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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Emergency Nursing 2019: Interactive Learning and Today’s Health Crises

The medical transport helicopter was at the ready. Meanwhile, the trauma team was in the midst of resuscitating a man. The crowd of onlookers remarked on the extreme pallor of the patient and were ready to jump in to help as needed. Fortunately, this was not a real life trauma but a scene in the exhibit hall of the sold-out Emergency Nurses Association (ENA) meeting in Austin, Texas, last week.

Four thousand ED nurses spent four days at Emergency Nursing 2019 attending educational sessions, skills labs (including a mock ED and a cadaver lab), and CE classes; viewing exhibit hall products; and relaxing in ‘Awesome Austin,’ celebrating themselves and the important work they do.

Documentary film producer Carolyn Jones (The American Nurse; Defining Hope) opened the meeting by presenting previews from her current documentary on emergency nurses, In Case of Emergency, a project in collaboration with the ENA for its 50th anniversary, to be released in May 2020. Jones and her film team traveled to seven EDs around the country, from an urban ED to rural farm country, to document ER nurses at work. […]

2019-10-07T10:13:54-04:00October 7th, 2019|Conference reports, Nursing|1 Comment
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What Would It Take to Make You Appreciate the Precious Moments of Your Life?

Illustration by McClain Moore for AJN.

Imagination vs. reality.

Who hasn’t thought about it from time to time, the sudden grim diagnosis, the force of the realization that all that time you thought you had to live, love, learn, explore, and change may really be finite after all? Who hasn’t wondered what you would do with the remaining time if that happened—and by corollary, what you should be doing differently now?

But that’s all in the mind and imagination. The real clarifying shock of such an experience remains out of reach for most of us—until it happens.

Collecting experiences ‘like Mario connecting coins.’

This month’s Reflections essay, “The Last One,” is by Fran Wiedenhoeft, a former nurse anesthetist in the military. In it, she describes her own reaction after she found herself, at a relatively young age, facing just such a diagnosis.

In the two weeks before the surgery . . . I threw myself with frantic determination into collecting lasts: last long run . . . , last trip to the zoo, last potato peeled, last kiss, last caress. . . . Rather than enjoying each precious moment and every last experience, I was rushing through […]

2019-10-04T11:29:52-04:00October 4th, 2019|Nursing|0 Comments
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October Issue: Infections in Acute Care, Understanding ‘Omics’ Sciences, Countering Vaccine Misinformation, More

“What we . . . may consider a passing moment in the course of our day—a short exchange with a family member, a few words of encouragement to a patient—might very well be a pivotal life event. . . . we must choose our words and actions carefully.”—editor-in-chief Shawn Kennedy, in her editorial, “It’s the Moments That Matter“

The October issue of AJN is now live. Here’s what’s new:

CE: Infection in Acute Care: Evidence for Practice

The author reviews the evidence on preventing and treating common infections in acute care settings, focusing on community- and hospital-acquired pneumonia, surgical site infections, and Clostridioides difficile infection.

CE: Knowledge of Precision Medicine and Health Care: An Essential Nursing Competency

This article provides a background in precision health care and the “omics” sciences—those that use genomic technologies to investigate the molecules in an organism’s cells—and discusses the implications for nursing practice, research, and education. […]

2019-09-30T09:16:31-04:00September 30th, 2019|Nursing|0 Comments
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Thoughts on Preventing Delirium During an ICU Stay

It’s well known that an ICU stay presents several risks to patients, whatever their reason for needing critical care.

  • Various infections are more likely to develop than in other care units.
  • Intense drug therapy can result in adverse drug interactions.
  • The excess stimulation and (often) windowless rooms increase the risk for delirium and its consequences.

Would you do anything to protect your own health if you knew that after surgery you would be spending time in an ICU?

In this month’s Viewpoint column, author Patricia Gavin describes how she coped with her own ICU stay, which she knew in advance would be part of her post-op care:

“…when I realized I would be there for a few days, I decided to create
my own ‘care plan’ to stave off delirium and its adverse outcomes.”

Does it help if the patient knows her own risk factors?

She goes on to explain what she knew about her own risk factors for delirium, and the things she could do to stave off the complication during this stressful time.

And she notes how one nurse made a particular difference in helping her to get through her stay without cognitive complications. Gavin reminds us of the practical strategies that nurses can employ, beginning with, “Extend […]

2019-09-26T10:31:05-04:00September 26th, 2019|Nursing, patient safety|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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