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Quality Improvement Program
Needs Assessment and Quality Improvement Plan
Paula Stechschulte, PhD, N
This paper discusses the process of drafting a quality improvement plan at a community level medical facility, a plan that is aimed at reducing days under urinary catheter and also reducing the rates of infections associated with the said catheters. As a high rate of incidence of infection related to catheter usage is costly for the hospital, this implementation strategy is aimed both at reducing hospital costs and boosting patient health, safety and satisfaction. The requirement for this strategy is a level of nursing education, dedication and commitment that will necessitate training and a "go-live" session of implementation which can be stressful for workers and for patients as both adjust to change. The management directors will need to not only monitor progress using the Six Sigma method but also will need to effectively maintain levels of…
APIC (2008). -- Home. Guide to the Elimination of Catheter-Associated Urinary Tract Infections (CAUTIs). Retrieved January 16, 2016, from http://www.apic.org/Resource_/EliminationGuideForm/c0790db8-2aca-4179-a7ae-676c27592de2/File/APIC-CAUTI-Guide.pdf
Brusch, J. (2015, August 18). Diseases & Conditions - Medscape Reference. Catheter-Related Urinary Tract Infection: Transmission and Pathogens, Guidelines for Catheter Use, Diagnosis. Retrieved January 15, 2016, from http://emedicine.medscape.com/article/2040035-overview#a2
Cetina, K. K., Bruegger, U. (2001). Transparency regimes and management by content in global organizations: The case of institutional currency trading. Journal of Knowledge Management, 5(2): 180-194.
Cooper, A. (2002). Six Sigma deployment in a large integrated health system. Quality Congress. ASQ's Annual Quality Congress Proceedings, ABI/INFORM Global: 71-76.
ordinal list of the causes of death in the US. It has been reported that the disease causes more havoc in developing countries. During a flu epidemic, up to 20% of Americans are infected by the virus. Of this figure, approximately 36 000 people might die of the infection. It is reported that over 200 000 of those infected are infected in various hospital facilities across the country. Indeed, few viruses have inflicted as much damage and endured as the influenza virus. espiratory ailments blamed on influenza are documented in records that trace the infection back to Greece and ome of the ancient world. The word influenza when viewed from its original Greek form: influentia points to the popular belief that the epidemics that people suffered were a result of the influence of stars. Indeed, people including medical experts refer to the infection of influenza as flu, yet most of…
Basarkar, S., 2016. Chapter-04 Infection, Prevention and Control. Practical Guide Book for Hospital Infection Risk Assessment, Prevention & Control, pp.27 -- 34.
Belser, J.A., Gustin, K.M., Maines, T.R., Pantin-Jackwood, M.J., Katz, J.M. and Tumpey, T.M., 2012. Influenza virus respiratory infection and transmission following ocular inoculation in ferrets. PLoS pathogens, 8(3), p.e1002569.
Centre for Health Protection, 2017. Statistics on Communicable Diseases. Centre for Health Protection - Sentinel Surveillance of Infectious Diseases among Chinese Medicine Practitioners (CMPs) Weekly Update. Available at: http://www.chp.gov.hk/en/sentinel_sur/26/44/419.html [Accessed June 26, 2017].
Cheng, V.C., Tai, J.W., Lee, W.M., Chan, W.M., Wong, S.C., Chen, J.H., Poon, R.W., To, K.K., Chan, J.F., Ho, P.L. and Chan, K.H., 2015. Infection control preparedness for human infection with influenza A H7N9 in Hong Kong. infection control & hospital epidemiology, 36(1), pp.87-92.
hospital acquired infections, popularly known as the nosocomial infections in adults, specifically elderly adults. In this research paper, the focus is built on infections caught by elderly people and the preventions that can be taken as measures to eradicate the causes of this infection. esearch reports have been taken as references to describe the current situation of nosocomial infection spread in the American society and all over the world.
This infection is developed in a person after a visit to hospital within 48 hours or by patients who are discharged from the hospital and are diagnosed within 30 days of leaving the hospital. Patients who are diagnosed with such an infection carry diseases that are caused by fungal infections or through unsanitary conditions of the hospital environment (Norton, Barie, & Bollinger, 2008). Moreover, they catch infection through contamination from air droplets via sneezing or coughing and from contact with patients…
Allen, J.E. (2011). Nursing Home Administration. New York: Springer Pub.
Katlic, M.R. (2011). Cardiothoracic Surgery in the Elderly. New York; London: Springer.
Nelson, K.E., & Williams, C.M. (2007). Infectious Disease Epidemiology. Sudbury, Mass.; Toronto: Jones and Bartlett Publishers.
Norton, J.A., Barie, P.S., & Bollinger, R.R. (2008). Surgery: Basic Science and Clinical Evidence. New York, NY: Springer.
The evidence-based approach utilized and advocated by all the authors cited in this essay can be viewed through the lens of a PDSA process as described by Hadaway (2006). For example, Pronovost and colleagues were interested in reducing the incidence of preventable C-BSIs in the ICU setting in Michigan. They first identified an evidence base supporting an intervention and then planned how to implement the intervention to cause a small-scale change. This evidence base, as well, is nothing more than the sum of several research groups engaging in the PDSA process. The intervention(s) is then implemented to test its efficacy, the results studied, and significant positive or negative outcomes are acted upon. The research reviews by Kampf et al. (2009) and Hadaway (2006) represent a synthesis of the findings from several studies, which they used to support their theses regarding hand hygiene and C-BSIs, respectively. hine's (2006)…
Hadaway, L.C. (2006). Best-practice interventions: Keeping central line infection at bay. Nursing, 36(4), 58-63.
Kampf, G., Loffler, H., & Gastmeier, P. (2009). Hand hygiene for the prevention of nosocomial infections. Deutsches Arzteblatt International, 106(40), 649-655.
Pronovost, P., Needham, D., Berenholtz, S., Sinopoli, D., Chu, H., Cosgrove, S. et al. (2006). An intervention to decrease catheter-related bloodstream infections in the ICU. New England Journal of Medicine, 355(26), 2725-2732.
Rhine, W.D. (2006). Eliminating nosocomial infections in the NICU: Everyone's duty. Journal of Perinatology, 26(3), 114-143.
coli bacteria was essential given the purpose of the study, which aimed at determining how repeated cases f urinary tract infections were caused. Specific strains of the bacteria were identified from each of the seventeen infants initially diagnosed with a urinary tract infection that were a part of the study, and these were compared to cultures taken from infant during subsequent infections. The results showed that each infant had at least one recurrent episode caused by the exact same strain of the bacteria, and that same-strain infections accounted for the vast majority of recurring infections. This suggests that infection occurs from pathogens still present in the body, and is therefore more effectively treated as a relapse then considering each case to be a separate infection.
Cohen, a.; Rivara, F.; Davis, R. & Christakis, D. (2005). "Compliance with guidelines for the medical care of first urinary tract infections in infants: A…
A patient realizes increased need to urinate at night. There are episodes of chills and persistent fever that last for more than two days. A patient may also realize pain in the flank that runs along the back at about waist level (Harvey & Zieve, D, 2013). Vomiting and nausea is also common.
Urinary Tract Infections in infants and toddlers tend to be more severe than in young women. This is because it is more likely to involve their kidneys. Symptoms of urinary tract infections in older children tend to be more standard (Harvey & Zieve, D, 2013). The severity of UTIs in infants and young children calls for screening to establish whether they have persistent high fever of unknown cause often accompanied by feeding problems, debility, listlessness, and fatigue; painful, frequent, and foul smelling urine; cloudy urine; recurrence of bed wetting or poor urine control during the day especially…
Harvey, S. & Zieve, D. (July 27, 2013). Urinary Tract Infections - Adults. New York Times.
Sobieszczyk, M.E. (2008). Urinary Tract Infections. Retrieved from http://www.columbia.edu/itc/hs/medical/pathophys/id/2008/utiNotes.pdf
Healthcare Associate Infections
Hospitals are often associated with providing care and treatment in the face of an illness. However, what is not often discussed is that many patients who are admitted to hospitals contract infections from the hospital itself. Infections which are acquired from a hospital are known in the medical community as nosocomial infections (Avic, 2012). I am interested in exploring how nosocomial infection occurs and how they can be prevented. I am specifically interested in assessing how nurses can contribute to reducing incidents of nosocomial infections and the role that they play in patient infection rates. By analyzing the most vulnerable patients, this paper attempts to identify when an infection is likely to occur, where they are most likely to be contracted, and the safeguards that must be put in place to prevent the nosocomial infections.
Avic, et al., review the frequency, types, and outcomes of hospital acquired…
Avci, M., Ozgenic, O., Coskuner, S., & Olut, A (2012). Hospital acquired infections (HAI) in the elderly: Comparison with younger patients. Archives of Gerontology & Geriatrics, 54(1), p. 247-250.
Rahim, R, A., & Barnett, T. (2009). Reducing nosocomial infection in neonatal intensive: An intervention study. International Journal of Nursing Practice, 15(6), pp. 580-584.
Urinary Tract Infection and Prevention
esearch write 5 literature review catheter acquired urinary tract infection prevention.
Catheter-associated (CA) bacteriuria is health care infection associated with the wide spreed urinary catheterization in hospitals and long-term care facilities worldwide. Considerable costs, personnel, time are spent by health care institutions to minimize the infection rate of CA infections, especially the urinary tract infections - CA urinary tract infections (Graves N. et al., 2007). Urinary catheterisation is defined as an intervention to enable emptying of the bladder by insertion of a catheter. Indwelling urinary catheterisation is categorised as either; short-term - less than 28 days, or long-term - greater than 28 days (Tambyah PA & DG., 2000). Urinary tract infections (UTIs) have been shown to be one of the most common in healthcare-associated infection (HCAI) with up to 80% related to the presence of urinary catheter (Gould CV, Umscheid CA, Agarwai K, Kuntz G,…
Cope M, Cevallos ME, Cadle RM, Darouiche RO, Musher DM, & BW., T. (2009). inappropriate treatment of Catherter-associated asymptomatic bacteria in tertiary care hospital. Clin Infect Dis, 48(9), 1182-1188.
