Blood Stream Infections

Healthcare mistakes can be costly (Kelly & Klim, 2013). One particular mistake that is a common source of costliness and wasteful spending on many levels is the improper collection of blood cultures. Blood culture collection is a necessity in the treatment of many conditions, including pneumonia, cellulitis, and other bacterial infections (). INSERT STUFF FROM PHONE HERE .Blood cultures provide a guide for diagnosing and treating a patient with sepsis (Kelly & Klim). Self et al. (2013) agrees that the unnecessary interventions from contaminated specimens prove to cost the hospital time, effort and thousands of dollars

Hospital acquired infections (HAI) will begin to display signs and symptoms within 48 hours. In order to treat the infections, physicians need to diagnostic tools quickly. The manufacturer of new diagnostic test makers, Kalorama Information stated last year that the world demand for testing and treatment of HAI will be over 10 billion dollars by the year 2015, increasing from 9 billion dollars in 2010. Kalorama also stated that HAI has a 5% infection rate of 40 million hospital visits a year, causing 100,000 deaths in the U.S. annually (Kalorama Information, July 14, 2011). Early diagnosis will improve the patient's outcome and decrease the chance of death. According to Kalorama, 20-30% of the HAI can be prevented by the simple use of better hand washing and cross contamination avoidance although the others need more intensive changes such as hospital ventilation systems and using more disposable supplies (Kalorama Information, p. 113) .

Blood culture (BC) contamination is a common, yet preventable problem for emergency departments (EDs) across the country (Self et al., 2014). Erlanger Hospital’s ED is no different and being the region’s only Level 1 Trauma Center, it is called to an excellent standard of practice. BC testing is a routinely applied intervention used to diagnose infections in symptomatic patients who arrive at the ED (Denno & Gannon, 2013). BCs are essential as they help identify accurate pathogens and provide targeted antibiotic therapy (Denno & Gannon, 2013). They are often viewed as the standard for diagnosing illnesses such as septicemia and other

Upper respiratory tract infections (URTI), including acute otitis media (AOM) are the most common cause of ambulatory physician visits and antimicrobial prescriptions in children1,2. The most common bacterial causes of URTI are Streptococcus pneumoniae and Haemophilus influenzae, though the majority of cases are caused by viral pathogens 3–10. Distinguishing between viral and bacterial URTI can be difficult. Reports on quality of antimicrobial prescriptions have shown a 30-50% of all out-patient prescriptions due to (upper) respiratory tract infections to be inappropriate2,10,11. In Europe the quality of prescription is higher in the north of the continent, including Iceland compared to in the south12. Conversely, many factors contribute to the overuse of antimicrobials2,13–15, which in turn results to increase in antimicrobial resistance16,17. Contributing factors cited by by physicians to cause over-prescription include uncertainty of diagnosis, fear of disease complications, lack of perception of harmful effects of antimicrobials, not perceiving their own prescription practices to be a problem, pressure by patients, limited time, fear of damaging doctor-patient relationship in addition to language, cultural and educational barriers2,13–15. Antimicrobials were long a mainstay treatment against AOM in fear of rare, but dangerous complications, which have later been found to be unfounded, asnd

The economic burden of central line infections is substantial. A recent research indicates that each case of CLABSI independently lengthens the hospitalization period from seven to twenty one days with increased cost of health per patient (O'Horo, Silva & Safdar, 2011). Given these economic and clinical challenges, policy-makers, health investigators, as well as regulatory agencies across the globe need to devote more time and synergy in curtailing the problems associated with infection of the central lines for the benefit of

While stewardship is extremely important to slow the rate of resistance, we must also make sure that patients in need of antimicrobial therapy receive the treatment they need. Price of medication and overly cautious prescribers are two of many barriers that patients may experience; as clinicians it’s important that we do our part to promote appropriate and affordable treatments. Ideally, prescribers could determine the exact pathogen using a swab or culture of the infected tissue. This would prevent misdiagnoses and reduce unnecessary costs to the

Sepsis is a life-threatening response to an infection and is the leading cause of death for hospitalized patients. It is estimated that 1.6 million hospitalized patients are treated for sepsis annually, with the approximate health care cost of $16.7 billion dollars. The mortality rate for sepsis is estimated to be as high as fifty percent. However, research evidence shows that early detection of sepsis can improve survival rates by twenty percent (Winterbottom, 2012, p. 247). In 2010, the Surviving Sepsis Campaign created evidence-based guidelines to improve outcomes for patients with early sepsis, and to create awareness and education for health care professionals regarding the impact of early detection (Levy et al., 2010). Recommendations for the early detection of sepsis include specific monitoring of lab work and vital signs, goal-directed therapy such as fluid replacement, and the early administration of the appropriate board-spectrum antibiotic’s.

