Health Technology Hazards, 2016: Inadequate Disinfection of Flexible Endoscopes Tops ECRI List

hazard/jasleen kaur, via Flickr hazard/jasleen kaur, via Flickr

The ECRI Institute has released its Top 10 Health Technology Hazards for 2016 report, highlighting health technology hazards for health care facilities and nurses to focus on this year.

Although alarm hazards, which topped the list for the past four years, still pose a significant threat, topping the list at number two, a different repeat offender has claimed the number one spot: inadequate cleaning of flexible endoscopes before disinfection.

Proper reprocessing and cleaning of biologic debris and other foreign material from instruments before sterilization is key, according to the report. And flexible endoscopes, especially duodenoscopes, are difficult to clean because of their long, narrow channels. Failure to clean properly can result in the spread of pathogens. The report points to a series of fatal carbapenem-resistant Enterobacteriaceae infections in the last two years to illustrate this particular threat, and recommends that facilities emphasize to their reprocessing staff that inattention to proper cleaning steps can lead to deadly infections.

Some hazards, such as those arising from health information technology (HIT) issues, insufficient training of clinicians in operating room technologies, and failure to appropriately operate intensive care ventilators, have been touched on in previous years. (See our past posts on ECRI top 10 health technology hazards from 2013, 2014, and […]

2016-11-21T13:01:33-05:00January 14th, 2016|Nursing|3 Comments
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‘I’m Worried About People in Pain’: A Nurse’s Take on Opioid-Prescribing Regulation Changes

by frankieleon/ via flickr by frankieleon/ via flickr

Many patients and clinicians have strong feelings about opioids: they’ve seen a loved one denied adequate pain control, or they’ve seen a family member or friend’s son or daughter lost to prescription pill and/or heroin addiction, or they’ve worked in an ED with too many drug-seeking patients, or they’ve seen a patient in terrible pain waiting for a new analgesic order from an unavailable or uncompassionate physician.

But feelings don’t solve complex problems, and an excessively punitive or permissive approach can do more damage than good. Recently, there have been almost daily headlines and policy recommendations about the importance of restricting opioid-prescribing practices. The trend is alarming a number of clinicians with expertise in working with patients in pain. Clinical nurse specialist and pain management consultant Carol Curtiss addresses what’s at stake in “I’m Worried About People in Pain,” the Viewpoint essay in the January issue of AJN:

According to a 2011 Institute of Medicine report, chronic pain is a public health crisis . . . Well-intended efforts to address prescription drug abuse—another public health crisis—may place heavy burdens on people with pain who benefit from opioids and use them responsibly as part of a comprehensive treatment plan. . . . Gains made in pain treatment are at risk. New regulations threaten access […]

2016-11-21T13:01:34-05:00January 12th, 2016|Ethics, nursing perspective, pain management, patient experience, Patients|3 Comments
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A Nursing Perspective on a Recent NEJM Palliative Care Article

Pam MolloyBy Pam Malloy, RN, MN, FPCN, director and co-investigator of the ELNEC Project, American Association of Colleges of Nursing (AACN), Washington, DC.

I just read a New England Journal of Medicine article by Drs. Craig D. Blinderman and the late J. Andrew Billings that came out on Christmas Eve, 2015. “Comfort Care for Patients Dying in the Hospital” was a thoughtful, informative article and I am grateful that it appeared in a journal that wasn’t focused solely on hospice/palliative care.

2016_ELNECLogoWhile the information in the article is essential for all health care professionals, I would like to take this opportunity to remind my nursing colleagues that we have a tremendous opportunity and privilege to plan, provide, and orchestrate the care that was described in this article—and we have been doing so for some time.

Nurses spend more time at the bedside and out in the community assessing and managing patients with serious, complex illness than any other health care professional. Our interdisciplinary colleagues depend on our assessments and we play a major role in developing plans of care with our diverse team. We are there having difficult conversations with patients—many times in the middle of the night when they cannot sleep.  We […]

2016-11-21T13:01:34-05:00January 8th, 2016|Nursing, nursing perspective, pain management, patient experience|2 Comments
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AJN in January: Year in Review, Fibromyalgia, Massage Redux, Fall Prevention, More

AJN0116 Cover Online

On this month’s cover, refugees clash with police as they attempt to cross the border into Macedonia from Greece. The photo, taken last August, depicts a chaotic scene that has become increasingly familiar as large numbers of migrants flee to Europe from the Middle East and Africa. At press time, the International Organization for Migration estimated that more than 832,000 refugees had crossed Europe’s borders by sea since January 2015. Many migrants, including those from Syria, are risking their lives to escape violence, destitution, and displacement caused by civil war.

Health concerns have arisen as Europe struggles to absorb the huge surge of arrivals. According to the World Health Organization (WHO), overcrowding in receiving facilities has led to unsanitary living conditions and instances of food- and waterborne diseases. But the journey itself also takes a toll: the WHO reports that injuries, burns, and psychological trauma are among the most frequent health problems refugees face. Those with chronic conditions like cardiovascular disease, diabetes, and hypertension find their diseases worsened by the interruption of treatment, and women suffer from pregnancy-related complications and sexual health issues.

As policy makers grapple with responding to the influx, the crisis is likely to remain a key global political and health issue in 2016. To read about this and other top health-related news stories of the past year related to nursing and health care policy […]

2017-03-24T03:43:24-04:00January 6th, 2016|Nursing, nursing perspective|1 Comment
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One Nursing Wish for the New Year

By Shawn Kennedy, AJN editor-in-chief

ShawnKennedyIf there’s one universal complaint by nurses, it’s that there aren’t enough of them on a shift to provide the care their patients need. We have a lot of data linking nurse staffing to patient outcomes and revealing the deleterious effects of missed care because of insufficient staffing. Yet, according to many hospital nurses I’ve spoken with, they still find themselves stretched to the breaking point by high patient acuity, rapid patient turnover, and increasing documentation requirements.

These nurses see no end in sight to this situation as hospitals argue that they have insufficient reimbursements and revenues to increase staffing. Ironically, as hospitals invest in pricey, cutting-edge new technologies that haven’t been shown to improve patient outcomes, the evidence about nurse staffing continues to be ignored.

In November, the ANA released a white paper, “Optimal Nurse Staffing to Improve Quality of Care and Patient Outcomes.” The paper summarizes and updates the research on staffing and outcomes, linking staffing to Medicare initiatives to reduce costs, adverse events, and readmissions. The report notes:

“Existing nurse staffing systems are often antiquated and inflexible. Greater benefit can be derived from staffing models that consider the number of nurses and/or the nurse-to-patient ratios and can be adjusted to account for unit and shift level factors. Factors that influence nurse staffing needs include: patient […]

2016-11-21T13:01:37-05:00January 4th, 2016|career, Nursing, nursing perspective|1 Comment
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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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