Stop Infections

Nasal Cannulas are causing infections because they are never cleaned and tossed or laid on contaminated surfaces


Is Medicine And Nursing An Art


The first time that I heard that medicine and nursing was an art I did not understand what that phrase entailed. I mean when I think of art, I think of beautiful paintings full of color presented in a way that evokes a feeling of what that painter must have felt when creating his master piece. So, how can this definition be applied to practicing medicine or even nursing? I decided to dig a little further to understand what the definition of art really is. According to Merriam-Webster, “art is a skill acquired by experience, study, or observation.” Again, I can visualize this happening when an artist adds his careful strokes and mixtures of colors to a blank canvas to form a picture, which at one point was buried deep in his mind. While it may appear that an artist has a natural talent that is not enough as he also has to have some set of skills. A person acquires a set of skills through studying under other mentors and by observing his environment. I will also add that every artist needs to gain an understanding of the science of the tools, lighting, and even the placement of strokes in order to define his craft as memorable. If this is true for painting then it can also be said that practicing medicine and nursing is indeed an art.

Medicine has been evolving over centuries. Its core is based on intuition and values to console patients when they become injured or are affected by disease. The science of medicine cannot stand alone without the humanistic qualities of compassion and the drive to do good without further harm. Medicine and nursing is a human to human relationship which is established when a patient reaches out for help and the clinician agrees to try their best to alleviate symptoms in order to help that person return to the best level of wellness possible.


If one really wanted to witness the true art form of medicine and/or nursing on full display it would be in the oncology population. Cancer does not discriminate and it has no bounds. It does not care about your age, how much money you have in the bank, and it does not care if you still had dreams left to complete. It comes out of nowhere and can ravage not only a person’s body, but it can also destroy a person’s soul. As a caregiver, we are on the front lines when they hear the dreadful news. We witness the fear in their eyes and give them hugs while they cry, but we can’t guarantee how it will all turn out.


We stand on the sidelines giving these patients the best care options possible along with as much compassion that we can muster. We do everything we can to help a patient maintain their dignity while they put up the best fight of their lives. So, if anyone ever had a doubt whether or not medicine or nursing is an art, ask an oncology patient. What you will often hear is that they did not survive the journey of cancer because of the technology or medicines, but rather they made it toward their destination point because of the kind act of the human touch mixed with experience and knowledge. One cannot stand without the other, but together they form an intricate piece which fits perfectly into the masterpiece called life. Now isn’t that art?



My hand began to throb as the blood returned back to my fingers. I looked down at my wife’s face, which began to relax as her contractions eased. “Please fill out all the highlighted areas and someone will be with you momentarily,” the admission clerk said to me. With the exception of giving up my first-born’s blood I gave them everything they needed in order for the hospital to deem us qualified, such as my address, phone number, SSN, insurance numbers, my employer’s name and address, my email, and both of our driver’s license numbers. Once completed, the clerk took all of the paperwork from my hands and began placing them all onto a printer-scanner to be inputted into my wife’s record. With a touch of a button the information feed into the machine as my entire wife’s and my data flowed throughout the hospital’s network. The clerk bent down to affix the wristband on my wife and with one click we both smiled, as we knew we were embarking on unknown journey. Meanwhile, 10,000 miles away the computer screen flashed notifying of incoming email. The tech moved his mouse over to open the message. With one click all the information of Mr. and Mrs. Bean was captured.


The Printer and Scanner


The media is full of stories where innocent victims fall prey to hackers at every corner. In fact, 40.8 million patients have been affected by these large data breaches only to find that this is the tip of the iceberg of what is yet to come with no protection in sight. While heal

thcare facilities are aware of these threats, many in healthcare IT lack the expertise needed in order to analyze or even solve the simplest chink in their facilities armor. One such overlooked access point is the commonly used wireless printer and scanner. After all, these machines often handle sensitive documents and information as well as provide easy access to a hospital network system. Since most health care facilities overlook this common technology by the time this breech is detected, the damage has already left its carnage for the patient to clean up months to even years after their hospital admission.


It’s time for healthcare facilities to take printer security seriously




The printer and scanner usually costs under $200 dollars so it is easily purchased with little to no red tape involved. However, once a unit is connected to the hospital network it is usually never monitored again. Hackers love these access points because most are not usually password protected especially in older models. Furthermore, if your printers have access via the Internet, a hacker can have limitless access and jumping off points to your networks, by simply rerouting anything that is printed faxed or scanned. Hackers can also send bizarre print jobs, or change its LCD readouts, disrupt service, or even install malware.

So the million-dollar question is why should patients’ trust us with their valuable information when we continue to prove that our systems and personnel lack the ability to safeguard any and all information that is currently being stockpiled?


We Owe It To Our Patients


The first order of business it to admit that we have built systems that can be compromised and that cyber criminals are the expert for identifying and taking advantage of any gaps within our system. Next, each facility should reallocate resources and hire a company whose expertise lies in security assessment. Some of the tops in the field are:

Core Insight Enterprise, Core Security

Redspin, An Auxilio Company

QualysGuard Vulnerability Management, Qualys Inc.


These companies provide testing of the facilities data access points, they identify vulnerabilities, they help to develop action plans and policies, and finally they help prioritize a winning strategy in order to help prevent any data breeches in the future. Remember while we are the experts in providing healthcare to our patients, these companies are the leading experts in monitoring and preventing our patients personal information from getting into the wrong hands.




The Cost of Infections


Anyone who has been a clinician in healthcare is fully aware of the possibilities of infections during admissions. In fact according the CDC, 1 in 25 hospital patients becomes infected with at least one type of Healthcare-Associated Infections (HAI) or another. To add insult to injury at least 75,000 hospital patients out of 722,000 who acquired an infection die. Furthermore, it should be stated that most infections were found to be acquired outside the ICU arena. So what is the common factor that could be contributing to these many infections?

Since the introduction of health care informatics, healthcare facilities have aggregated data on the most common infections that affect our patient population today. According to the CDC, the most common infections that affect the patient population are pneumonia, gastrointestinal illness, urinary tract infection (CAUTI), Primary Bloodstream Infections (CLABSI), Surgical Site Infections (SSI) from any inpatient surgery, and finally other type of infections. These infections result up to $4.5 billion in additional healthcare costs annually. To combat, regulatory bodies form prescripted suggestions on how to tackle these common culprits from infections to medication errors, to even falls. Then it is up to a medical facility to design a workflow, form policy, and instruct health care providers to follow the outlined workflow or be fined by insurance companies for failure to rectify the situation. But what if our good intentions cause a greater risk to all patients? Well let’s look at the workflow common in healthcare facilities today.


It Is All About Understanding the Workflows


When a patient is admitted to a healthcare facility the common workflow is for a Registered Nurse to fill out a nursing assessment and admission paperwork. Within that paperwork a patient is asked about their current and past health history regarding falls or anything that could be a trigger to falls. Could it be true that our fall prevention programs have anything to do with HAI rates? Based on the adopted practice for falls prevention a patient is given a wristband, instructions of what to do or not to do, as well as non-skid socks in which the patient wears throughout their stay. Whether you are clinician or a patient, you know that being admitted is a journey. This journey may consist of being transported all over a medical facility while never taking off those same issued, non-skid socks. These same fall prevention socks have walked around patient rooms, hospital units, into bathrooms and have touched footplates on wheelchairs picking up all kinds of infective particles. Then a patient is assisted or climbs back into bed where any and all infectious particles contaminate the patients bedding and sheets. As we lovingly cover our patients with these now deadly sheets their fresh surgical sites, Foley catheter tubes, central lines, or any other access points have now become breeding grounds for the same infections that are plaguing our patients today.


Do ICUs Give Better Care


While patients in the ICU have different Registered Nurse to patient staffing ratios and their skill sets in lifesaving equipment is advance this does not mean patients receive better quality of care in the ICU than on another unit. Simply put, a patient in the ICU does not have the same freedom that a patient on a medical surgical floor experiences. These patients are usually too sick, on lifesaving monitors and they cannot ambulate around their rooms or even the unit. They also are usually transported to diagnostic tests via a gurney, their own bed or these diagnostic machines can be transported to them. Therefore, it could be stated that the ICU workflows alone prevent their patients from experiencing the same rate of infections than patients who are on medical surgical units.


But We Are Getting Better Aren’t We


Skeptics may point to the data and state that there are noted decreases in SSI and CLABSI rates, but this may only be due to the newly adopted practices of using sliver impregnated dressings or discouraging the practice of inserting central lines into a patient’s groin. But how many more workflows are we going to add to our already task saturated clinicians before we admit we are working harder, but not smarter in decreasing our infections rates?


New Steps To Consider


As clinicians we all strive to return the patient back to as normal a wellness state as possible. This can only be achieved if we all decide to work together and admit that we may have glossed over the most obvious root cause effect to our hospital acquired infections. Here are just a few suggestions that may pave the way for change and in the process to save lives:

1. Establish a program to determine if infection rates are directly correlated to non-skid socks contaminating patient bedding and patients themselves.

2. Educate your entire facility what was identified as the root cause for potential infections and how it could also effect another regulatory body prescription such as falls preventions.

3. Initiate a hospital wide campaign: You May Hold the Key to Change Health Care Infection Rates.

a. Employees thrive on competition

i. Use the competitive spirit to help solve your healthcare facilities problems.

4. Share the fruit of your facilities labor and watch how some small changes can make the biggest impact in healthcare today.


The Cost of Infections


Anyone who has been a clinician in healthcare is fully aware of the possibilities of infections during admissions. In fact according the CDC, 1 in 25 hospital patients becomes infected with at least one type of Healthcare-Associated Infections (HAI) or another. To add insult to injury at least 75,000 hospital patients out of 722,000 who acquired an infection die. Furthermore, it should be stated that most infections were found to be acquired outside the ICU arena. So what is the common factor that could be contributing to these many infections?

Since the introduction of health care informatics, healthcare facilities have aggregated data on the most common infections that affect our patient population today. According to the CDC, the most common infections that affect the patient population are pneumonia, gastrointestinal illness, urinary tract infection (CAUTI), Primary Bloodstream Infections (CLABSI), Surgical Site Infections (SSI) from any inpatient surgery, and finally other type of infections. These infections result up to $4.5 billion in additional healthcare costs annually. To combat, regulatory bodies form prescripted suggestions on how to tackle these common culprits from infections to medication errors, to even falls. Then it is up to a medical facility to design a workflow, form policy, and instruct health care providers to follow the outlined workflow or be fined by insurance companies for failure to rectify the situation. But what if our good intentions cause a greater risk to all patients? Well let’s look at the workflow common in healthcare facilities today.

It Is All About Understanding the Workflows

When a patient is admitted to a healthcare facility the common workflow is for a Registered Nurse to fill out a nursing assessment and admission paperwork. Within that paperwork a patient is asked about their current and past health history regarding falls or anything that could be a trigger to falls. Could it be true that our fall prevention programs have anything to do with HAI rates? Based on the adopted practice for falls prevention a patient is given a wristband, instructions of what to do or not to do, as well as non-skid socks in which the patient wears throughout their stay. Whether you are clinician or a patient, you know that being admitted is a journey. This journey may consist of being transported all over a medical facility while never taking off those same issued, non-skid socks. These same fall prevention socks have walked around patient rooms, hospital units, into bathrooms and have touched footplates on wheelchairs picking up all kinds of infective particles. Then a patient is assisted or climbs back into bed where any and all infectious particles contaminate the patients bedding and sheets. As we lovingly cover our patients with these now deadly sheets their fresh surgical sites, Foley catheter tubes, central lines, or any other access points have now become breeding grounds for the same infections that are plaguing our patients today.


Do ICUs Give Better Care


While patients in the ICU have different Registered Nurse to patient staffing ratios and their skill sets in lifesaving equipment is advance this does not mean patients receive better quality of care in the ICU than on another unit. Simply put, a patient in the ICU does not have the same freedom that a patient on a medical surgical floor experiences. These patients are usually too sick, on lifesaving monitors and they cannot ambulate around their rooms or even the unit. They also are usually transported to diagnostic tests via a gurney, their own bed or these diagnostic machines can be transported to them. Therefore, it could be stated that the ICU workflows alone prevent their patients from experiencing the same rate of infections than patients who are on medical surgical units.

But We Are Getting Better Aren’t We

Skeptics may point to the data and state that there are noted decreases in SSI and CLABSI rates, but this may only be due to the newly adopted practices of using sliver impregnated dressings or discouraging the practice of inserting central lines into a patient’s groin. But how many more workflows are we going to add to our already task saturated clinicians before we admit we are working harder, but not smarter in decreasing our infections rates?


New Steps To Consider


As clinicians we all strive to return the patient back to as normal a wellness state as possible. This can only be achieved if we all decide to work together and admit that we may have glossed over the most obvious root cause effect to our hospital acquired infections. Here are just a few suggestions that may pave the way for change and in the process to save lives:

1. Establish a program to determine if infection rates are directly correlated to non-skid socks contaminating patient bedding and patients themselves.

2. Educate your entire facility what was identified as the root cause for potential infections and how it could also effect another regulatory body prescription such as falls preventions.

3. Initiate a hospital wide campaign: You May Hold the Key to Change Health Care Infection Rates.

a. Employees thrive on competition

i. Use the competitive spirit to help solve your healthcare facilities problems.

4. Share the fruit of your facilities labor and watch how some small changes can make the biggest impact in healthcare today.

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