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Joseph Boslego, Founder

410-458-4433 Cell443 438 9148 Main #

Joseph@MedZipUp.com

Marvin L. Singer,Attorney , Legal Council 

Richard C. Vogt, CPA,PA

410-799-7484

Email: RCVogt@verizon.net

Or use our contact form.

 

Med Zip Up
604 Evesham Ave
Baltimore, MD 21212

OUR TEAM

Joseph Boslego, Founder

cell 410-458-4433office 443 438 9148

Marvin L. Singer,Attorney , Legal Council 

Richard C. Vogt, CPA,PA

410-799-7484

Email:Joseph@medzipup.com

           RCVogt@verizon.net

Or use our contact form.

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Stay Informed

Here is what people are saying about our shirts:

 

From: Genny Murray, Manager of Greenspring, Davita, Inc. "the Zip Up Shirts - I love them"

From: Ms. Nellie Brown, Fresenius patient, "I am a dialysis patient that was fortuanately chosen to evealuate the Med Zip Up Shirt. I found the shirt to be very comfortable and convenient for my treatment. I like the fact that the zippers are directional, and accomodate the AVF, the catheter and the arm graft. The material keeps me warm during treatment and there is little to no shrinkage after several washings."

 

Message from the founder The following articles, are here to inform you the need for prevention of diseases. They are to make you aware of what is coming and the need to prepare for those that are most vunerable.  Joseph D. Boslego

 

Please follow this link for the FACT SHEET: Obama Administration Releases National Action Plan to Combat Antibiotic-Resistant Bacteria

 

https://www.whitehouse.gov/the-press-office/2015/03/27/fact-sheet-obama-administration-releases-national-action-plan-combat-ant

 

Preventing Infections in Cancer Patients

People receiving chemotherapy are at risk for developing an infection when their white blood cell count is low. White blood cells are the body’s main defense against infection. This condition, called neutropenia, is common after receiving chemotherapy. For patients with this condition, any infection can become serious quickly.

If you have cancer now or have had cancer in the past, you are at higher risk for complications from the flu. Learn what cancer patients, survivors, and caregivers should know about the flu.

Living with cancer increases your risk for complications from influenza (“flu”). If you have cancer now or have had cancer in the past, you are at higher risk for complications from the seasonal flu or influenza, including hospitalization and death.

To help prepare you for the flu this season, CDC answers some of your most important questions about special considerations for cancer patients, survivors, and caregivers.

Are cancer patients and survivors more likely to get the flu than others?

While we don’t know this specifically, we do know that cancer may increase your risk for complications from the flu. If you have cancer now or have had certain types of cancer in the past (such as lymphoma or leukemia), you are at high risk for complications from the seasonal flu or influenza, including hospitalization and death.

Should cancer patients and survivors get a flu shot?

Yes. People with cancer or a history of cancer should receive the seasonal flu shot. People with cancer should NOT receive the nasal spray vaccine because their immune system may be weakened. The flu shot is made up of inactivated (killed) viruses, and the nasal spray vaccine is made up of live viruses. The nasal spray vaccine is not approved for use in people with weakened immune systems (immunosuppression). The flu shot can be given to people 6 months and older even if they have a weakened immune system or other health conditions.

People who live with or care for cancer patients and survivors also should be vaccinated against seasonal flu. Additionally, CDC recommends that everyone aged six months and older get a flu vaccine for the upcoming season.

What other vaccines should cancer patients and survivors be aware of?

Many people who are at increased risk for flu are also at increased risk for pneumococcal disease. People with cancer or other diseases that compromise your immune system should ask their health care providers if pneumococcal shots are needed.

Fluzone High-Dose is a flu vaccine manufactured by Sanofi Pasteur Inc. specifically for people who are 65 years of age and older. Immune defenses become weaker with age, which places older people at greater risk of severe illness from flu. Also, aging decreases the body’s ability to have a good immune response after getting a flu shot. A higher dose of antigen in the vaccine is supposed to give older people a better immune response and better protection against flu.

Preventing Healthcare-associated Infections

Healthcare-associated infections (HAI) are a threat to patient safety. CDC provides national leadership in surveillance, outbreak investigations, laboratory research, and prevention of healthcare-associated infections. CDC uses knowledge gained through these activities to detect infections and develop new strategies to prevent healthcare-associated infections. Public health action by CDC and other healthcare partners has led to improvements in clinical practice, medical procedures, and the ongoing development of evidence-based infection control guidance and prevention successes.

