Categories: Hemodialysis
August 21st, 2012 5:44 am ET -
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Priti R. Patel, MD, MPH
Author: Priti Patel, MD MPH
Medical Officer
CDC’s Division of Healthcare Quality Promotion
While undergoing dialysis, patients have a lot on their minds. The last thing they need to worry about is getting a bloodstream infection in the process.
In the United States, more than 370,000 people receive long-term hemodialysis. Infection is a leading cause of illness and is the second leading cause of death in these patients. Bloodstream infections are one of the most serious types of infections dialysis patients can get. Since 1993, there has been a 40 percent increase in the rates of hospitalizations for bloodstream infection among hemodialysis patients, underscoring the importance of protecting this population.
In 2009, CDC established the CDC Dialysis Bloodstream Infection Prevention Collaborative, a partnership of freestanding and hospital-based outpatient dialysis facilities from across the country. These early adopters have seen great success in preventing bloodstream infections among their patients. Collaborative participants have demonstrated a 31 percent decrease in bloodstream infections and a 53 percent decrease in access-related bloodstream infections when CDC prevention guidelines are implemented.
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Categories: Hemodialysis
August 15th, 2012 12:53 pm ET -
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Staff volunteers demonstrate the use of scrub-the-hub protocol checklist
Guest Author – Gemma Downham, MPH
Infection Prevention Epidemiologist,
AtlantiCare Regional Medical Center
We have all heard about the heroic feat of
Captain “Sully” Sullenberger when he performed
an emergency landing of a passenger jet on the Hudson River in 2009. It was amazing that no
lives were lost during that potentially disastrous situation. Checklists, which have been used for decades in the airline industry, were said to have helped Captain Sully and his co-pilot run through tasks to attempt to restart the engines—and when all else failed, perform an emergency landing.
Dr. Atul Gawande, professor of surgery at Harvard Medical School and bestselling author, has advocated in his book, The Checklist Manifesto, for the use of checklists in medicine to improve patient outcomes in surgery, prevent infections, etc., by reducing the potential for human error. So, when one of the nurses in our dialysis unit asked for a checklist for putting catheterized patients on and off the dialysis machines, I was both delighted (and overwhelmed.) Where to start?
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Categories: Healthcare-associated infections
August 13th, 2012 12:08 pm ET -
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Ann Marie Pettis, RN, BSN, CIC
Guest Author – Ann Marie Pettis, RN, BSN, CIC
Director of Infection Prevention, University of Rochester Medical Center,
Rochester, New York
Chair, APIC Communications Committee
I always wanted to be a nurse. You could say it was in my DNA because my grandmother and grandfather were both registered nurses, and my father was a navy corpsman in World War II. Being an “infection prevention nurse,” however, was not even on my radar. In fact, microbiology was one of my least favorite courses in nursing school, and I had no particular interest in germs.
Early in my nursing career, as a result of several Staph aureus outbreaks in the newborn nursery, I developed a close working relationship with the infection preventionist (IP) assigned to our unit. That relationship led to my recruitment to fill a vacancy in the infection control department. Ready for a change, and flattered by the IP’s confidence in me, I made the decision to “give it a try.”
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Categories: Healthcare-associated infections
August 1st, 2012 12:00 pm ET -
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Jeannie P. Cimiotti, DNSc, RN
Author – Jeannie P. Cimiotti, DNSc, RN
Executive Director, NJ Collaborating Center for Nursing;
Associate Professor, Rutgers University College of Nursing
Job-related burnout has been well-documented among individuals who provide care to others. The etiology of burnout points to chronic stress that results not only from the close interaction with people, but with the organizational climate in which people work. One organizational area that has been extensively identified as a contributing factor to this complex syndrome is workload.
Historically, nurses provide care under less than desirable circumstances. Often overworked and under appreciated, nurses are the only professionals who are in constant contact with patients, and they deal with life and death issues on a daily basis. It’s not surprising then that our survey of nurses in Pennsylvania showed that more than a third reported high levels of emotional exhaustion, a key component of burnout syndrome. We must ask ourselves, what happens when nurses suffer from high emotional exhaustion? It’s simple – they begin to feel like they lack control. Then, they psychologically and cognitively detach from the care environment. The result is less than optimal nursing care.
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Categories: Healthcare-associated infections, Injection Safety, Outpatient Care
July 16th, 2012 11:35 am ET -
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Michael Bell, MD
Author: Michael Bell, MD,
Associate Director for Infection Control at CDC′s Division of Healthcare Quality Promotion.
CDC released a report today detailing two outbreaks that occurred when healthcare providers failed to follow basic injection safety elements of Standard Precautions. These breaches resulted in life-threatening – yet completely preventable – infections in a number of patients receiving injections for pain relief. How does this happen in today’s advanced medical settings?
In both outbreaks, healthcare providers were splitting single-dose/single-use medication vials meant for one patient into new doses for multiple patients. There was a lack of awareness that this practice puts patients at risk of infection. Because injections were prepared with new needles and syringes and, in one of the clinics, in a separate “clean” medication preparation room, providers thought they were being safe. However, these preservative-free medications are not safe for multi-patient use. Ultimately, ten patients in these two clinics required hospitalization for treatment of mediastinitis, bacterial meningitis, epidural abscess, septic arthritis, bursitis, and sepsis – all severe infections caused by either Staphylococcus aureus (Staph) or its drug-resistant form MRSA.
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