Infections in Acute Care: Still More to Do

A sharply increased focus on hospital-acquired infections (HAIs).

This month marks the 14th anniversary of the National Healthcare Safety Network (NHSN), the CDC’s data repository for health care–associated infections. Since 2005, when a limited number of hospitals began reporting infections data, the health care community has sharply increased its focus on the prevention, early recognition, and treatment of infections in the hospital. Research on risk factors, closer attention to limiting device use (urinary catheters, central lines), and support for meticulous hand hygiene and environmental cleaning protocols have decreased rates of CAUTIs, CLABSIs, and surgical site infections.

The risk is always there.

Still, as nurses well know, hospitalized patients remain at increased risk for developing infections, especially if they are immunosuppressed or have diabetes, need invasive devices, have many comorbidities, or stay in a critical care unit.

The current evidence reviewed.

In “Infection in Acute Care: Evidence for Practice” in this month’s AJN, Douglas Houghton reviews the latest evidence on common infections in acute care settings, including community- and hospital-acquired pneumonia, surgical site infections, and C. difficile. […]

2019-10-09T10:09:54-04:00October 9th, 2019|infection control, Nursing|1 Comment
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Much Ado About a Fist Bump Study

hands touching illustrates post about fist bump study and germsBy Karen Roush, clinical managing editor

In this world of evidence-based care, is there anything to be said for common sense? Last week a study was published in the American Journal of Infection Control that found that a fist bump transmitted fewer organisms than a handshake.

Really? We know that hands carry untold numbers of organisms. We know that skin-to-skin contact transmits organisms. We know that duration of contact plays a role in how many organisms are transmitted. Did we need a study to tell us that hand-to-hand contact with less surface area for a shorter duration of time would transmit fewer organisms?

With the attention being paid to this study, you might think it was a major discovery. Why? Because it’s fun to talk about fist bumps versus handshakes? (David Letterman seems to think so; he recently opened his monologue with a joke about the study results.) Because we kind of like the visual of everyone, from the staid to the cool, walking around giving fist bumps?

Or perhaps, on a serious note, because we’re still struggling unsuccessfully to get people to simply wash their hands and are ready to jump on anything that mitigates the risk of transmission when they don’t? (Adherence to hand hygiene guidelines among health care workers remains low. Read our March 2013 CE–Original Research feature, in which authors […]

2016-11-21T13:04:12-05:00August 4th, 2014|Nursing, nursing perspective|1 Comment
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Hand Washing: What’s It Going to Take to Get the Job Done?

Handwashing Handwashing (Photo credit: kokopinto)

By Shawn Kennedy, AJN editor-in-chief

I took a few days off last week and caught up on some reading. Perhaps the article that struck me most was one from the New York Times on the various methods that many hospitals are using to improve rates of hand washing among nurses, physicians, and other direct care providers. Hospitals are trying everything from buttons that offer gentle reminders to camera monitors to mandating that direct caregivers wear electronic sensors that indicate whether or not they washed their hands.

Perhaps the most disturbing part of the article was the remarks made by Elaine Larson, a nursing professor at Columbia University School of Nursing who had done extensive research on hand washing. She spoke of how some health professionals go out of their way to avoid washing their hands, even ducking under scanners.

A 2009 report from the Centers for Disease Control and Prevention estimated that HAIs (hospital-acquired infections), cost U.S. hospitals between $28.4 to $33.8 billion annually in direct medical costs. Just think about what could be done with that money.

I don’t get it. We all know the importance of hand washing. From Ignaz Semmelweis, who introduced hand washing in obstetrical clinics in 1847 and as a result reduced puerpal fever, to Florence Nightingale, whose insistence on good hygiene and basic cleanliness helped to reduce death rates during the Crimean War, to the extensive body of research conducted by […]

2016-11-21T13:07:04-05:00July 10th, 2013|nursing research|7 Comments
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Nurses Doing Primary Care, Hospital-Acquired Infections, Questionable Celebrity Advice, and Tort Reform

With a looming shortage of primary care doctors, 28 states are considering expanding the authority of nurse practitioners. These nurses with advanced degrees want the right to practice without a doctor’s watchful eye and to prescribe narcotics. And if they hold a doctorate, they want to be called “Doctor.”

That’s the start of an MSNBC story called “Doc Deficit? Nurses Role May Grow in 28 States.” Much of the article is about nurse practitioners (NPs)–and the different ways they are (or are not) allowed to practice in different states, as well as the ongoing efforts of physician groups to limit their practice (even as the health care overhaul increases the demand for primary care physicians and invests in nurse-managed clinics). We’ve posted on scope of practice issues here more than once—what’s your take as nurses, or patients?

HAIs persist. Also today, as described from a number of perspectives in a collection of articles on Kaiser Health News, the Department of Health and Human Services (HHS) released a report stating that the rate of hospital-acquired infections did not improve in 2009, despite ongoing attention to this issue in studies, IHI initiatives, nursing journals, and nearly everywhere else. What gives?

Does getting sick make you an expert? Elsewhere, at Covering Health (the blog of the Association of Health Care Journalists), Andrew Van Dam is critical of tennis star Martina Navratilova’s public advocacy for yearly mammograms for women over 40.

In February, Martina […]

2016-11-21T13:18:11-05:00April 14th, 2010|health care policy|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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