Gould CV, Umscheid CA, Agarwai RK, Kuntz G, & DA., P. (2009). Guideline for prevention of catheterassociated urinary tract infections. Centre of Disease Control 22(5), 122-145.
Graves N, Tong E, Morton AP, Halton K, Curtis M, & Lairson D. (2007). Factors associated with health care-acquired Urinary tract infection. Am J. Infect Control 35(6), 387-392.
Nicolle L, Classen D, Arias KM, Podgorny K, & Anderson DJ. (2008). Strategies to prevent catheter-associated Urinary tract infections in acute care hospitals. Infect Control Hosp Epidemiol 29(1), 41-50.
Urinary tract infections (UTIs) are characteristically the most prevalent healthcare-associated infection or HAI for short, in critical care place in America. The CDC or Centers for Disease Control and Prevention has projected that up over 150,000 hospital-onset, indicative catheter-associated UTIs (CAUTIs) happened in 2013, which brought about in as much as $160 million in superfluous straight medical costs (Kuntz, 2010, p. 319). Existing research inspects the possible reasons for such an elevated incidence of infection by offering ways it can be improved or researched. oughly three quarters of healthcare-associated UTIs are associated with inappropriate use of indwelling urinary catheters. This comes as a result of over 25% of patients becoming exposed to prolonged and unnecessary catheter use. Adult ICUs have the maximum experience rate for catheter use and expose over 95% of UTIs connected to catheter use.
A study by Hyder et al. examined six key areas in their cross…
Hyder, A., Syed, S., Puvanachandra, P., Bloom, G., Sundaram, S., Mahmood, S. . . . Peters, D. (2010). Stakeholder analysis for health research: Case studies from low- and middle-income countries. Public Health, 124(3), 159-166. doi:10.1016/j.puhe.2009.12.006
Institute of Medicine (IOM) and the Robert Wood Johnson Foundation (2011). The Future of Nursing: Leading Change, Advancing Health. Retrieved from http://www.aacn.nche.edu/government-affairs/IOMFactSheet.pdf
Lavis, J.N., Permanand, G., Oxman, A.D., Lewin, S., & Fretheim, A. (2009). SUPPORT Tools for evidence-informed health Policymaking (STP) 13: Preparing and using policy briefs to support evidence-informed policymaking. Health Research Policy and Systems, 71-79. doi:10.1186/1478-4505-7-S1-S13
Lowery, B. (2009). Obesity, Bariatric Nursing, and the Policy Process: The Connecting Points for Patient Advocacy. Bariatric Nursing and Surgical Patient Care, 4(2), 133-138. doi:10.1089/bar.2009.9977
Toxoplasmosis is an infection involving the central nervous system. Until quite recently, it was considered to be a very rare disease. Now, however, the infection is more common, and is seen as a rather frequent cause of encephalitis, particularly among AIDS patients. The infection itself is caused by an obligate intracellular protozoan called Toxoplasma gondii (Caffazana, et al., 292). This protozoan has a worldwide distribution. In those that have AIDS, it causes encephalitis and neurological symptoms. Among the symptoms that should be looked for and are usually present are headaches that are nonpulsating, severe, and usually in both sections of the front of the head (Caffazana, et al., 295). These headaches caused by the disease are not relieved, as most normal headaches would be, by taking over-the-counter headache remedies such as analgesics. Having the headache pain in the front of the head does not reflect T. gondii lesions, but rather…
Caffazana, EJ, Rossitch, E, Jr., & Samuels, MA. (1989). "Cerebral toxoplasmosis in the acquired immune deficiency syndrome." Clinical Neurology & Neurosurgery, 91: 291-301.
Leport, C, Raffi, F, Matheron, S. (1988). "Treatment of central nervous system toxoplasmosis with pyrimethamine/sulfadiazine combination in 35 patients with the acquired immunodeficiency syndrome. Efficacy of long-term continuous therapy." American Journal of Medicine, 84: 94-100.
Snider, VM, Simpson, DM, Neilsen, S, Gold, M, Metroka, CE, & Posner, JB. (1983). "Neurological complications of acquired immune deficiency syndrome: analysis of 50 patients." Annals of Neurology, 14: 403-418.
Urinary tract infection (UTIs) refers to urinary tract symptomatic bacterial infection. As mentioned in the lesson, Escherichia coli is the most common infecting microorganism with Staphylococcus saprophyticus as the second most common (Huether & McCance, 2015, p. 753). While other organisms like fungi or viruses can infect the urinary tract, bacterial infections are most common. The lower UTI is called cystitis and affects the bladder. The upper UTI is called acute pyelonephritis and affects the kidney. Although these are the main areas for both upper and lower UTI the symptomatic bacterial infection can extend past those anatomical areas.
For lower UTIs, the onset can be sudden, with typical urgency, burning, and frequency of urination. There is often painful voiding of minor volumes of urine. Lower back pain is a common symptom. The urine may appear turbid and potential development of a low-grade fever (Huether & McCance, 2015). The symptoms for…
Huether, S. E., & McCance, K. L. (2015). Understanding Pathophysiology - E-Book (6th ed.). Elsevier Health Sciences.
Mitchell, B., Ferguson, J., Anderson, M., Sear, J., & Barnett, A. (2016). Length of stay and mortality associated with healthcare-associated urinary tract infections: a multi-state model. Journal of Hospital Infection, 93(1), 92-99. doi:10.1016/j.jhin.2016.01.012
Mody, L., & Juthani-Mehta, M. (2014). Urinary Tract Infections in Older Women. JAMA, 311(8), 844. doi:10.1001/jama.2014.303
Advances in medicine have resulted in the further enhancement of patient outcomes in healthcare settings. It is, however, important to note that the treatment of many patients in close proximity does have some downsides. Hospital acquired infections (HAIs) are one such downside. In basic terms, HAIs are inclusive of all the infections that were not part of the original diagnosis of the patient during his or her admission at the hospital. Research studies conducted in the past have clearly indicated that HAIs are a major health care concern for not only patients, but also healthcare providers. For this reason, the relevance of reigning in HAIs cannot be overstated. Indeed, as Gupta at al. (2014) point out, taking into consideration “morbidity, mortality, increased length of stay and the cost, efforts should be made to make hospitals as safe as possible by preventing such infections” (150).
In seeking to further…
Gupta, A., Todi, S., Myatra, SN., Samaddar, D.P., Patil, V., Bhattacharya, P.K. & Ramasubban, S. (2014). Guidelines for Prevention of Hospital Acquired Infections. Indian Journal of Critical Care Medicine, 18(3), 149-163.
IOWA Department of Public Health – IDPH (2019). Surgical Site Infections (SSI): What is SSI? Retrieved from https://idph.iowa.gov/hai-prevention/information/ssi
Saint, S., Krein, S.L. & Stock, R.W. (2014). Preventing Hospital Infections: Real-world Problems, Realistic Solutions. New York, NY: Oxford University Press.
Schmier, J.K., Hulme-Lowe, C.K., Semenova, S., Klenk, J.A., DeLeo, P.C., Sedlak, R. Carlson, P.A. (2016). Clinicoeconomics and Outcomes Research, 8, 197-205.
World Health Organization – WHO (2002). Prevention of Hospital-Acquired Infections. Retrieved from http://apps.who.int/medicinedocs/documents/s16355e/s16355e.pdf
Cellulitis, as Sullivan (2018) points out, happens to be an acute skin infection that largely affects the subcutaneous and dermis tissues. In the present scenario, the patient developed the symptoms described as a consequence of the entry of bacteria through the laceration/cut in the leg. According to Kellerman and Rakel (2018), there are two kinds of bacteria that are responsible for a majority of cellulitis cases, i.e. staphylococcus aureus and streptococcus. Once the organisms gain entry, defensive cells are overwhelmed. Under normal circumstances, the defensive cells are often instrumental in the containment and localization of inflammation. As a result, there is the accumulation of cellular debris. It is important to note that in the present case, tissue around the cut (point of entry) could have been invaded by the organism as cellulitis progressed.
In the words of Herchline (2019), “immunogenetic factors may play a role in…
Coleman, K. & Neilsen, G. (2019). Wound Care: A practical guide for maintaining skin integrity. Elsevier Health Sciences.
Carey, J.C., Cassidy, S.B., Battaglia, A. & Viskochil, D. (Eds.). (2020). Cassidy and Allanson\\'s Management of Genetic Syndromes. John Wiley & Sons.
Herchline, T.E. (2019). Cellulitis. Med Scape. https://emedicine.medscape.com/article/214222-overview#a4
Kellerman, R.D. & Rakel, D. (2018). Conn’s Current Therapy. Elsevier Health Sciences.
Sullivan, T. (2018). Diagnosis and management of cellulitis. Clin Med., 18(2), 160-163.
A patient has visited the clinic with an abscess that clearly needs to be incised and drained. An abscess is basically a skin infection that is common among people of all ages. Since these infections are common to all age groups, incision and drainage is usually carried out in a variety of settings including pediatric, adult-geriatric, and family practice settings. As a family nurse practitioner, the incision and drainage of an abscess is within my scope of practice. While incision and drainage is not widely taught in nurse practitioner programs, this clinical procedure is common in nursing practice settings. Current programs that offer training on this clinical procedure focus on providing a basic competency level using simulation-based learning (Adams et al., 2017). Therefore, the responsibility of the family nurse practitioner in abscess incision and drainage is to collaborate with other healthcare professionals to carry out the procedure.
In light of…
Adams, C.M., Nigrovic, L.E., Hayes, G., Weinstock, P.H. & Nagler, J. (2017, July). Teaching Incision and Drainage: Perceived Educational Value of Abscess Models. Pediatric Emergency Care, 34(3). DOI: 10.1097/PEC.0000000000001240
Subramaniam, S., Bober, J., Chao, J. & Zehtabchi, S. (2016, October 21). Point-of-care Ultrasound Diagnosis of Abscess in Skin and Soft Tissue Infections. Academic Emergency Medicine, 23(11), 1298-1306. Retrieved October 26, 2020, from https://onlinelibrary.wiley.com/doi/full/10.1111/acem.13049
Due to their contact with different patients, it allows them to become carriers of the disease.
