Sharps management in hospital
January 31, 2009
Intravenous literature: Aziz, A.M., Ashton, H., Pagett, A., Mathieson, K., Jones, S. and Mullin, B. (2009) Sharps management in hospital: an audit of equipment, practice and awareness. British Journal of Nursing. 18(2), p.92-98.
Abstract:
The safe handling and disposal of needles and other sharp instruments forms part of an overall strategy to protect staff, patients and visitors from exposure to blood-borne pathogens. As with many infection prevention and control policies, the assessment and management of the risks associated with the use of sharps is paramount, and safe systems of work and engineering controls must be in place to minimize any identified risks. The use of sharps in hospitals should be avoided where possible; when their use is essential, particular care is required in handling and disposal – if possible, use safer sharps devices. An audit of sharps management was undertaken to observe equipment, practice and awareness. The audit reported very positive results. However, some areas needed further review to improve practice. The infection control team implemented an action plan as a result of the audit and set about initiating measures for training and awareness. It is necessary to audit sharps management routinely to have an accurate assessment of current practice and prevent occupational exposure to blood-borne pathogens.
BBraun investment
January 30, 2009
Intravenous products: BBraun Medical Industries announced yesterday that it was investing RM300mil over three years to expand its facility at the Bayan Lepas Industrial Zone, starting from this year. BBraun board chairman Prof Dr L.G. Braun said the expansion would be carried out on the company’s newly acquired 9,000sq m plot in front of its current facility.
“The expansion will provide B. Braun with an average 15% increase in manufacturing capacity over the next 10 years while providing additional employment opportunities,” he told a press conference at the Bayan Lepas plant yesterday after the handing over ceremony of the plot named “Lebuh Sungai Tiram”.
Click here for the full story.
Needlestick injuries reported to HSE
January 29, 2009
Intravenous news: Using Freedom of Information laws the Mirror.co.uk approached more than 150 NHS Trusts across England and found that in the first nine months of 2008 there were 85 incidents reported to the Health and Safety Executive as either the escape of dangerous substances or an accident involving a biological agent.
For example, at Manchester Royal Infirmary a staff member was pricked by a needle removed from an HIV-positive patient who had died. Of the 85 incidents, 40 involved staff pricked by needles with the potential to infect with a serious disease. Karen Jennings, of union Unison, said: “It is shameful to see just how many of these injuries are preventable.” Kim Sunley, for the Royal College of Nursing, said: “These instances are just the tip of the iceberg. We want to see legislation on needlestick injuries which makes it mandatory to provide safer needle devices that reduce the risk of injury.”
Click here for the full story.
Five moments for hand hygiene
January 25, 2009
Intravenous news: IVTEAM have added the World Health Organizations (WHO) ‘Five Moments for Hand Hygiene’ as a recommended link. The work defines the key moments for hand hygiene, overcoming misleading language and complicated descriptions. It presents a unified vision and promotes a strong sense of ownership.
Not only does the Five Moments align with the evidence base concerning the spread of HAI but it is interwoven with the natural workflow of care and is designed to be easy to learn, logical and applicable in a wide range of settings.
Find out more about your Five Moments by clicking here.
Reporting CRBSI
January 25, 2009
Intravenous news: Beginning January 2009 New Hamphire hospitals are now required report quarterly to the N.H. Department of Health and Human Services on two types of infections. These reportable infections are bloodstream infections related to central lines, or ports installed directly into a patient’s major blood vessel to allow for quick medication delivery, and surgical-site infections for procedures including coronary artery bypass grafts, colon surgeries and knee replacements.
The first quarterly reports are due in March and will be submitted to a Web site run by the Healthcare Quality Promotion Division of the U.S. Centers for Disease Control and Prevention. The information won’t be available to the public until after the the state health department compiles it in May, said Rachel M. Rowe, administrator of the N.H. Health Care Quality Assurance Commission.
Click here for the full story.
Intrathecal injection error
January 25, 2009
Intravenous news: Hospital equipment that was partly responsible for an 18-year-old’s death has still not been improved eight years after his death, MPs have been told. Leukaemia sufferer Wayne Jowett died after a chemotherapy drug was injected into his spine instead of his veins at the Queen’s Medical Centre in 2001.
