Nursing Notes

May 7, 2010

Real-World Proof of Hand Washing’s Effectiveness

Handwashing
Image by kokopinto via Flickr

Here is an article from ScienceDaily that shows how handwashing or the lack thereof causes problems in the real world as well as in our hospital settings.  When the Infection Control nurse tells you to “wash your hands, please” they are citing from statistical data like that below.

Really, handwashing is such a small thing but this small thing controls many really big things in the medical world.

Please read this article and leave me a comment, won’t you?

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ScienceDaily (May 5, 2010) — Scientists are reporting dramatic new real-world evidence supporting the idea that hand washing can prevent the spread of water-borne disease. It appears in a new study showing a connection between fecal bacteria contamination on hands, fecal contamination of stored drinking water, and health in households in a developing country in Africa.

The study is in ACS’ Environmental Science & Technology, a semi-monthly journal.

Alexandria Boehm, Jenna Davis, and their students note that almost half of the world’s population — over 3 billion people — have no access to municipal drinking water supply systems. They obtain drinking water wells, springs, and other sources, and store it in jugs and other containers in their homes. Past research showed that this stored water can have higher levels of bacterial contamination than its source. But nobody knew why.

The scientists found a strong link between fecal contamination on the hands of household residents and bacterial contamination in stored water in Dar es Salaam, Tanzania. Stored water contained nearly 100 times more fecal bacteria than the source where it was collected. “The results suggest that reducing fecal contamination on hands should be investigated as a strategy for improving stored drinking water quality and health among households using non-networked water supplies,” the report notes.

Here’s the link to the original article and links to many similar stories

Story Source:

Adapted from materials provided by American Chemical Society, via EurekAlert!, a service of AAAS.


Journal Reference:

  1. Amy J. Pickering, Jennifer Davis, Sarah P. Walters, Helena M. Horak, Daniel P. Keymer, Douglas Mushi, Rachelle Strickfaden, Joshua S. Chynoweth, Jessie Liu, Annalise Blum, Kirsten Rogers, Alexandria B. Boehm. Hands, Water, and Health: Fecal Contamination in Tanzanian Communities with Improved, Non-Networked Water Supplies. Environmental Science & Technology, 2010; 44 (9): 3267 DOI: 10.1021/es903524m
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May 6, 2010

Nurses Week, Past & Present

National Nurse’s Week begins tomorrow, May 6th and goes until May 12th, which is the birthday of Florence Nightingale.  Nurses all around the world will be honored by their hospitals, the doctors they work for in clinics, and the management will pass out food and gifts to mark this week as significant.

I don’t speak for anyone but myself, but don’t give me a new mug with the hospital logo on it or a bag with the logo on it.  Since I don’t work days, I usually miss the food because administration only works during the day time.

What I want instead of trinkets is a voice.  I want to have some say in how I do my job and how I care for my patients.  I want to be respected for my knowledge of my patients’ and their families’ needs.  I want to have the right to say, “I can only take care of 5 patients today because two of them are critically ill and will need constant attention.”

I want to be allowed to actually nurse, not spend most of my time searching for supplies, answering phones because we don’t have a clerk, talking to other departments that cannot be bothered to come to the floor to do their own  work, and let’s not forget all the documentation that MUST be done to protect me from lawsuits.  All I want is to take care of my patients the way I, myself, want to be taken care of when I am ill.  Is that really too much to ask?

This article asks “What would Florence Nightingale think about nursing now?” I think she would be saddened and appalled at what nursing now involves.  But read this article and see if you agree with this author.

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What would Florence Nightingale think of the profession today?

By Pat Veitenthal, BSN, RN

Congratulations! You made it to another Nurses Week!

As we celebrate our profession from May 6 to 12, it is time to reflect. Not on the mugs or key chains, or notes, or ice cream socials and free pizza from our employers, but on who and what we collectively are. We are, after all, members of a very exclusive society and we should definitely embrace that.

Putting it in demographic perspective, current U.S. population estimates say there are 305 million people in our country, and only 1.09 percent of us are working as RNs or LP/VNs.

That’s pretty amazing, and it’s what makes us so exclusive. That and the fact the only people on earth who actually understand what it is we do are other nurses.

Recent History

I wonder how much you actually know about Nurses Week? I strongly encourage you to research its history, but let me get you started. In February 1982, a joint resolution by Congress designated May 6 as “National Recognition Day for Nurses,” and in March of that same year, President Ronald Reagan signed the official proclamation.

It wasn’t until 1990 that the American Nurses Association board of directors expanded it to a week-long celebration. We do like good long celebrations, don’t we! Work hard, play hard.

But as we celebrate, let’s also take time to remember our beginnings and Florence Nightingale, who, by the way, has now been dead for 100 years this year, and whose birthday, May 12, marks the end of Nurses Week.

I wonder what Florence would think about the current state of nursing? [...]

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May 5, 2010

Screening for Sleep Apnea

Day 46 - Breathe
Image by Robbie Kennedy (Expresbro) via Flickr

This article really opened my eyes and gave me food for thought.  I am sure that most if not all of my patients would probably meet the criteria as set forth in this article.  This is an area that gets little or no attention, yet this condition sets the stage for so many chronic and life-threatening disorders.  Makes you wonder why it has taken so long for anyone to get interested in patient’s sleep, doesn’t it?

I will be more aware and observant of my patients now that I have read this article.  I hope you, too, will be able to translate this information into your own practice.

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By Haydn Bush

A hospital observes patients for signs of the condition and creates a care plan for those who have it.

