Blog 11. Engage. Just do it. Number 3

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Hey what is up #univ349dc. Hope y’all had a good weekend. So, some cool things happened this week with my engagement. Well my engagement with the refugee crisis. I started talking to this German women who attends CSUSB. My sister attends that school and we able to introduce me to her this week and we have been talking on social media, and then we actually met up this weekend when I went to pick my sister up from school. She began telling me about the refugee crisis in Germany, and how it has affected her family. Quick background though, Germany is highly involved with the refugee crisis. They have taken in so many refugees and continue to. However, is hasn’t been a fantastic experience for everyone involved.

Germany is collapsing under the weight of all these refugees that they have let into their country. According to an article from the Atlantic the refugee crisis in Germany is described as the following excerpt: “German police and politicians are frustrated. Exhausted migrants who traveled hundreds of miles to escape civil war only to be held in weeks-long waiting lines are even more so. And adding to Germany’s existing logistical problems now is another: The impending arrival of a freezing, harsh winter.” Germany unfortunately doesn’t have enough room to house the refugees, and current Germans are frustrated with the influx of people that have come into their country. She told me that her family told her there are huge lines to get the required paper work as well as meals and other supplies which has caused people to become frustrated. It has led to violence in cities both coming from the refugees as well as the German people who live there. She explained that some cities just don’t have the required room or resources to house thousands of people.

She asked me, what I thought it would be like if 300,000 refugees came to live in Ventura. Where would they stay? How would current people who live in Ventura, and are poor, feel when these “Outsiders” are coming into their city and taking up room? It’s shocking to think of it like this, but it is true. Germany is going to continue taking in refugees, which is great, but exactly how can they be helped? She told me that what is frustrating people in Germany, is that there was no way authorities could be prepared for an event like this. There is so much anger from the refugees because they have nowhere to go, and they aren’t always being treated with respect where the countries stay. My new friend explained to me that there have been more cases of rape, and some extreme cases of culture clash within the cities that house the refugees.

Being social is all about who you know. I found it useful to network within my own social circle, or social circles close to me, to reach out to people who have perspectives from the other side of the world.

 Also, there are actually a lot of German exchange students who came here this year. CI View, which I write for, will hopefully have an article about the refugee crisis next semester. Keep an eye out for it, and thanks for reading.

Below is a picture that shows the refugees in a line in Germany. It looks like a riot, and this is a daily routine for many Germans and refugees. 

germany refs

Neuro Patients have Higher Rates of CAUTIs?

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I decided to report on this article since it incorporates a bit of our NRS420 topic of sepsis (prevention) and current topic of neuro. As we know, preventing HAI is paramount in the hospital setting, and the neuro ICU seems to be no exception.

According to the CDC’s National Healthcare Safety Network which tracks national infection statistics, 30% of infections are UTIs and 75% of UTIs acquired from the hospital occur from catherization (CDC, 2015). Since 15%-20% of hospitalized patients receive catherization, this can amount to large numbers.

Due to the possible delicate nature/acuity of neuro-spine conditions, these patients are especially prone to longer ICU stays, increased needs for invasive devices (central lines, ventilators), limited mobility and urine retention. Reduction of CAUTIs (catheter-associated urinary tract infections) is especially difficult in the NSICU due to the neuro-spine patient’s debility which generally requires long-term foley-catheterization and longer stays. Topping the list of neuro conditions seen in neuro ICUs is the incidence of acute ischemic stroke, which averages a hospital stay of 5-14 days average (George et al,2013). Considering that occurrence of CAUTIs peaks at 12 days (plus) puts these particular stroke patients at high risk if catheterized with a foley-catheter (George et al,2013).

This article was written about a study done at one hospital’s neuro-spine ICU unit, as it represented that hospital’s unit with the greatest number of HAI/UTI. This is not unusual I surprisingly found, as neuro-spine ICUs have been found to nationally represent the unit with the most incidences of CAUTI, (Edwards, 2008).

Great concern has arisen for the neuro-spine patient population; the hospital cited in the study decided to utilize their in-house Infection Prevention team to assess and advise the neuro-spine ICU staff. Their conclusion was to implement a plan where either nursing leadership or Infection Prevention staff performed separate rounding to identify at-risk patients. Assessments and recommendations were made on the following gathered criteria: catheter presence, indication and possibility of removal. Their NSICU now includes an increased mindfulness when evaluating catheter necessity, care, and removal.

It is eye-opening that neuro-spine ICU units have been identified as the top needs-to-be-watched unit concerning catheter associated UTIs. I found no less than 5 studies about CAUTI concern conducted in neuro units during my research regarding infection. I originally began research on infection (general) and neuro topics, but found this one topping the list of searches…and it turned out to be enlightening and has served to increase my overall vigilance during my clinical rotations.

 

REFERENCES:

Center for Disease Control (2015, October 16). Catheter-associated Urinary Tract Infections (CAUTI). Retrieved November 10, 2015, fromhttp://www.cdc.gov/HAI/ca_uti/uti.html

Edwards JR, Peterson KD, Andrus ML, Dudeck MA, Pollock DA, Horan TC (2008). Center for Disease Control and Healthcare safety network (NHSN) report, data summary for 2006 through 2007. Retrieved November 10, 2015, from http://www.cdc.gov/nhsn/NationalAm J Infect Control. 2009 Jun;37(5):425.

George, A., Boehme, A., Siegler, J., Monlezun, D., Fowler, B., Shaban, A., Martin-Schild, S. (2013). Hospital-Acquired Infection Underlies Poor Functional Outcome in Patients with Prolonged Length of Stay. Am J Infect Control; 36:609-26.

Schelling, K., Palamone, J., Thomas, K., Naidech, A., Silkaitis, C., Henry, J., Zembower, T. (2015). Reducing catheter-associated urinary tract infections in a neuro–spine intensive care unit. American Journal of Infection Control, 83(1), 892-894.

 

Protected: Managing urinary incontinence in patients with neurogenic bladder dysfunction

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