corporate personhood, among others, suffuse constitutional jurisprudence, raising difficult questions regarding the nature of beliefs that qualify as 'religious', and the reach of law into the realm in which those beliefs are held. The essays collected in this volume explore in a selective and instructive way the intellectual and philosophical roots of religious liberty and contemporary confrontations between this liberty and the authority of secular law.

  • Determinism: Did Libet Make the Case?

  • Daniel N. Robinson
  • Journal:
    Philosophy / Volume 87 / Issue 3 / July 2012
    Published online by Cambridge University Press:
    15 June 2012, pp. 395-401
    Print publication:
    July 2012

  • Benjamin Libet's influential publications have raised important questions about voluntarist accounts of action. His findings are taken as evidence that the processes in the central nervous system associated with the initiation of an action occur earlier than the decision to act. However, in light of the methods employed and of relevant findings drawn from research addressed to the timing of neurobehavioural processes, Libet's conclusions are untenable.

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