Disinfecting the surfaces of ventilators

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The risk of spreading disease through the proliferation of pathogens is a real concern in the hospital setting. The current narrative in infection control focuses in hand washing as a primary and first line of defense in preventing the transmission and spread of pathogens. But should health personnel focus only on hand washing as a tool to combat the spread of pathogens? In the ICU ventilators are common. While these devices are crucial in sustaining life, they are also possible sources of life threatening diseases. An interesting study by researchers in Taiwan suggest that frequently disinfecting the surfaces of ventilators with 75% alcohol could significantly reduce the spread of pathogens.

As nurses, we are acutely aware of the possibility of our patients contracting bloodstream infections and ventilator associated pneumonia. Microorganism such as E-coli, C-diff, and Stpahylococcus aureus grow and proliferate on environment surfaces. In the study the authors assessed the effectiveness of using 75% alcohol and found out that this particular solution is quite effective in combating the offending microorganism. However, the study also postulated that without proper hand hygiene the effectiveness of the disinfectant was compromised. One suggestion that the authors made was to use sterile gauze to wipe 75% alcohol on ventilator surfaces.

Reference:

http://web.a.ebscohost.com.summit.csuci.edu:2048/ehost/pdfviewer/pdfviewer?sid=cbe5062b-d583-423c-bcaf-747e1afdd9ab%40sessionmgr4001&vid=0&hid=4101

Blogging My Findings

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Informed Patient: Changing the Sedation Status Quo in the ICU

Changing the Sedation Status Quo in the ICU

Summary: Prolonged sedation and paralytic therapy has negative effects on  patients. One of the negative effects is delirium which is associated with hallucinations and nightmares. This delirium leads to devastating and long lasting effects on cognitive function. Several studies have identified positive effects by attempting wean patients off of stronger medications to milder ones that provide the same benefit and getting them ambulating earlier even if its a few steps.Pros for changing sedation methods: Reduce delirium, reduces depression, reduces anxiety, and reduces muscle wasting. Cons: Risk of self injury by pulling out ET tube, tracheotomy tube, and/or, IV lines.

Agree Or Disagree? :  I agree with this article. Especially, after watching the video of the patient in the ICU’s personal account of his ordeal. I am sure in his case this wasn’t an option since his case was so severe. I feel the positive effects out weigh the possible negative outcomes.

Week 4 Discussion

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The article I had was titled, “Informed Patient: Changing the Sedation Status Quo in the ICU,” by Laura Landro. The article talks about changing the treatment methods in the ICU to improve patient outcomes. The new approach includes waking patients from sedation to assess pain and getting them to breathe on their own as soon as possible. This gives the patient a break from being in delirium for too long which can cause effects on cognitive function. Also, by lowering exposure to potent sedative medications and shortening the duration of delirium in the ICU, this can prevent some part of brain injury. Lastly, getting patients up and moving even when on ventilator can prevent muscle weakness.

I agree with these new methods because I feel that this will shorten the length of time in the ICU and ultimately get the patient to a healthier state sooner, and that is always our goal.

The next steps are to gel the senior nurses to adapt to these new methods as the article states that they are having trouble with this. To help with this new graduate nurses are being trained with this new method in the ICU.

– Brittany Sandoval

ICU Delirium

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According to the American Psychiatric Association’s (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV delirium is defined as “a disturbance of consciousness and cognition that develops over a short period of time (hours to days) and fluctuates over time.”  Delirium is an all too common problem in the ICU and according to Girard, Pandharpande, & Ely (2008),  “Delirium occur[s] in up to 80% of the sickest intensive care unit (ICU) populations.”   Patients in the ICU share some common risk factors for developing ICU Delirium which, according to Girard, Pandharpande, & Ely (2008), include  “exposure to sedative and analgesic medications.” To help reduce the risk of a patient developing delirium, factors such as sedatives and analgesia can be closely monitored and titrated. Girard, Pandharpande, & Ely (2008), also suggest “that all ICU patients be monitored using a validated delirium assessment instrumentmay be modified to reduce risk.”  It is important to decrease the risk and the occurance of delirium in ICU patients because “delirium is now recognized to be a significant contributor to morbidity and mortality in the ICU…Patients with delirium have longer hospital stays and lower 6-month survival than do patients without delirium, and preliminary research suggests that delirium may be associated with cognitive impairment that persists months to years after after discharge” (Girard, Pandharpande, & Ely, 2008).  As nurses we should be aware of the signs and symptoms of ICU delirium and attempt to implement assessment tools to monitor for this complication.