It is important to study the relevance of SARS to epidemiology because epidemiology can provide an amount of diverse and important information that can facilitate the process of controlling, if not totally preventing, its spread. y relating SARS to epidemiology, people can become aware of the whole story on SARS. Moreover, epidemiology can be a fundamental source in finding solutions to combat the disease. Thus, providing another measure in the management and control of its spread. For instance, in the outbreak cases of SARS in many places worldwide, the article indicated that epidemiology provided appropriate models in containing the disease.
Emerging Infections: What Have We Learned from SARS?
Retrieved on Nov. 12, 2004, from CDC.GOV.
Web site: http://www.cdc.gov/ncidod/EID/vol10no7/pdfs/04-0166.pdf
Emerging Infections: What Have We Learned from SARS?
Retrieved on Nov. 12, 2004, from CDC.GOV.
Web site: http://www.cdc.gov/ncidod/EID/vol10no7/pdfs/04-0166.pdf
Failure to implement infection control precautions can lead to potential complications that include the spread of infection to otherwise healthy individuals within the ward or facility where the infection occurs and even out into the community through visitors who become infected (Banach, Bearman, Morgan & Munoz-Price, 2015). Thus, complications that arise from infection spreading may not be confined to the hospital or facility where they occur but can easily become an issue that impacts the outside world as well. Examples abound, whether they are influenza related, SARS-related, and so on. Communities can suffer significantly when even the simplest infection control precautions are not followed by nurses in health care facilities.
Another potential complication can be resource-related, as infection spreading can lead to a drain on resources as procedures are put in place to stem the spread and deal with contamination, quarantine and clean-up (Koutlakis-Barron & Hayden, 2016; Revolinski, Huang &…
Nurse burnout is a common occurrence. This can exacerbate an ongoing problem that is seen in hospitals, nosocomial infections. Nosocomial infections remain prevalent for patients with extended hospital stays like those in intensive care units. An infection that starts roughly 48 hours after admission, those in intensive care units (ICUs) experience a continued rate of infection leading to increase length of stay, mortality, and morbidity. The number of patients that develop a nosocomial infection are from 7 to 10% internationally (Dasgupta, Das, Hazra, & Chawan, 2015). As such, hospitals have decided to classify nosocomial infection sites based on clinical and biological criteria.
esearch has led to the discovery of several bacterial strains that involve the formation of nosocomial or hospital acquired infections. "The agents that are usually involved in hospital-acquired infections include Streptococcus spp., Acinetobacter spp., enterococci, Pseudomonas aeruginosa, coagulase-negative staphylococci, Staphylococcus aureus, Bacillus cereus, Legionella and Enterobacteriaceae family members,…
CDC. (n.d.). HAI Data and Statistics. Retrieved from https://www.cdc.gov/hai/surveillance/
Cheng, C., Bartram, T., Karimi, L., & Leggat, S. (2016). Transformational leadership and social identity as predictors of team climate, perceived quality of care, burnout and turnover intention among nurses. Personnel Review, 45(6), 1200-1216. doi:10.1108/pr-05-2015-0118
Cimiotti, J. P., Aiken, L. H., Sloane, D. M., & Wu, E. S. (2012). Nurse staffing, burnout, and health care -- associated infection. American Journal of Infection Control, 40(6), 486-490. doi:10.1016/j.ajic.2012.02.029
Dasgupta, S., Das, S., Hazra, A., & Chawan, N. (2015). Nosocomial infections in the intensive care unit: Incidence, risk factors, outcome and associated pathogens in a public tertiary teaching hospital of Eastern India. Indian Journal of Critical Care Medicine, 19(1), 14. doi:10.4103/0972-5229.148633
Healthcare Associated Infections: Critical Analysis
The prevention and control of healthcare associated infections is an issue that has attracted considerable attention across the globe given the increase of healthcare associated infections. Despite the development and use of several strategies and measures to lessen the burdens caused by healthcare associated infections, the practices of healthcare professionals are largely suboptimal while the infections persist. As a result, the prevention and control of these infections has attracted considerable concern, which has resulted in several studies on the practices and behaviors of healthcare practitioners. Carole Jackson, Karen Lowton and Peter Griffiths have conducted a research on nurses' prevention behaviors to control healthcare associated infections. The qualitative study utilizes vignettes created from nurses' reports of infection prevention behaviors and practices.
Healthcare associated infections can be described as infections that emerge from medical interventions like clinical or surgical processes or from contact with a…
Burns, N., & Grove, S. (2011). Understanding nursing research (5th ed.). Amsterdam, Netherlands: Elsevier.
Jackson, C. Lowton, K. & Griffiths, P. (2013, July). Infection Prevention As "A Show": A Qualitative Study of Nurses' Infection Prevention Behaviours. International Journal of Nursing Studies, 10(16).
"Prevention and Control of Healthcare-Associated Infections." (2011, November). Quality Improvement Guide. Retrieved from National Institute for Health and Clinical Excellence website: http://www.his.org.uk/files/9213/7483/8498/Prevention_and_control_of_healthcare-associated_infections_Quality_improvement_guide_NICE_Guidance_2011.pdf
"Qualitative Research Perspective." (n.d.). Chapter 4. Qualitative Research in Information Systems: Consideration of Selected Theories. Retrieved from Australian National University Press website: http://press.anu.edu.au/info_systems/mobile_devices/ch04s02.html
In the U.S healthcare environment, the clinical practice guidelines are the effective healthcare protocol to enhance patient’s safety as well as achieving evidence-based practice. The clinical guidelines provide recommendations to the best available practice to assist clinicians and other healthcare professionals to deliver best and quality care. More importantly, the clinical practice guidelines are designed to optimize patients’ care using the systematic assessment and evidence based review to assess pros and cons of the alternative care options. The guidelines serve as the strongest resources to assist the healthcare professionals to make clinical decisions as well as incorporating evidence gained through practice and scientific investigations into patient practice. Healthcare organizations develop the guidelines in form and policies, which are endorsed across the organization to create a platform that employees will follow and holding employees accountable to achieve a standard of care.
Clabsi Hospital is one of the best healthcare organizations…
One possible explanation for the differences observed in the studies could be that the strengths of the chlorhexidine solution were different. It could also be that over time more effective techniques have been developed in the application of the solution, as the results do appear to improve over time.
There are limitations to the methodology of the study which are centered on the use of secondary data for analysis. The use of secondary data allows a wider range of data to be gathered from across the U.S. than would be practical from primary data collection which is the reason for the choice in this study. However this puts the control of several variables beyond the researcher. The results of the techniques may have been affected by the application of different individuals, departments and hospitals, all of whom may vary techniques and other factors influencing the success of these techniques. The…
Adams, D., Quavum, M., Worthington, T., Lambert, P., & Elliott, T. (2005). Evaluation of a 2% chlorhexidine gluconate in 70% isopropyl alcohol skin disinfectant. Journal of Hospital Infections, 61 (4), 287-290.
Brungs, S., & Render, M. (2006). Using Evidence-Based Practice to Reduce Central line Infections. Clinical Journal of Oncology Nursing, 10 (6), 723-725.
CDC. (2002). Guidelines for Prevention of Intravascular Catheter-Related Infections. Morbidity and Mortality Weekly Report; Recommendations and Reports, 51 (RR-10), 1-34.
CDC Mission. (n.d.). Retrieved February 6, 2006, from CDC Web site: http://www.cdc.gov/about/mission.htm
Case Study: Urinary Tract Infection
CHIEF COMPLAINT: Urination with a burning sensation, pelvic genital pain, frequent and urgent urination, urine which is colored for the past three days and dribbling urination.
HISTORY OF PRESENT ILLNESS: A patient visits complaining about urination with a burning sensation, pelvic genital pain, frequent and urgent urination, urine which is colored for three days and dribbling urination. He is an African American who is 58 years old. However, he denies having fever.
This 58-year-old man describes his symptoms as having urination with a burning sensation, pelvic genital pain, frequent and urgent urination, urine which is colored for three days and dribbling urination. These symptoms show that he has a urinary tract infection commonly known as UTI. This infection has been often diagnosed in older adults. Most of the times, it has been diagnosed in residents with long-term care. This accounts for over a third…
From the onset, it is important to note that nosocomial or healthcare-acquired infections (HAIs) happen to be rather common in our healthcare settings. In basic terms, nosocomial infections could be defined as the all those infections that are acquired or contracted within the healthcare environment. To be more specific, the World Health Organization – WHO (2020) defines the said infections as all those infections that “affect patients in a hospital or other health-care facility, and are not present or incubating at the time of admission.” Further, according to WHO (2020), this category of infections could also be inclusive of infections acquired by hospital staff in the course of executing their functions within a healthcare facility. This is the definition that will be adopted in this policy brief. As the Centers for Disease Control and Prevention – CDC (2018) observes, at least 1 out of a total of 31 hospitals…
Andersen, B.M. (2019). Prevention and Control of Infections in Hospitals: Practice and Theory. New York, NY: Springer.
Centers for Disease Control and Prevention – CDC (2018). HAI Data. Retrieved from https://www.cdc.gov/hai/data/index.html
Centers for Disease Control and Prevention – CDC (2020). States with HAI Reporting Mandates. Retrieved from https://www.cdc.gov/hai/state-based/required-to-report-hai-nhsn.html
Despotovic, A., Milosevic, B., Milosevic, I., Mitrovic, N., Cirkovic, A., Jovanovic, S. & Stevanovic, G. (2020). Hospital-acquired infections in the adult intensive care unit—Epidemiology, antimicrobial resistance patterns, and risk factors for acquisition and mortality. American Journal of Infection Control, 48(10), 1211-1215.
McIntosh, D.G. (2018). Healthcare-associated infections: potential for prevention through vaccination. The Adv Vaccines Immunother., 6(1), 19-27.
Stone, P.W., Pogorzelska-Maziarz, M., Reagan, J., Merrill, J.A., Sperber, B., Cairns, C. …Skillen, E. (2015). Impact of laws aimed at healthcare-associated infection reduction: a qualitative study. BMJ Qual Saf., 24(10), 637-644.
