On the weekend of May 27th, a strong odor was noted to be coming from the basement IV laboratory anteroom. After detecting liquid on the floor near the IV Room door on Sunday, May 28, pharmacy associates alerted plant engineering and Eric Warren. Infection Prevention was then paged through the hospital switchboard. It was determined after discussion with Reta Gibbons (IP) that the basement IV room was safe to use as there most likely was a leak coming from the sink in the Anteroom and the water supply to that sink was interrupted. On Tuesday May 30th, Plant Engineering assessed the leak following their Leak Response Procedure (Appendix A) and determined the wall in the anteroom needed to be opened up. It was also determined at that time
According to the Centers for Disease Control and Prevention [CDC] (2017), “Urinary tract infections (UTIs) are the fourth most common type of healthcare-associated infection, with an estimated 93,300 UTIs in acute care hospitals in 2011. UTIs additionally account for more than 12% of infections reported by acute care hospitals. Virtually all healthcare-associated UTIs are caused by instrumentation of the urinary tract” (p. 7-1).
1) Summary of Article: Indwelling catheter use is common, but so are infections associated with them. About 80 percent of all urinary tract infections in hospitals are caused by catheters, and about 20 percent of all hospital infections total are UTIs. Evidence-based practice should be used for insertion, maintenance, and removal. Catheters should not be left in longer than they need to be. Unfortunately, this research shows poor administrative efforts are to blame for
During the transitioning process to the new hemodialysis unit, Ms. Conlon anticipated the challenges acquired by learning to set up and use new water equipment in an acute situation. In response to this, Ms. Conlon created and implemented a reverse osmosis flow sheet to assist her colleagues with the quick set-up of the portable RO in the ICU care setting. This tool resulted in a smoother transition for her colleagues, improvement in the delivery of care to the acute dialysis patient, and a decrease in the possibility of staffing overtime.
Urinary tract infections are one of the most hospital-acquired infections in the country. With so much technology and evidence based practice, why is this still an ongoing problem worldwide? Could it simply be the basics of hygiene or just patient negligence? The purpose of this paper is to identify multiple studies that have been done to reduce or prevent hospital associated urinary tract infections. In these articles you will find the use of different interventions that will aid in lowering the risk of these hospital acquired infections.
National Patient Safety Goals (NPSGs), established in 2002 by the Joint Commission, is to help accredited organizations address specific areas of concern in regard to patient safety ("Catheter-Associated," 2015). NPSG.07.06.01 Implement evidence-based practices to prevent indwelling catheter-associated urinary tract infections (CAUTI) is a 2015 NPSG ("The Joint Commission," 2015). Our facility has 1.32 CAUTIs per 1000 device days (Carson, 2015). Decreasing CAUTIs can be achieved with a strict goal, addressing the financial implications, interdisciplinary collaboration, nursing leadership, a measurement tool, and discussing the future healthcare delivery methods.
* Aprons used for patients who have transmissible infection, or have been contaminated with blood or body fluids, should be discarded immediately into a yellow clinical waste bag.
On my first day on the ward it was decided that I should shadow one of the staff nurses to acustomise myself with the ward. During this induction we had to assist an elderly gentleman with sever diarrhoea the gentleman in question was quit large and almost completely immobile. On inspection of the
What should the nurse suspect when hourly assessment of urine output on a postcraniotomy patient exhibits a urine output from a catheter of 1,500 mL for 2 consecutive hours?
1. Place a small amount of wax from a birthday candle into a test tube. Heat gently over a burner flame until the wax melts completely; then allow
Until recently it was not uncommon for patients admitted to an acute care facility to have an indwelling catheter anchored for unnecessary reasons. Patients that came in thru the emergency department typically were sent to the units with unnecessary indwelling catheters in place and it was not unusual for a surgery patient to have an indwelling catheter anchored before or during a procedure. Once a patient was admitted and was transported to the units nursing would also anchor indwelling catheters for multiple unnecessary reasons. These Catheters could be
a) Tap and drag over the area of the graph where the resting heart rate is displayed to select the data.
On the early morning of August 17, 2002, James C., a patient in one of the wards under the supervision of Ellen Hughes Finnerty, RN, went into respiratory depression. Between 3:00 and 4:00 a.m., Ann Mugi, the patient’s primary nurse, sought the assistance of a respiratory therapist, Hiran Obeyesekere, to help her care for the patient. As Obeyesekere suctioned the patient airway, Mugi called the service of the patient’s primary care physician, Dr. Jackson, to report the changes in the patient’s respiratory status, e.g., respiratory rate of 40 breaths per minute and low urine output.
The patient is a 45 year old man who had GI surgery 4 days ago. He is NPO, has a nasogastric tube, and IV fluids of D51/2saline at 100 mL/hr. The nursing physical assessment includes the following: alert and oriented; fine crackles; capillary refill within normal limits; moving all extremities, complaining of abdominal pain, muscle aches, and "cottony" mouth; dry mucous membranes, bowel sounds hypoactive, last BM four days ago; skin turgor is poor; 200 mL of dark green substance has drained from NG tube in last 3 hours. Voiding dark amber urine without difficulty. Intake for last 24 hours is 2500mL. Output is 2000mL including urine and NG drainage. Febrile and diaphoretic; BP 130/80; pulse 88; urine specific gravity 1.035; serum
The Quality Improvement nursing process that I have chosen to research is patient safety. I have chosen to focus specifically on the topic of catheter associated urinary tract infections (CAUTI’s) during hospitalization and their preventions. It is estimated that 15-25% of hospitalized patients receive a urinary catheter throughout their stay, whether or not they need it. A large 80% of all patients diagnosed with a urinary tract infection (UTI) can be attributed to a catheter (Bernard, Hunter, and Moore, 2012). The bacteria may gain entry into the bladder during insertion of the catheter, during manipulation of the catheter or drainage system, around the catheter, and after removal.
The Material Flow Committee (MFC) knew that there were many problems associated with this process and that they had to change. The people involved in this group were Sridhar Seshardi, who was the vice president of Process Excellence; Nick Gaich, who was the vice president for Materials Management; Candace Reed, who was the director of the Sterile Processing Department (SPD); and Joan Rickley, who was the director of the OR. The first step that was taken by this committee was a pilot project called the “Early Morning Instrument Prep.” This development would involve a neurosurgery nurse coming to the hospital in the early mornings to make sure that all supplies and instruments were where they would be required for neurosurgery. Another aspect of this project was to “Provide early data into possible sources of problems” (p. 5). Once the MFC had reviewed the data that came back from the “Early Morning Instrument Prep,” they decided the Hospital would greatly benefit from hiring an Implementation Specialist for Healthcare (ISH). The ISH is a firm that has a specialization in