HHS Action Plan to Prevent Healthcare-associated Infections

 

The prevention and reduction of healthcare-associated infections is a top priority for the U.S. Department of Health and Human Services (HHS). The HHS Steering Committee for the Prevention of Healthcare-Associated Infections was established in July 2008, the Steering Committee, along with scientists and program officials across HHS, developed the , providing a roadmap for HAI prevention in acute care hospitals.

 

Health Care-Associated Infections (HAIs)

Health care-associated infections, or HAIs, are infections that people acquire while they are receiving treatment for another condition in a health care setting. HAIs can be acquired anywhere health care is delivered, including inpatient acute care hospitals, outpatient settings such as ambulatory surgical centers and end-stage renal disease facilities, and long-term care facilities such as nursing homes and rehabilitation centers. HAIs may be caused by any infectious agent, including bacteria, fungi, and viruses, as well as other less common types of pathogens.

These infections are associated with a variety of risk factors, including:

  • Use of indwelling medical devices such as bloodstream, endotracheal, and urinary catheters
  • Surgical procedures
  • Injections
  • Contamination of the health care environment
  • Transmission of communicable diseases between patients and healthcare workers
  • Overuse or improper use of antibiotics
  •  

Magnitude of the Problem

HAIs are a significant cause of morbidity and mortality. At any given time, about 1 in every 25 inpatients has an infection related to hospital care. These infections cost the U.S. health care system billions of dollars each year and lead to the loss of tens of thousands of lives. In addition, HAIs can have devastating emotional, financial and medical consequences. 

A majority of hospital-acquired HAIs include:

  • Urinary tract infections
  • Surgical site infections
  • Bloodstream infections
  • Pneumonia

The U.S. Department of Health and Human Services (HHS) has identified the reduction of HAIs as an Agency Priority Goal for the Department and is committed to reducing the national rate of HAIs by demonstrating significant, quantitative, and measurable reductions in hospital-acquired central line-associated bloodstream infections and catheter-associated urinary tract infections.

GOAL OVERVIEW

At any given time, about one in every 25 hospitalized patients has an HAI while over 1 million HAIs occur across the U.S. healthcare system every year. These infections can lead to significant morbidity and mortality, with tens of thousands of lives lost each year.

Of these hospital-acquired events, catheter-associated urinary tract infections (CAUTI) are among the most common. Research has shown that a significant portion of these infections can be prevented, avoiding patient morbidity and mortality from this HAI while reducing costs accrued to the healthcare system.

The HAI Agency Priority Goal is to reduce the national rate of healthcare- associated infections by  demonstrating significant, quantitative and measurable reductions in hospital-acquired CAUTI. As such; the FY2014-15 HAI Agency Priority Goal (APG) is to reduce the national CAUTI standardized infection ratio by 10% by September 2015 over the current 2012 baseline of 1.03. Of note, this SIR baseline was recently changed from 1.02 to 1.03 in this goal. This reflects the fact that the CDC released preliminary final numbers for 2012 in September 2013, the time at which this goal was written. However, hospitals still had through the end of the year to report final data to NHSN. Accounting for the last three months of data submitted by some hospitals caused a slight adjustment in the final (and thus baseline) 2012 SIR from 1.02 to 1.03. We make this adjustment in the HAI.APG to reflect the finalized SIR and to maintain consistency with other HAI reports moving forward.

As we carry this portion of the goal from the FY2011-13 goal, a concerted effort between the Centers for Medicare and Medicaid Services (CMS), Agency for Healthcare Research and Quality (AHRQ), Centers for Disease Control and Prevention (CDC), and Occupational Safety and Health Administration (OASH) will continue to be a crucial to meeting goal targets. The main US Department of Health and Human Services (HHS) operating divisions that constitute this workgroup will focus on applying their HAI programmatic efforts in a way that aligns strategy and metrics, provides consistent messaging to its audience, uses data to target those facilities in most need of improvement, and creates synergy to achieve CAUTI reduction outcomes.

We will continue to use combined HHS programmatic levers to contribute to the achievement of CAUTI targets. These initiatives include:

  • Quality Improvement Organization (QIOs) Program
  • Hospital Inpatient Quality Reporting (HIQR) Program
  • Development and maintenance of the National Healthcare Safety Network (NHSN)
  • Funding of state HAI programs
  • Partnership for Patients (PfP)
  • Comprehensive Unit-based Safety Program (CUSP) for CAUTI
  • Ongoing coordination through HAI strategic planning, HAI Regional and National Meetings
  • Regular review and updates to the National Action Plan to prevent HAIs: "Roadmap to Elimination."

Attention to several factors will be necessary to assess progress toward goals in this new period. As in the previous HAI goal and consistent with a measurement strategy used by a majority of hospitals that participate in national HAI reporting initiatives, this goal will use the standardized infection ratio (SIR) as the measure, NHSN, the CDC-run infection surveillance system as the primary data source and report data points on  a biannual basis. A six month lag in data will remain in order to ensure the most complete and accurate data being reported out and minimize statistically insignificant variations in the data.

Lessons learned from the previous goal allow us to predict potential increases in the CAUTI SIR trend in the months following January 2015 when CMS' Hospital Inpatient Quality Reporting (HIQR) program requires participating hospitals to report CAUTI innon-intensive care units in order to receive their full annual payment update. The influx of new CAUTI reporters in the middle of the previous 2011-13 HAI.APG was identified as one but not the sole, etiology behind an increase in the CAUTI SIR over the life of this goal. However, the degree to which this could again be a factor again is unknown especially since through programmatic outreach, many hospitals already report non-ICU CAUTI data to NHSN voluntarily.

Further analysis of the CAUTI data reveals a marked difference in reductions between intensive care and non-intensive care units. Intensive care units have significantly higher SIRs, higher number of catheter-days, and show less reductions in these indicators of progress than in the non ICU setting. The difference in CAUTI reductions between ICUs and non-ICU settings have been highlighted in analysis of both NHSN and CUSP for CAUTI data. Given the fact that sicker patients are admitted in ICUs, retaining a urinary catheter for longer may be a rooted in practice necessity or provider belief that it is a necessity and so concentrating on behavioral and systems process change may need to be further emphasized as we work in this setting to reduce CAUTI. The 10% goal for CAUTI reduction in this APG effort represents a composite goal that reflects greater reductions in non-ICU settings and lesser reductions in ICUs.

  • Collaboration among multiple stakeholders in the healthcare community.

Collaboration among multiple stakeholders in the healthcare community is necessary to spread and sustain reductions in HAIs on a broad scale. Collaboration creates synergy around CAUTI prevention and reduction efforts by leveraging the combined programmatic efforts of stakeholders, both across HHS and outside HHS, including those of the Department of Defense (DoD), the Veterans' Administration (VA), state governments, professional organizations, academia, provider and patient groups. Through continued emphasis on coordinating programs and strengthening our network of resources, we are able to provide technical assistance, testing, and financial support for the development and implementation of strategies to prevent HAIs, particularly those focused at the level where patient care occurs. Application of evidence-based guidelines for CAUTI prevention through the CDC’s Healthcare Infection Control Practices Advisory Committee (HICPAC) can be accomplished on a national scale by disseminating this knowledge through healthcare experts in the field. Through programs such as the QIO’s 11th Statement of Work, Partnership for Patients AHRQ’s CUSP national initiatives and state and local collaboratives, science-based guidelines can be both spread to a wide audience and tailored to state, local and facility needs.

 

Annual Performance Plan and Report

Fiscal Year 2016

Released February, 2015

Topics on this page: Goal 1. Objective B | Table of Related Performance Measures | Analysis of Results | Plans for the Future | Objective Progress Update Summary


Goal 1. Objective B: Improve healthcare quality and patient safety

HHS is committed to improving health care quality and patient safety by ensuring safe and effective medical products, promoting professional practices focused on improving quality of client care, and reducing healthcare-associated infections (HAI).

Several HHS components focus on achieving goals that improve health care quality. FDA protects the Nation’s health by ensuring the safety, effectiveness, and security of human and veterinary drugs, vaccines, and other biological products and medical devices. HHS also ensures quality of care and patient safety through HAI surveillance and prevention activities at AHRQ and CDC. CDC’s HAI program protects patients receiving care in U.S. healthcare settings through outbreak detection and control, identifying emerging threats, establishing prevention guidelines and supporting staffing to improve healthcare practitioner and hospital system practice. AHRQ develops strategies to strengthen quality and promotes improved practices through Patient Safety Organizations. The IHS Improving Patient Care (IPC) initiative is implementing the patient centered medical home model to help transition IHS to more continuous quality improvement and a greater focus on improvement through the use of measures and other results.