At a meeting of the Commons Health Committee last week, Professor Brian Toft, who held an inquiry into the teenager’s death, told the committee that the connector he recommended in 2001 to prevent the mistake being made again had still not been produced. He told the committee: “My conclusions regarding Wayne were that there had been procedure failures. There was inadvertent human error (that was certainly the case) but there was also systems failure.” The connector Prof Toft recommended would stop intravenous needles being mistakenly connected to spinal needles.
Click here for the full story.
HIV exposure and needlestick injury
January 25, 2009
Intravenous news: The Guardian reports that “Health care workers can get HIV if they prick themselves with a needle that’s been used on someone who has the virus. The chance that they’ll get HIV is very small. The chance of getting infected from a needlestick is less than 1 in every 300 accidents”.
They continue “Up to 2005, only five health care workers in the UK had become infected with HIV through their work. There’s also a chance that a further 14 people may have got HIV through a needlestick injury. But these people may have got HIV another way.”
Click here for the full story.
Upper arm PICC placement
January 24, 2009
Intravenous literature: Simcock, L. (2008) No Going Back: Advantages of Ultrasound-Guided Upper Arm PICC Placement. JAVA. 13(4), p.191-197.
Abstract:
Background, Method and Purpose – The use of peripherally inserted central catheters (PICCs) in the UK has been steadily increasing since they were first introduced in 1995. Ultrasound-guided upper arm placement – which has become prevalent in the USA over the last few years – is gradually attracting interest amongst PICC placers in the UK. The literature shows that upper arm placement improves insertion success rate (Hockley, Hamilton, Young Chapman, Taylor, Creed et al 2007; Hunter, 2007; Krstenic, Brealey, Gaikwad & Maraveyas, 2008) and patient satisfaction (Polak, Anderson, Hogsppiel, & Mungovan, 1998; Sansivero, 2000; McMahon, 2002). Following a switch to upper arm placement at her institution, the author examined audit data from before and after the change in practice to see if there were other measurable clinical improvements.
Results – Comparison of data from a four-year period shows that upper arm placement in our patient population increased insertion success rate and line longevity, while reducing exit site infection, thrombosis and catheter migration.
Implications for Practice – This data shows that ultrasound-guided upper-arm placement improves patient outcomes. PICC placers still using the more traditional antecubital approach should consider a change in practice.
Safer IV for staff
January 24, 2009
Intravenous literature: Baker, B. (2008) Improving Safety for Nurses Providing IV Therapy. JAVA. 13(4), p.188-189.
Abstract:
Objectives – The risk nurses face related to exposure to blood borne pathogens associated with IV therapy are daily challenges. Providing a product with the least risk of exposure is the responsibility of the healthcare organization. Where the two meet creates an environment that fosters a safe work environment and raises the awareness that safety is everyone’s job.
Project – Follwing identification of exposure rates from IV catheter stylets the Carilion Clinic undertook a project to improve the practices and provide a higher level of safety for its staff.
Results – Following staff evaluation and selection of a new IV catheter, the exposure rate related to contaminated IV catheter stylets dropped from 13 in 2005 to 2 in 2007. Numerous other practices and products related to IV therapy were reviewed and improved upon following the catheter conversion as well.
Conclusions and implications for practice – A higher level of safety can be achieved when nurses are involved in the selection of a product, staff education, and support from leadership.
EKG method for positioning PICCs
January 24, 2009
Intravenous literature: Pittiruti, M., Scoppettuolo, G., La Greca, A., Emoli, A., Brutti, A., Migliorini, I., Dolcetti, L., Taraschi, C. and De Pascale, G. (2008) The EKG Method for Positioning the Tip of PICCs: Results from Two Preliminary Studies. JAVA. 13(4), p.179-186.
Abstract:
Two preliminary studies were conducted to determine feasibility of using the electrocardiography (EKG) method to determine terminal tip location when inserting a peripherally inserted central catheter (PICC). This method uses the guidewire inside the catheter (or a column of saline contained in the catheter) as a intracavitary electrode. The reading on the EKG monitor reflects the closeness of the intracavitary electrode (the catheter tip) to the superior vena cava (SVC). The studies revealed that the EKG method was extremely precise; all tips placed using the EKG method has clear advantages in terms of accuracy, cost-effectiveness, and feasibility in conditions where x-ray control may be difficult or expensive to obtain. The method is quite simple, easy to learn and to teach, non-invasive, easy to reproduce, safe, and apt to minimize malpositions due to failure of entering the SVC.
