Time to Eliminate Dangerous Injection Practices by Clinicians : Health in 30

By Barbara Ficarra, RN, BSN, MPA

Thanks to Laura Landro for shining light on unsafe injections in her WSJ blog, “Unsafe Injection Practices Persist Despite Education Efforts.”

Landro writes:

“A new push is underway to eliminate unsafe injection practices, which remain a persistent safety problem despite years of efforts to educate clinicians about the risks of re-using needles, syringes and drug vials.

In the U.S., failure to follow safe practices in delivering intravenous medications and injections has resulted in more than 30 outbreaks of infectious disease including hepatitis C, and the notification of more than 125,000 patients about potential exposure just in the last decade, according to health-care purchasing alliance Premier Inc.”

As a registered nurse this is unthinkable.  Learning to administer injections safely is “patient care 101.”  There is no excuse for any health care professional to unsafely inject patients.

via healthin30.com

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Multidrug-Resistant Staphylococcus aureus in US Meat and Poultry

Abstract

We characterized the prevalence, antibiotic susceptibility profiles, and genotypes of Staphylococcus aureus among US meat and poultry samples (n = 136). S. aureus contaminated 47% of samples, and multidrug resistance was common among isolates (52%). S. aureus genotypes and resistance profiles differed significantly among sample types, suggesting food animal–specific contamination.

Antimicrobials are used extensively in food animal production, where they are often applied subtherapeutically for growth promotion and routine disease prevention [1]. Surveys conducted by the National Antimicrobial Resistance Monitoring System (NARMS) indicate that retail meat and poultry products are frequently contaminated with multidrug-resistant Campylobacter species, Salmonella species, Enterococcus species, and Escherichia coli [2]; but little is known about the prevalence of other antibiotic-resistant pathogens in the US food supply.

via cid.oxfordjournals.org

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MRSA Protocols- Are They Being Used In Practice? | Registered Nurse Blog

Posted: April 2nd, 2011

In Advance For NPs and PAs, a March 9, 2011 article was featured on the following study of protocols used by health care providers to treat MRSA infections. I was surprised to see that some providers were still using Keflex to treat these infections. Some providers still were not sending cultures on these infections. How can we adequately treat an infection without knowing what will actually kill the bacteria? My impression of the following information is that the protocol that I do is somehow a new treatment regimen. I have been doing incision and drainage with appropriate culturing with first line Septra for the last 3 plus years. I also use mupricion ointment to nares twice daily and Hibaclens during the regimen if they have had more than one outbreak within a 6 month period.

Taking Aim at MRSA
Protocol use by an NP-PA team
Anita D. Barnes is a family nurse practitioner who is an assistant professor of nursing at Stephen F. Austin State University in Nacogdoches, Texas.
A 2009 study reported a variety of approaches used by ED physicians to treat CA-MRSA SSTIs.6 The study surveyed 225 ED physicians nationwide: 56% reported always sending cultures for testing and 19% said they never did so. The physicians prescribed trimethoprim-sulfamethoxazole (TMP-SMX) 60% of the time, either alone or in combination with another antibiotic. Nineteen percent treated patients with cephalexin alone, and 13% prescribed cephalexin in combination with another antibiotic. Cephalexin is not recommended in the CDC protocol.

What are you doing as providers to treat MRSA infections? Do you find the information alarming that some providers are still not culturing infections?

via registerednurseblog.com

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Education Resources, Association for Professionals in Infection Control and Epidemiology, Inc APIC |

APIC works to provide information to both the general public and healthcare professionals. The brochures on this page are regularly reviewed and updated as needed to insure that the information provided is current. These materials are available for you to download, copy and distribute free of charge.  These pamphlets are intended to provide a general reference to each topic. No brochure can adequately diagnose a medical condition. If in doubt regarding your symptoms, please contact a healthcare professional.

10 tips for preventing the spread of infection Los Hechos Sobre Chlamydia Antibiotic Safety Meningococcal Meningitis Chlamydia Mold in Your Home Companion Animals and Your Health Patient Safety - Protecting Yourself from Medical Errors

via apic.org

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Central line-associated bloodstream infections (CLABSIs) Portal | Home Content

As a healthcare professional, you recognize the importance of preventing healthcare-associated infections (HAIs) and keeping your patients safe. Yet, even with advances in modern-day medicine, HAIs persist. Central line-associated bloodstream infections (CLABSIs) have the highest patient mortality and the highest financial cost of any HAIs.

The good news: Scientific evidence demonstrates — time and again — that CLABSIs are preventable!
 
Why are CLABSIs so prevalent and how can they be prevented?

This “I Believe in Zero CLABSIs” website was created to be a comprehensive, multidisciplinary resource to discuss and answer questions about CLABSIs while providing resources and answers.

Here you will find information on the root causes of CLABSIs and the tools you need to address this devastating — and preventable — problem.

  Throughout this website, you will find tools, resources, case studies, and personal stories of success to prepare you — and inspire you — to help all healthcare institutions achieve ZERO CLABSIs.

These credible, proven strategies have been shared by the most renowned experts in the field. They are led by Dr. Peter Pronovost and represent a broad spectrum of clinical experts.

We not only believe in Zero CLABSIs — we know it is possible, and these tools and resources will show you how.

via clabsi.apic.org

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Impact of a statewide intensive care unit quality improvement initiative on hospital mortality and length of stay: retrospective comparative analysis -- Lipitz-Snyderman et al. 342 -- bmj.com

The US Institute of Medicine highlighted the serious problem of patient safety and importance of evidence based quality improvement initiatives to reduce adverse events.1 Evidence that quality improvement initiatives intended to reduce adverse events result in a measurable impact on other important outcomes, such as mortality and length of hospital stay, is limited. Without this evidence, hospitals and healthcare payers face uncertainty about whether investment in any specific quality improvement intervention will significantly benefit patients and represent a good use of limited financial resources.

The Michigan Health and Hospital Association Keystone ICU (intensive care unit) project, developed by researchers at Johns Hopkins and undertaken by the Michigan Health and Hospital Association, about 80 of its member hospitals, and researchers at Johns Hopkins Medical Institutions, is a recent example of a successful, large scale quality improvement initiative.2 3 4 The project adopted a comprehensive approach to improving patient safety that included promoting a culture of safety, improving communication between providers, and implementing evidence based practices to reduce rates of catheter related bloodstream infections and ventilator associated pneumonia. Evidence based interventions for preventing catheter related bloodstream infections were promoting handwashing, full barrier precautions, skin antisepsis with chlorhexidine, avoiding the femoral site during catheter insertion, and removing unnecessary catheters. Interventions to prevent ventilator associated pneumonia included a mechanical ventilator “bundle” consisting of use of semirecumbent positioning, daily interruption of sedation infusions, and prophylaxis for peptic ulcer disease and deep venous thrombosis.5 The project showed that measures of culture and infection rates in the intensive care unit were substantially improved for up to 36 months after implementing the quality improvement measures.2 4 5 6

via bmj.com

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