World Health Organization – WHO (2020). Health care-associated infections FACT SHEET. Retrieved from https://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdf?ua=1
Infections of the implantation area the mainly widespread of the dental implant complications. Implant infection is a state which is known as peri-implantitis which has a sign of swelling or inflammation of the tissues adjacent to the implantation area. Peri-implantitis is a type of periodontal disease that is able to result to inflammation, bone loss and failure in dental implant in any case it is not treated appropriately. A flame is part of a fire. Inflammation is a situation where a tissue gets swollen, red, and frequently hurts. About dental implants, it is an inflammation that can be caused by trauma or infection. Inflammation causes several special defensive cells to move to the inflamed area. Inflammation is capable of resulting to bone loss together with dental implants, where bone loss is a dangerous situation. The supporting bone holds the dental implant in the jaw.
Generally, the purpose of the…
Hayek (2005) Comparative study between the effects of photodynamic therapy and conventional therapy on microbial reduction in ligature-induced peri-implantitis in dogs. Journal of Periodontology 76, 1275 -- 1281.
Loe, H., Theilade, E. & Jensen, S.B. (1965) Experimental gingivitis in man. Journal of Periodontology 36, 177 -- 187.
Mombelli, A., Nyman, S.R. & Lang, N.P. (1994) Experimentally induced peri-implant mucositis. A clinical study in humans. Clinical Oral Implants Research 5, 254 -- 259.
Renvert, S., Roos-Jansa"ker, A.M., Lindahl, C., Renvert, H. & Persson, G.R. (2007) Infection at titanium implants with or without a clinical diagnosis of inflammation. Clinical Oral
Chlorhexidine to Prevent Ventilator-Associated Pneumonia
Ventilator-associated Pneumonia (VAP) is one of the most common infections acquired by patients who've utilized mechanical ventilation in health care facilities. This infection is a major concern because it leads to several deaths, extends hospital stay, and increases the costs of medical care services. The infections are commonly developed when pathogenic bacteria colonize the aero digestive tract. According to Babcock et al. (2004), the prevention of these infections has usually entailed preventing bacteria colonization and the subsequent aspiration of the contaminated secretions to the lower airways. Given the increased incidents of ventilator-association pneumonia, this paper proposes the use of chlorhexidine in preventing it. Chlorhexidine has proven effective in prevention of VAP as shown in baseline data. The implementation of this proposed procedure in patient care will entail various logistics based on approval from organizational leadership.
Methods for Obtaining Necessary Approval and Support
One of the…
Babcock, H., Zack, J.E., Garrison, T., Trovillion, E., Jones, M., Fraser, V.J., & Kollef, M.H. (2004). An educational Intervention to Reduce Ventilator-associated Pneumonia in an Integrated Health System. Chest, 125 (6), 2224-2231.
Hoshijima et al. (2013, December). Effects of Oral Hygiene Using Chlorhexidine on Preventing Ventilator-associated Pneumonia in Critical-care Settings: A Meta-analysis of Randomized Controlled Trials. Journal of Dental Sciences, 8(4), 348-357.
Keyt, H., Faverio, P. & Restrepo, M.I. (2014, June). Prevention of Ventilator-associated Pneumonia in the Intensive Care Unit: A Review of the Clinically Relevant Recent Advancements. Indian Journal of Medical Research, 139, 814-821.
Klompas M., Speck, K., Howell M.D., Greene, L.R., & Berenholtz, S.M. (2014). Reappraisal of Routine Oral Care with Chlorohexidine Gluconate for Patients Receiving Mechanical Ventilation: Systematic Review and Meta-analysis. JAMA Internal Medicine, 174 (5), 751-761.
The facility should strive to bring the SSI rate down below the expected level for the types of patients and surgeries that the facility has.
Plan of Action
In order to achieve better-than-average results in the SSI rates for our facility, there are a number of tactics that can be used. The first is that the culture of the organization needs to emphasize safety to a degree greater than the current degree. As of now, there is no particular focus on SSIs, and this contributes to a culture where there is little accountability with respect to the SSI rates, or to individual SSI cases. The organization must improve the accountability, so that staff members are specifically held accountable for the mistakes that they make that result in an SSI.
Beyond culture, there are specific things that the organization can do to promote an improved rate of SSI. The first is…
Anderson, D. (2009). Surgical site infections. Division of Infectious Diseases, Duke University Medical Center. Retrieved September 29, 2012 from http://www.hapmd.com/home/hapmdcom/public_html/wp-content/uploads/2009/03/cirugia/bibliografica-cx/20110504_articulo_2.pdf
Barie, P. & Eachempati, S. (2005). Surgical site infections. The Surgical Clinics of North America. Vol. 85 (6) 1115-35.
Harbarth, S., Samore, M., Lichtenberg, D. & Carmeli, Y. (2000). Prolonged antibiotic prophylaxis after cardiovascular surgery and its effect on surgical site infections and antimicrobial resistance. Circulation. Vol. 101 (2000) 2916-2921.
Lauwers, S. & de Smet, F. (1998). Surgical site infections. Acta Clin Belg. Vol 53 (5) 303-310.
Behavioral risk for HIV infection among gay and bisexual men in the United States
According to reports published by the Centre for Disease Control and Prevention (CDC), they state that by the year 2004, more than nine hundred and forty thousand individuals in the United States of America had been diagnosed with AIDS, majority of who were gay men and African-Americans. This report including others have brought the issue of HIV infection in gay and bisexual men into sharp focus and more in particular the behavioral risks that the group exposes themselves to, which have contributed to the sharp increase in HIV infection amongst members of this group. This research intends to focus of this behavioral risk and preventive measures that have been established to prevent HIV infection in gay and bisexual men in the United States.
Another recent research conducted by Centre for Disease Control and Prevention…
Hockenbury, D., & Hockenbury, E., (2008), Psychology, Word publishers, pp 232-234
Kelly, J.A. (1992). HIV risk behavior reduction following intervention with key opinion leaders of population: An experimental analysis. American Journal of Public Health, 82, 1483 -- 1489.
Latkin, C.A., Sherman, S., & Knowlton, A. (2003). HIV prevention among drug users: Outcome of a network-oriented peer outreach intervention. Health Psychology, 22, 332 -- 339.
Wasserheit, J.N., & Aral, S.O., (1996), the dynamic topology of sexually transmitted disease epidemics: Implications for prevention strategies. The Journal of Infectious Diseases, 201 -- 213.
After 10 days, when pharyngeal infection becomes more acute, patients have an increased risk for myocarditis and peripheral neuritis. These can result in circulatory loss and loss of motor functions in the peripheral organs. Diphtherial infection should be immediately treated and even suspected cases should be treated on a prophylactic basis since the infection has a high mortality rate. Airway management is critical for patients presenting with respiratory complications. Intubation is essential in cases where the laryngeal membrane growth affects normal breathing process. Failure to secure airway passage is one of the main causes of death due to diphtheria. . [Allysia & Mark, 2009]
Firstline medication involves antibiotic treatment with penicillin or erythromycin to control bacterial growth and the use of antipyretics to control temperature. . Concurrent intravenous treatment with Diphtheria antitoxin is also critical to check the spread of the toxin and control further tissue damage. Patients manifesting respiratory…
1) Allysia M. Guy & Mark a Silverberg, (Oct 2009), 'Diphtheria', Accessed March 7th 2010, available at, http://emedicine.medscape.com/article/782051-overview
Vancomycin should be given for at least 60 minutes. The initial dosage for pediatrics with renal impairment is not less than 15 mg/kg per day or 15 times the GF in mL/min. Premature infants should have longer dosing intervals. PO administration should be 40 mg/kg/day in 3-4 divided doses for 7-10 days. The maximum is 2,000 mg/day, which may be diluted in 1 oz of water or administered through an NG tube (PD).
Vancomycin is contraindicated to patients with hypersensitivity to vancomycin (Drug.com, 2012). Commercially prepared frozen Vancomycyn Hydrochloride injections in 5% dextrose may also be contraindicated to those with known allergic reaction to corn or corn products (Drug.com).
The patient should inform the doctor or pharmacist of all prescription and non-prescription or herbal products currently used (Medicine Net, 2012; Levinson, 2012). Aminoglycosides, amphotericin B, other antibiotics, and live bacterial vaccines are special mentions. If treatment requires…
Reference: PDR Network LLC.
Retrieved on April 20, 2012 from http://www.pdr.net/drugpages/concisemonograph.aspx?concise=688
AIDS to prevent infection: a bargain?" And is written by Julie Steenhuysen for Reuters and published April 17, 2012. The article begins by describing why AIDS is still a very much-discussed topic within the medical community, despite many breakthroughs, after so many years of being in the news, and so many advances in the technology that treats it. According to the article, one of the most successful treatments in preventing AIDS for healthy individuals is called Truvada, which is a combination of Emtriva, and Viread. (Truvada, 2012) This treatment was created in an effort to create a "pre-exposure prophylaxis" or PrEP. (Steenhuysen, 2012). This treatment would require men who are at high risk of contracting HIV to take a daily pill in order to provide a better defense from this disease.
This treatment may greatly reduce the number of men who contract HIV each year, already at a very high…
Steenhuysen, J. (2012). Abs-cbn news. Retrieved from http://www.abs-cbnnews.com/lifestyle/04/17/12/using-aids-drugs-prevent-infection-bargain
Truvada. "About TRUVADA - TRUVADA." TRUVADA.com. N.p., n.d. Web. 17 Apr. 2012. .
Alcohol and/or Drug Users for HIV / AIDS Infection
People abuse/use a number of both legal and illegal substances, recreationally. Of these, the most commonly abused substance is alcohol. Drugs include cocaine (which includes crack), pot or marijuana, amphetamines (speed), ecstasy, and heroin. Drugs have the potential to intensify risks of an individual contracting HIV infection, and are capable of giving rise to special issues in already-infected individuals (University of California, 2011).