Difficult peripheral venous access
January 24, 2009
Intravenous literature: Walsh, G. (2008) Difficult Peripheral Venous Access: Recognizing and Managing the Patient at Risk. JAVA. 13(4), p.198-203.
Abstract:
Nurses commonly face challenges placing peripheral intravenous (IV) lines in adults and children, a situation described as difficult venous access (DVA). Multiple venipuncture attempts can heighten patient anxiety and suffering, delay vital treatment, and increase costs. Numerous factors such as small, fragile or hidden veins can predispose patients to DVA, and collapsed veins due to dehydration are especially problematic. Several techniques can improve venous performance, but when IV access cannot be achieved promptly, other routes of administration can be valuable. For rehydration fluids and certain drugs, subcutaneous administration may be a safe and effective alternative, providing cost and ease-of-use advantages.
Targeting zero CRBSI with APIC
January 24, 2009
The Association for Professionals in Infection Control and Epidemiology (APIC) has expanded its Targeting Zero initiative for 2009 to offer comprehensive education and guidance to prevent the most common and fatal healthcare-associated infections (HAIs).
Targeting Zero features Webinars, conferences and practical tools such as HAI elimination guides. APIC’s evidence-based elimination guides translate CDC recommendations into straightforward infection prevention strategies for healthcare workers.
Click here for the full story.
Home infusion legislation
January 24, 2009
The ICT website report on the following statement was made by Donald M. Poretz, MD, immediate past president of the Infectious Diseases Society of America (IDSA). Poretz practices medicine in Annandale, Va., and has provided home infusion therapy to his privately insured patients for several years.
Poretz states, “The bipartisan group of senators and representatives who reintroduced home infusion legislation in the new Congress have taken an important step toward delivering on a key promise that President Obama made on his inauguration—to raise healthcare’s quality and lower its cost. As an infectious disease doctor, I often prescribe home infusion drugs, such as antibiotics and antivirals, for patients who have serious infections, like pneumonia or heart infections. Home infusion therapy allows my patients to be treated safely in the comfort of their own homes. Not only are they happier, but they are also less likely to be exposed to hospital-acquired infections, many of which are drug-resistant.
Dialysis hepatitis C exposure
January 24, 2009
A Manhattan dialysis center is notifying patients after the facility identified, and a State Department of Health (DOH) investigation confirmed, one patient who contracted hepatitis C after undergoing dialysis there.
Approximately 170 patients of the Upper Manhattan Dialysis Center of Beth Israel Medical Center at 2465-67 Broadway in Manhattan are being notified in person or by mail that they may have been exposed to hepatitis C and possibly other bloodborne viruses while being treated at the facility.
IV extension set alert
January 21, 2009
The MHRA have issued an alert that concerns the Sae-Flo MD extension set with Y-connector (lot number 80623/1 only). Manufacturer: Wescott Medical Ltd. Product code: WEPCA200AY. NHS Supply Chain code: FSB025 (England only).
A number of devices from this lot have been reported to leak at the connection between the anti-siphon valve (female Luer) and the tubing. Very few of the leaks were detected during priming. This can lead to inadequate pain relief or treatment of patients.
Please click here to view the Medical Device Alert for further information.
MicroAccess WAND is CE marked
January 21, 2009
Intravenous products: Access Scientific, Inc. announced today that it has obtained CE Mark approval for its MicroAccess WAND(R), the world’s first all-in-one safety introducer. The CE Mark enables Access Scientific to sell the MicroAccess WAND broadly around the globe. The device has already received FDA clearance.
The MicroAccess WAND is a sophisticated new medical device that enables clinicians to more quickly and safely insert a sheath or catheter into a patient’s peripheral vasculature. The device combines all components of the older, Modified Seldinger Technique into a unitary device that provides faster, safer, simpler over-wire vascular access in a relatively bloodless procedure.
Read the full press release here.
Safety phlebotomy device
January 21, 2009
Intravenous products: medGadget report that Medigard, out of Queensland, Australia, has received FDA approval to market the company’s blood collection device in the US. Though the company has not officially named the product, we have some information to believe it will be called Vacugard BCD. In the meantime, Medigard is looking for manufacturing and distribution partners in America.
Click here for the full story.
Retrieval of lost guide wire
January 17, 2009
Struck, M.F., Kaden, I., Heiser, A. and Steen, M. (2008) Cross-over endovascular retrieval of a lost guide Read more
Retrieval of PICC fragment
January 17, 2009
Robbins, A.B. and Patel, H. (2008) Transvascular retrieval of a catheter remnant from the peripheral vein of a preterm neonate. The Journal of Vascular Access. 9(4) p.299-300.
Abstract:
We report the first case of transvenous removal of a peripheral inserted central catheter (PICC) fragment embolized to a peripheral vein in a 32-week gestational age 1450 g infant. The technical aspect of this alternative method to surgery is discussed.
Implanted port dislodgment
January 17, 2009
M.I. Elkhoury, M.I, Boeckx, W.D., Chahine, E.G. and Feghali, M.A. (2008) Retrieval of port-A catheter fragment from the main and right pulmonary arteries 3 years after dislodgment. The Journal of Vascular Access. 9(4) p.296-298.
Abstract:
Vascular access (VA) is one of the serious problems that chemotherapy recipient cancer patients face. Fractures of catheter and cardiac migration rarely occur; the catheter fragments migrate distally along the blood stream finally lodging anywhere in the vena cava, right atrium, right ventricle, or the main pulmonary artery or one of its branches. Percutaneous retrieval method is always suggested first.
Handling chemotherapy safely
January 17, 2009
Eisenberg, S. (2009) Safe Handling and Administration of Antineoplastic Chemotherapy. Journal of Infusion Nursing. 32(1), p.23-32.
Abstract:
Antineoplastic chemotherapy describes a group of hazardous drugs commonly used in the treatment of cancer. Since the discovery of their presence in nurses and pharmacists more than 2 decades ago, numerous studies have reported on the short- and long-term consequences of exposure. Guidelines describing proper equipment and procedures have been established in an effort to eliminate or minimize environmental and biologic exposure. Nursing compliance, however, has been variable. This article describes the dangers of exposure, how it occurs, and steps to keep nurses safe while working with these hazardous drugs.
Prevention of catheter occlusion
January 17, 2009
Jasinsky, L.M. (2009) Occlusion Reduction and Heparin Elimination Trial Using an Antireflux Device on Peripheral and Central Venous Catheters. Journal of Infusion Nursing. 32(1), p.33-39.
Abstract:
Catheter occlusion and thrombosis are common problems associated with central venous catheters, peripherally inserted central catheters, and peripheral intravenous catheters. A prospective study was performed at a community hospital to determine whether an antireflux valve device would reduce the frequency of complications in these catheters and safely allow the elimination of heparin flushes for central venous catheters and peripherally inserted central catheters. The study compared complications with current intravenous practice to complication rates for the antireflux valve device. The study used evidence obtained during this trial to institute the best clinical practice.
Hypodermoclysis
January 17, 2009
Lybarger, E. (2009) Hypodermoclysis in the Home and Long-term Care Settings. Journal of Infusion Nursing. 32(1), p.40-44.
Abstract:
Hypodermoclysis is the subcutaneous administration of isotonic infusates to correct short-term fluid and electrolyte balances. It has recently begun to regain recognition as a safe and effective alternative to intravenous fluid hydration in the mild to moderately dehydrated patient, particularly in the areas of palliative care and long-term care. Hypodermoclysis is easy to establish and maintain and has fewer complications than intravenous hydration. The medication hyaluronidase can be injected as a spreading agent to facilitate subcutaneous fluid absorption. Hypodermoclysis has the potential to help reduce the $1 billion annual US cost of avoidable hospitalizations for dehydration.
