...“Compliance with surgical antibiotic prophylaxis at an Australian teaching hospital” (Friedman, Styles, Gray, Low, & Athan 2013, p. 71) the use of certain antibiotics and or combinations for prevention of surgically related infections has shown to be an effective method in prevention of surgical site infections. The focus of the research was to measure to effectiveness of prophylactic use of antibiotics in regards to surgical procedures such as cardiac, orthopedic joint replacements, and colorectal procedures. The American Journal of Infection Control listed the following key elements of focus which were “(1) receipt of prophylaxis within 1 hour before surgical incision, (2) administration of an antimicrobial agent consistent with published guidelines and (3) discontinuation of SAP within 24 hours after surgery” (Friedman et al., 2013). The research was conducted at a teaching hospital in Victoria, Australia. The time span that the data was collected took 33 months total. The data gathered in...
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...Appropriate hair removal and normathermia are two areas that show consistent compliance. Maintaining current processes and procedures is recommended. While antibiotic selection was meeting the desired goal as set forth in the Surgical Care Improvement Project (SCIP) Inf-2, after May a significant decrease in compliance is noted. Use of prophylactic antibiotics prior to incision (SCIP Inf-1), stopping the antibiotic within 24 hrs. of surgery end time (SCIP Inf-3), beta blockers given during perioperative period (SCIP Card-2), recommended VTE prophylaxis ordered (SCIP VTE-1) and given within 24 hrs. prior through 24 hrs. after surgery (SCIP VTE-2) Corrective Action Plan The goal of the prophylactic antibiotic before and after surgery is to promote serum levels and gain bactericidal tissue. There is no known benefit for the patient to continue these antibiotics greater than 24 hrs. post-surgery (qualitymeasures.ahrq.gov, 2013). Physicians have been educated regarding the selection of antibiotics and the importance of administering the first dose within one hour of surgery (jointcommission.org, 2014). Concurrent audits to capture data in real time of these cases will help to ensure compliance by physicians in these two areas. Check lists, pre-printed order sets and pharmacy stocking the operating room with approved antibiotics will assist in maintaining compliance (medscape.org, 2006)....
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...by measures and dimensions in specific domains. For 2015, these domains consisted of the clinical process, patient experience, outcome and efficiency. These include clinical processes measuring fibrinolytic therapy received within 30 minutes of hospital arrival, primary PCI received within 90 minutes of hospital arrival, blood cultures performed in the emergency department prior to initial antibiotic received in hospital, prophylactic antibiotic received within one hour prior to surgical incision, prophylactic antibiotic selection for surgical patients, prophylactic antibiotics discontinued within 24 hours after surgery end time, cardiac surgery patients with controlled 6 a.m. postoperative serum glucose, urinary catheter removal on postoperative day 1 or day 2, surgery patients on a beta-blocker prior to arrival who received a beta-blocker during the perioperative period, surgery patients with recommended venous thromboembolism prophylaxis ordered and surgery patients who received appropriate venous thromboembolism prophylaxis within 24 hours prior to surgery to 24 hours after surgery. ...
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...What Can We Do About Antibiotic-Resistant Bacteria Giana Dominguez SCI 214 September 04, 2013 Gloria Young, PhD After reading the information in this assignment and looking at the plot values I honestly still do not understand everything that I read. So I will try to write this summary the best that I possibly can. What I understood from my reading was that antibiotics have been in development over the last eighty years. Antibiotics help fight infections we get from bacteria. Antibiotics come in different classes to fight multiple strains of a bacterial infection (Cummings). I also learned that over the years new antibiotic development has become slower. Over the last eighty years bacteria has become sort of built up immunity to some antibiotics. Not all infections can be treated with the same antibiotics. Sometimes a prescribed antibiotic does not cure an infection. I know this from my own personal experience. I had to have surgery. After the surgery I had gotten an infection and was given an antibiotic. The infection I had was resistant to the type of antibiotic that I was given. The antibiotic actually made my infection worse. The symptoms I felt at the beginning of my infection caused me so much more pain. I had to be put on a different class of antibiotic. The second antibiotic I was given was stronger and it was hopefully supposed to cure my infection. The new antibiotic cured the infection I had gotten but I had developed another infection and had to be put on...