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Haydn Bush

Several years ago, Napoleon Knight, M.D., the vice president of medical affairs for Carle Foundation Hospital in Urbana, Ill., noticed that a growing number of patients admitted to the hospital were overweight. Knight began researching the connection between obesity and other medical complications, and learned that the hospital’s clinicians were encountering more patients with sleep apnea, a potentially deadly ailment in which breathing is interrupted during sleep due to blockages of the airway.

When Knight was in medical school, sleep apnea was a relatively rare condition, but its prevalence has increased in recent decades along with obesity rates. The American Association for Respiratory Care now estimates that 18 million Americans suffer from sleep apnea, which can lead to high blood pressure, cardiovascular disease, headaches and memory loss. Sleep apnea has also been linked to workplace impairment, and a 2008 study by the Vancouver Coastal Health Research Institute and the University of British Columbia found that patients with sleep apnea have double the risk of being in a car accident.

“It’s a problem that gradually crept into the environment,” Knight says.

Looking at All Patients

Undetected sleep apnea can pose a major problem for hospitals, Knight says, especially with patients who are admitted for related chronic conditions. Knight helped form a sleep apnea prevention work group at Carle Foundation Hospital, and in the summer of 2009, the group adapted a sleep apnea screening tool that had been used for bariatric surgery patients to screen the entire patient population for the condition.

At admission, staffers now ask all patients if they have already been diagnosed with sleep apnea, and those who answer yes are given continuous positive airway pressure masks to aid their breathing during their stay at the hospital.

In addition, patients who have not been diagnosed with the condition are asked a series of questions to determine if they are at risk for developing it. When patients answer yes to more than three of the questions, the hospital’s electronic medical record automatically opens a sleep apnea prevention patient care plan, which is sent directly to the patient’s nursing unit. So far, roughly 40 percent of adult patients are screening positive for sleep apnea susceptibility, according to Daniel Picchietti, M.D., a board-certified sleep medicine physician at Carle Foundation Hospital.

“That’s a huge number of patients at risk,” Picchietti says.

The patients are monitored remotely with pulse oximeters that alert unit nurses to sleep interruptions, and they are visited regularly. According to Kristina Vasnaik, R.N., a night shift nurse at the hospital and a member of the sleep apnea prevention work group, nurses are trained to quietly enter patients’ rooms while they are sleeping and watch their breathing for several minutes at a time. The work group carefully trained nurses to complete the observations without waking patients and disturbing their sleep patterns, Vasnaik says.

“There was a big education push on the protocol and what it entailed,” Vasnaik said. “We have a lot of new people on nights, and constant education is needed for them.”

Educating Patients and Doctors

The effort has proven successful; since Carle Foundation Hospital began screening for sleep apnea susceptibility, there have been no sleep apnea-related deaths at the hospital, and internal compliance with the screening process has reached 92 percent.

But the initiative doesn’t end at discharge. Patients deemed at risk of developing sleep apnea are given educational materials on the condition during their stay, and their primary care physicians are alerted to the risk. Knight says the work group plans to begin evaluating screening tools aimed at pediatric patients, who are increasingly susceptible to sleep apnea due to rising child obesity rates.

Knight also hopes to expand the initiative beyond the hospital to Carle’s outpatient affiliates, which he believes are uniquely positioned to diagnose potential sleep apnea sufferers before they land in the hospital.

“In the ideal world, this issue would be picked up in the outpatient environment before they get to the hospital,” Knight says. “All we would have to do is know they have sleep apnea.”

Knight urges all providers to research the potential impacts of obesity on their patient populations, noting that sleep apnea is one of many complications. “Once you identify it as an issue, it allows you to focus on the interventions you can put in place,” Knight says. “I look at it as a patient safety issue.”

Haydn Bush is a quality resources specialist at the AHA Quality Center.

For further information on this topic, visit www.hpoe.org.

This article 1st appeared on May 3, 2010 in HHN Magazine online site.

Here’s the link to the original article

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May 2, 2010

Interrupting a Nurse Makes Medication Errors More Likely

Here is a great article I read on another blog.  I love to read posts on Heidi’s blog, KitchRN.  She talks about nursing as well as dieting and eating.  She is witty and posts very informative and intelligent information on her blog.

This article was really an eye opener.  I have always thought that medication administration needed to be more focused but I never really pursued the issue.  I am glad that Johanna I. Westbrook, director of the Health Informatics Research and Evaluation Unit at the University of Sydney in Australia picked up the baton and ran with it.  This study is good and shows why we nurses need to have focused time to pass meds.   Please read this entire article and let me know what you think about both the article and Heidi’s blog.

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In hospitals, mishaps increase along with distractions, study finds

By Karen PallaritoHealthDay Reporter
In hospitals, mishaps increase along with distractions, study finds.

MONDAY, April 26 (HealthDay News) — Distracting an airline pilot during taxi, takeoff or landing could lead to a critical error. Apparently the same is true of nurses who prepare and administer medication to hospital patients.

A new study shows that interrupting nurses while they’re tending to patients’ medication needs increases the chances of error. As the number of distractions increases, so do the number of errors and the risk to patient safety.

“We found that the more interruptions a nurse received while administering a drug to a specific patient, the greater the risk of a serious error occurring,” said the study’s lead author,

For instance, four interruptions in the course of a single drug administration doubled the likelihood that the patient would experience a major mishap, according to the study, reported in the April 26 issue of the Archives of Internal Medicine.

Experts say the study is the first to show a clear association between interruptions and medication errors….

Click here to read the rest of this article

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