Substance abuse is associated with innumerable risk factors. One factor that serves to hamper efforts towards preventing HIV spread and proper treatment of those who are infected is alcohol use or misuse by infected or at-risk populations. esearchers are now gaining deeper insights into the multifaceted link between HIV infection and consumption of alcohol. Drug/alcohol abuse may impair an individual's judgment, causing him/her to participate in sexual activities that put him/her at risk (Bryant, Nelson, Braithwaite & oach,…
Bryant, K. J., Nelson, S., Braithwaite, R., & Roach, D. (2010). Integrating HIV / AIDS and alcohol research. Alcohol Health & Research World, 33(3), 167-178
Substance Abuse Issues (2014). Retrieved June 20, 2016 from https://www.aids.gov/hiv-aids-basics/staying-healthy-with-hiv-aids/taking-care-of-yourself/substance-abuse-issues/
University of California (2011). What is the connection between alcohol, other drugs, and HIV? Retrieved June 20, 2016 from http://hivinsite.ucsf.edu/hiv?page=basics-00-16
The salmonella bacteria had been the twentieth century’s archetypical organism causing food poisoning, highly notorious for the 1988-89 crisis of salmonella in eggs. By that time, however, it had already been a topic of scientific and public health focus for more than a hundred years. Previously linked to animal foods, phage typing’s introduction during the 1940s started revealing the complex nature of its associations with its environment (Hardy, 2004).
The salmonella bacterium resides in living beings’ intestines. A majority of individuals contract salmonella infection after consuming feces-contaminated foods. Salmonella is an umbrella term referring to the cluster of bacteria giving rise to salmonellosis or salmonella infection within the intestinal tract. Different forms of salmonellosis include typhoid fever, enteric fever, food poisoning, and gastroenteritis. Salmonella poisoning has typically been associated with contaminated foods or water, particularly eggs, meat, and poultry. Disease symptoms, which typically manifest…
HIV Infection and Your Child
It is a very frightening and traumatic to know that one of your children is suffering from a life threatening disease, especially if you feel that you may be partially responsible for what has happened. That is one reason why parents are reminded repeatedly to talk to their children about sex and related matters before they reach an age where they start mingling intimately with the members of the opposite sex. Sex education in schools only covers a small part of the awareness process, the real education begins at home where the parents are responsible for discussing sensitive subjects with their children.
If I find that my daughter was having unprotected sex with multiple partners, and upon screening she is found to be infected with HIV virus, my first reaction would be that of complete shock and disbelief. I would be gripped with intense fear…
Current Areas of esearch
Much of the current research on staphylococcus aureus centers on the emergence of antibiotic-resistance strains. In particular, the resistant strain MSA is resistant to methicillin and related drugs. This has created a number of issues for medical practitioners, as staph infections are one of the more common infections that occur in a health setting.
One of the threads of research in this regard concerns the spread of staph infection in the hospital setting. It has long been believed that s. aureus infections were transmitted between patients. Where outbreaks have occurred, the response has generally reflected this view, with patients being segregated, and other similar remedies. ecent research has shown, however, that transmission between patients in the intrahospital setting does not occur nearly as much as previously thought (Long, Beres, Olsen & Musser, 2014). This is an important finding for health care facilities, because it changes…
Haba, E., Bouhdid, S., Solana, N., Marques, A., Espuny, M., Celma, M. & Manresa, A. (2014). Rhamnolipids as emulsifying agents for essential oil formulations:
Antimicrobial effect against Candida albicans and methicillin-resistant
Staphylococcus aureus. International Journal of Pharmaceutics. Vol. 476 (2014) 134-141.
Kriegeskorte, A., Block, D., Drescher, M.., Windmuller, N.,Mellmann, A.,Baum, C., Neumann, C., Lore, N., Bragonzi, A., Liebau, E., Hertel, P., Seggeweiss, J., Becker, K., Proctoer, R., Peters, G., & Kahl, B. (2014). Inactivation of thyA in staphylococcus aureus attenuates virulence and has a strong impact on metabolism and virulence gene expression. mBio. Vol.5(4) 1-15
Human Immunodeficiency Virus (HIV)
Description of the communicable disease
Infection by the Human Immunodeficiency Virus (HIV) has become a global epidemic. It causes acquired immune deficiency syndrome (AIDS). The major causal sources of this communicable disease are through semen, blood, breast milk of infected mothers, and vaginal fluid. In addition, the virus can be found in sweat, saliva, and also tears; however, in the latter cases, generally not in sufficient amounts to cause spreading of the virus to another individual. The main common means of being infected with HIV are through having unprotected sex and through sharing of needles. HIV may be transferred through unprotected heterosexual or homosexual anal, vaginal, and perhaps oral sex. Even though the risk of infection is minimal with oral sex, there remains the same imperative to use protection such as a condom in the course of oral sex. Due to new treatments, the risk of…
Aids.gov. (2015). Global HIV / AIDS Organizations. Retrieved 19 May 2014 from: https://www.aids.gov/federal-resources/around-the-world/global-hiv-aids-organizations/
Body and Health Canada. (2015). HIV / AIDS. Retrieved 19 May 2014 from: http://bodyandhealth.canada.com/channel_condition_info_details.asp?channel_id=1020&relation_id=70907&disease_id=1&page_no=2
Cabieses Valdes, B.B. (2011). The living conditions and health status of international immigrants in Chile: Comparisons among international immigrants, and between them and the Chilean-born.
CDC. (2012). CDC Global Health Strategy 2012 -- 2015. Retrieved 19 May 2014 from: http://www.cdc.gov/globalhealth/strategy/pdf/CDC-GlobalHealthStrategy.pdf
hospitals is the spread of MSA (staphylococcus aureus). This pathogen remains a leading cause of hospital-acquired infection. Current 'typing' methods for the genome to identify the pathogen include "phage typing, multi-locus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE)" but these methods "have serious limitations when used to investigate the finer details of infection outbreaks" (Price et al. 2013: 14). This is why the use of whole genome sequencing that allows scientists to create distinctions up to a single nucleotide is useful. Whole genome sequences can be used to classify and characterize genetic differences in a far more refined fashion than previous methods "and additionally provides information about the genetic basis of phenotypic characteristics, including antibiotic susceptibility and virulence" (Price et al. 2013: 14). Local-level awareness of the history of disease transmission allows a more carefully matched protocol for treatment as well as improves tracking. "Combined with epidemiological data, such…
Blot, S.I. (2002 et al.). Outcome and attributable mortality in critically Ill patients with bacteremia involving methicillin-susceptible and methicillin-resistant Staphylococcus aureus. Archives of Internal Medicine, 162(19):2229-35.
Price, J.R. (2013) .Whole genome sequencing in the prevention and control of Staphylococcus aureus infection. Journal of Hospital Infection, 83: 14-21.
Challenges and Opportunities
The major challenge is how to keep track of any inserted urinary catheter in a patient. It has been shown that most times physicians and nurses will forget about a urinary catheter, and this is one of the major causes of infections in patients. Therefore, there should be a strategy in place for monitoring any urinary catheter that has been inserted in a patient and ensuring that it is removed when it is no longer needed. Removal of unnecessary catheters ensures that HAIs associated with the catheter is prevented. Another challenge is the time it takes to recognize that a catheter is in place and the physician determines it is no longer needed and issues a removal order. This might take hours or days. According to (Meddings et al., 2014) any delay in removing a catheter increases the patient's risk of infections and catheter-associated complications.
Urinary tract infections (UTIs) are typically the most prevailing healthcare-associated infection (HAI) in acute care facilities in the U.S. The Centers for Disease Control and Prevention (CDC) has estimated that up to 150,000 hospital-onset, symptomatic catheter-associated UTIs (CAUTIs) occurred in 2013, resulting in as much as $161 million in excess direct medical costs (Kuntz, 2010, p. 319). Current research examines the reason for such a high occurrence of infection. oughly 75% of healthcare-associated UTIs are connected to improper use of indwelling urinary catheters, to which up to a quarter of hospitalized patients are exposed. Adult ICUs have the highest exposure rate for catheter use and reveal over 95% of UTIs related to catheter use.
In the last twenty years, various strategies have been implemented to aid in reducing the risk of CAUTI in healthcare settings. One of which includes identifying proper times to use catheters and proper care and insertion…
Deron, D.C., Edwards, J.R., Srinivasan, A., Fridkin, S.K., & Gould, C.V. (2011). Trends in Catheter-Associated Urinary Tract Infections in Adult Intensive Care Units -- United States, 1990 -- 2007. Infection Control and Hospital Epidemiology, 32(8), 748-756.
Flynn, M.B., Martins, S.A., Burns, S., Philbricks, D., & Rauen, C. (2013). Putting Evidence Into Nursing Practice: Four Traditional Practices Not Supported by the Evidence. Critical Care Nurse, 23(2), 37. Retrieved from http://www.aacn.org/wd/Cetests/media/C1322.pdf
Goeschel, C.A., Cosgrove, S.E., Romig, M., & Berenholtz, S.M. (2011). Prevention of Central Line -- Associated Bloodstream Infections: A Journey Toward Eliminating Preventable Harm. Current Infectious Disease Reports, 13(4), 343-349.
Kuntz, G. (2010). Guideline for Prevention of Catheter-Associated Urinary Tract Infections 2009. Infection Control and Hospital Epidemiology, 31(4), 319-326.
Management of Immunocompromised Patients
In beginning I writer specific nursing assignment. The Question: 2000 Words While clinical placement asked prepare a single room an admission. The patient requiring admission isolation room immunocompromised.
Immunocompromised patients usually require isolation in order to prevent them from becoming infected with infections from other patients which is known as protective isolation. For the immunocompromised patients, their immune system is unable to fight the infectious diseases. There are many diseases or conditions that lead to immunodeficiency in patients.
One is AIDS (acquired immunodeficiency syndrome). The pathophysiology of AIDS starts when the person's CD4+ T cell count begins to decrease as the disease kills these cells. This is HIV-induced cell lysis where the virus enters the CD4+ cells where it inserts its genetic information to the cell nucleus thus taking over the cell and replicating itself. The virus then mutates extremely rapidly thus making it more and…
Agusti, C., & Torres, A. (2009). Pulmonary Infection in the Immunocompromised Patient: Strategies for Management. New York: John Wiley & Sons.
Bodey, G.P. (2010). Managing Infections in the Immunocompromised Patient. Clinical Infectious Diseases, 40(Supplement 4), S239. doi: 10.1086/427328
Glauser, M.P., & Pizzo, P.A. (2009). Management of Infections in Immunocompromised Patients New York: Elsevier Health Sciences.
