AVA 22nd annual conference

The Association of Vascular Access are accepting abstracts for podium and poster presentations for their 22nd Annual Conference, September 11-14, 2008 in Savannah, GA.

Presentations must fit one of the following categories and bear a direct relevance to the field of vascular access - a) Clinical Research, b) Innovations in Education or Practice, c) Health Care Policy & Delivery or d) Clinical Case Study/Quality Improvement.

All abstract submissions must be submitted NO LATER THAN 12:00 Midnight PDT on June 16, 2008. Authors will be notified by email of acceptance as soon as possible following review.

Submission forms are available online.  Click here  to download or by calling 1-877-924-2821. Authors must submit their abstract submission forms electronically by e-mail to cchernecky@mcg.edu.

Infection benchmarking tool

We first reported news about the MedMined system from Cardinal Health in February 2008 (Click here for original post). We can now report that 46 Alabama hospitals are using the tool to benchmark their infection rates with their state peers.

Cardinal Health report “The MedMined benchmarking tool, produced by Cardinal Health, graphs the incidence of health care associated infections (HAIs) in all of the units in a hospital to visually present the current infection rate compared to its peers… Hospitals can compare their incidence of HAIs with other hospitals in the same peer category… The benchmarking capability will be rolled out to hospitals across the country starting in May”. Click here for the full report.

 

Superbug iceberg

Edwina Rawson, an associate at Charles Russell Solicitors, writes in the AvMA Medical & Legal Journal about the tip of the superbug iceberg.

“Thousands of patients die or are made seriously ill by healthcare infections, popularly known as ’superbugs’. This is a fact. It is also a fact that a proportion of these could have been avoided if hospitals and staff were, simply, cleaner.

The press is littered with heartbreaking stories of superbugs: 33 die and 334 are infected due to an outbreak of Clostridium difficile at Stoke Mandeville Hospital; 90 die following a similar outbreak at Maidstone Hospital; a two-day old baby dies from MRSA at Ipswich Hospital; a mother dies of MRSA shortly after giving birth at Stoke-on-Trent Hospital; a young nurse dies, a male patient nearly dies and 17 others are infected after a pseudomonas outbreak at Guy’s Hospital. There are many others. It is a major national problem. Despite this, we are told only of the tip of the iceberg. In addition, one would hope that the law provided appropriate redress to superbug victims, but this is often not the case” (Rawson 2008).

Reference

Rawson E. (2008) The tip of the superbug iceberg. AvMA Medical & Legal Journal. 14(2), p.72-76.

 

Drug calculations

Paul Lee, a medical devices training manager at Singleton Hospital, Swansea, UK has published an article that describes a risk-score system for mathematical calculations in intravenous therapy.

“This article outlines a training needs analysis to identify the mathematical confidence levels of qualified staff working in a large, acute NHS trust. A risk scoring tool was developed to gauge the confidence levels of nursing staff using drug calculations in their clinical areas. This now forms part of the organisation’s risk assessment strategy and a learning tool has been developed for intravenous therapy study days” (Lee P. 2008).

Reference

Lee P. (2008) Risk-score system for mathematical calculations in intravenous therapy. Nursing Standard. 22(33), p. 35-42.

Hydration at end of life

Pamela van der Riet, Philip Good, Isabel Higgins and Ludmilla Sneesby have published an article examining palliative care professionals’ perceptions of nutrition and hydration at the end of life.

“The provision of medically administered nutrition and hydration (MNH) for the terminally ill patient is a controversial issue and there has been much debate in the literature concerning this sensitive subject. This article reports on a qualitative research study that explores palliative care nurses’ and doctors’ perceptions and attitudes to patient nutrition and hydration at the end of life. Participants were from an urban and rural palliative care service. Three main discourses were identified: carers’ distress at the non-provision of MNH; palliative care doctors’ and nurses’ position that terminal dehydration lessened the burden of suffering for dying patients; an polarisation between the acute care setting and the palliative care setting. Overlaying these three main discourses are contesting discourses involving cure vs comfort, and acute care vs palliative care. Importantly, the findings of this study reveal that palliative care doctors and nurses believe that medically assisted nutrition and hydration at the end stage of life rarely benefits patients, and as long as adequate mouth care is given, patients do not suffer. However, family members do experience emotional distress in dealing with this situation. In caring for dying people, the nurse’s and doctor’s role is one of education and communication, involving a team approach to manage this difficult issue” (van der Riet et al 2008).