Enzyme replacement therapy
January 17, 2009
Tifft, C., Proud, V., Levy, P., DeMarco, K., Nicely, H. and Turbeville, S. (2009) Enzyme Replacement Therapy in the Home Setting for Mucopolysaccharidosis VI: A Survey of Patient Characteristics and Physicians’ Early Findings in the United States. Journal of Infusion Nursing. 32(1), p.45-52.
Abstract:
Galsulfase, a Food and Drug Administration-approved enzyme replacement therapy for mucopolysaccharidosis VI, is administered once weekly in a hospital setting as a 4-hour intravenous infusion. To improve convenience and alleviate family responsibilities associated with clinic visits, some physicians are transitioning appropriate patients to home infusion therapy. An online survey was conducted with 3 physicians treating 4 patients with mucopolysaccharidosis VI to better understand the factors motivating the transition to home infusion therapy, identify characteristics of appropriate candidates, and evaluate the potential impact on the lives of patients and their families. Survey results showed that home infusion may offer patients and their families increased flexibility of schedule and enhanced family life.
Cannulation team poster
January 17, 2009
Peter Carr has submitted his ‘Nurse led intravenous cannulation team’ poster to the IVTEAM website. The origins of the team started with the European Working Time Directive Initiative Pilot Project. This identified the need for a specialist vascular access team to allow for the provision of an efficient and safe cannulation service to patients.
Click here to view the poster.
Adherence to correct hand antisepsis
January 17, 2009
Laustsen, S., Lund, E., Bibby, B.O., Kristensen, B., Thulstrup, A.M. and Møller, J.K. (2009) Cohort Study of Adherence to Correct Hand Antisepsis Before and After Performance of Clinical Procedures. Infection Control and Hospital Epidemiology. 30, p.172–178.
Abstract:
Objective – To investigate the rate of adherence by hospital staff members to the correct use of alcohol‐based hand rub before and after performance of clinical procedures.
Design – A cohort study conducted during the period from 2006 through 2007 and 2 cross‐sectional studies conducted in 2006 and 2007.
Setting – Århus University Hospital, Skejby, in Århus, Denmark.
Participants – Various hospital staff members.
Methods – Following an ongoing campaign promoting the correct use of alcohol‐based hand rub, we observed rates of adherence by hospital staff to the correct use of alcohol‐based hand rub. Observations were made before and after each contact with patients or patient surroundings during 5 weekdays during the period from 2006 through 2007 in 10 different hospital units. A logistic regression model was used to estimate the rate of adherence to the correct use of alcohol‐based hand rub before and after performance of a clinical procedure.
Results – A total of 496 participants were observed during 22,906 opportunities for hand hygiene (ie, 11,177 before and 11,729 after clinical procedures) that required the use of alcohol‐based hand rub. The overall rates of adherence to the correct use of alcohol‐based hand rub were 62.3% (6,968 of the 11,177 opportunities) before performance and 68.6% (8,041 of the 11,729 opportunities) after performance of clinical procedures. Compared with male participants, female participants were significantly better at adhering to the correct use of alcohol‐based hand rub before performance (odds ratio [OR] 1.51 [95% confidence interval {CI}, 1.09–2.10]) and after performance (OR, 1.73 [95% CI, 1.27–2.36]) of clinical procedures. In general, the rate of adherence was significantly higher after the performance of clinical procedures, compared with before (OR, 1.43 [95% CI, 1.35–1.52]). For our cohort of 214 participants who were observed during 14,319 opportunities, the rates of adherence to the correct use of alcohol‐based hand rub were 63.2% (4,469 of the 7,071 opportunities) before performance and 69.3% (5,021 of the 7,248 opportunities) after performance of clinical procedures, and these rates increased significantly from 2006 to 2007, except for physicians.
Conclusion – We found a high and increasing rate of adherence to the correct use of alcohol‐based hand rub before and after performance of clinical procedures following a campaign that promoted the correct use of alcohol‐based hand rub. More hospital staff performed hand hygiene with alcohol‐based hand rub after performance of clinical procedures, compared with before performance. Future campaigns to improve the rate of adherence to the correct use of alcohol‐based hand rub ought be aware that certain groups of hospital staff (eg, male staff members) are known to exhibit a low level of adherence to the correct use of alcohol‐based hand rub.
