Multi-Drug-Resistant Organisms and Contact Precautions

When MRSA was new on the scene, strict isolation precautions were the norm.

Photo by Rick Sforza, Redlands Daily Facts / SCNG.

Years ago, when we first started to see patients with methicillin-resistant Staphylococcus aureus (MRSA) infections at the hospital where I worked, we kept them in what was then called “strict isolation.” These patients were kept on one unit and cohorted in two rooms at the end of the hall. Staff wore gowns, gloves, masks, and hair covering. How we hated having to put on all that gear!

The current challenge of MDROs.

Today, we understand more about transmission, and isolation precautions are better tailored to the epidemiology of each drug-resistant organism. Unfortunately, though, since that time antibiotic resistance has rapidly increased, and we now find ourselves not only with a lot more MRSA to contend with, but with patients whose infections are susceptible to only one or two antibiotics (and occasionally, to none).

Some of these multi-drug-resistant organisms (MDROs) seem to be persistent colonizers—that is, the organism “takes up residence” on or in the body without causing infection, and can still be transmitted to others. In some cases these patients will need to be on isolation precautions every time they are admitted […]

2018-08-06T09:07:11-04:00August 6th, 2018|infection control, Nursing, Public health|0 Comments
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NPs ‘Move Mountains’

Rear Admiral Susan Orsega, chief nurse officer of U.S. Public Health Service

Last week I attended the annual conference of the American Association of Nurse Practitioners (AANP) in Denver. Yes, I was there for the record attendance (over 5,000) and the record heat wave (104 degrees). As with most large nursing conferences, there were numerous concurrent sessions—but here, many of them were like skills labs, including things not part of most RNs’ skill set, like performing a thoracentesis.

What was also different from other meetings was that the legislative and policy sessions, which were of high interest to me in order to find out how NPs are doing with scope of practice authority, were closed to media. No one could say exactly why.

Audio interview with U.S Public Health Service CNO Susan Orsega.

I did get a chance to speak with the keynote speaker, Rear Admiral (RADM) Susan Orsega, MSN, FNP-BC, FAANP, FAAN, chief nurse officer and assistant surgeon general of the U.S. Public Health Service. She focused on the critical role of NPs in addressing health inequities. She urged NPs to become active advocates to improve health, and, mindful of our Colorado setting, she charged them to “Go, move mountains.” You can listen […]

2018-07-06T08:27:26-04:00July 6th, 2018|Conference reports, Nursing, nursing perspective, Public health|0 Comments
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Separating Children from Parents as Policy? Really?

Photo by Will Hedington via Wikimedia Commons

We’ve all seen the images of the migrant children who have been separated from their parents at the border and are living in pens in detention centers. We’ve read reports of their distraught parents, and of various government officials being turned away from the detention facilities. We’ve heard heart-wrenching audio of children sobbing for their parents, and of one young girl reciting a carefully memorized phone number and pleading to make a call to her aunt. And we’ve heard the stories of parents who have been deported without knowing where their children are being held or when they might see them again.

As a nurse, I worry about the acute and long-term health effects that this horrific experience will have on both parents and children.

As a mother, I cannot think about what these parents must be feeling without a knot forming in my stomach and my eyes tearing up—it’s a parent’s worst nightmare.

As a rational person, I cannot understand how any politician could think such actions would make for good policy.

As a citizen, I am grieved to see this unprecedented level of callousness, lack of empathy, and disregard for basic human decency from our government leaders. I’m ashamed that so […]

2018-06-28T10:04:01-04:00June 25th, 2018|Public health|11 Comments
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Smoking Still Kills…in So Many Ways

Seven million tobacco deaths per year.

Today, May 31, is World No Tobacco Day, declared by the World Health Organization (WHO) to bring attention to the health problems caused by smoking. According to the WHO fact sheet on tobacco,

“Tobacco kills more than 7 million people each year. More than 6 million of those deaths are the result of direct tobacco use while around 890,000 are the result of non-smokers being exposed to second-hand smoke.”

When nurses smoked at the nurses’ station.

It’s amazing to me how far we’ve come in a relatively short time in curbing smoking. When I first started working in hospitals, nurses would be smoking at the nurses’ station; shift report was often in a smoke-filled room; patients and visitors were allowed to smoke as long as there was no oxygen tank in the room. And I always hated sitting in the airline seat that was the dividing row from the smoking section—as if a small sign on the seat made a difference in keeping the smoke at bay!

Some resources.

This year, the focus is on smoking as a leading cause of cardiovascular disease—second only to hypertension. Here are some articles from AJN, plus resources that provide information about the mulitple negative health effects of tobacco […]

2018-05-31T12:27:31-04:00May 31st, 2018|personal health practices, Public health|1 Comment
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Earth Day 2018: Making the Connection Between Environmental and Human Health

Trafalgar Square during the Great London Smog of 1952. Photo © TopFoto / The Image Works.

This Sunday is Earth Day, an annual event started by a bipartisan group of citizens and congressional representatives in 1970 to highlight the need for a healthier environment and the importance of legislative protections.

Along the mighty Hudson—beautiful, but still contaminated

Growing up just north of New York City, along one of the most beautiful but contaminated sections of the Hudson River, I’ve seen up close the effects of industrial pollution before environmental protections were put in place. In addition to producing electrical wire, cables, munitions, and other products, the factories that lined my town’s waterfront for much of the 20th century were also responsible for extensively contaminating the surrounding area with polychlorinated biphenyls (PCBs) and petroleum hydrocarbons.

For many decades, the environmental damage caused by such industry was accepted as the price of progress. Raw sewage and oil slicks in the waters of the Hudson were not unusual sights, and relatives tell stories of a popular spot along the river, from which swimmers in the 1960s would emerge covered in the dye produced—and dumped—by a nearby riverfront factory. Most […]

2018-04-21T08:49:06-04:00April 21st, 2018|environmental health, Nursing, Public health|0 Comments
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