Category Archives: Hospital-acquired infections
In a time of progress against hospital-acquired infections, a new nurse-led study offers a reminder of the work that remains to be done. The study finds that approximately one in five U.S. health care facilities fails to place alcohol-based hand sanitizer at every point of care, missing an opportunity to prevent the spread of infectious diseases.
A research team jointly led by Laurie Conway, RN, MS, CIC, a PhD student at the Columbia University School of Nursing, and Benedetta Allegranzi, MD, of the World Health Organization (WHO), surveyed compliance with WHO hand-hygiene guidelines at 168 facilities in 42 states and Puerto Rico. Just over 77 percent reported that alcohol-based sanitizer was continuously available at every point of care. They also found that only about half of the hospitals, ambulatory care, and long-term care facilities had allocated funds for hand-hygiene training.
This is part of the February 2014 issue of Sharing Nursing’s Knowledge.
Nurses’ Perceptions of Their Workplaces
A new survey offers insights into how hospital nurses perceive their workplace and profession. Jackson Healthcare, a health care staffing company, surveyed 1,333 hospital nurses. Among the findings:
- Nearly two-thirds of surveyed nurses (64 percent) say they are satisfied or very satisfied with their jobs.
- Sixty-seven percent say they have less time at patients’ bedsides than they wish because they must perform activities that other hospital personnel could be doing, including looking for equipment and supplies, and restocking supply areas.
- Sixty-six percent cite inadequate staffing levels in their hospitals, saying that limited coverage and clinical support force nurses to divide their time between more patients.
- Almost half of nurses surveyed reported a nursing shortage at one or more of the units in their hospitals, with 35 percent citing the medical-surgical department as short-staffed, 18 percent pointing to critical care, and 17 percent to the emergency department.
Guidelines and a toolkit released this week by the Joint Commission highlight the key role nurses play in preventing central line-associated bloodstream infections (CLABSIs). CLABSIs are among the most deadly and costly hospital-associated infections, accounting for 31,000 deaths annually and costing the health system an estimated $9 billion. Studies funded by the Robert Wood Johnson Foundation’s Interdisciplinary Nursing Quality Research Initiative (INQRI) revealed that nurses can play a key role in preventing these infections.
Patricia Stone, PhD, MPH, RN, FAAN, a principal investigator for an INQRI-funded study on the impact of nurse staffing, skill mix, and experience on quality and costs in long-term care, contributed to the new guidelines. Stone is the Centennial Professor of Health Policy in Nursing at Columbia University School of Nursing.
Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the work of RWJF’s nursing programs, and the latest news, research, and trends relating to academic progression, leadership, and other critically important nursing issues. These are some of the stories in the October issue:
Three Years Later, Institute of Medicine Report is Fueling Innovations in Nursing Practice and Education
Three years after its release , the Future of Nursing report has become a motivational tool that is transforming nursing and improving health care across the country. Read about some of the national accomplishments and achievements of the state Action Coalitions, which are working to advance nurse education, remove barriers to practice, cultivate more nurse leaders, diversify the profession, collect better data about the nursing workforce, promote interprofessional collaboration and education, and more.
Waging War Against Drug-Resistant Bacteria
RWJF Nurse Faculty Scholar Jason Farley has traveled far on the path he set out on as a young university student, and the world is taking notice of his groundbreaking work to treat patients with HIV. His research focuses on the spread of Methicillin-Resistant Staphylococcus Aureus (MRSA) and other antibiotic resistant organisms among HIV patients. MRSA poses a major threat to patients with compromised immune systems, and is increasingly placing financial burdens on health care facilities.
This is part of the October 2013 issue of Sharing Nursing's Knowledge.
Modeling Poor Infection-Prevention for Nursing Students
Clinical practice is a critical part of nursing students’ education, a chance to learn by watching and working alongside trained professionals in a real-world setting. But a new study from Great Britain suggests that in at least one important area of care, students could pick up some bad habits along the way.
An online survey of student nurses, conducted by researchers at Cardiff University and City University, London, found that all 488 respondents had witnessed lapses in infection-prevention and -control practices during their clinical practicums. According to the study, “Over 75 percent reported witnessing failure to cleanse hands between patient contacts, 61.2 percent reported health workers wearing rings (in addition to wedding bands), and 60 percent reported health workers wearing painted nails or nail extensions. Failure to comply with isolation precautions, poor standards of cleaning in the near patient environment, not changing personal protective equipment between patients, and poor management of sharp instruments had each been witnessed by over half the sample.” The researchers conclude, “The study findings indicate that ensuring safe infection control practice remains a challenge in the United Kingdom despite its high priority.”
This is part of the September 2013 issue of Sharing Nursing's Knowledge.
More New Nurse Practitioners Heading to Primary Care
Two recent analyses of workforce data offer new insights into the role nurse practitioners (NPs) are likely to play in combating the coming shortage of primary care providers in the U.S.
The first analysis, commissioned by the Agency for Healthcare Research and Quality (AHRQ) and released in August, finds that slightly more than half the nation’s nurse practitioners are practicing primary care. In all, 55,625 of the nation’s 106,073 nurse practitioners are in primary care, according to data drawn from the Centers for Medicare and Medicaid Services’ National Provider Identifier database.