Umbilical cord blood processor
January 17, 2009
Intravenous products: The FDA has given clearance to PrepaCyte-CB umbilical cord blood processing system from BioE Inc. out of St. Paul, Minnesota. The device, already approved in the EU, filters blood for progenitor stem cells, total nucleated cells, and mononucleated cells for a possible use in therapeutic applications.
Click here for the full story on medgadget.
Click here for the press release.
Thirty patients test positive
January 17, 2009
Thirty out of approximately 1,000 former endoscopy and dental surgery patients of the High Prairie Health Complex have tested positive for hepatitis B, hepatitis C or HIV, health officials in High Prairie told CBC News on Wednesday.
The tests were ordered last fall after it was revealed single-use syringes had been reused at the health complex to inject medication into intravenous lines for years.
Final numbers are not in yet, and the statistics could simply be a reflection of the prevalence of these infections in the general population, according to Alberta’s acting chief medical officer of health, Dr. Gerry Predy.
“These infections they’re looking for … hepatitis B and C and HIV, are relatively common. So if you’re going to test hundreds of people, you will get some positives,” he said.
Click here for the full story.
Smart infusion pumps
January 17, 2009
New “smart” drug pumps at Rice Memorial Hospital have been alerting nurses to errors — a dose of Dilaudid, a painkiller, that was accidentally programmed for 2 milligrams per hour instead of 0.2 milligrams, for instance — so that the error can be fixed before it reaches the patient.
Carnie Allex, director of pharmacy at the hospital, knows this because it’s one of the things being tracked in Rice Hospital’s efforts to improve patient safety.
Click here for the full story.
V-Link is Smart Solutions winner
January 11, 2009
Intravenous products: Nine products have been selected as winners in the Smart Solutions for HCAI competition to find new ways to help combat healthcare associated infections (HCAIs).
They have been chosen from around 250 applications submitted to the Smart Solutions for HCAI programme, which aimed to identify innovative technologies from different industry sectors with the potential to fight hospital bugs. The winning products will all be evaluated in a hospital setting beginning in early 2009, with a view to supplying them across the NHS if they prove to be effective.
The successful products, and the companies behind them, are:
- V-link luer-activated device with VitalShield protective coating – Baxter Healthcare
- UV Lighting Equipment Range – UV Light Technology Ltd
- Medixair – GE Healthcare
- The AD (air disinfection unit) – Inov8 Science Ltd
- AirManager, driven by Close Coupled Field Technology (CCFT) – Quest International (UK) Ltd
- Recombinase Polymerase Amplification - TwistDx
- MedMat - Ergomedica
- Liquid glass layering technology – Nanopool
- Formula 429 and Formula 429 plus – Chemspec
Home IV service
January 10, 2009
People who need to have intravenous (IV) therapy for their antibiotics will be able to complete their treatment at home thanks to a new pilot scheme from NHS Heywood, Middleton and Rochdale.
IV therapy is when medication or fluids are administered directly into the vein through a cannula or catheter. The Community IV Therapy Service provides intravenous antibiotics to patients in their own home up to three times per day, helping to reduce the number of patients having to stay in hospital.
Click here for the full story.
Click here for more IV news at IVTEAM
MaxGuard needleless connector
January 10, 2009
Medegen, a leading innovator in infusion therapy products, today announced that it has received 510(k) clearance from the Food and Drug Administration (FDA) for its new MaxGuard™ Advanced Luer Activated Device featuring Agion® Antimicrobial Technology. MaxGuard is the first positive displacement needleless connector featuring impregnation of the antimicrobial additive into each of the components of the device. Laboratory testing has demonstrated this new antimicrobial device exhibits a kill rate of greater than 99.99 percent representing a 4-plus log reduction on infection-causing organisms predominantly responsible for catheter-related bloodstream infections.
Medegen routinely receives input from IV therapy clinicians regarding unmet needs and new product concepts. In 2006 clinical end users requested that Medegen’s leading device, the MaxPlus® Positive Displacement Connector, be offered with a clear housing to facilitate visualization of the fluid path. In February 2008, Medegen released the MaxPlus Clear™ which quickly became a leading product for the company because of the consistent and dramatic bloodstream infection reduction results it has brought to hospitals nationwide. Last year, MaxPlus clinical users requested an antimicrobial version of the MaxPlus Clear device for use on immunocompromised patients. Today, Medegen is once again fulfilling the clinical users’ requests by announcing FDA clearance of the new MaxGuard Advanced Luer Activated Device with Antimicrobial Technology.