Girard, T., Pandharipande, P., Ely, E.W. (2008). Delirium in the intensive care unit. Critical Care 12(3).

 

ICU Delirium

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The article I chose is called “Delirium assessment in intensive care units: practices and perceptions of Turkish nurses” by Aysel Özsaban PhD. The aim of the article was to identify current practices of intensive care nurses regarding the delirium assessment  and to find factors that affect these perceptions. Being an ICU nurse is a very important job, it is different from any floor in the hospital. The patients are more critical and the nurse to patient ratio is more intimate. It is very important for a nurse to know how to do an appropriate delirium assessment. Data were collected from five Turkish public hospitals using a structured survey questionnaire. The study sample comprised 301 nurses who agreed to participate. Data were analysed using descriptive statistics. Results showed more than half of the nurses performed delirium assessments. However, the proportion of nurses who use delirium assessment tools was quite low. Almost all of the nurses perceived delirium as a problem and serious problem for ICU patients. The patient group least monitored for delirium was that of unconscious patients. While most nurses know the importance of doing a delirium assessment and understand this is a serious problem, the proportion of those who perform routine delirium assessments was less. It was found that delirium assessment practices of nurses were affected from their perceptions of delirium and the implementation of patient-centred care delivery.

I would say that I agree with this article because in nursing school we are taught that doing a good assessment could make a difference in the care that we provide for a patient. Just because most of the patients we do a delirium assessment on are sedated, does not mean we have to skip important steps. Steps needed to reduce this problem is to teach nurses the correct way to do this assessment and the importance of it. There should be classes that help nurses understand and comprehend what exactly they are assessing for.

Thank You, Ashleigh

http://onlinelibrary.wiley.com.summit.csuci.edu:2048/doi/10.1111/nicc.12127/full

Sugaah Overload! Group Project Guidelines!

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Group number 3: Jennifer Haldeman, Arely Rosales, Eugenie Fasulo
Group name: Sugaah Overload!

Member strengths, limitations and values:

  • Limitations – timing and scheduling
  • Strengths- Were all good teamworkers! Were all positive people!! Yayy!
  • Values- We value trust, respect, and hard work. No slackers here!

Roles and Accountability: We are not going to have a leader. We will share all roles equally.

Communication Style: We are utilizing google docs and we will be meeting before class.

Leadership Style: We will be utilizing a democratic leadership style with an emphasis on teamwork and collaboration

Strategies: Utilize good communication and if we are having problems brainstorm with the others.

candy

Group Project Rules

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State a team name, letter of your group (A-F), and describe the reason the name was chosen:
Group 11 (Nikki, Carl, Janine)
COPD – we chose this name because it is the disease we chose to highlight in our project

Group Meeting time(s) and location(s) for the duration of the semester:

 Broome Library
Jan. 28 – Broome Library – delegated first portion of project
Feb 8 – Deadline for voicethread outline and powerpoint on Googledocs
Feb 13 – Nikki’s home – recording voicethread/PPT for 1st part of project

March – TBD
April – TBD

 

 

Role of each group member (Are there roles? Or delegated tasks?):

 Nikki – Leader
Voicethread assignment – Patho/Presentation of disease
Carl – Recorder/Online coordinator
Voicethread assignment – Interventions & related complications to disease process

Janine – Researcher
Voicethread assignment – Pharmacological interventions

 

Who will lead each meeting? If you will rotate, detail how this will occur?:

 Nikki Ives

 

Who will take minutes and record action items? If you will rotate, detail how this will occur?:

 Carl Eisenthal

 

What will your process be for dealing with group members who miss meetings or who are late? How will you address first time offense and repeat offenses? Will the discussion happen one-on-one or as a group?