At the same time, an analysis of graduation trends conducted by Robert Wood Johnson Foundation Executive Nurse Fellow alumna Debra Barksdale, PhD, RN, FAAN, and colleagues, finds that graduation rates for NPs suggest more help is on the way. According to Barksdale’s reading of data from the American Association of Colleges of Nursing and the National Organization of Nurse Practitioner Faculties, 84 percent of NP graduates in 2012 were prepared in primary care. That represents an eye-catching 18.6 percent increase from 2011 to 2012.
Ode to My Favorite Gadget – This One Saves 99,000 Lives Per Year in the U.S. Can Your iPhone Do That?
Timothy Landers, RN, CNP, PhD is a 2012-2015 Robert Wood Johnson Foundation Nurse Faculty Scholar and an assistant professor at The Ohio State University.
A piece of technology that has transformed modern health care—and our careers—is the underappreciated hand sanitizer dispenser.
Nearly every field of nursing and medicine depends on advances in the prevention and treatment of infection. For example, it is now possible to perform extended surgeries on the brain or heart while controlling the risk of later death from infection. Combined with infection prevention activities, it is now possible to give immune-suppressing drugs to cancer patients who would otherwise certainly die of an infection at some point in their disease process. One hundred years ago, patients with trauma often died of infectious complications several days after the acute injury.
Advances in every field of medicine depend on good infection control. And good infection control depends on good hand hygiene. And good hand hygiene depends on the hand sanitizer dispenser.
Deverick J. Anderson, MD, MPH, is an alumnus of the Robert Wood Johnson Foundation Physician Faculty Scholars program and an associate professor of medicine at Duke University School of Medicine. He recently led a study, published in the July issue of Infection Control and Hospital Epidemiology, that finds small, community hospitals have higher rates of ventilator-associated pneumonia than larger hospitals, even though they use ventilators less frequently.
Human Capital Blog: Why did you decide to look at this particular topic?
Deverick Anderson: Our group is very interested in infectious diseases and hospital epidemiology in community hospitals. Despite the fact that more than half of the health care provided in the United States is provided in this setting, data are rarely, if ever, published from small, community hospitals.
HCB: What did your study look at?
Anderson: We analyzed prospectively collected surveillance data on ventilator-associated pneumonia (VAP) from 31 community hospitals over a five year period (2007-2011).
HCB: What did you find?
Anderson: As expected, VAP led to significant morbidity and mortality. The most common cause of VAP was methicillin-resistant Staphylococcus aureus, or MRSA. Most surprisingly, however, we noted that the incidence of VAP was inversely associated with hospital size. In other words, the smallest community hospitals in our network (with less than 30,000 patient-days per year) had the highest rates of VAP.
Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the latest nursing news, research and trends. Here are descriptions of some of the stories in the September issue:
Advocates Call on Nurses to Take Leading Role in Palliative Care
The United States is facing a growing need for palliative care, which focuses on symptom relief and optimizing quality of life at all stages of serious illness—but the country has a serious shortage of palliative care providers. Experts say nurses can help fill the void. Advanced practice registered nurses can provide high quality palliative care, and nurse leadership can help reshape and build the field.
Study: Nurse-Led Intervention Can Dramatically Reduce Deadly, Costly Infections
A study funded by the RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) reveals that combining several tested and proven practices for preventing central line associated bloodstream infections with a program to improve safety, teamwork and communication can dramatically reduce infection rates. While health care teams using the bundles were interdisciplinary, in each unit, nurses were responsible for ensuring adherence to the intervention.
Nurse’s Mobile App Idea Helps New Parents
Anna Wroble, a nurse and a mother of four in Nevada, recently won a contest sponsored by Dignity Health, a national hospital chain, for her idea for a mobile application that would enable parents to track their babies’ growth during the first year of their lives. The NICU Baby Growth Tracker app—one of three projects that received funding through the contest—became available for free download in August.
2012 RWJF Nurse Faculty Scholars: The Next Generation of Leaders in Academic Nursing
Twelve talented and diverse junior nurse faculty from across the country have been chosen as the fifth cohort of RWJF Nurse Faculty Scholars. The award is given to junior faculty who show outstanding promise as future leaders in academic nursing. It is designed to promote their academic careers, support their research, and reduce the severe nurse faculty shortage that is facing the nation. Each scholar receives a three-year $350,000 grant to pursue research, leadership training in all aspects of the faculty role, and mentoring from senior faculty at his or her institution.
Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:
The Associated Press reports that “as many as 700,000 minority voters under age 30 may be unable to cast a ballot in November because of photo ID laws in certain states.” That’s according to a study led in part by Cathy Cohen, PhD, an alumna of the RWJF Scholars in Health Policy Research program and recipient of an RWJF Investigator Award in Health Policy Research. The story was picked up by CBS News, ABC News, and U.S. News & World Report, among other outlets.
Health Canal reports on a study by grantees of the RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) that finds combining several tested and proven practices for preventing central line associated bloodstream infections with a program to improve safety, teamwork and communication can dramatically reduce infection rates. Read more about the study.
RWJF Physician Faculty Scholar Deverick J. Anderson, MD, MPH, was a guest on NPR to talk about infection control in hospitals with limited resources.
As fast food chain McDonald's begins posting the calorie counts of its food on menus, Health & Society Scholars alumnus Jason Fletcher, PhD, spoke to the Chattanooga Times Free Press about how the move will affect consumer choices and obesity.
Physician Faculty Scholar Ruchi S. Gupta, MD, MPH, is part of a group of researchers publishing results from a study that concludes children with mild-to-severe food allergies “should be receiving better care, including diagnostic testing and attention to severe allergic reaction symptoms,” Medical News Today reports.