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You Want To Put What In My Family Members Nose?




If you are admitted to a health care facility you are likely to be 1 out of the 25 hospital patients admitted on a give day to acquire a Healthcare-Associated Infection (HAI). According to the CDC, each year at least 722,000 of these patients die. Over the years regulatory bodies have recommended prescriptive techniques while health care facilities have implemented stringent policies and educational tools in hopes of seeing a trending change for the better. However, HAIs are still plaguing our systems. So what now? Should better technology be developed in hopes of eradicating these deadly HAIs or should we, the health care leaders, go back to the basics and look for common root causes in our practices?


Are We Getting Farsighted


Over the last two decades electronic health records have been able to provide health care leaders with all kinds of information of current business processes, which we can analyze and make changes accordingly. On the other hand, it could be making us farsighted and thus preventing us from solving the root causes, which cause infections? Sure data can provide significant pieces where it can point to trends, but if the clinician’s hands on care are not evaluated in the actual working environment can we say that we are really seeing the entire picture? What if our data just can’t capture the behind the scenes processes that could be subjecting our patients to the very microorganisms we are trying to prevent? Let’s take a look at one such practice.


The Common NasalCannula


Nasal cannulas are tubes, which deliver a drug known as oxygen to the patient. Cannulas are commonly used in health care settings because they allow the patient to function in as normal of a capacity as possible. The cannula has two prongs at the end where they are inserted into a patient’s nose while the rest of the tube is snaked over the patient’s ears and down the neck where is could come into contact with items such as central hubs or other access ports. During a patient’s stay, clinicians are documenting this source of treatment throughout the record in the orders section, respiratory flow sheets, and even in notes. However, what is never captured are the clinicians action regarding to the tube itself.


The Dirtiest Secret of All


So how can the common nasal cannula be a source of infection? While a patient is receiving oxygen therapy with a nasal cannula sometimes that very same tube ends up becoming dislodged or even removed by a health care provider or the patient. Often times these tubes are not found nicely coiled up and placed on a clean surface. Instead they are found in the bedding or on the floor. Then usually with good intentions a health care provider or even family member may replace this same tube back on the patient and into their nose without being properly cleaned. Could this be just another root cause to our HAIs such as pneumonia and CLABSI?


Workflows Are the Key to Preventions


As health care providers we all have the same goals to provide the safest most efficient health care possible. However, sometimes the little things that we do in our practice could be the root cause to something bigger. Our technological advancement in the last two decades have been amazing, but we should remember that sometimes the data is not going to always point us in the right direction. Sometimes solving big problems only takes getting out there among the staff, getting to know their workflows, and getting them involved in problem solving.


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