 

-Missing meetings or being late is understandable with proper reason.
– First time offense will be excused and we will try to work on scheduling around
everyone’s schedule
– Repeat offenses will be communicated with member of the group alongside
all the members of the group
– If it is merely difficult to meet based on differing schedules we will attempt
to meet evenings utilizing Skype

 

What will your process be for dealing with distractions (side bar conversations, cell phone conversations, etc.) during a meeting? How will you address first time offense and repeat offenses? Will the discussion happen one-on-one or as a group?

– First time: the group member will respectfully and courteously be asked to put
away distracting devices to have an efficient meeting

– Repeat offenses: will communicate to the member of the group how these
distractions affect other group members.

 

What will your process be for decision making? If you decide on a consensus vote, what will your process be for making a decision if consensus cannot be reached?:

 -We will democratically vote on an agreement.
– If consensus cannot be met, we will agree to compromise on other aspects of the
project in order to fairly reach agreement.

 

What will your process be for dealing with team member who does not fulfill his or her team assignment(s)? How will you address first time offense and repeat offenses? Will the discussion happen one-on-one or as a group?:

–       If a group member does not fulfill their assignment after expectations have been
communicated, an extension will be made so that they may be able to turn in
their portion of the assignment in time.
– If the offense continues, other group members will have to step in to complete
the assignment to receive credit by instructor. However, the group member’s
failure to cooperate and meet deadlines will be communicated to the professor.
The amount & quality of work (or lack thereof) will be evaluated by the group
alongside Dr. Jaime Hannans to designate the grade this group member merits.

 

What will your process be for resolving conflict within the group? Will the discussion happen one-on-one or as a group?:

 Conflict will be resolved using discussion and compromise by all group members.
If conflict is due to a group member underperforming, the process mentioned
above will be utilized. Discussion will occur as a group and will involve
respect of all group members and their opinions.

 

List any other applicable group norms that your group committed to:

 It was agreed by the group that constant communication and early deadlines will
be set throughout the course of the semester. Group deadlines will be prepared far
in advance of the class deadlines in order to control any unexpected
complications. All group members agreed to respect the early deadlines and
each others’ opinions.

 

 

 

First and Last Name of all group members:
Nikki Ives
Carl Eisenthal
Janine Villanueva

The Fluid Resuscitators Group Rules

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Group #7
• Group Name: Fluid Resuscitators
• Group Members: Maria Magaña, Robert (Bobby) Martinez, Emily Sentianin

• Why group name was chosen: We chose to study sepsis for our group project and fluid resuscitation is a very important concept in sepsis management.

• Meeting times and locations for duration of semester: Meeting times 1100 on Wednesdays in the Student Union as needed.

• Role of each group member: Bobby-Researcher, Emily-Editor, Maria- Making presentations, everyone: Voice Thread Contributors. The duties will be shared but the ultimate responsibility will be the assigned person for each task.

• Who will lead each meeting? We will rotate leaders each week so that everyone has a chance to run a meeting.

• Who will take minutes and record action items? Maria

• What will the process be for dealing with group members who miss meetings or who are late? How will you address first time offense and repeat offenses? Will the discussion happen one on one or as a group? If the reason for missing meetings or tardiness is valid, then it will be excused. First time offense, if reasonable, will be given a warning. If repeat offenses occur and assigned workload is not completed, then this will be reflected in the final project grade. The discussion will happen as a group because it affects the entire group.

• What will your process be for dealing with distractions during your meeting? How will you address first time offense and repeat offenses? Will the discussion happen one on one or as a group? Meeting times need to be productive so will be no cell phone use rule during meetings unless expecting an important call/message. First time offense will be and repeat offenses will result in dismissal from the meeting. The discussion will happen as a group.