Click here to access the full news item on ITC.
Click here for more IV news at IVTEAM
Extravasation guidelines
January 10, 2009
The North Trent Cancer Network have published extravasation guidelines. “This policy describes the procedure to be followed following extravasation of cytotoxic chemotherapy. Not all chemotherapy is vesicant (i.e. can cause severe tissue damage when given into the surrounding tissue) but most chemotherapy potentially causes irritation and injury to the tissue and should be treated according to the following procedure. If tissue damage is suspected then treatment must be initiated quickly” (NTCN 2008).
The contents of the guidelines include:
- Recognition of an Extravasation from a Peripheral cannula
- Recognition of an extravasation from a Central Venous Access Device
- Action to be Taken if Extravasation Occurs via a Peripheral Cannula
- Action to be taken if an extravasation Occurs via a Central Venous Access Device
- Guidelines for the Management of Extravasation during Administration of Cytotoxic Chemotherapy
- Quick Reference Guide for Immediate Treatment of Extravasation via a Peripheral Cannula – Algorithm
- Principles for Minimising Extravasation while Administering Cytotoxic Drugs
- Guidelines for Assessing Patency
- North Trent guidelines for the management of extravasation from cytotoxic chemotherapy
Click here to access the full guideline.
Click here for more IV news at IVTEAM
Enteral feed mistaken for IV
January 6, 2009
An 87-year-old bedridden man suffering the aftereffects of a brain hemorrhage died after a serving of his liquid diet was mistakenly fed into a vein via an intravenous drip instead of a feeding tube into his stomach by an assistant nurse of a hospital in Ibaraki, Osaka Prefecture, police said.
The 45-year-old assistant nurse of Yukoukai General Hospital admitted the error, saying that she was too busy to realize her mistake. The police are investigating the case on suspicion of professional negligence resulting in death.
According to the hospital, the nurse mistakenly attached a 250-milliliter package of liquid meal to the man’s intravenous drip tube at around 4 p.m. on Jan. 2. Another assistant nurse noticed the error about 30 minutes later, and a doctor undertook procedures to try to save the man’s life, but the man died about 90 minutes later.
Read the original news story here.
60,000 patients at risk for Hepatitis B
January 6, 2009
In the last decade, more than 60,000 patients in the United States were asked to get tested for hepatitis B virus (HBV) and hepatitis C virus (HCV) because healthcare personnel in settings outside hospitals failed to follow basic infection control practices, according to a new study by the CDC.
This first full review of all the CDC investigations over the past 10 years of healthcare-associated viral hepatitis outbreaks appears in the Jan. 6, 2009 issue of the journal Annals of Internal Medicine.
“This report is a wake-up call,” said Dr. John Ward, director of CDC’s Division of Viral Hepatitis. “Thousands of patients are needlessly exposed to viral hepatitis and other preventable diseases in the very places where they should feel protected. No patient should go to their doctor for healthcare only to leave with a life-threatening disease.”
In the United States, transmission of HBV and HCV while receiving healthcare has been considered uncommon. However, a review of CDC outbreak information revealed a total of 33 identified outbreaks outside of hospitals in 15 states, during the past decade: 12 in outpatient clinics, six in hemodialysis centers and 15 in long-term care facilities, resulting in 450 people acquiring HBV or HCV infection.
Patients were exposed to these potentially deadly diseases because health care personnel failed to follow basic infection control procedures and aseptic technique in injection safety. Reuse of syringes and blood-contamination of medications, equipment and devices were identified as common factors in these outbreaks.
Click here for the full news item.
