CVME Insider: Nursing Knowledge That Matters

Is it truly the 3rd leading cause of death in America? According to the CDC , in 2015,  633,842  people died of heart disease,  595,930  died of cancer, and  155,041  died of chronic respiratory disease—the top three causes of death in the U.S.  However, according to Dr. Martin Makary, MD, M.P.H a professor at John Hopkins and a recent study he conducted may prove the CDC wrong putting medical errors as the cause of death behind cancer but ahead of respiratory disease. Dr. Martin goes on to state that;    “Incidence rates for deaths directly attributable to medical care gone awry haven’t been recognized in any standardized method for collecting national statistics,” says  Martin Makary, M.D., M.P.H. , professor of surgery at the Johns Hopkins University School of Medicine and an authority on health reform. “The medical coding system was designed to maximize billing for physician services, not to collect national health statistics...

Is a Respiratory Therapist (RT) more than just a breathing treatment provider? So I have had experience in nursing for over 20 years and have specialized in Infusion Therapy for over 6 years.  Recently, I was teaching an IV class in which the facility was using a Respiratory Therapist to insert and maintain their PICC's.  I was a little taken aback by this discovery as I have never heard of such a thing. Well I contacted the California Board for Respiratory Therapist and they responded back fairly quick and the following was their response; "Good afternoon Mr. Stansbury. The Respiratory Care Board of California (Board) often receives inquiries related to PICC and central line insertion.   In its responses the Board has stated that that licensed respiratory care practitioners are authorized to insert and care for PICC lines, so long as appropriate training, guidelines, and competencies are provided/documented by the licensed health care facility ...

Intravenous Lipids Intravenous Lipids have been used in the clinical setting for over 3 decades. However, the use of these intravenous fluids have had a widespread element of controversy. Some healthcare providers question whether we should be using intravenous lipids due to the potential compromise of patient outcomes. Over the past 15 years new lipids that include olive oil and/or fish oil have been introduced with some remarkable findings seen when these new lipids replace the more traditional ones.     The most widely available intravenous lipids are prepared from soybean oil or a combination of soybean and safflower oil. All of the emulsions are emulsified with egg yolk phospholipid, with glycerol added to achieve an isotonic solution.  The issue of  Lipid function and use in pediatric, adult surgical and critically ill patients were covered in a Swedish Symposium with the aim of developing a clearer picture of the current situation.  ...

Does Your Hospital Use the  The Surviving Sepsis Campaign ? This c ampaign  was created to help healthcare workers implement the recommended guidelines for Severe Sepsis patients in the Emergency Room (ER) and Intensive Care Units (ICU).  The  Surviving Sepsis Campaign  kits include posters, pocket guides, bundle cards, lapel pins and a list of resources to aid your implementation efforts using the most recent edition of the international sepsis guidelines.   The Surviving Sepsis Campaign has developed pre-packaged kits to help clinicians within institutions to improve sepsis identification, management and treatment.   "The Surviving Sepsis Campaign (SSC) partnered with the Institute for Healthcare  Improvement (IHI) to incorporate its “bundle concept” into the diagnosis and treatment  of patients with severe sepsis and septic shock. We believe that improvement in  the delivery of care should be measured one patient a...

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, ...

Free ECG Tip Placement Webinar by  International Vascular Access Expert Using x-ray to confirm PICC tip placement wastes clinical care time, exposes patients to harmful radiation, and delays medical therapy. The ECG Tip Confirmation Systems available on the market can help alleviate these problems by using an adult patient's cardiac electrical activity to position the tip of the PICC in close proximity to the cavoatrial junction (CAJ). Final tip location is confirmed by the nurse at the bedside and infusion therapy can begin immediately without the need for a confirmatory chest x-ray. In a clinical study, 99.1% of 114 PICCs were placed at the CAJ or within +/- 1 cm using Bard® Tip Confirmation Technology.   "Rare ECG tip placement webinar by international vascular access expert Mauro Pittiruti of the Università Cattolica del Sacro Cuore in Rome, Italy, is being offered free next month to healthcare professionals, in association with Vygon (UK) Ltd." ...

Subphrenic abscesses are localized collections of pus, usually underneath the right or left hemi- diaphragm.There  is a accumulation of infected fluid between the diaphragm, the liver and the spleen Abstract: "We describe an unusual case of subphrenic abscess complicating a central venous catheter infection caused by Pseudomonas aeruginosa in a 59-year-old woman undergoing hemodialysis. The diagnosis was made through computed tomography, and Pseudomonas aeruginosa was isolated from the purulent drainage of the subphrenic abscess, the catheter tip and exit site, and the blood culture samples. A transesophageal echocardiography showed a large tubular thrombus in superior vena cava, extending to the right atrium, but no evidence of endocarditis or other metastatic infectious foci. Catheter removal, percutaneous abscess drainage, anticoagulation, and antibiotics resulted in a favourable outcome." Introduction: "Infection is a common complicati...

Giving old mice young blood reversed age-related declines in brain function, muscle strength and stamina, researchers say Researchers in the US are close to proving that a type of infusion therapy can possibly reverse harmful aging processes in the brain, muscles, heart and other organs. It gives hope as three separate reports released by major journals on Sunday that demonstrate in experiments on mice the dramatic rejuvenating effects of chemicals found naturally in young blood. Infusing younger blood reversed age-related declines in memory and learning, brain function, muscle strength and stamina, researchers found. In two of the reports, scientists identified a single chemical in blood that appears to reverse some of the damage caused by aging. Although all three studies were done in mice, researchers believe a similar rejuvenating therapy may work in humans as well. A clinical trial is expected to begin in the next three to five years. "The ev...

  Needleless devices are used for connecting to IV catheters , administration sets, and/or syringes.   They were introduced in the 1990s for the purpose of reducing the risk of needlestick injuries among health care providers.    However, in 2000 the Needlestick Safety and Prevention Act mandated that all employers provider these devices as they have shown to reduce needlestick injuries significantly.   On the other hand; their use has been associated with an increase in complications such as catheter-related bloodstream infection (CRBSI) and catheter lumen occlusion. The reason for these complications are not totally understand and efforts to study their design, user knowledge, poor clinical practices have gotten underway to help reduce or eliminate these complications. The Food and Drug Administration is requiring nine companies to conduct a post market study on positive displacement needleless conne...