Healthstream : miscellaneous (CAUTI/CLABSI, Palliative Care, Comfort Measures, Mental Health, Alcohol Abuse, Substance Abuse) with Complete Solutions!!
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Healthstream :
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Healthstream :
Catheter-associated urinary tract infection (CAUTI) - ANSWER-Identified in 2007 by TJC as requiring special attention and included as a National Patient Safety Goal under "Health care-associated Infections"
Approved as a separate NPSG by TJC for 2012 (ongoing for 2015)
Identified in 2008 by CMS a...
Healthstream : miscellaneous
(CAUTI/CLABSI, Palliative Care, Comfort
Measures, Mental Health, Alcohol Abuse,
Substance Abuse) with Complete
Solutions!!
Catheter-associated urinary tract infection (CAUTI) - ANSWER-Identified in 2007 by
TJC as requiring special attention and included as a National Patient Safety Goal under
"Health care-associated Infections"
Approved as a separate NPSG by TJC for 2012 (ongoing for 2015)
Identified in 2008 by CMS as a preventable hospital-acquired condition
CAUTI care is not reimbursed by CMS
Length of indwelling time is the most significant risk factor
Data is insufficient to prove antibiotic or silver-coated catheters are more effective at
preventing CAUTI
CAUTI: What to Do - ANSWER-Obtain urine sample from sampling port (if new catheter
will not be reinserted)
Remove old catheter
Obtain an order for a new one or replace if pt still requires one according to facility or
TJC/CDC criteria
Obtain urine specimen for culture from new catheter sampling port
Implement prevention practices according to TJC and CDC guidelines
Central-line associated bloodstream infection (CLABSI) or Catheter-related bloodstream
infection (CRBSI) - ANSWER-Most common cause of healthcare-associated
bloodstream infection
Identified in 2007 by TJC as requiring special attention and included as a National
Patient Safety Goal under "Health care-associated Infections"
Approved as a separate NPSG by TJC for 2012 (ongoing for 2015)
Identified in 2008 by CMS as a preventable hospital-acquired condition
Proven by several facilities as capable of being reduced to ZERO incidence
ICU patients are at highest risk due to insertion condition, access frequency, and
extended indwelling time
CLABSI: What to Do - ANSWER-Notify practitioner and obtain blood cultures via
venipuncture
If catheter still necessary, insert new in alternate site before removing old catheter
, Send tip of old catheter for culture (send entire implanted port for culture)
Administer ABx as ordered
Implement prevention practices according to TJC and CDC guidelines
Palliative care - ANSWER-Care designed not to heal or cure, but to relieve suffering,
usually in the end stages of a disease process
Focus is relief for progressive or poorly-controlled symptoms that decrease quality of
life; usually a major part of hospice care
Should not be delayed for patients in distress who are still pursuing disease-directed
treatment
Discussion of palliative care should begin early, and include discussion of advance
directives and patient goals
New S/S that do not relate to current dx or expected progression should be investigated
Palliative care signs and symptoms - ANSWER-Pain (most common)
Dyspnea
GI S/S (e.g., N/V, anorexia)
Psych (e.g., depression, anxiety)
Comfort measures - ANSWER-actions or items that increase comfort (mental,
emotional, spiritual) as well as relieve physical pain
Some practitioners interchange the term "comfort measures" with "nonpharmacologic
pain control"
Do not confuse with the term "comfort measures only (CMO)," which usually applies to
DNR or terminal patients
Examples of comfort measures - ANSWER-Religious symbols: crosses, pictures of
spiritual leaders or icons
Fan: may provide relief for patients who feel short of breath or claustrophobic
Family presence: depends on the relationship!
Pain control: nonpharmacologic pain relief measures may incorporate physical modes
of relief such as massage and heat/cold, as well as cognitive modes such as imagery
Delirium - ANSWER-acute restlessness and confusion with incoherency and decreased
awareness of true surroundings; occurs with fever, sepsis, medication withdrawal, after
general anesthesia, and during other acute illnesses
Dementia - ANSWER-nonacute gradual changes in memory and intellect that manifest
as confusion, altered communication, and decreased ADL abilities; may be reversible if
due to a vitamin deficiency or drug interaction
Alzheimer's - ANSWER-progressive, irreversible brain disorder that is the primary cause
of most cases of dementia
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