 

CMS is transforming into an agency that positively promotes and incentivizes the quality of care for its beneficiaries through payment policy. Examples include continued development of physician, hospital, and post-acute care provider quality reporting systems that will link payments to the quality and efficiency of care, while also reducing healthcare-associated infections.

 

 

Analysis of Results

Healthcare-associated infections (HAIs) are a significant cause of death in the United States. Of these, central line-associated bloodstream infections (CLABSI) have a strong potential to cause serious illness or death and catheter-associated urinary tract infections (CAUTI) are among the most common. The HHS National Action Plan to Prevent Healthcare-Associated Infections identified CLABSIs as a priority for prevention with national 5-year prevention targets and metrics proposed. Likewise, new Healthy People 2020 objectives have been proposed to address the substantial human suffering and financial burden attributable to healthcare-associated infections, one of which is to reduce CLABSIs. CDC’s National Healthcare Safety Network (NHSN) is a surveillance system used for tracking and prevention of HAIs across healthcare settings, including hospitals in all 50 states, and non-hospital settings (e.g. hemodialysis and long-term acute care facilities). Exceeding its goal for FY 2013, CDC extended tracking capacity to more than 12,400 facilities. In FY 2013, CLABSIs decreased to 0.54 Standardized Infection Ratio (SIR) nationally in U.S. hospitals. This represents an improvement over the prior year but misses the target.

 

Clostridium difficile Infection

People getting medical care can catch serious infections called healthcare-associated infections (HAIs). One type of HAI – caused by the germ C. difficile – was estimated to cause almost half a million infections in the United States in 2011, and 29,000 died within 30 days of the initial diagnosis. Those most at risk are people, especially older adults, who take antibiotics and also get medical care. CDC provides guidelines and tools to the healthcare community to help prevent Clostridium difficile infections as well as provides resources to help the public safeguard their own health.

From the CDC

Catheters Give Life but Sometimes Take It

Catheters Give Life but Sometimes Take It


© 2015 Informa Exhibitions LLC. All rights reserved.

http://www.infectioncontroltoday.com/

By:

Posted on: 04/16/2008

 

Central venous catheters (CVCs) are becoming increasingly popular in outpatient and inpatient settings to provide long-term venous access. Their benefit is undeniable, but there are consequences and they can be startling. CVCs disrupt skin integrity and therefore leave the epidermis susceptible to fungus and bacteria. Infection may spread to the bloodstream and create organ dysfunction or death.

Nosocomial bloodstream infections prolong hospitalization by a mean of seven days and cost between $3,700 and $29,000 per case.¹

When a patient has a catheter, he or she is at constant risk for catheter-related bloodstream infection (CR-BSI). Factors at play are the catheter type, the frequency of access or manipulation, and the patient’s clinical status.²

CVCs are associated with a greater quantity and seriousness of infection than short peripheral catheters, partly because patients who need CVCs are often sicker, and their catheters are likely to be accessed more often.²

Approximately 90 percent of CR-BSIs occur with CVCs.¹

There is a “tremendous” amount of work being done to decrease CVCs in intensive care units, but there should be more focus on at-risk populations, says Trish Perl, MD, MSc, professor of medicine, pathology and epidemiology at Johns Hopkins Medical University, and an epidemiologist at Johns Hopkins medical institutions in Baltimore. The vulnerable populations she speaks of include dialysis patients, patients with long-term central lines, or who are undergoing chemotherapy. “In some of these groups the bundle may need to be changed and adapted to the risk factors that these patient populations are affected by,” Perl says.

Why Catheters are Dangerous

Forty-eight percent of ICU patients have CVCs, and that adds up to a whopping 15 million CVC days per year in ICUs.¹ Approximately 5.3 central line infections occur per 1,000 catheter days in ICUs, and deaths range from 14,000 to 28,000 per year.¹

How do infectious organisms use catheters to invade the body? When the catheter is inserted, it breaks the skin and this creates a convenient path for organisms to enter the patient’s bloodstream. Skin antisepsis with proper technique can’t eliminate all organisms in the lower layers of the epidermis, and that means the catheter has access to these organisms as it passes through the skin.²

The danger doesn’t stop there. Medication administration, flushing, and tubing or cap changes require catheter manipulation and can introduce microorganisms to the lumen. Hub manipulation is the most common source of infection in long-term catheters but can also spur CR-BSI in short-term catheters.²

Reducing catheter-related infections is vital, but doing so requires staff members to implement changes. Employees meet these changes with any mix of hope or doubt. Attitude depends on the institution and the people, and whether they think there is even a problem to correct, Perl says. “So you see a myriad of attitudes and these attitudes depend on the safety climate, the leadership and the engagement of leadership and the clinical/medical perception of the problem,” she adds. “Finally, I think that the amount of personal accountability organizations place on healthcare workers affects their perception of the problem and their willingness to participate in solutions.”