Future studies should concentrate on introducing intravenous antibiotics to pre-hospital setting, which would dramatically decrease the time interval to administration of antibiotics. However, safety, efficacy and cost-effectiveness would need to be taken into account through conducting randomized controlled trials to find out the effect on reducing delay, infection and occurrence of adverse effects

Central venous catheters, usually called CVCs, are extremely important for patients in any type of intensive care unit. It is because of their crucial role in the care of these patients that their troublesome risk of catheter-related bloodstream infections, sometimes referred to as CR-BSIs, has developed into such a problem. There are approximately 80,000 CR-BSIs diagnosed each year in the United States alone. These infections lead to nearly 28,000 patient deaths in intensive care units. Not only is this a dreadful loss of life; it is also incredibly expensive. Extra care and treatment for a patient suffering from a CR-BSI can cost an average of $45,000. In fact, these infections can cost as much as $2.3 billion for the United States each

Bloodstream infections are a common outcome of patients with a central line and are known to be a cause of mortality in hospitals. There are a multitude of risk factors that can contribute to a central line-associated bloodstream infection (CLABSI). This can include, but are not limited to, intrinsic factors that are not controllable by healthcare team members, such as a patient’s age, underlying diseases or conditions, and patients’ gender. There are also extrinsic factors that are within the control of healthcare members, such as prolonged hospitalization before for central line insertion, nutrition, location of site, multilumen lines, deficiency of sterile barriers for central line insertion and effective cleaning of ports (The Joint Commission,

Central lines are a one of the major risk factors for infections in the bloodstream and many occur outside of the intensive care units (Medina, Serratt, Pelter, & Brancamp, 2014). An increase in the amount of patients who are admitted to the hospital with central lines has increased the amounts of central line infections. Reducing the amount of central line infections on a general Medical-Surgical unit with in a facility is very important for both patients and healthcare facilities.

The incidence and mortality associated with Candida bloodstream infection (CBSI) have increased over the past two decades, despite the introduction of several extended-spectrum triazole and echinocandin antifungal agents for prophylaxis, empiric and targeted therapy [1],[2]. Likewise, CBSI has emerged as an important public health problem with one the highest costs of any healthcare-associated infections. Candida has been described as the fourth most common cause of healthcare-associated BSI surpassed only by coagulase-negative staphylococci, Staphylococcus aureus and Enterococcus [3], [4]. CBSI has the highest pathogen related mortality [4] because the signs and symptoms of disease are non-specific. Moreover, the general indications for ordering a blood culture are fever and leukocytosis, which are absent in around 20% and 50% of patients with CBSI, respectively [5]. Early identification of CBSI is critical and still depends on blood cultures, despite the fact that is an insensitive technique [3] and that prophylactic or empiric antifungals may render false negative results. (???)

Sepsis continues to be a major cause of death and morbidity in the intensive care unit (ICU), with documented mortality rates as high as 50% (Nargis, Ibrahim, & Ahamed, 2014). It is also estimated to be the principal cause of death and illness worldwide (Singer et al., 2016). Moreover, the socioeconomic costs related to sepsis were determined to be more than $20 billion in 2011 in the United States (Balk et al., 2017). Also, there has been a steady increase in the incidences of sepsis as the technological advances in medicine allow for more invasive procedures, the growth of multi-drug resistant organisms, and an aging demographic (Nargis, Ibrahim, & Ahamed, 2014). Therefore, timely diagnosis and treatment of sepsis is paramount. Even a one-hour delay in treatment has been associated with increased mortality rates of 5%-10% (Mehanic & Baljic, 2013; Sawaya, Chedid, & Majzoub, 2017). Isolation of microbiological cultures have traditionally been held as a definitive diagnosis of sepsis. However, result times for these cultures are typically 48-72h and may

In a single drop of blood, there is about 7,000 - 25,000 white blood cells. The white blood cell works for the immune system. The white blood cell is small and it is shaped like an oval to move quickly around the body and to not get stuck. The main function of the white blood cell is to kill any pathogen that tries to harm the human body system. When a group of cancer called leukemia attacks the bone marrow, it cause the bone marrow to produce abnormal white blood cells that do not function properly.

Infections will occur if pathogens enter the urinary tract, and catheter-associated urinary tract infection will appear in patient’s body in most case. Germs are usually enter the urinary tract when the catheter is inserted or while the catheter stays in the patient’s bladder (Centers for Disease Control and Prevention, 2015).