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...identify the different bacteria and viruses that infect humans and other plants and animals. Being able to better identify what is causing an illness, treatment can be greatly improved. Today there are cameras the size of a pill that you can swallow and a computer outside the body records it for the doctor to review. This makes it more appealing to the patients since it is less invasive. Technology in the medical field has come a long way in the past century. We have went from tonics that some Dr. and concocted in his office to being able to perform the major transplants that we can today. 50 years ago people would've never thought that a doctor would be able to operate by a robot; remotely from another location in the world or that a major surgery could be performed through an incision only an inch long. The first organ transplant was performed in the 1930s by a Ukrainian physician, but ultimately ended in failure due to the recipient’s body rejecting the organ. At this time there were no drugs to suppress the immune system to prevent their...
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...several areas of concern in regards to infection rates. Although the results of the Quality Improvement project have not been published, the number of reported infections has decreased since implementing this bundle. As a result, the institution continues to practice according to the project’s recommendations to help reduce postoperative surgical infections and lower health care costs. The focus of the study was to create a bundle that would help decrease surgical site infection rates related to cesarean deliveries. The guidelines outlined within the bundle address treatment suggestions for patients on preadmission and on the day of surgery. Being a Magnet hospital, all practices of the project are guided by evidence based research. There were several topics incorporated into the bundle such as skin prep, skin closure options, and prophylaxis antibiotics. The facility uses a system called VIPER to track infections and this data is reported to the Centers for Disease Control. The Quality Control Consultant of Women’s Health gathered together various members of the healthcare team to participate in the project. As a group, the committee worked together to help problem solve and create a plan to improve the infection scores. It was essential that all areas of the department were represented such as physicians, nurses, surgical techs, environmental services, pharmacy, and equipment supply personnel. A briefing was presented during the first meeting explaining the current data on our...
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...Response/Recommendation: Yes, autograft tissue should be soaked in an antibiotic solution prior to implantation during ACL reconstruction. Strength of Recommendation: Strong Rationale: Infection after ACL reconstruction is uncommon but can cause serious complications.1 Contributing factors that may lead to infection include diseases such as diabetes, smoking, increased time of surgery and tourniquet inflation, additional or larger incisions for arthroscopic portals and the use of a drain.2 The use of preoperative prophylactic antibiotic has been previously established to reduce infection rates in orthopedic surgery procedures.3 Traditionally, allograft anterior cruciate ligament (ACL) grafts have been associated with a higher concern...
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...Case: A 62year-old woman is admitted for total knee replacement surgery. Following surgery, an order was written for cefazolin sodium (Ancef) 2gm intravenous piggyback (IVPB) every 8 hours for 24 hours. She received her first dose when she arrived on the orthopedic unit after surgery. Vital signs upon arrival: BP 136/84, pulse 88, Respirations 12, and temperature 98’F. Thirty minutes after the medication was started, the patient calls the nurse and reports “itching all over” and difficulty breathing. The nurse notes facial edema and audible wheezing. The patient’s skin is red with large, swollen blotches over her arms, trunk and back. Her systolic blood pressure is 118/78, pulse 108 and respirations 24. The IVPB antibiotic bag has infused about 3/4ths of the dose. The patient states, “I had this once when I took a drug called amoxil. The doctor said I am allergic to amoxil.” 1. Describe the mechanism of disease of Anaphylaxis and possible signs and symptoms. Anaphylaxis is a type of severe, whole body allergic reaction. It is characterized by a rapid onset after exposure to a triggering chemical which has become an allergen. The symptoms of anaphylaxis result from histamine release from the mast cells, which can lead to swelling, itching, and constriction of the air ways.There are two primary types of anaphylaxic reactions: true and pseudo anaphylaxis. Pseudo anaphylaxis has the same symptoms, treatments, and triggers as true anaphylaxis, but occurs...
