Title: Technological Platform for the Prevention and Management of Healthcare Associated Infections and Outbreaks
Authors: Maria Iuliana Bocicor, Maria Dascalu, Agnieszka Gaczowska, Sorin Hostiuc, Alin Moldoveanu, Antonio Molina, Arthur-Jozsef Molnar, Ionut Negoi, Vlad Racovita
Published: Springer International Publishing, 2018
Abstract: Hospital acquired infections are infections that occur in patients during hospitalization, which were not present at the time of admission. They are among the most common adverse events in healthcare around the world, leading to increased mortality and morbidity rates, prolonged hospitalization periods and considerable financial burden on both hospitals and patients. Preventive guidelines and regulations have been devised, however compliance to these is frequently poor and there is much room for improvement. This paper presents the prototype of an extensible, configurable cyber-physical system, developed under European Union funding, that will assist in the prevention of hospital infections and outbreaks. Integrating a wireless sensor network for the surveillance of clinical processes with configurable monitoring software built around a workflow engine as key component, our solution detects deviations from established hygiene practices and provides real-time information and alerts whenever an infection risk is discovered. The platform is described from both hardware and software perspective, with emphasis on the wireless network’s elements as well as the most important software components. Furthermore, two clinical workflows of different complexity, which are included in the system prototype are detailed. The finalized system is expected to facilitate the creation and automated monitoring of clinical workflows that are associated with over 90% of hospital infections.

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Title: Patient autonomy and disclosure of material information about hospital-acquired infections
Authors: Sorin Hostiuc, Arthur-Jozsef Molnar, Alin Moldoveanu, Maria Aluaş, Florica Moldoveanu, Iuliana Bocicor, Maria-Iuliana Dascalu, Elisabeta Bădilă, Mihaela Hostiuc, Ionut Negoi
Published: Dove Press, Journal of Infection and Drug Resistance, November 2018
Abstract: Hospital-acquired infections are nowadays a major health care problem worldwide. The morbidity and mortality associated with them are highest in intensive care units, but their effects are identifiable in virtually any medical department. Information about hospital-acquired infections, especially about their preventive measures, are rarely presented nowadays in a correct fashion to patients. This article aims to present, in a structured manner, the theoretical and practical aspects related to disclosure of hospital-acquired infections–related information to patients and its importance in preventing their spread. We will analyze both the conceptual framework for disclosing medical information related to nosocomial infections (autonomy, veracity, social justice, the principle of double effect, the precautionary principle, and nonmaleficence) and the practicalities regarding the disclosure of proper information to patients.

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Title: Wireless Sensor Network based System for the Prevention of Hospital Acquired Infections
Authors: Iuliana Bocicor, Maria Dascălu, Agnieszka Gaczowska, Sorin Hostiuc, Alin Moldoveanu, Antonio Molina, Arthur-Jozsef Molnar, Ionuț Negoi and Vlad Racoviță
Published: Proceedings of the 12th International Conference on Evaluation of Novel Software Approaches to Software Engineering (ENASE 2017), Vol. 1 – 978-989-758-250-9
Abstract: Hospital acquired infections are a serious threat to the health and well-being of patients and medical staff within clinical units. Many of these infections arise as a consequence of medical personnel that come into contact with contaminated persons, surfaces or equipment and then with patients, without following proper hygiene procedures. In this paper we present our ongoing efforts in the development of a wireless sensor network based cyber-physical system which aims to prevent hospital infections by increasing compliance to established hygiene guidelines. The solution, currently developed under European Union funding integrates a network of sensors for monitoring clinical workflows and ambient conditions, a workflow engine that executes encoded workflow instances and monitoring software that provides real-time information in case of infection risk detection. As a motivating example, we employ the workflow in the general practitioner’s office in order to comprehensively present types of sensors and their positioning in the monitored location. Using the information collected by deployed sensors, the system is capable of immediately detecting infection risks and taking action to prevent the spread of infections.
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Title: Antibiotic prophylaxis in gynecological surgery. A literature review
Authors: Ionuț Negoi, Mircea Beuran Sorin Păun, Alin Moldoveanu, Ruxandra Irina Negoi, Iuliana Bocicor, Arthur Molnar and Mihaela Hostiuc
Published: GINECOeu, Volume 12 Issue 3 (September 2016), pages 142-145
Abstract: Gynecological surgical procedures are associated with significant morbidity, and a major impact on the quality of life. The antibiotic prophylaxis should minimize the risk of postoperative infections complications, preventing in the same time the adverse effects of long-term antibiotic usage. The aim of this paper is to detail the current recommendations for antibiotic prophylaxis in gynecological surgical procedures performed by open abdominal or laparoscopic approach. We have performed a review of the English language literature from the PubMed/Medline database using the following search details: (“Antibiotic Prophylaxis”[Mesh]) AND “Gynecologic Surgical Procedures”[Mesh]. We used the similar articles function to find additional secondary resources. Antibiotic prophylaxis should not be performed in elective laparoscopic gynecological procedures without the opening of the uterus or vagina. During hysterectomy for benign or malignant disease, the first dose of antibiotic prophylaxis should be infused one hour prior to skin incision, excepting Vancomycin and Fluoroquinolone that should be started two hours before. The antibiotic should be repeated if the duration of the surgery lasts more than two half-lives of the drug or the intraoperative bleeding is greater than 1500 mL. The antibiotic prophylaxis should be discontinued within the first 24 hours after surgery. Timely administration of adequate antibiotics and a meticulous surgical technique are mandatory for effectively decreasing the risk of postoperative infectious complications. Thorough adherence to international recommendations for antibiotic prophylaxis discontinuation within 24 hours should minimize the adverse events of antibiotic usage.
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Title: Preventing Hospital Acquired Infections through a Workflow-based Cyber-physical System
Authors: Maria Iuliana Bocicor, Arthur-Jozsef Molnar, Cristian Taslitchi
Published: Proceedings of the 11th International Conference on Evaluation of Novel Software Approaches to Software Engineering – Volume 1: ENASE, 63-68, 2016, Rome, Italy
Abstract: Hospital acquired infections (HAI) are infections acquired within the hospital from healthcare workers, patients or from the environment, but which have no connection to the initial reason for the patient’s hospital admission. HAI are a serious world-wide problem, leading to an increase in mortality rates, duration of hospitalisation as well as significant economic burden on hospitals. Although clear preventive guidelines exist, studies show that compliance to them is frequently poor. This paper details the software perspective for an innovative, business process software based cyber-physical system that will be implemented as part of a European Union-funded research project. The system is composed of a network of sensors mounted in different sites around the hospital, a series of wearables used by the healthcare workers and a server side workflow engine. For better understanding, we describe the system through the lens of a single, simple clinical workflow that is responsible for a significant portion of all hospital infections. The goal is that when completed, the system will be configurable in the sense of facilitating the creation and automated monitoring of those clinical workflows that when combined, account for over 90% of hospital infections.
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