Hayden, R.T. (2008). Diagnostic Microbiology of the Immunocompromised Host. Washington, DC: ASM Press.
Evidence-Based Solution to educing Incidence
The goal of this assignment is to increase my ability to appraise and synthesize evidence to provide experience a logical argument in support of a proposal for practice change, and to provide experience in designing a detailed implementation and evaluation plan for my project. I need to discuss my project plan with you.
An evidence-based solution to reducing incidence of hospital acquired infections through indwelling medical devices
Hospital-acquired or nosocomial infections are the fourth leading cause of disease in developed countries. The increased insertion and implanting of prosthetic or indwelling medical devices is a leading cause of these infections since the introduction of a foreign body significantly reduces the body's immunity and decreases the number of bacteria needed to produce an infection. Prosthetic or indwelling medical devices such as urethral catheters, suprapublic catheter, nasogastric tubes, hemodialysis catheters, central venous catheters, and tracheostomy tubes are associated…
Chambless, J.D., Hunt, S.M., & Stewart, P.S. (2006). A three-dimensional computer model of four hypothetical mechanisms protecting biofilms from antimicrobials. Appl Environ Microbiol, 72(3), 2005-2013. doi: 10.1128/aem.72.3.2005-2013.2006
Chu, V.H., Crosslin, D.R., Friedman, J.Y., Reed, S.D., Cabell, C.H., Griffiths, R.I., . . . Fowler, V.G., Jr. (2005). Staphylococcus aureus bacteremia in patients with prosthetic devices: costs and outcomes. Am J. Med, 118(12), 1416. doi: 10.1016/j.amjmed.2005.06.011
Cookson, S.T., Ihrig, M., O'Mara, E.M., Denny, M., Volk, H., Banerjee, S.N., . . . Jarvis, W.R. (1998). Increased bloodstream infection rates in surgical patients associated with variation from recommended use and care following implementation of a needleless device. Infect Control Hosp Epidemiol, 19(1), 23-27.
Digiovine, B., Chenoweth, C., Watts, C., & Higgins, M. (1999). The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive care unit. Am J. Respir Crit Care Med, 160(3), 976-981. doi: 10.1164/ajrccm.160.3.9808145
Caglar S; Yildiz S; Savaser S. (2010). Observation results of hand-washing by health-care workers in a neonatal intensive care unit. International Journal of Nursing Practice, 16(2), 132-137.
In this article the authors wanted to determine whether healthcare professionals were washing their hands and if they were doing so effectively. The researchers observed 344 incidents in which hand washing was warranted and found that nurses were 63% compliant and physicians were 53% compliant. However, when it came to making sure that the job was done thoroughly, physicians were able to do a better job than nurses at a 24% to 13% rate of success. Since hand washing has been proven to be the most effective and simplest method for preventing infection, it is imperative that healthcare professionals perform it as often as needed and thoroughly.
amos M.M., Schrader, ., Trujillo, ., Blea, M., & Greenberg, C. (2011). School nurse inspections improve…
Researchers are trying different techniques to increase the incidence of compliance with hand washing guidelines and in this study they used social pressure. Initially, compliance with hand washing regulations was deemed to be significantly below expected standard within the nursing staff. To hopefully combat this, researchers told the staff that they were going to weigh the soap dispenser bags to see if people were actually using them or not. The object of the study was to determine if this type of pressure would induce the staff into better compliance with hand washing regulations. The researchers found that this type of behavioral technique is very effective.
15. Parish, C. (2008). Patient campaigner calls for TV cameras to check hand-washing. Nursing Standard, 22(38), 6.
The author of the article looked at the compliance records of staff and whether patients and visitors used infection controls. The campaigner, Roger Goss, said that because MRSA and other similar healthcare-acquired infections were becoming more dangerous that staff and visitors needed to be monitored more closely to prevent spread. The man advocated that close-circuit televisions be used to determine compliance with regulations, and he encouraged staff to be fired and visitors not welcomed if they did not comply. The warning here to nurses is that people are watching whether they wash their hands properly, and they are ready to have them terminated if they do not.
Osteomyelitis in the Diabetic Patient
Management OF OSTEOMYELITIS IN THE DIABETIC PATIENT
Osteomyelitis is an infection of the bone or bone marrow which is typically categorized as acute, subacute or chronic.1 It is characteristically defined according to the basis of the causative organism (pyogenic bacteria or mycobacteria) and the route, duration and physical location of the infection site.2 Infection modes usually take one of three forms: direct bone contamination from an open fracture, puncture wound, bone surgery, total joint replacement, or traumatic injury; extension of a soft tissue infection such as a vascular ulcer; or hematogenous (blood borne) spread from other infected areas of the body such as the tonsils, teeth or the upper respiratory system.2(p807) Bacteria such as Staphylococcus aureus, Pseudomonas, Klebsiella, Salmonella, and Escherichia coli are the most common causative agents of the disease, although viruses, parasites and fungi may also lead to the development of osteomyelitis.3
1. Stedman's Medical Dictionary. 27th ed. Baltimore, MD: Lippincott Williams & Wilkins; 2000.
2. Butalia S, Palda V, Sargeant R, Detsky A, Mourad O. Does This Patient With Diabetes Have Osteomyelitis of the Lower Extremity?. JAMA: Journal of The American Medical Association [serial online]. February 20, 2008; 299(7):806-813. Available from: Academic Search Premier, Ipswich, MA. Accessed September 19, 2012.
3. Lavery L, Peters E, Armstrong D, Wendel C, Murdoch D, Lipsky B. Risk factors for developing osteomyelitis in patients with diabetic foot wounds. Diabetes Research & Clinical Practice [serial online]. March 2009; 83(3):347-352. Available from: Academic Search Premier, Ipswich, MA. Accessed September 19, 2012.
4. Turns M. The diabetic foot: an overview of assessment and complications. British Journal of Nursing [serial online]. August 12, 2011;:S19-S25. Available from: Academic Search Premier, Ipswich, MA. Accessed September 19, 2012.
Abnormal Uterine Bleeding and Issues
Reproductive Tract Diseases for human females are typically focused in the upper reproductive tract or the lower reproductive tract. The upper tract includes the fallopian tubes, ovary and uterus, while the lower reproductive tract focuses on the vagina, cervix and vulva. There are three major types of infections: endogenous, iatrogenic and sexually transmitted diseases. Endogenous diseases arise from internal cellular structures and may be bacterial, viral or genetic, usually the most common and arise from an overgrowth of organisms that are already present in the vagina; iatrogenic diseases are the result of medical or surgical treatment, and sexually transmitted diseases occur between humans as a result of sexual behavior. In addition to infections, there are congenital abnormalities, cancers and functional problems. Each infection has its own specific cause and symptoms; caused by bacteria, virus, fungi or other organisms. Indeed, some are easily treatable and cured,…
Azim, P., et al. (2011). Evaluation of Abnormal Uterine Bleeding. Isra Medical Journal, 3(3). Retrieved November 2013, from http://184.108.40.206/Isra%20Medical%20Journal%20Volume-III%20Issue-III.pdf#page=6
Davidson, B., et al. (2012). Abnormal Uterine Bleeding During the Reproductive Years. Journal of Midwifery and Women's Health, 57(3), 248-54.
Fraser, I., et al. (2011). The FIGO Recommendations on Terminologies and Definitions for Normal and Abnormal Uterine Bleeding. Seminars in Reproductive Medicine, 29(5), 383-90.
Gray, S. (2013). Menstural Disorders. Pediatrics in Review, 34(1), 6-18.
Cutaneous Candidiasis: A Case Study
This case study involves a 35-year-old woman diagnosed with candidiasis of the inner thighs. The goal of this report is to provide the patient with information about the most likely cause of her condition and how best to resolve the infection. In order to accomplish this goal a review of Candida pathogenesis will be presented first.
Members of the Candida genus, in particular C. albicans, can be detected in the oral cavities of 75% of the general population (Mayer, Wilson, & Hube, 2013). This mostly commensal microbe colonizes oral, vaginal, gastrointestinal, anal, and cutanous locations (az-Pasteur, Ullmann, & Berdicevsky, 2011). Candida species are commensal in health people and rarely cause any problems, but in persons who suffer from mild medical conditions with impaired immunity the commensal relationship can quickly evaporate and turn pathogenic (Mayer, Wilson, & Hube, 2013). For example, Candida is…
Mansur, A.T., Aydingoz, I.E., & Artunkal, S. (2012). Facial Candida foliculitis: Possible role of sexual contact. Mycoses, 55, e20-e22. Doi: 10.1111/j.1439-0507.2011.02075.x.
Mayer, F.L., Wilson, D., & Hube, B. (2013). Candida albicans pathogenicity mechanisms. Virulence, 4(2), 119-128.
Raz-Pasteur, A., Ullmann, Y., & Berdicevsky, I. (2011). The pathogenesis of Candida infections in a human skin model: Scanning electron microscope observations. International Scholarly Research Network, 2011, 1-6. Doi: 10.5402/2011/150642.
Scheinfeld, N.S. (2004). Obesity and dermatology. Clinics in Dermatology, 22, 303-309.
Customer Inserts His/Her Name
Explain how HIV infects CD4+ cells?
The HIV (human immunodeficiency virus) is the virus which belongs to a group of viruses known as the retroviruses. HIV causes in AIDS (acquired immunodeficiency syndrome) by infecting the cells of the human and uses up all the energy inside the cells which is required for the growth and development of human cells. AIDS is a fatal disease in which the immunity system of the human body is destroyed due to which the body becomes vulnerable to various infections and also the weakness of the body's immune system also allows other diseases to attack the body. Once a person is infected with HIV, this virus feeds on the energy present in the cells and multiplies in the white blood cells. White blood cells are the ones which build up the immune system and when they are weakened by the HIV…
McClatchey, Kenneth D (2002). Clinical Laboratory Medicine. 2nd. Edition. Lippincott, Williams & Wilkins.
Rose, Hamilton (2002). Manual of Clinical Immunology. 6th. Edition, ASM, 2002.
Whiteside, Alan (2008). HIV / AIDS: A Very Short Introduction. Publisher: Oxford University Press, USA; 1st edition. ISBN-10: 0192806920.