• What will your process be for decision making? If you decide on a consensus vote, what will be your process for making a decision if consensus cannot be reached? The decision making will consist of discussing options and ideas from all members and coming to a consensus. If consensus cannot be reached, further options will be explored and final decisions will be decided by a 2/3 majority vote.

• What will your process be for dealing with a team member who does not fulfill team assigments? How will you address first time offense and repeat offenses? Will the discussion happen one on one or as a group? Perform a verbal root cause analysis of failure to complete duties to ensure that assignment was fully understood. If deadlines are not met then, the first time offense will have an extension of 1 day, additional failures to meet deadlines will be reflected in the final grade. This discussion will happen as a group.

• What will your process be for resolving conflict within the group? Will the discussion happen one on one or as a group? The conflict will attempt to be resolved within the group by a roundtable discussion of issues; if the issue cannot be resolved then it will be taken up with the course instructor. This discussion will occur one on one if only involving two people but will occur as a group if the conflict is amongst the entire group.

• List any other applicable group norms:
o If you can’t make it to a meeting, let the group members know in advance as soon as possible, preferably the day before.
o Respect other group members.
o Collaboration and teamwork will be utilized.
o Do not be afraid to verbalize disagreement.

The Fluid Resuscitators Group Rules

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Group #7

  • Group Name: Fluid Resuscitators
  • Group Members: Maria Magaña, Robert (Bobby) Martinez, Emily Sentianin
  • Why group name was chosen: We chose to study sepsis for our group project and fluid resuscitation is a very important concept in sepsis management.
  • Meeting times and locations for duration of semester: Meeting times 1100 on Wednesdays in the Student Union as needed.
  • Role of each group member: Bobby-Researcher, Emily-Editor, Maria- Making presentations, everyone: Voice Thread Contributors. The duties will be shared but the ultimate responsibility will be the assigned person for each task.
  • Who will lead each meeting? We will rotate leaders each week so that everyone has a chance to run a meeting.
  • Who will take minutes and record action items? Maria
  • What will the process be for dealing with group members who miss meetings or who are late? How will you address first time offense and repeat offenses? Will the discussion happen one on one or as a group? If the reason for missing meetings or tardiness is valid, then it will be excused. First time offense, if reasonable, will be given a warning. If repeat offenses occur and assigned workload is not completed, then this will be reflected in the final project grade. The discussion will happen as a group because it affects the entire group.
  • What will your process be for dealing with distractions during your meeting? How will you address first time offense and repeat offenses? Will the discussion happen one on one or as a group? Meeting times need to be productive so will be no cell phone use rule during meetings unless expecting an important call/message. First time offense will be and repeat offenses will result in dismissal from the meeting. The discussion will happen as a group.
  • What will your process be for decision making? If you decide on a consensus vote, what will be your process for making a decision if consensus cannot be reached? The decision making will consist of discussing options and ideas from all members and coming to a consensus. If consensus cannot be reached, further options will be explored and final decisions will be decided by a 2/3 majority vote.
  • What will your process be for dealing with a team member who does not fulfill team assigments? How will you address first time offense and repeat offenses? Will the discussion happen one on one or as a group? Perform a verbal root cause analysis of failure to complete duties to ensure that assignment was fully understood. If deadlines are not met then, the first time offense will have an extension of 1 day, additional failures to meet deadlines will be reflected in the final grade. This discussion will happen as a group.
  • What will your process be for resolving conflict within the group? Will the discussion happen one on one or as a group? The conflict will attempt to be resolved within the group by a roundtable discussion of issues; if the issue cannot be resolved then it will be taken up with the course instructor. This discussion will occur one on one if only involving two people but will occur as a group if the conflict is amongst the entire group.
  • List any other applicable group norms:
    • If you can’t make it to a meeting, let the group members know in advance as soon as possible, preferably the day before.
    • Respect other group members.
    • Collaboration and teamwork will be utilized.
    • Do not be afraid to verbalize disagreement.

 

 

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