The Bundle

The Institute for Healthcare Improvement (IHI)’s 100,000 Lives Campaign seeks to prevent catheter-related bloodstream infections by implementing components of care called the “central line bundle.” The central line bundle is a group of evidence-based interventions that are more effective together than alone. The bundle has five components:

Hand hygiene

Maximal barrier precautions

Chlorhexidine skin antisepsis

Optimal catheter site selection, with the subclavian vein as the preferred site for non-tunneled catheters

Daily review of line necessity, with prompt removal of unnecessary lines

1. Hand Hygiene

According to the IHI, caregivers tending central lines should wash their hands thoroughly before and after palpating catheter insertion sites; before and after inserting, replacing, accessing, repairing, or dressing an intravascular catheter; when hands are obviously soiled; before and after invasive procedures; between patients; before donning gloves and after removing them, and after using the restroom.

To improve hand hygiene facility wide, it is wise to include hand hygiene as part of a central line placement checklist. Staffs should keep soap or alcohol-based dispensers in convenient areas, and should make certain that personal protective equipment is located near hand sanitation equipment. IHI also advises staffs to post hand hygiene signs for education purposes, and to foster an environment where reminding each other about hand hygiene is encouraged.

2. Maximal Barrier Precautions

One key to decreasing central line infection risk is to apply maximal barrier precautions when preparing for line insertion. The operator who is placing the central line and everyone assisting him or her should wear a cap, mask, sterile gown and gloves.¹

“The cap should cover all hair and the mask should cover the nose and mouth tightly,” IHI suggests. “These precautions are the same as for any other surgical procedure that carries a risk of infection. For the patient, applying maximal barrier precautions means covering the patient from head to toe with a sterile drape, with a small opening for the site of insertion. Include maximal barrier precautions as part of your checklist for central line placement.”

The equipment should be well-stocked in a cart specifically for central line placements.

3. Chlorhexidine Skin Antisepsis

Chlorhexidine skin antisepsis has been proven to provide better skin antisepsis than other antiseptic agents such as povidone-iodine solutions, IHI researchers claim.

For most kits the technique is to:¹

prepare skin with antiseptic/detergent chlorhexidine 2 percent in 70 percent isopropyl alcohol.

pinch wings on the chlorhexidine applicator to break open the ampule; hold the applicator down to allow the solution to saturate the pad.

press the sponge against the skin and apply chlorhexidine solution using a back-and-forth friction scrub for at least 30 seconds. Do not wipe or blot.

allow antiseptic solution to dry completely before puncturing.

IHI recommends including chlorhexidine antisepsis as part of your checklist for central line placement, and putting chorhexidine antisepsis kits in carts or grab bags specifically for central line equipment.

4. Optimal catheter site selection

“Percutaneously inserted catheters are the most commonly-used central catheters,” IHI researchers say. “Several risk factors have been identified, however, that are associated with bloodstream infections. These include the site of placement. Whenever possible, and not contraindicated, the subclavian line site should be preferred over the jugular and femoral sites for non-tunneled catheters in adult patients.”

It is necessary to assess daily whether the central line is still necessary. It is common for central lines to stay in place simply because the caregiver has not considered taking them out. This is a critical misstep, as it’s clear that infection risks increase the longer a line remains. Daily review should be part of multidisciplinary rounds.¹ Record the time and date of line placement and make this information accessible to staff so they can draw upon it when making decisions.

Barriers to Bundling

Bundling is a simple idea overall, but many factors thwart it. According to Perl, one main barrier to proper bundling is that some employees may not know why bundling is important. Logistics are also vital. “Do you have the equipment you need, does the equipment work, does the institution make it easy for you to perform the correct behaviors?” Perl suggests asking. Staff also may not support bundling if they do not receive reinforcing factors such as outcome measures, Perl adds.

All bundling goals should be time-specific and measurable and should define which patient population will be affected.¹

Effective central line bundle programs cannot be implemented instantly. An efficacious program includes careful planning and implementation, observation, modifications, and readjustment.

According to IHI, some barriers to effective implementation may include fear of change. “All change is difficult,” IHI researchers write. “The antidote to fear is knowledge about the deficiencies of the present process and optimism about the potential benefits of a new process.”

Another culprit is communication breakdown, and inadequate buy-in from physicians and staff. They may be wondering if bundling is just another flavor of the week. To engage staff, share the good results of improvement measures, and make baseline data on CR-BSI rates accessible.¹ “If the run charts suggest a large decrease in CR-BSIs compared to baseline, issues surrounding ‘buy-in’ tend to fade,” the researchers continue.

Another roadblock to CR-BSI reduction is improper nurse-to-patient staffing ratios. A direct relationship between understaffing and high CR-BSI rates has been shown.²

Forming a Team

IHI leaders recommend a multidisciplinary, heterogeneous team-approach to patient care. They say the value of bringing diverse personnel together is that people from several levels (nurses, therapists, physicians) share a stake in the outcome. This can lead to greater camaraderie, and therefore, better communication and synergy.

Attracting and retaining an excellent team requires education, finding visible, credible champions within the facility, and recruiting people who want to be part of the project, not people who have to be forced.¹

“The team needs encouragement and commitment from an authority in the intensive care unit,” IHI leaders say. “Identifying a champion increases a team’s motivation to succeed. When measures are not improving fast enough, the champion readdresses the problems with staff and helps to keep everybody on track toward the aims and goals.”

Eventually, the program is established and becomes the norm, but that doesn’t mean the team members or patients are out of the woods yet.

“At some point ... changes in the field or other changes in the ICU will require revisiting the processes that have been developed,” IHI leaders continue. “Identifying a ‘process owner,’ a figure who is responsible for the functioning of the process now and in the future, helps to maintain the long-term integrity of the effort.”

Case Studies

In 2001 through 2005, the Pittsburgh Regional Healthcare Initiative invited the Centers for Disease Control (CDC) to ICUs in southwestern Pennsylvania to provide technical assistance for a hospital-based intervention to prevent central line-associated infections. During the intervention, infection rates among ICU patients declined 68 percent, from 4.31 to 1.36 per 1,000 central line days.³ The results suggest that a coordinated, multi-institutional infection-control initiative is a worthwhile approach, according to authors of, “Reduction in central line-associated bloodstream infections among patients in intensive care units.”

The intervention included 32 hospitals from 10 counties.

The median size of the hospitals involved was 215 beds. Among the participating hospitals, 66 ICUs contributed data. Forty eight percent were medical/surgical, 11 percent cardiothoracic, 14 percent coronary, 9 percent surgical, 6 percent neurosurgical, 5 percent trauma, 3 percent medical, 3 percent burn, and 3 percent pediatric.³

The promoted prevention practices were hardly a space-age creation; they have been included in the Healthcare Infection Control Practices Advisory Committee recommendations since 1996.³ Sometimes, however, older, more simple techniques are the best. “The results described in this report suggest that adhering to these evidence-based preventive practices can prevent BSIs,” the report authors write. “Nonetheless, previous reports suggest that adherence to these practices remains low.”

A study conducted at Banner Desert Hospital, in Mesa Ariz., sought to decrease CVC infections in the adult medical/surgical ICU by using literature from the CDC and IHI, and benchmarks from the National Institute of Health Services.4

Project leaders gathered initial data about the nature of central line infections with the help of a central line audit tool, which included aspects such as patient symptoms, cultures and culture sites, and the date the central line was placed.4 The central line audit tool was used to track the number and nature of infections after the central line bundle and safety checklists were instituted, writes Jeanette Meyer, MSN, RN, CCRN, CCNS, PCCN, in her paper, “Decreasing central line infections with evidence-based practice.”

The result was that in seven consecutive months after the practice change, no CVC infections were noted. The recommendation from Meyer’s paper is to continue using the central line bundle and safety checklists.

“Examine each specific infection that occurs in detail to attempt to determine causative factors,” Meyer writes. “Create specific criteria for evaluating line necessity and use this criteria in determining whether to maintain or discontinue central lines.”

Some research supports bundling, but the process should not be mandatory at every hospital, Perl says.