The Gram-negative, motile, rod-shaped bacterium Pseudomonas aeruginosa is an opportunistic killer that takes advantage of people suffering from medical problems (Van Delden and Iglewski, 1998).For this reason, P. aeruginosa is one of the most common nosocomial infection that occurs in hospitals. P. aeruginosa is responsible for causing 16% of pneumonia cases, 12% of urinary tract infections, 10% of bloodstream infections, and 8% of surgical infections due to hospital care. Patients who are immune-compromised are also susceptible to P. aeruginosa infections, such as patients undergoing chemotherapy, suffering from HIV / AIDS, recovering in burn units, and suffering from cystic fibrosis. With death rates ranging from 30 to 60% for these patients, P. aeruginosa is considered to be a significant threat to patient health.
P. aeruginosa can switch between a free-swimming planktonic form and colonies enclosed within slime-protected biofilms attached to surfaces (Baltch and Smith, 1994,…
Baltch, A.L. And Smith, R.P. (Eds.). (1994). Pseudomonoas aeruginosa Infections and Treatment. New York, NY: Marcel Dekker, Inc.
Botzenhart, Konrad and Doring, Gerd. (1993). Ecology and Epidemiology of Pseudomonas aeruginosa. In M. Campa, M. Bendinelli, H. Friedman (Eds.), Pseudomonas aeruginosa as an Opportunistic Pathogen (pp. 1-18). New York, NY: Plenum Press.
Hawkey, Peter M. And Kerr, Kevin G. (2004). Laboratory investigation of health care-associated infection. In P. Hawkey and D. Lewis (Eds.), Medical Bacteriology: A Practical Approach (pp. 331-354). Oxford, UK: Oxford University Press.
Hurley, Matthew N., Camara, Miguel, and Smyth, Alan R. (2012). Novel approaches to the treatment of Pseudomonas aeruginosa infections in cystic fibrosis. European Respiratory Journal, published online ahead of print, 1-19. Retrieved 23 July 2012 from http://erj.ersjournals.com/content/early/2012/06/27/09031936.00042012.long .
dozens of internal parasites that infect horses, the most dangerous and most capable of causing serious harm are the large strongyles parasite. They are considered to be the ones in charge of causing severe parasite related health problems in horses and they have the ability to kill. They have cylindrical bodies and unlike other parasites like tapeworms, strongyles have different sexes- male and female and can be told apart by the shape of their tails. The female lays eggs almost all the time and even though this makes it easier to detect any signs of infection, it does not stop it from growing. Several horses are affected by this disease every year, but careful research and study has been done and soon this disease will be a thing of the past and horses will be able to live a longer and healthier life.
Since an encounter against internal parasites was…
Gore, T., P. Gore, and J. Giffen. Horse Owner's Veterinary Handbook. John Wiley & Sons,
2008. 692. eBook.
The illustrated veterinary encyclopedia for horsemen. Equine Research Publications, 1975.
Bloodstream Infections in NICU
Bloodstream infections in the neonatal intensive-care unit (NICU) are a serious concern for parents and health care professionals. Exposure to bloodstream infections for most patients will caused delayed hospital stays and higher costs associated with hospital visit (Marschall et. al., 2008). There are many procedural changes that can be made at the hospital to decrease risk of bloodstream infections. ecommendations for decreasing bloodstream infections will be based on the practices of the Connecticut Children's Medical Center (CCMC), which is successful in decreasing bloodstream infections. In this paper I will discuss how to get the employees engaged in their work, how to receive buy-in for quality work, how this will reduce errors and increase the quality of work.
Engaging employees in their Work
It is important to train the employees on the recommended techniques for inserting a catheter since this is main cause of blood…
Buttes et. al. (2006). Drive down infection rates. Nursing Management. October.
Deaver, K. (2010). Preventing Infections in Hemodialysis Fistula and Graft Vascular Accesses. Nephrology Nursing Journal. 37 (5) 503-506
Marschall et. al. (2008). Strategies to prevent central line-associated bloodstream infections in acute care hospitals. Infection Control and Hospital Epidemiology. 29 (1) S22-30.
This clearly shows that alcohol-based hand-washing, when used regularly and vigorously (e.g. prior to any healthcare procedure by any level of personnel), infection will be reduced.
The Saudi study was a bit more detailed, with protocols varying depending on severity of procedure (surgery, etc.) and the administering of prophylactic antibiotics as part of the regular treatment procedure. Statistical analysis of the samples showed no significant differences between the Betadine Group and the Alcohol-Based Gel Group. However, the total number of infections within both groups were quite small, 20 out of 600 subjects in the trial. This suggests that the conditions at the Saudi hospital were already more sterile, with less than 5% (3.33%) even developing infections; compared to 13.1% in Vietnam. In both cases, demographic differences between patients were not statistically significant in the protocol.
Combining the data from the two studies, however, results in two conclusions: 1) There is…
Al-Naami, M.Y., et al., (2009). EWMA Journal. 9 (3): 5-10.
Nguyen, K., et al., (2008). Tropical Medicine and International Health. 13 (10): 1297-1302.
These efforts include: expansion of international efforts to prevent terrorist acquisition of biological agents, initiated Bioatch program to detect initial releases of biological weapons within the environment, launched food programs to carefully inspect foods for potential bioagents (with greater focus on foreign foods), expanded bioterrorism research (including Project Bioshield, a program to develop medical ripostes to biological agents), and increased medical stockpiles and training for dealing with bioterrorism attacks (Cordesman; Lindler, Lebeda, & Korch; Petsko; Fidler & Gostin). These efforts will help to both prevent the initial release of any biological agents within the general populace or environment, as well as effectively treat afflicted individuals and slow spread through appropriate treatments.
Once biological agents are released into the general population, the extent of disease spread and number of individuals afflicted will be significantly affected by the role and effectiveness of the government through quarantine and treatment (Cordesman; Lindler, Lebeda, &…
Cole, Leonard A. The Eleventh Plague. Macmillan, 2002. Print.
Cordesman, Anthony H. The challenge of biological terrorism. CSIS, 2005. Print.
Fidler, David P., and Lawrence O. Gostin. Biosecurity in the global age. Stanford University Press, 2008. Print.
Kortepeter, MG, and GW Parker. "Potential biological weapons threats." Emerging Infectious Diseases 5.4 (1999): 523-527. Print.
Metrics, Implementation, and Enforcement (Security Governance)
How can you determine whether there has been a malware outbreak?
The threat situation today has become more dangerous than in the past. Security and safety threats have been increasing in an alarming rate; there are more than 70,000 brand new bits of malware recognized daily. Well-funded cybercriminals have been currently making advanced malware that has been made to bypass present security options by launching prior to the operating-system and then evading antivirus defence (Mitre, 2012). Consequently, danger vulnerability has hit unprecedented degrees that need a brand new method of security and safety. With built-in security and safety options from McAfee as well as Intel, one might gain an additional layer of safety that is effective aside from the operating-system to avoid attacks instantly whilst successfully managing security over to a system of endpoints. These revolutionary options gather world-class processor chip technologies from Intel…
McAfee Labs (Q1 2012).
Intel IT Centre. (2012). Planning Guide: Preventing Stealthy Threats with Next-Generation Endpoint Security -- A Proactive Approach from Intel and McAfee. Intel IT and McAfee.
Mitre. (2012). Standardizing Cyber Threat Intelligence Information with the Structured Threat Information eXpression (STIX). Mitre Corporation.
Jones, D.R. (2011). Managing Cyber Threats Risk Management & Insurance Solutions. Roach Smith and Howard Burton.
What are Bacteria and Viruses?
The most basic difference between bacteria and viruses is their size. Whereas both bacteria and viruses are too tiny to notice with the naked eye, most bacteria are about one micrometer in length and can be perceived with a good optical microscope. On the other hand, viruses are smaller than the wavelength of visible light, which suggests that they can only be perceived by using an electron microscope (Nursing Times, 2006). Infection, every so often the initial phase, takes place when bacteria, viruses or other microbes that cause disease enter the human body and start to multiply. Disease comes about and ensues when the cells in the human body are damaged, as a result of the infection, and signs and symptoms of a disease appear.
Bacterial and viral infections are contaminations caused by bacteria and viruses. Bacteria release poisons known as toxins into the…
What are Bacteria and Viruses?
The most palpable variance between bacteria and viruses is their size. Whereas both bacteria and viruses are too tiny to notice with the naked eye, most bacteria are about one micrometer in length and can be perceived with a good optical microscope. On the other hand, viruses are smaller than the wavelength of visible light, which implies that they can be solely perceived by using an electron microscope (Nursing Times, 2006). Infection, every so often the initial phase, takes place when bacteria, viruses or other microbes that cause disease enter the human body and start to proliferate. Disease comes about and ensues when the cells in the human body are damaged, as a result of the infection, and signs and symptoms of a disease appear.
Bacterial and viral infections are contaminations caused by bacteria and viruses. Bacteria release toxins into the blood stream whereas…
As to catheter straps, if fastened too tightly they can act as tourniquets, cutting off the needed flow of blood and presenting. And at least theoretically, use of straps brings about a risk of increasing the complications such as "…deep vein thrombosis and pulmonary embolism" in those patients with "impaired lower extremity circulation" (Billington 504). Research presented in this article shows that the problem of infection due to poorly attached catheters can be reduced significantly through the use of a product called "Bard StatLock" -- which, the authors insist, is an effective stabilization device because it allows movement (through a swivel clip), because it is a "sterile latex-free, tug-resistant product" (Billington 504). An article in the journal RN, incidentally, states that treating "hemodialysis catheter-related bacteremia" can cost a hospital up to $45,000.
ashing "Bloody Hands": An article in the Australian Nursing Journal asserts, "…hand hygiene is the single most effective…
Aziz, a.M., Ashton, H., Pagett, a., Mathieson, K., Jones, S., & Mullin, B. (2009).
Sharps management in hospital: an audit of equipment, practice and awareness.
British Journal of Nursing, 18(2), 92-98.
Billington, a., Crane, C., Jownally, S., Kirkwood, L., & Roodhouse, a. (2008).
