Mathematical Sciences
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Mathematical research at MSU is focused primarily on related topics in pure and applied mathematics. Research programs complement each other and are often applied to problems in science and engineering. Research in statistics encompasses a broad range of theoretical and applied topics. Because the statisticians are actively engaged in interdisciplinary work, much of the statistical research is directed toward practical problems. Mathematics education faculty are active in both qualitative and quantitative experimental research areas. These include teacher preparation, coaching and mentoring for in-service teachers, online learning and curriculum development.
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Item Impact of an automated hand hygiene monitoring system and additional promotional activities on hand hygiene performance rates and healthcare-associated infections(2019-07) Boyce, John M.; Laughman, Jennifer A.; Ader, Michael H.; Wagner, Pamela T.; Parker, Albert E.; Arbogast, James W.Objective: Determine the impact of an automated hand hygiene monitoring system (AHHMS) plus complementary strategies on hand hygiene performance rates and healthcare-associated infections (HAIs). Design: Retrospective, nonrandomized, observational, quasi-experimental study. Setting: Single, 93-bed nonprofit hospital. Methods: Hand hygiene compliance rates were estimated using direct observations. An AHHMS, installed on 4 nursing units in a sequential manner, determined hand hygiene performance rates, expressed as the number of hand hygiene events performed upon entering and exiting patient rooms divided by the number of room entries and exits. Additional strategies implemented to improve hand hygiene included goal setting, hospital leadership support, feeding AHHMS data back to healthcare personnel, and use of Toyota Kata performance improvement methods. HAIs were defined using National Healthcare Safety Network criteria. Results: Hand hygiene compliance rates generated by direct observation were substantially higher than performance rates generated by the AHHMS. Installation of the AHHMS without supplementary activities did not yield sustained improvement in hand hygiene performance rates. Implementing several supplementary strategies resulted in a statistically significant 85% increase in hand hygiene performance rates (P < .0001). The incidence density of non–Clostridioies difficile HAIs decreased by 56% (P = .0841), while C. difficile infections increased by 60% (P = .0533) driven by 2 of the 4 study units. Conclusion: Implementation of an AHHMS, when combined with several supplementary strategies as part of a multimodal program, resulted in significantly improved hand hygiene performance rates. Reductions in non–C. difficile HAIs occurred but were not statistically significant.Item Randomized controlled trial evaluating the antimicrobial efficacy of chlorhexidine gluconate and para-chloro-meta-xylenol handwash formulations in real-world doses(2019-06) Arbogast, James W.; Bowersock, Lisa B.; Parker, Albert E.; Macinga, D. R.Chlorhexidine gluconate-based soaps have become the gold standard for handwashing in critical care settings and para-chloro-meta-xylenol is an effective alternative antibacterial active ingredient. This study benchmarked 2 novel foaming handwashes, compared to a bland soap for antimicrobial effectiveness using the health care personnel handwash method at realistic soap doses (0.9 mL and 2.0 mL). To our knowledge, this is the first published efficacy study on realistic soap doses. Both soaps met Food and Drug Administration success criteria.Item Who goes in and out of patient rooms? An observational study of room entries and exits in the acute care setting(2019-05) Arbogast, James W.; Moore, Lori; Clark, Tracy; Thompson, MariaThe objective of this study is to determine what percentage of patient room entries and exits (opportunities) are attributed to health care personnel (HCP) and non-HCP. A total of 14,876 opportunities were observed by clinicians in 29 units of 16 hospitals. HCP accounted for 83.6%; 95% confidence interval, 81.3%-87.6%. This finding provides hospitals an initial baseline for HCP room traffic when implementing community-based automated hand hygiene monitoring and compliance improvement efforts.Item Who Goes in and Out of the Hospital Patient Room?(2017-06) Arbogast, James W.; Quinn, Jeff; Clark, Tracy; Moore, Lori; Thompson, Maria; Wagner, Pamela; Young, Elizabeth; Parker, Albert E.BACKGROUND: The objective of this study was to determine what percentage of entries and exits (E/E) in and out of the patient room should be attributed to healthcare workers (HCWs) in a wide variety of hospital units. This is a critical question for hospitals considering an automated monitoring system (AMS) to measure hand hygiene performance (HHP) as a complement to data from visual observation. HCWs often implicate others and do not perceive a need to change their HH behavior because they are convinced that visitors, patients, and others are responsible for very low HHP data. METHODS: Events (defined as patient room E/E) were observed and recorded by nurses not employed by the hospital. Observations were made in US and Canadian hospital units including emergency, ICU, medical surgical, oncology, and pediatrics. Observers classified events by: HCWs (e.g., nursing staff, aides, doctors, EVS, etc.), patients plus visitors, and other (e.g., clergy, hospice workers). Logistic regression was used to determine who was responsible for the most E/E events by category of individuals. RESULTS: Observers recorded a total of 14,876 E/E events in 29 units of 16 hospitals with units varying in size from 10 to 41 beds. 84.3% of all E/E were attributed to HCWs; 15.0% were from patients plus visitors and 0.7% from others. The odds are 6 to 1 that an E/E into a patient room is by a HCW (P < .0005). Pediatric units had the lowest percentage of HCWs E/E (76.7% total) CONCLUSIONS: This study demonstrates HCWs account for the greatest proportion of hospitalized patient room E/E. Further, the data show that others share a very small percentage of room E/E countering the argument that those individuals are responsible for the low unit HHP measured by AMS. This study demonstrates that other categories of individuals are not a deterrent to increasing unit-level HHP.Item The relative influences of product volume, delivery format and alcohol concentration on dry-time and efficacy of alcohol-based hand rubs(2014-09) Macinga, David R.; Shumaker, David; Werner, Heinz-Peter; Edmonds, Sarah; Leslie, Rachel; Parker, Albert E.; Arbogast, James W.Background Alcohol-based hand rubs (ABHR) range in alcohol concentration from 60-95% and are available in a variety of delivery formats, such as rinses, gels, and foams. Recent studies suggest that some ABHR foams dry too slowly, thereby encouraging the use of inadequate volumes. This study investigates the influence of product volume, delivery format, and alcohol concentration on dry-time and antimicrobial efficacy of ABHR foams, gels and rinses. Methods ABHR dry-times were measured using volunteers to determine the influences of product volume, delivery format, and alcohol concentration. ABHR efficacies were evaluated according to the European Standard for Hygienic Hand Disinfection (EN 1500) using 3-mL application volumes rubbed for 30 s, and additionally, using volumes of the products determined to rub dry in 30 s. Results Volumes of six ABHR determined to rub dry in 30 s ranged from 1.7 mL to 2.1 mL, and the rate of drying varied significantly between products. ABHR dry-times increased linearly with application volume and decreased linearly with increasing alcohol concentration, but were not significantly influenced by product format. An ABHR foam (70% EtOH), rinse (80% EtOH), and gel (90% EtOH) each met EN 1500 efficacy requirements when tested at a volume of 3 mL, but failed when tested at volumes that dried in 30 s. Conclusions Application volume is the primary driver of ABHR dry-time and efficacy, whereas delivery format does not significantly influence either. Although products with greater alcohol concentration dry more quickly, volumes required to meet EN 1500 can take longer than 30 s to dry, even when alcohol concentration is as high as 90%. Future studies are needed to better understand application volumes actually used by healthcare workers in practice, and to understand the clinical efficacy of ABHR at such volumes.