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CDC Promotes Infection Prevention Guidance For Outpatient Settings

As healthcare professionals, we must recognize our responsibility to protect patients – care should not provide any avenue for the transmission of infections. By working together, we can ensure infection prevention practices are understood and followed by all, during every patient visit. Healthcare continues to transition to settings outside the hospital, and efforts to prevent infections must extend to all settings where patients receive care.

Today, CDC is pleased to present the Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care. a summary guide of infection prevention recommendations for outpatient settings. Although these recommendations are not new, this guide is a concise, one-stop resource where ambulatory care providers can quickly find evidence-based guidelines produced by the CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC).

Repeated outbreaks and notification events resulting from unsafe practices highlight the need for better infection prevention across our entire healthcare system, not just in our hospitals. Based primarily upon elements of Standard Precautions, including medical injection safety and reprocessing of reusable medical devices, this guide reminds healthcare providers of the basic infection prevention practices that must be followed to assure safe care.

I urge you to use this guidance document, and the accompanying Infection Prevention Checklist for Outpatient Settings to assess the practices in your facility to assure that patients are receiving the safe care that they expect and deserve.

I also invite you to view our CDC Expert Video Commentary on Medscape titled New Infection Prevention Guidance for Outpatient Settings to learn more about the guidance.

*This blog post was originally published at Safe Healthcare*

Pregnant Female Prisoners Must Remain In Shackles During C-Section Procedures?

“But for the grace of God go I.” My late aunt drilled that value into my six-year old head and it has never left. An article regarding a New York politician recently caught my attention. When New York State enacted a bill to ban the shackling of pregnant prisoners, a New York State Assemblywoman objected. The article goes on to discuss the case of Jeanna M. Graves, who, in 2002 was arrested on a drug charge and began a three year sentence. Graves was pregnant with twins and while in labor, was handcuffed during her entire C. Section. How utterly ridiculous.

Before a C. Section begins, a patient is usually given either an epidural or spinal anesthesia. On rare occasions, she is put to sleep with general anesthesia if the baby must be delivered emergently. On all accounts, the patient’s legs will either be numb from anesthesia or she will be sleeping. Why then does she need shackles? She’s certainly not in a position to run. Although I addressed this issue last August, it needs to be revisited again. Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Pregnant And Itchy? It Could Be A Dangerous Liver Problem

If a pregnant woman finds herself scratching and itching during the third trimester, these symptoms should not be ignored. Each year, approximately 0.1 to 15% of pregnant women are affected by a liver disorder called Intrahepatic Cholestasis of Pregnancy or (ICP). ICP patients tend to develop symptoms of itchiness of their hands and feet that becomes progressively worse and then spreads all over their body. The itchiness usually worsens at night and if untreated can cause jaundice and several life-threatening complications to the unborn fetus. When a pregnant woman complaints of itchiness (pruritus) all over her body, the first order of business is to determine whether a rash is present. If a rash is absent, ICP should be suspected.

The liver is the largest gland in the body and in addition to filtering harmful substances such as alcohol it is also responsible for processing fats, carbohydrates and proteins. To process fat, the liver makes bile salts. In ICP, bile salts are increased which contributes to the symptoms of itchiness. Affected women will not only be plagued by pruritus but their unborn babies are at risk for stillbirth, preterm labor, fetal distress and abnormal heart rates. South American women and especially those from Chile have a greater risk of developing ICD as do women from South Asia and Sweden. Read more »

*This blog post was originally published at Dr. Linda Burke-Galloway*

Safe Injection Protocols Are Not Being Followed By Clinicians

Thanks to Laura Landro for shining light on unsafe injections in her WSJ blog, “Unsafe Injection Practices Persist Despite Education Efforts.”

Landro writes:

“A new push is underway to eliminate unsafe injection practices, which remain a persistent safety problem despite years of efforts to educate clinicians about the risks of re-using needles, syringes and drug vials.

In the U.S., failure to follow safe practices in delivering intravenous medications and injections has resulted in more than 30 outbreaks of infectious disease including hepatitis C, and the notification of more than 125,000 patients about potential exposure just in the last decade, according to health-care purchasing alliance Premier Inc.”

As a registered nurse this is unthinkable.  Learning to administer injections safely is “patient care 101.”  There is no excuse for any health care professional to unsafely inject patients.

Patients in the hospital, ambulatory surgical centers or outpatient settings, should expect that their nurses, doctors and other clinicians are administering injections safely. Read more »

*This blog post was originally published at Health in 30*

Cardiologists Not Needed: A Nurse And A Computer Will Do

Wait…

Before reading any further, I would like to issue a warning. If your ideas about healthcare delivery are of an older ilk; if you cling white-knuckled to past dogma, please stop reading now. What follows may cause your atria to fibrillate.

Last month I wrote that the best tool for treating atrial fibrillation (AF) was to give patients information—to teach them about their AF, its complications, role of lifestyle factors and the many treatment options. I didn’t say this was easy. In fact, thoroughly explaining AF takes nearly the same time it takes me to isolate the pulmonary veins–a lot longer than the 10 minutes allotted for a typical office visit. (Remember: of a 30 minute office visit, I have to review your chart, listen attentively to your story, examine you, and complete the e-record. That doesn’t leave much time for teaching.)

I was serious about the role of education in AF therapy, but I didn’t have any hard data to support such a bold claim. All I could offer was 15 years of experience on the front lines of treating AF—cardiology’s most expensive and prevalent disease.

But now I have found some real-world data to support the thesis that good teaching translates to better AF outcomes. Read more »

*This blog post was originally published at Dr John M*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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