“It would be a shame to force reporting of something that is not supported by the literature,” Perl says. “While I think the bundle is important, these data are lacking. Also, we need to make sure people know that the bundle in itself will not prevent all CA-BSI—there are other reasons patients get these and we cannot forget these other important components of infection prevention programs.”ICT

References

1. Institute for Healthcare Improvement: Getting Started Kit: Prevent Central Line Infections, How-to Guide. www.ihi.org/ihi.

2. Hadaway LC. Best-practice interventions: keeping central line infection at bay. Nursing2006. April 2006

3. Centers for Disease Control and Prevention. Reduction in Central Line-Associated Bloodstream Infections Among Patients in Intensive Care Units: Pennsylvania, April 2001-March 2005. Oct. 2007.

4. Meyer JM. Decreasing central line infections with evidence-based practice. Academic Center for Evidence-Based Practice.

SEPSIS FACT SHEET

 

ACT SHEET A POTENTIALLY DEADLY OUTCOME FROM AN INFECTION What should I do if I think I have an infection or sepsis? • Call your doctor or go to the emergency room immediately if you have any signs or symptoms of an infection or sepsis. This is a medical emergency. • It’s important that you say, “I AM CONCERNED ABOUT SEPSIS.” • If you are continuing to feel worse or not getting better in the days after surgery, ask your doctor about sepsis. Sepsis is a common complication of people hospitalized for other reasons. What is sepsis? Sepsis is the body’s overwhelming and life-threatening response to an infection which can lead to tissue damage, organ failure, and death. When can you get sepsis? Sepsis can occur to anyone, at any time, from any type of infection, and can affect any part of the body. It can occur even after a minor infection. What causes sepsis? Any type of infection that is anywhere in your body can cause sepsis, including infections of the skin, lungs (such as pneumonia), urinary tract, abdomen (such as appendicitis), or other part of the body. An infection occurs when germs enter a person’s body and multiply, causing illness and organ and tissue damage. Who gets sepsis? Anyone can get sepsis as a bad outcome from an infection, but the risk is higher in: • people with weakened immune systems • babies and very young children • elderly people • people with chronic illnesses, such as diabetes, AIDS, cancer, and kidney or liver disease • people suffering from a severe burn or wound Ask your doctor about your risk for getting sepsis. What are the symptoms of sepsis? There is no single sign or symptom of sepsis. It is, rather, a combination of symptoms. Since sepsis is the result of an infection, symptoms can include infection signs (diarrhea, vomiting, sore throat, etc. ), as well as ANY of the symptoms below: Shivering, fever, or very cold Extreme pain or general discomfort (“worst ever”) Pale or discolored skin Sleepy, difficult to wake up, confused ”I feel like I might die” Short of breath

 

SEPSIS FACT SHEET Why should I be concerned about sepsis? Sepsis can be deadly. It kills more than 258,000 Americans each year and leaves thousands of survivors with life-changing after effects. According to CDC, there are over 1 million cases of sepsis each year, and it is the ninth leading cause of disease-related deaths. How is sepsis diagnosed? Doctors diagnose sepsis using a number of physical findings like fever, increased heart rate, and increased breathing rate. They also do lab tests that check for signs of infection. Many of the symptoms of sepsis, such as fever and difficulty breathing, are the same as in other conditions, making sepsis hard to diagnose in its early stages. How is sepsis treated? People with sepsis are usually treated in the hospital. Doctors try to treat the infection, keep the vital organs working, and prevent a drop in blood pressure. Doctors treat sepsis with antibiotics as soon as possible. Many patients receive oxygen and intravenous (IV) fluids to maintain normal blood oxygen levels and blood pressure. Other types of treatment, such as assisting breathing with a machine or kidney dialysis, may be necessary. Sometimes surgery is required to remove tissue damaged by the infection. Are there any long-term effects of sepsis? Many people who have sepsis recover completely and their lives return to normal. But some people may experience permanent organ damage. For example, in someone who already has kidney problems, sepsis can lead to kidney failure that requires lifelong dialysis. How can I prevent sepsis? 1 Get vaccinated 2 Prevent infections that can lead to sepsis by: • Cleaning scrapes and wound • Practicing good hygiene (e.g., hand washing, bathing regularly) 3 If you have an infection, look for signs like: fever, chills, rapid breathingand heartrate, rash, confusion, and disorientation.

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