Other signs include a child who has numerous of colds and ear infections; a child who speaks overly loudly; frequently asks for words or phrases to be repeated and who does not understand someone unless the person is facing him or her. (Hearing Health for Children)
While ear infection is usually treated with prescription antibiotics, many physicians state that use of these media is not a good idea at an early age. As one experts states, "Contrary to common practice, most children with ear infections should not be treated with antibiotics..." (DrGreene Content:
evolution in Ear Infection Treatment). These findings refer to guidelines released by the American Academy of Pediatrics and the American Academy of Family Physicians in 2004, which state that, "...currently in the United States there are more than 10 million antibiotic prescriptions for the 5 million ear infections diagnosed in children each year - about half of…
Dr Greene Content: Revolution in Ear Infection Treatment. Retrieved April 9, 2008 at http://www.drgreene.com/21_1769.html
Ear infection (acute otitis media) Retrieved April 9, 2008, at http://www.webmd.com/hw-popup/ear-infection-otitis-media
Hearing Health for Children. Retrieved April 9, 2008, at http://www.northwords.com/Hearing.htm
How to Clean Your Preschooler's Ears. Retrieved April 9, 2008, at http://preschoolrock.com/index.php/health_exercise/clean_ears
Treatment to Patients
The main objective of providing treatment to patients is to relieve symptoms along with decreasing the progression of the disease as well as the mortality or morbidity. However, in some cases, this objective is not fully achieved, especially in the case of the patients who are admitted to the ICU with some serious and almost always a terminal stage of the disease. For example, when old patients are admitted in the ICU, their immunity is extremely low and this is the perfect time for the opportunistic infections to make matters worse for these patients. There are many infections that are specifically associated with patients admitted in the hospitals. Pseudomonas Aurigeonosa is a micro-organism that is well documented to cause bacterial pneumonia and bacteremia in the patients who are terminally ill and are receiving treatment in the hospital setting. Since most of the patients in the ICU are…
Beekmann, SE;Diekema, DJ; Chapin, KC;Doern, GV (2003) Effects of rapid detection of bloodstream infections on length of hospitalization and hospital charges.J ClinMicrobiol, 41:3119-3125.
Boussekey, N, Leroy, O, Georges, H, Devos, P, d'Escrivan, T, Guery, B (2005).Diagnostic and prognostic values of admission procalcitonin levels in community-acquired pneumonia in an intensive care unit.Infection, 33:257-263.
Charles, PE, Dalle, F, Aho, S, Quenot, JP, Doise, JM, Aube, H, Olsson, NO, Blettery, B: Serum procalcitonin measurement contribution to the early diagnosis of candidemia in critically ill patients. Intensive Care Med, 32:1577-1583.
Digiovine, B; Chenoweth, C; Watts, C; Higgins, M (1999)The attributable mortality and costs of primary nosocomial bloodstream infections in the intensive care unit. Am J. RespirCrit Care Med, 160:976-981.
air traffic has continued to increase and it now constitutes a considerable proportion of the travelling public. The amount of long-hour flights has increased significantly. Based on the International Civil Aviation authority, air traffic can be anticipated to double amid till 2020. Airline travel, especially over longer distances, makes air travelers vulnerable to numerous facets that will impact their health and well-being. Particularly, the speed with which influenza spreads and mutates, via transportation routes, is the reason why the influenza pandemic is considered to be a huge threat to the human population. Pandemic is a term, which is used for a virus or microbe when it spreads over a large area, in severe cases even the whole world and large number of people start getting affecting by it (CDC, 2009).
In the past 300 years, there have been ten significant influenza pandemics outbreaks that have taken place in this world.…
Airports Council International (2009) Airport preparedness guidelines for outbreaks of communicable disease. Available at: http://www.airports.org/aci/aci/file/ACI_Priorities/Health/Airport%20preparedness%20guidelines.pdf (Accessed: 28 November 2011)
Bouma, G.D. (2002) The research process. 4th edn. Melbourne: Oxford University Press.
Brigantic, R., Delp, W., Gadgil A., Kulesz, J., Lee, R., Malone, J.D. (2009) U.S. airport entry screening in response to pandemic influenza: Modeling and analysis. Available at: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B7578-4W2M6SG1&_user=10843&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000000150&_version=1&_urlVersion=0&_userid=10843&md5=44685b11dd53d74a8ef85a4f03e185f2 (Accessed: 28 November 2011)
Bush, George W. (2003a). Homeland security presidential directive -- 5: Management of domestic incidents. Available at: http://www.whitehouse.gov/news/releases/2003/02/20030228-9.html (Accessed: 28 November 2011)
Nursing Case Study
Managing a possible Case of Gastroenteritis: A Nursing Case Study
The effective delivery of optimal nursing care requires a comprehensive treatment plan that addresses both the patient's symptoms and the security of the immediate environment. This report presents a case study of appropriate evidence-based nursing practices in treating an elderly female patient presenting with abdominal discomfort in a residential care setting.
The client presents with new onset faecal incontinence, diarrhoea and increasing abdominal discomfort and cramps. These symptoms suggest a possible gastrointestinal disturbance (Crisp & Taylor, 2009) and present a number of possible diagnoses. While the client's nursing care plan indicates that she is normally continent, her confidential disclosure to the nurse suggests that her symptoms may be more prolonged. Another relevant client characteristic is her advanced age of 85 years.
The client's proximity to the dirty utility room in the aged care facility and the report…
1. Crisp J, Taylor C. (2010). Potter & Perry's fundaments of nursing (3rd ed.). Chatswood, N.S.W.: Elsevier, Australia.
2. Kirk MD, Hall GV, Veitch MGK, Becker N. (2010). Assessing the ?incidence of gastroenteritis among elderly people living in long-term care facilities. Journal of Hospital Infection, 76, 12.
3. Australian Government: Department of Health and Ageing. (2007). Retrieved from- http://www.health.gov.au/internet/main/publishing.nsf/content/icg-guidelinesindex.htm .
4. Andrew E, Simor MVD. (2010). Diagnosis, Management, and Prevention of Clostridium difficile Infection in Long-Term Care Facilities: A Review. The-Americans Geriatric Societ, 58(8), 1557-1593.
Safety and Health Issues in Meat Processing Industry
In the meat processing industry, health and safety issues are of vital importance, in view of the several risks arising out of microbial contamination of meat and the occupational hazards faced by workers. Past experiences have shown that microbial reproduction in meat and meat products can reach alarming proportions traversing across countries and even continents. The infamous mad cow disease and the foot and mouth disease in cattle has rattled the British meat industry for a considerable period, resulting in loss of image, confidence and erosion of profits. North America's main problem is the widespread prevalence of eschericia coli in meat, more commonly known as the hamburger disease. It is well-known that meat is highly susceptible to attack of bacteria and virus and hence there is a constant need to address this risk. When microbial activity sets in, the quality of meat…
American Meat Industry Fact Sheet: 'Worker Safety in the Meat and Poultry Industry', (2002) Available at www.meatami.com/content/presscentre/factsheets_infobits/FactSheetWorkerSafety.pdf. Accessed 11/28/2003
Brodeur, C. (n.d) Agriculture and Agri-food Canada - 'Meat Safety: The war on bacteria', Available at http://www.res2.agr.gc.ca/orda/pubs/art8_e.htm. Accessed 11/28/2003
Cannon, J.E et. al (1996) 'Pork Chain Quality Audit Survey: Quantification of Port Quality Characteristics', Journal of Muscle Foods (7), 56-62
Chesworth, N (1997) 'Food Hygiene Auditing', Blackie Academic & Professional, London
STDs: A MAJO CONTEMPOAY PUBLIC HEALTH CONCEN
Sexually Transmitted Diseases
Given the advances in medicine and public health over the past several decades, most people might assume that the incidence and prevalence of sexually-transmitted diseases (STDs) is declining; however, the scientific evidence suggests otherwise. ecent estimates from the Centers for Disease Control and Prevention (CDC) in the United States suggest that 20 million new STD infections occur every year and cost the U.S. health care system close to $16 billion dollars annually (CDC, 2013). This is up from 12 million STD infections and $10 billion dollars annually during the mid-1990s (Zenilman, 2004). In 2011, reports of chlamydia incidence set another annual record, double from what it was just 10 years ago (CDC, 2011). To better understand the health threats facing Americans when they engage in sexual activity this report will review what is known about the most common STDs infecting…
CDC. (2013). CDC Fact Sheet: Incidence, prevalence, and cost of sexually transmitted infections in the United States. Retrieved from: http://www.cdc.gov/std/stats/STI-Estimates-Fact-Sheet-Feb-2013.pdf .
CDC. (2011). Sexually Transmitted Disease Surveillance, 2011. Altlanta, GA: Department of Health and Human Services. Retrieved from: http://www.cdc.gov/std/stats11/Surv2011.pdf .
Dyck, E.V., Meheus, A.Z., & Piot, P. (1999). Laboratory Diagnosis of Sexually Transmitted Diseases. Geneva: World Health Organization.
Katz, A.R., Lee, M.V.C., & Wasserman, G.M. (2012). Sexually transmitted disease (STD) update: A review of the CDC 2010 STD treatment guidelines and epidemiologic trends of common STDs in Hawai'i. Hawai'I Journal of Medicine & Public Health, 71(3), 68-73.
ationalism Politics Impacts Public's View
Web Article eview
The principle best-practice strategy elucidated within Louis DePaola's article entitled "Infection control in the dental office" is for practitioners to adhere to sanitary and hygiene mandates as noted within a pair of documents produced by the Centers for Disease Control. The first document is the Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care (which was published in 2011), and the companion Infection Prevention Checklist for Outpatient Settings: Minimum Expectations for Safe Care. These documents have a number of specific measures for those working in dental offices to follow to reduce the incidence of healthcare associated infections (HAI).
In addition to denoting several of the key guidelines for practitioners to adhere to in order to ensure safety and reduce the rate of infection transmission, the author also reinforces several key facets of this literature that apply to dental office…
DePaola, L. (2012). "Infection control in the dental office." http://static.ow.ly/. Retrieved from http://static.ow.ly/docs/RICDE%20Infection%20Control%20in%20the%20Dental%20Office,%20Standards%20of%20Care%202012%20(CE%20Article%20PDF)_Mcl.pdf