Reference

van der Riet et al (2008) Palliative care professionals’ perceptions of nutrition and hydration at the end of life. International Journal of Palliative Nursing. 14(3), p.145-151.

Syringe drivers in palliative care

John Costello, Brian Nyatanga, Carole Mula and Jenny Hull have written about the benefits and drawbacks of syringe drivers in palliative care.

“This article will outline the use of continuous subcutaneous infusion pumps, known as syringe drivers, including their benefits and drawbacks in a palliative care context. There have been over 5000 articles published globally describing syringe drivers in the medical and nursing literature in the last decade. Many provide guidance on their use, although much of the data are repetitious, disease or age-group specific, and focussed on pragmatic issues to do with clinical application. Several trusts and hospices across the UK are carrying out trials of the recently launched McKinley T34 syringe driver. Therefore, it seems timely to consider their wider use internationally. Globally, practitioners in palliative care are very familiar with their use, although the literature lacks specific guidance and, at times, the information is ambiguous. Having briefly reviewed their benefits, the article considers the limitations  of using syringe drivers and comments on some of the lesser known/reported practical and patient-focussed drawbacks associated with their use. We conclude by considering why, when so much education and training exists to help practitioners use these devices effectively, so many human errors occur” (Costello et al 2008).

Reference

Costello J. et al (2008) The benefits and drawbacks of syringe drivers in palliative care. International Journal of Palliative Nursing. 14(3), p.139-144.

COSMOS study launched

The Hospital San Carlos, Madrid, Spain has started to recruit patients into a randomized study of closed peripheral intravenous systems versus open systems. The research team have named it the COSMOS Study (great name… lets hope the results are out of this world).

The purpose of this study is to investigate, in a prospective and randomized fashion, the clinical performance of a closed intravenous system (Nexiva®) versus an open conventional one (Vasocan®), with respect to ease of handling and effectiveness (as defined by time of survival without complications), security provided to professionals and patients against accidental blood exposure or needlestick injury, catheter-related complications such as phlebitis, pain and blockage and overall costs of the two systems.

Primary Outcome Measures:

Length of time catheter remains in place without clinical symptoms.

Secondary Outcome Measures:

Incidence of complications of the catheter, bacterial colonization of catheter tips and costs of therapy.

The study is due to complete July 2008. Click here for further information.

Community IV article

Sue O’Hanlon, Ruth Glenn and Belinda Hazler write in the Nursing Standard (2008) about delivering intravenous therapy in the community setting… “This article provides an overview of how an intravenous (IV) therapy service was developed in one primary care trust in England, the challenges that were faced and how they were overcome. The article includes some recommendations for others considering setting up a community IV therapy team” (O’Hanlon et al 2008).

Reference

O’Hanlon S. et al (2008) Delivering intravenous therapy in the community setting. Nursing Standard. 22(31), p.44-48.

Apheresis article

Sandra Leighton writes about apheresis in the April (2008) edition of Nursing… “During apheresis, a blood component (red cells, white cells, platelets, or plasma) is removed from blood using a cell separator; the remaining blood components are then returned to the donor or patient. Many types of apheresis are available to treat various conditions, from initiating the process of reproducing bone marrow in cancer patients after chemotherapy to treating graft-versus-host disease…” (Leighton 2008).

Reference

Leighton S.C. (2008) The spin on apheresis. Nursing. 38(4), p.29-31.

EPIC2 & Saving Lives Study Day

Epic2 & Saving Lives Implementation Study Day

London 2nd June

Bristol 3rd June

Birmingham 4th June

Manchester 5th June

A free study day aimed at helping your Trust implement national guidelines in preventing infections and to help save even more patients’ lives.

