Monthly Archives: November 2014

80 percent reduction in ‘alarm fatigue’ in hospitals

Nurses

The sound of monitor alarms in hospitals can save patients’ lives, but the frequency with which the monitors go off can also lead to “alarm fatigue,” in which caregivers become densensitized to the ubiquitous beeping.

Researchers at Cincinnati Children’s Hospital Medical Center have tackled this problem and developed a standardized, team-based approach to reducing cardiac monitor alarms. The process reduced the median number of daily cardiac alarms from 180 to 40, and increased caregiver compliance with the process from 38 percent to 95 percent.

“Cardiac monitors constitute the majority of alarms throughout the hospital,” says Christopher Dandoy, MD, a physician in the Cancer and Blood Diseases Institute at Cincinnati Children’s and lead author of the study. “We think our approach to reducing monitor alarms can serve as a model for other hospitals throughout the country.”

The main accrediting body for healthcare organizations and programs, the Joint Commission, reported 80 alarm-related deaths between January 2009 and June 2012.

Dr. Dandoy’s study of this project was published in the eFirst pages of the journal Pediatrics.

The researchers developed a standardized cardiac monitor care process on the 24-bed, pediatric bone marrow transplant unit at Cincinnati Children’s. The project involved a process for initial ordering of monitor parameters based on age-appropriate standards, daily replacement of electrodes in a manner that was pain-free for patients, individualized daily assessment of cardiac monitor parameters and a reliable method for appropriate discontinuation of the monitors.

“With fewer false alarms, the staff can address significant alarms more promptly,” says Dr. Dandoy. “We believe the roles and responsibilities entailed in this process can be applied to most units with cardiac monitor care.”

Dr. Dandoy designed and conducted the study along with colleagues in the Cancer and Blood Diseases Institute and in the James M. Anderson Center for Health Systems Excellence at Cincinnati Children’s.

http://www.medicalnewstoday.com/releases/285215.php

 

 

Advertisements

Tightened guidance for U.S. healthcare workers on personal protective equipment for Ebola

Nurses

The Centers for Disease Control and Prevention is tightening previous infection control guidance for healthcare workers caring for patients with Ebola, to ensure there is no ambiguity. The guidance focuses on specific personal protective equipment (PPE) health care workers should use and offers detailed step by step instructions for how to put the equipment on and take it off safely.

Recent experience from safely treating patients with Ebola at Emory University Hospital, Nebraska Medical Center and National Institutes of Health Clinical Center are reflected in the guidance.

The enhanced guidance is centered on three principles:

  • All healthcare workers undergo rigorous training and are practiced and competent with PPE, including taking it on and off in a systemic manner
  • No skin exposure when PPE is worn
  • All workers are supervised by a trained monitor who watches each worker taking PPE on and off.

All patients treated at Emory University Hospital, Nebraska Medical Center and the NIH Clinical Center have followed the three principles. None of the workers at these facilities have contracted the illness.

Principle #1: Rigorous and repeated training

Focusing only on PPE gives a false sense of security of safe care and worker safety. Training is a critical aspect of ensuring infection control. Facilities need to ensure all healthcare providers practice numerous times to make sure they understand how to appropriately use the equipment, especially in the step by step donning and doffing of PPE. CDC and partners will ramp up training offerings for healthcare personnel across the country to reiterate all the aspects of safe care recommendations.

Principle #2: No skin exposure when PPE is worn

Given the intensive and invasive care that US hospitals provide for Ebola patients, the tightened guidelines are more directive in recommending no skin exposure when PPE is worn.

CDC is recommending all of the same PPE included in the August 1, 2014 guidance, with the addition of coveralls and single-use, disposable hoods. Goggles are no longer recommended as they may not provide complete skin coverage in comparison to a single use disposable full face shield. Additionally, goggles are not disposable, may fog after extended use, and healthcare workers may be tempted to manipulate them with contaminated gloved hands. PPE recommended for U.S. healthcare workers caring for patients with Ebola includes:

  • Double gloves
  • Boot covers that are waterproof and go to at least mid-calf or leg covers
  • Single use fluid resistant or imperable gown that extends to at least mid-calf or coverall without intergraded hood.
  • Respirators, including either N95 respirators or powered air purifying respirator (PAPR)
  • Single-use, full-face shield that is disposable
  • Surgical hoods to ensure complete coverage of the head and neck
  • Apron that is waterproof and covers the torso to the level of the mid-calf should be used if Ebola patients have vomiting or diarrhea

http://www.medicalnewstoday.com/releases/284226.php

 

%d bloggers like this: