2011 March 02

Validation of the surveillance and reporting of central line-associated bloodstream infection data to a state health department.

Am J Infect Control Start a Discussion »

Mar 022011

Validation of the surveillance and reporting of central line-associated bloodstream infection data to a state health department.

Am J Infect Control. 2010 Dec;38(10):832-8

Authors: Backman LA, Melchreit R, Rodriguez R

The primary goal of health care-associated infection reporting is to identify and measure progress towards achieving the irreducible minimum number of infections. Assessing the accuracy of reporting data using independent validation is critical to this goal. In January 2008, all 30 acute care hospitals in Connecticut began mandatory reporting of central line-associated bloodstream infections (CLABSI) to the National Healthcare Safety Network (NHSN) system.

PMID: 21093699 [PubMed - indexed for MEDLINE]

Link to Article at PubMed

Real-time three-dimensional ultrasound-guided central venous catheter placement.

Anesth Analg Start a Discussion »

Mar 022011

Real-time three-dimensional ultrasound-guided central venous catheter placement.

Anesth Analg. 2011 Feb;112(2):378-81

Authors: Dowling M, Jlala HA, Hardman JG, Bedforth NM

We present the first description of real-time 3-dimensional ultrasound for insertion of a central venous catheter in a surgical patient. An HD11 XE™ ultrasound machine with a V8-4 transducer (Philips Medical Systems, Bothell, WA) was used throughout. Three-dimensional multiplanar and volume-rendered views allowed us to simultaneously view the neck anatomy in 3 orthogonal planes. Needle entry into the vein and subsequent catheter placement were also visualized. We were able to rotate the views in real time, thereby enabling visualization of the catheter within the lumen of the vein. The ability to see simultaneous real-time short- and long-axis views along with volume perspective without altering transducer position is an exciting development with the potential to confer a safety benefit to the patient. Although the operator is required to assimilate more information, the limitations we encountered were mainly related to processing power and transducer size, which we expect will be overcome with advancing technology.

PMID: 21156975 [PubMed - indexed for MEDLINE]

Link to Article at PubMed

Patients’ perspectives of falling while in an acute care hospital and suggestions for prevention.

Appl Nurs Res Start a Discussion »

Mar 022011

Patients' perspectives of falling while in an acute care hospital and suggestions for prevention.

Appl Nurs Res. 2010 Nov;23(4):238-41

Authors: Carroll DL, Dykes PC, Hurley AC

Patient falls and falls with injury are the largest category of reportable incidents and a significant problem in hospitals. Patients are an important part of fall prevention; therefore, we asked patients who have fallen about reason for fall and how falls could be prevented. There were two categories for falls: the need to toilet coupled with loss of balance and unexpected weakness. Patients asked to be included in fall risk communication and asked to be part of the team to prevent them from falling. Nurses need to share a consistent and clear message that they are there for patient safety.

PMID: 21035035 [PubMed - indexed for MEDLINE]

Link to Article at PubMed

D-dimer and residual vein obstruction as risk factors for recurrence during and after anticoagulation withdrawal in patients with a first episode of provoked deep-vein thrombosis.

Uncategorized Start a Discussion »

Mar 022011

Shared by Robert Mahoney
Link: http://dx.doi.org/10.1160/TH10-08-0559

D-dimer and residual vein obstruction as risk factors for recurrence during and after anticoagulation withdrawal in patients with a first episode of provoked deep-vein thrombosis.

Thromb Haemost. 2011 Feb 28;105(5)

Authors: Cosmi B, Legnani C, Cini M, Guazzaloca G, Palareti G

D-dimer and residual venous obstruction (RVO) have been separately shown to be risk factors for recurrent venous thromboembolism (VTE) after a first episode of unprovoked proximal deep-vein thrombosis (DVT). It was the objective of this study to assess the predictive value of D-dimer and residual vein obstruction (RVO), alone and in combination, for recurrence after provoked DVT of the lower limbs. A total of 296 consecutive patients with a first episode of symptomatic provoked proximal DVT were evaluated at a university hospital in Bologna, Italy. On the day of anticoagulation withdrawal (T0), RVO was determined by compression ultrasonography. D-dimer levels (cut-off: 500 ng/ml) were measured at T0 and after 30 ±10 days (T1). The main outcome was recurrent VTE during a two-year follow-up. D-dimer was abnormal in 11.6% (32/276) and 31% (85/276) of subjects at T0 and at T1, respectively. RVO was present in 44.8% (132/294) of patients. Recurrence rate was 5.1% (15/296; 95% confidence interval [CI]: 3-8%; 3% patient-years; 95% CI: 2-5 %). An abnormal D-dimer either at T0 or at T1 was associated with an adjusted hazard ratio (HR) for recurrence of 4.2 (95% CI:1.2-14.2; p=0.02) and 3.8 (95%CI: 1.2-12.1; p=0.02), respectively, when compared with normal D-dimer. The HR for recurrence associated with RVO was not significant, and RVO did not increase the recurrence risk associated with an abnormal D-dimer either at T0 or T1. In conclusion, an abnormal D-dimer during vitamin K antagonist (VKA) treatment or at one month after VKA withdrawal is a risk factor for recurrence in patients with provoked DVT, while RVO at the time of anticoagulation withdrawal is not.

PMID: 21359409 [PubMed - as supplied by publisher]

Link to Article at PubMed