A Closer Look at Preventing C. Diff Transmission

Clostridium difficile/ CDC

It’s estimated that Clostridium difficile (C. diff) causes about 450,000 infections and 15,000 deaths each year. Recently, on Facebook, AJN’s question of the week asked about isolation precautions for patients with C. diff. Most readers could not provide the correct answer to the multiple choice question.

In this month’s issue, “Six Things You Can Do Today to Prevent Hospital-Onset C. difficile Tomorrow” offers a quick update of the best ways to prevent C. diff infection and transmission in hospitalized patients.

Author and infection prevention nurse Nancy O’Connor explores the finer points of key basics, including the importance of maintaining a high index of suspicion for cases, performing excellent hand hygiene, and cleaning all surfaces in a case patient’s room with a bleach solution. (And did you know that if the patient remains in the same room posttreatment, after symptoms have resolved, the room should be terminally cleaned to avoid reinfection?)

Isolation precautions and C. diff.

So, what about isolation precautions, which need to be started as soon as C. diff is suspected? Most respondents to our Facebook question thought that standard precautions were sufficient until a C. diff diagnosis was confirmed. But if this “rule-out” patient with diarrhea is positive, does s/he begin to shed C. diff only after the infection […]

2017-09-22T11:21:11-04:00September 22nd, 2017|infectious diseases, Nursing|0 Comments
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Inside an Ebola Treatment Unit: A Nurse Shares Her Experiences in Liberia

By Sylvia Foley, AJN senior editor

“It is extraordinarily difficult to establish an IV line in a dehydrated patient by generator-powered light while double gloved, with one’s goggles fogging.”—Deborah Wilson

Author Deborah Wilson at the Foya ETU cemetery. Photograph by Marcos Leitão.In one of this month’s CE features, “Inside an Ebola Treatment Unit: A Nurse’s Report,” author Deborah Wilson offers readers a rare look from the frontlines of the 2014 Ebola epidemic. Her stories about her patients and colleagues are as compelling as they are informative. Here’s a short overview of the article:

In December 2013, the first cases of the most recent outbreak of Ebola virus disease (EVD; formerly known as Ebola hemorrhagic fever) emerged in the West African nation of Guinea. Within months the disease had spread to the neighboring countries of Liberia and Sierra Leone. The international humanitarian aid organization Médecins Sans Frontières (MSF; known in English as Doctors Without Borders) soon responded by sending staff to set up treatment centers and outreach triage teams in all three countries. In August 2014, the World Health Organization declared the outbreak an international public health emergency.

In September 2014, the author was sent by MSF to work as a nurse in an Ebola treatment unit in Foya, Liberia for five weeks. This article describes her […]

2017-07-27T14:39:21-04:00December 11th, 2015|infectious diseases, narratives, nursing perspective|4 Comments
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Revisiting Katrina’s Lessons 10 Years Out, from a Nursing Perspective

By Shawn Kennedy, MA, RN, AJN editor-in-chief

Hurricane Katrina Hits New Orleans, August 29, 2005/ Wikimedia Commons Hurricane Katrina Hits New Orleans, August 29, 2005/ Wikimedia Commons

This past week we’ve seen many media retrospectives on the devastation Hurricane Katrina visited on the Gulf Coast on August 29, 2005. I remember it vividly—as AJN’s news director at the time, I cut short a Labor Day vacation and flew to Mississippi on September 10 to report firsthand on how relief efforts were progressing.

I visited the emergency shelter staged at the Meridian Naval Air Station and then drove as far as I could south from Meridian toward the Gulf of Mexico. I got as far as Hattiesburg, Mississippi, before I had to turn around because there were no open gas stations and my gas tank was at half-empty. The devastation along the highway was remarkable; trees were completely flattened and debris of all sorts was scattered about as if a giant trash can had been overturned. And this was still about 70 miles inland from the Gulf.

Over the following months and then years, AJN published a number of articles and reports on health-related issues that arose from Hurricane Katrina (see the list below). We highlighted the heroics of many nurses who found ways to deliver care with few resources, discussed […]

2016-11-21T13:02:05-05:00August 31st, 2015|career, Ethics, Nursing, nursing perspective|0 Comments
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An Unending Series of Challenges: APIC Highlights the ‘New Normal’ in Infection Control

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

Panelists to the Opening Plenary, Mary Lou Manning, Michael Bell, CDC, Russell Olmsted, Trinity Health, Phillip W. Smith, Nebraska Biocontainment Unit discuss various topics pertaining to infection control. APIC panelists (APIC president Mary Lou Manning; Michael Bell, CDC; Russell Olmsted, Trinity Health; Phillip W. Smith, Nebraska Biocontainment Unit) discuss various topics pertaining to infection control.

At the 42nd annual conference of the Association for Professionals in Infection Control and Epidemiology (APIC), held in late June in Nashville, experts from around the world shared information and insights aimed at infection preventionists but of interest to nurses in many practice settings.

APIC president Mary Lou Manning, PhD, CRNP, CIC, FAAN, opened the first plenary with the observation that to be presented with an unending series of challenges is the “new normal” in infection control and prevention. Collaboration is more important than ever in health care, she said, and “there is strength in our combined efforts.”

Cathryn Murphy, […]

2016-11-21T13:02:19-05:00July 6th, 2015|infectious diseases, Nursing, nursing perspective|2 Comments
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MERS: Where Are We Now and What Do Nurses Need to Know?

WHO map of MERS cases by country WHO map of MERS cases by country. Click to enlarge.

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

Middle East respiratory syndrome (MERS) first emerged in Saudi Arabia in September 2012. Until last month, most MERS cases have occurred in that country. But on May 20, South Korea reported its first laboratory-confirmed case of MERS, in a 68-year-old man who had recently returned from a business trip to the Middle East.

The diagnosis was made only after the man had visited four health care facilities since his return home. This resulted in nosocomial transmission to other patients, health care workers, and visitors. To date, the Republic of Korea’s Ministry of Health has identified 108 cases of MERS in South Korea. Nine patients (all with serious preexisting health conditions) have died.

The WHO notes that all of these cases are epidemiologically linked to the index case. That is, there is no evidence that a new “reservoir” of MERS virus has suddenly surfaced in South Korea—all cases thus far stem from the Korean traveler who acquired his infection while visiting the Arabian Peninsula.

This is the largest outbreak of MERS so far outside of the Middle East, and therefore a reason for some concern. However, person-to-person transmission of MERS is not new, and there has as yet been no […]

2016-11-21T13:02:22-05:00June 15th, 2015|infectious diseases, Nursing, nursing perspective|0 Comments
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