Infection prevention in outpatients
January 6, 2009
The Association for Professionals in Infection Control and Epidemiology (APIC) has issued a statement from Kathy Warye, CEO of APIC, in conjunction with an article being published in the January issue of the Annals of Internal Medicine about outbreaks of hepatitis B and C in outpatient clinics nationwide. The outbreaks are linked to unsafe injection practices. In the statement Warye addresses the need for increased infection prevention measures in outpatient settings and also APIC’s work with HONOReform, a national coalition formed to bring a halt to unsafe needle practices in outpatient centers. APIC is providing educational resources and expertise to this effort spearheaded by a hepatitis C survivor. As this year progresses, APIC will play an increasingly active role in monitoring legislation and educating the profession about safe injection practices.
Blood tests whilst shopping
January 6, 2009
Shoppers at a West Midlands Supermarket are now able to get a hospital blood test taken as they shop. The West Bromwich ‘Asda’ supermarket has teamed up with Birmingham City Hospital and nearby Sandwell Hospital under an NHS pilot scheme.
The blood tests are taken by a qualified phlebotomist, in a location removed from where any food is sold.
Click here for the full story.
Sharps injury protection
January 6, 2009
OSHA is making healthcare employers and employees aware of the sale of pre-filled syringes with fixed needles containing Fluvirin. Manufactured by Novartis, it is one of the 2008 seasonal flu vaccines. OSHA says the needles do not have engineered sharps-injury protections. The needles cannot be removed and replaced with products containing sheaths or shields.
Agency standards require needles used by healthcare workers who administer flu vaccine to have built-in antistick protection. While unprotected syringes pose a safety risk to employees, they do not affect the safety or efficacy of the vaccine in patients, says OSHA.
In response to an inquiry by the state safety agency, Novartis says that it replaced the fixed-needle syringes provided to public health departments in the state.
Click here for the full story.
Cancer medication errors
January 3, 2009
Seven percent of adults and 19 percent of children taking chemotherapy drugs in outpatient clinics or at home were given the wrong dose or experienced other mistakes involving their medications, according to a new study supported in part by HHS’ Agency for Healthcare Research and Quality through its Centers for Education and Research on Therapeutics program.
Researchers analyzed data on nearly 1,300 patient visits at three adult oncology outpatient clinics and 117 visits at one pediatric facility between September 1, 2005 and May 31, 2006. The study, “Medication Errors among Adults and Children with Cancer in the Outpatient Setting,” is in the January 1, 2009 issue of the Journal of Clinical Oncology .
Of the 7 percent of medication errors involving adults, 55 had the potential to harm the patient and 11 did cause harm. The errors included administration of incorrect medication doses due to confusion over conflicting orders – one written at the time of diagnosis and the other on the day of administration. Some consequences of errors included patients being over-hydrated prior to administration of chemotherapy and complaints of abdominal pain in patients taking narcotics without treatment for constipation. More than 50 percent of errors involving adults were in clinic administration, 28 percent in ordering of medications, and 7 percent in use of the drugs in patients’ homes.
Click here for the full story on News-Medical.Net
New central venous catheter book
January 2, 2009
Product description from Amazon: This book addresses all the issues a patient may experience prior to receiving a VAD. Selection of equipment, practical aspects of technique, the pros and cons of the various veins, and modifications of technique for certain circumstances are examined. Covereage also includes the roles played by radiologists, anaesthetists, surgeons, nurses, and other team memebers. Throughout the chapters a reference is made to the IV Therapy Standards published by the Royal College of Nursing IV Therapy Forum in 2003. Each chapter is evidence based and fully referenced.
Product details
Paperback: 272 pages
Publisher: WileyBlackwell (20 Feb 2009)
Language English
ISBN-10: 0470019948
ISBN-13: 978-0470019948
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FDA approve test for donated blood
January 2, 2009
The Food & Drug Administration (FDA) today approved a new nucleic acid test from Roche to screen donated blood for HIV-1 Group M RNA, hepatitis C RNA and hepatitis B DNA in a single, automated assay. The test, called the cobas TaqScreen MPX Test for use on the cobas s 201 system, is a qualitative in vitro test for comprehensive single-assay detection of HIV-1 Group M RNA, HIV-1 Group O RNA, HIV-2 RNA, hepatitis C virus RNA and hepatitis B virus DNA in human plasma. The test, which is not intended for use as an aid in diagnosis, is designed to further increase the safety of blood supplies by identifying infections earlier than traditional serology tests.