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...oxygen levels within the heart chambers. TREATMENT Treatment for this condition depends on your child's age, the size of the hole, and where the hole is located. Many VSDs will close by themselves by age 2 without treatment. Others may stay the same. VSDs do not get bigger with time. Approaches to treatment vary: • If your child has a small VSD that causes no symptoms, regular checkups with a health care provider are important to make sure there are no problems. Usually, there are no activity limitations. • If your child has symptoms of a VSD, but there is a chance that the VSD may close, medicines that strengthen your child's heart and help control blood pressure may be needed. Your child may take these medicines until the VSD closes or surgery becomes...
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...Methods: 4 Table 1: Search strategy 5 Critical appraisal of the literature: 5 Discussion: 17 Conclusion: 17 References: 18 Introduction: Surgical Site Infection (SSI) is a common complication in surgical practice. The incidence depends on multiple factors including the type and location of surgical procedure ranging from 2%-4% in simple skin lesions (Rogues et al., 2007) to 36% in cases of reversal of stoma (Liang et al., 2013). Incidence of SSI can be kept low by simple measures such as rescheduling elective procedures in presence of infection; e.g.: Urinary Tract Infection, Respiratory Tract Infection which can seed Bacteria to surgical wounds (Ollivere et al., 2009). Prophylactic Antibiotics given prior to elective surgery remains debatable and of questionable value considering the risk of side effects, emergence of Multi-drug resistant Pathogens and Anaphylaxis, and therefore should be used according to guidelines like in patients with higher risk for developing SSI (Wright et al., 2008, Dixon et al., 2006). Also, procedures at certain body sites and those involving surgical reconstruction are better covered with prophylactic Antimicrobial agent (Rosengren and Dixon, 2010). Use of antiseptic scrub has been shown to reduce the incidence of SSI. Studies suggest that Chlorhexidine is superior to Povidone Iodine solutions in reducing Bacterial Colonization and SSI in postoperative patients (Paocharoen et al., 2009, Mimoz, 2010 and, Lee et...
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...Clostridium difficile also known a C. difficile or C. diff is an inflammatory infection created in the intestine primarily caused by taking antibiotics. Most people don’t show symptoms of having the C. diff bacteria in your intestines until that person has taken a course of antibiotics. Clostridium difficile bacteria can be found anywhere in the environment. It is found is soil, water, human and animal feces, food products and processed meats (Mayo clinic staff, 2013). Treatments to cure C. diff include antibiotics and surgery. Once having C. diff you want to make sure that you can prevent from getting it again. The best way to prevent from getting C. diff for the first time or a recurring time is to simply wash your hands, avoid unsanitary environments, disinfect surfaces that could possibly be infected, and try to avoid antibiotics when possible (Mayo clinic staff, 2013). Every person has bacteria already in their intestines that help to fight off illness and other bad bacteria that are introduced into the body. When a person takes antibiotics it not only kills that bad bacteria but also kills the good bacteria as well. If a person has Clostridium difficile bacteria in their system it allows the bacteria to grow and causes inflammation in the intestines. Once someone has the Clostridium difficile bacteria in their body and taking antibiotics it allows them to grow out of control causing symptoms such as diarrhea, abdominal cramping and pain, fever, blood and pus in the stool,...