This national programme in June has been jointly developed by the Infection Prevention Society (IPS) and the EPIC2 authors/Thames Valley University.  A faculty of experts in their field has been assembled to lead the delivery of each study day.  It is free to all healthcare workers.

To register free visit www.fitwisereg.com or complete the application form.

Spaces are limited to 150 per venue.

 

IV Nurse Specialist

Basingstoke and North Hampshire NHS Foundation Trust are advertising for ‘Clinical Nurse Specialist in Intravenous Therapy’. The advert states… “Tasked with the reduction of infections caused by vascular access devices (VAD) you’ll be involved in developing, implementing and monitoring standards of clinical practice in intravenous therapy”.

Further information can be obtained from Zena Ludick, Head of Nursing, Elective Division on 01256 473202 ext 3536.

The job reference is P1178.

You can apply online at www.jobs.nhs.uk or visit www.northhampshire.nhs.uk

Amiodarone and DEHP

The team at Cardinal Health have just informed us that users of Amiodarone should consider administering Amiodarone through a specific aministration set. As Amiodarone may cause the plasticizers to leach into the fluid path.

Medicines.org.uk state that “The use of administration equipment or devices containing plasticizers such as DEHP (di-2-ethylhexyphthalate) in the presence of amiodarone may result in leaching out of DEHP. In order to minimise patient exposure to DEHP, the final amiodarone dilution for infusion should preferably be administered through non DEHP-containing sets.”

Heparin concerns grow in China

The Los Angeles Times has reported that the FDA has asked Chinese manufacturers of products that may contain heparin to test their supplies. This action follows reports of two serious allergic reactions following the use of devices that contain heparin. The FDA will write to 82 medical device manufacturers urging them to test their heparin.

 

Cannulation in Africa

Dr Ngatia writes about task-shifting of health workers on the African continent. He describes how midwives have inserted cannula in the past even though it is illegal for them to do so. However, in Mozambique and Malawi midwives are now trained to set up intravenous drips. Click here to read the full story.

Intraosseous in Dubai

The Khaleej Times reports that paramedics in Dubai are to begin a trial of the intraosseous (IO) route for intravenous access in four mobile intensive care units. The IO route allows for emergency vascular drug administration when venous access is unobtainable e.g. severe burns.

 

Journal of Infusion Nursing

Body image

I have always been interested in the impact of IV therapy on body image. Yes I know, I should be concerned about infection etc (well I am)… however, the impact of body image on patients may help to address any number of problems… including those catheter related blood stream infections (CRBSI).

 

3M launch chlorhexidine IV dressing

3M have developed a range of IV dressings that incorporate chlorhexidine gluconate. Click here for further information

CRBSI systematic review

Ramritu et al (2008) publish a systematic review and meta-analysis of catheter related blood stream infections in intensive care units. The full reference is… Ramritu P., Halton K., Cook D., Whitby M. & Graves N. (2008) Catheter-related bloodstream infections in intensive care units: a systematic review with meta-analysis. Journal of Advanced Nursing 62 (1) , 3–21.

IV contributes to infection

An inquest in Belfast took four hours to find that 43 year old Brendan McDowell died of multiple organ failure brought on by a  ’hospital acquired infection’. This included an infection at his intravenous line which was being used to administer antibiotics. Click here to view the full story. 

3M acquire Les Entreprises Solumed

3M Canada have acquired Les Entreprises Solumed. 3M medical division vice president Chuck Kummeth stated… “The addition of Solumed positions 3M for growth in the fast-growing segment of intravenous site care and in preoperative care and hand hygiene, where CHG-based products are gaining momentum” Click here for more information. 

New extravasation guidelines

The European Oncology Nursing Society have just issued new chemotherapy extravasation guidelines. The guidance is comprehensive and includes risk factors, explains recognition and includes examples of documentation… plus much more. Click here to view the full document.