CVME Insider: Nursing Knowledge That Matters

Sepsis is a consequence of infection that is difficult to predict, diagnose, and treat. Patients who develop sepsis have an increased risk of complications and death and face higher healthcare costs and longer treatment.  CDC is working to increase sepsis awareness and improve treatment among the public, healthcare providers, and healthcare facilities.  It kills more people than HIV/Aids, prostate cancer and breast cancer combined. What is sepsis? Sepsis is an illness that affects all parts of the body that can happen in response to an infection and can quickly become life-threatening. In severe cases of sepsis, one or more organs fail. In the worst cases, sepsis causes the blood pressure to drop and the heart to weaken, leading to septic shock. Once this happens, multiple organs may quickly fail and the patient can die. Sepsis is a serious illness that is very difficult to predict, diagnose, and treat. Patients who develop sepsis have an increased risk of complic...

SO I have been thinking about Nina Pham.  Who is Nina?  Well if you have to ask; then I think you should stop reading and go check your heart and soul.  The Center for Disease Control and Prevention  ( CDC ) has a poster that has been put out that shows you exactly how to put on and take off your Personal Protective Equipment (PPE) in case you have a patient in isolation for whatever reason. However, I have been studying this poster and thinking about all my years of training; not only in the civilian world; but the military as well.  What is missing from the poster?  Can you guess? The Poster provided to us by the CDC is shown as follows:   Well, have you guessed?  What about the healthcare provider cover their hair or head?  What is a patient with the EBOLA virus is having a coughing spell; or having massive diarrhea and you are the one having to help them and care for them?  What if those small particles g...

EBOLA The Ebola virus has been around for quite some time and in fact first appeared in 1976 in the Democratic Republic of Congo. 1 However, with the invention of social media our population has 24 hour news coverage and this news can be brought to us immediately from around the world. We have recently seen an uptick in the discussion of the Ebola Virus due to the recent outbreak in Western Africa. “The U.S. Centers for Disease Control and Prevention said that from 550,000 people to as many as 1.4 million people when under reporting of cases is taken into account could be infected by mid-January in Liberia and Sierra Leone, in a worst-case scenario generated by a computer modeling tool the agency constructed. Around 21,000 cases would occur by Sept. 30.” 2 So with this information at your fingertips; are you ready for the increase in Ebola cases here in the U.S.? Is your hospital and medical staff ready to treat these types of patients? “The current outbreak in West Africa, ...

The CDC 2011 Guidelines for the Prevention of Intravascular Catheter-Related Infections CDC Recommendations In patients not receiving blood, blood products or fat emulsions, replace administration sets that are continuously used, including secondary sets and add-on devices, no more frequently than at 96-hour intervals, [ 177 ] but at least every 7 days [ 178–181 ]. Category IA No recommendation can be made regarding the frequency for replacing intermittently used administration sets. Unresolved issue No recommendation can be made regarding the frequency for replacing needles to access implantable ports. Unresolved issue Replace tubing used to administer blood, blood products, or fat emulsions (those combined with amino acids and glucose in a 3-in-1 admixture or infused separately) within 24 hours of initiating the infusion [ 182–185 ]. Category IB Replace tubing used to administer propofol infusions every 6 or 12 hours, when the vial is changed, per the manufacturer’s r...

3.8 million central venous catheters (CVCs).... 2 million peripherally inserted central catheters (PICCs)..... and 310 million peripheral intravenous devices sold yearly in the US......   "Based on average salary and benefits for an RN, the average time of 36 minutes for a nurse to trouble shoot and restart a PIV translates to a labor cost of an estimated $22.79 per incident ( Rosenthal, 2005 )."   Vascular access and Infusion Therapy  is clearly a high priority and nurses take a lot of time performing these procedures for our patients. Getting the right vascular access device placed early in the hospital stay can speed treatment and patient discharge while minimizing cost as well as restarts.   Maintaining the health of our patients veins and arteries has become an important issue as patients now come to hospitals more acutely ill, living longer, often having chronic conditions. According to the Centers for Disease Control (CDC) selection of the...

  A Huber Needle is a specially designed hollow needle used with implanted ports. A Huber needle has a long, beveled tip that is inserted through the patients skin as well until it accesses the silicone septum the implanted port's reservoir. The beveled tip of a Huber needle will not remove a core of silicone from implanted port as this is the way it is designed.   This design will allow as much as 2000 needle sticks into the implanted port’s reservoir without having to be changed. Dr. Ralph L. Huber , a dentist, designed the sharp, beveled, directional needle tip and Dr. Edward B. Tuohy, an anesthesiologist, refined it for use in spinal catheters. Huber needles are used to access ports implanted under the skin of patients who may be suffering from a chronic illness, such as cancer, pancreatitis, or has the need for repeated access to veins for blood withdrawal.   These patients often need the implanted port for infusion of medication , nutritional solutions, blo...

Medical personnel automatically think of CPR when it comes to the saying Look! Listen! & Feel! However, they should also think about Infusion therapy as well. So many times nursing staff attempt to perform an IV catheter on a patient and without fail they do not succeed on the first time.  Why does this happen? Many times the nurse looks for the vein and fails to listen to the patient and fails to feel for the vein.  It is very important to not attempt an IV Catheter on the first look.  Every patient has a vein; however, sometimes those veins may be hard, they may take a curve, or even stop short of what they appear to be at first glance.  Learning your patients anatomy can help save their veins and help you as a medical professional become more successful in your infusion therapy skill. Look  When looking for a vein on your patient; try and look for the most straight vein. Do not just stick the first vein you see.  Look at ev...

CHLORA-PREP   ™ for infection Control Every year, a lot of lives are lost due to the spread of infections in hospitals. Health care workers can take precautions to prevent the spread of infectious diseases. This is a vital part of nursing and as patient advocates it is our duty to follow these steps as a part of infection control. Proper hand washing is the single most effective method to prevent the spread of infections in our hospitals. If you were a patient or one of your family members was a patient would you not be concerned then? Don't be afraid to remind friends, family and other health care providers to wash their hands before getting close, performing a procedure, or touching the patient before starting an IV. DONT FORGET Cover the coughs and sneezes Using gloves, masks and protective clothing Making tissues and hand cleaners available to everyone Following hospital policies and procedures when working with paitents in regards to bloo...