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...Treatment and Prevention Table Your Name: |Medical Management or Treatment |Medical Setting |Surgical Management or Treatment |Surgical Setting |Prevention Activities |Prevention Setting | |1. Heart disease |Conventional & Alternative medicine: Vasodilator, Beta-blocker drugs, adrenergic, aspirin |Outpatient: Cardiologist office and home. |Angioplasty or even open heart surgery. |In patient: hospital. |Healthy eating, exercise, knowing family history, have annual cardiac screening done. |Outpatient: home, gym. | |2. Cancer |Radiation therapy, chemo therapy, Nutritional therapy. |Inpatient/outpatient: Hospital or Radiation outpatient clinics. |Tumor embolization, tumor removal, mastectomy, Surgical removal of infected organ or body part. |Inpatient: Hospital |Nutrition, don’t smoke, avoid prolonged times to sun, minimize red meat intake, know your family hx, have annual cancer screenings. |Outpatient: Home. | |3. Stroke (cerebrovascular diseases) |Ischemic: Clot-busting drugs immediately. Aspirin, warfarin, speech therapy, physical therapy. TIA stroke: very difficult to manage, attempt to control high blood pressure, reduce brain swelling. |Inpatient/outpatient: Hospital, rehabilitation center. |Carotid Endarterectomy, angioplasty, stent placement. |Inpatient: Hospital. |Avoid smoking and excessive alcohol consumption, exercise, and minimize foods with much fat, healthy eating overall. |Outpatient: Home, gym, support group organizations. | |4. Chronic lower respiratory...
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...Tube # 16 Colonial characteristics of the broth (3pts): The morphological unknown colonial characteristics consist of small and round shapes. It forms a shiny texture with entire margins and a convex elevation. In addition, the color is yellow-tan. Gram reaction (5pts): The morphological unknown is gram-negative. Shape (4pts): The shape of the morphological unknown is coccobacillus. For example, the unknown is rod-shaped (Bacillus) yet short and rounded or spherical (coccus). Arrangement (4pts): The arrangement of the morphological unknown is arranged in pairs and singles. Motility (2pts): The morphological unknown tested to be a motile microorganism. Capsule (3pts): The morphological unknown tested to be encapsulated. Acid-fast (2pts): The morphological unknown is a non-acid fast microorganism. Endospore (3pts): The morphological unknown tested to not contain endospores. Identification (12pts): As a result, the morphological unknown is the microorganism Enterobacter aerogenes. Write-up on your founded microorganism in one page attached to the typed worksheet (12pts) (Biochemical characteristics, medical, pharmaceutical, and scientific applications and researches) The genus Enterobacter belongs to the family Enterobacteriaceae. Enterobacter originates primarily in the intestinal tracts of most warm-blooded animals and one of the most clinically important and studied species is the microorganism Enterobacter aerogenes (E. aerogenes)...
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...Postoperative pain Postoperative pain is an unpleasant sensory and emotional discomfort associated with the tissue damage caused by the surgery. Postoperative pain management should include a precise and a systematic assessment to manage appropriately. Pain is an internal subjective experience which cannot be seen by others or detected by investigations. Therefore the postoperative pain assessment largely rely on the clients complain and should be ongoing, individualized and documented. As the etiology is clear in postoperative pain, a single dimensional pain scale, that measures the intensity of the pain, is usually used that rates the pain out of 10 through the clients self-reporting. In some cases a multi-dimensional pain scale is used...
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...Surgical Site Infection Last Name, First Name HCA 375 April 14, 2013 Instructor Surgical Site Infection Surgical site infection (SSI) is a continuous representation of a large part of health care related infections. The impact on mortality, cost of care, and morbidity has resulted in surgical site infections being recognized as a high priority in the US Department of Health and Human Services Action Plan to Prevent Healthcare-Associated Infections. “The majority of SSIs are largely preventable and evidence-based strategies have been available for over ten years and implemented in many hospitals, as nationally recognized by SCIP and SHEA in the US” (Institute for Healthcare Improvement, 2014). Surgical site infections may range from as little as redness around an incision to treacherous sepsis. Surgical site infections add an average of an additional seven days to the hospital stay of a patient which is also very costly. By following seemingly undemanding steps that are supported by scientific evidence, surgical site infections can be prevented. However, the culture of the workplace as well as the multifaceted systems of health care services, habitually make it a practical challenge to adhere to several of the steps. In this paper I will discuss the hospital acquired condition surgical site infection and why it is considered preventable; explain the legal implications related to a patient developing the condition and the role that disclosure plays; describe accreditation...
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