Critical Care Weekly Pulse Weekly

The Critical Care Weekly Pulse™, a weekly e-news publication packed with career empowerment resources including the latest clinical, industry, and product news, clinical education, market research, and of course, the most recently posted jobs requiring expertise in the critical care nursing and medicine. Over 10,000 clinicians now receive the Critical Care Weekly Pulse.

Read the most recent issue of the Critical Care Weekly Pulse™

Receive your own complimentary subscription to the Critical Care Weekly Pulse™

Sign Up Now!


Featured Articles

July 2, 2019

Acupuncture Training May Lessen Burnout Symptoms

Researchers found a link between acupuncture training and decreased physician depersonalization, according to findings reported in the Journal of the American Board of Family Medicine. “Primary care physicians seek to practice acupuncture as a way to provide options for their patients, to focus on patients’ whole-person health, and to expand their knowledge and skills,” Paul F. Crawford III, MD, of the department of family medicine at the Uniformed Services University of the Health Services, and colleagues wrote.  Read More

Deep Learning Can Make Reliable Coma Outcome Prediction

After cardiac arrest and resuscitation, part of the patients will be in a coma and treated at an intensive care unit. Their prospects are uncertain. What is needed to get an outcome prediction that is reliable? Researchers of the University of Twente and the 'Medisch Spectrum Twente' hospital, both in Enschede, The Netherlands, developed a learning network that is capable of interpreting EEG-patterns. It can make a reliable outcome prediction, and thus forms a valuable extra source of information. The researcher present their approach in Critical Care Medicine journal. In The Netherlands, about one third of the people that had a cardiac arrest followed by resuscitation, will have to be treated at the ICU. These patients, about 7000 each year, are in a coma. More than half of them will not regain consciousness.  Read More

A Hidden Truth: Hospital Faucets Are Often Home to Slime and Biofilm

Sinks and faucets tested at the University of Michigan Health System revealed slime and biofilm.Hand hygiene is a critical component of infection prevention in hospitals, but the unintended consequences include water splashing out of a sink to spread contaminants from dirty faucets according to new research presented last week in Philadelphia at the 46th Annual Conference of the Association for Professionals in Infection Control and Epidemiology (APIC). Read More

Penn Finds a Way to Reduce ICU Doctor Burnout

Cutting the length of rotations in medical intensive care units in half also cut rates of physician burnout in half while additionally improving feelings of fulfillment, according to a new pilot study from Penn Medicine.The results were strong enough that Penn has changed rotations for critical-care doctors on its medical intensive care units (MICUs) at Hospital of the University of Pennsylvania, Penn Presbyterian Medical Center, and Corporal Michael J. Crescenz VA Medical Center.   Read More

  • June 25, 2019

    Hospital Insects Harbour Drug-Resistant Bacteria 

    More than 50 percent of bacteria recovered from flying insects in a group of English hospitals were resistant to one or more antibiotics, posing a potential infection risk to patients, according to a new study. The Aston University study collected almost 20,000 insect samples—including houseflies, 'filth flies' such as bluebottles and greenbottles and a variety of 'drain flies' - from seven NHS hospital sites in England.  Read More

    Risk for Death After Discharge Increases with Hospital-Acquired MRSA

    Researchers found that MRSA bacteremia did not increase the risk for death in hospitalized children compared with methicillin-susceptible Staphylococcus Aureus, or MSSA. However, MRSA infections acquired in the hospital were associated with an increased risk for mortality 1 year after discharge. Oren Gordon, MD, PhD, a pediatric infectious disease fellow at the Johns Hopkins University School of Medicine, and colleagues wrote that two meta-analyses conducted in the early 2000s examined mortality rates of patients with MRSA compared with those with MSSA. However, they wrote that the baseline mortality risk varied considerably in the studies, as did the researchers’ attempts to adjust for potential confounders. Additionally, few pediatric cases were included in these analyses. Read More

    Patients of Surgeons with Unprofessional Behavior More Likely to Suffer Complications

    Patients of surgeons with higher numbers of reports from co-workers about unprofessional behavior are significantly more likely to experience complications during or after their operations, researchers from Vanderbilt University Medical Center (VUMC) reported today in JAMA Surgery. "Surgical teams require every team member to perform at their highest level. Read More

    Flu Virus Coinfection Occurs More Often Than Previously Thought

    A case-control study conducted in southern Brazil described the first case of triple influenza virus infection, and researchers said their findings indicate that “influenza virus coinfections probably occur more often than has been previously documented.” “The clinical implications of coinfections with distinct influenza viruses in the respiratory tract is not well understood,” Ana B. G. Veiga, PhD, from the Federal University of Health Sciences of Porto Alegre, Brazil, and colleagues wrote. “Moreover, [influenza A virus] and [influenza B virus] coinfections have been reported only occasionally. The factors that are responsible for mixed influenza virus infection have not been determined; they can be associated with the host’s immune system, virus properties, and other factors.”  Read More

  • June 18, 2019

    Rapidly Removing Fluid from ICU Patients in Kidney Failure Linked to Increased Death Risk

    The faster fluid is removed using continuous dialysis from patients with failing kidneys, the higher the likelihood they will die in the next several months, according to a study published today in JAMA Network Open by University of Pittsburgh School of Medicine researchers.Nearly two-thirds of critically ill patients with acute kidney injury have extra fluid accumulating in their bodies, which can put pressure on their lungs and cause injury to other organs. To relieve that pressure, clinicians routinely remove the excess fluid from the blood while performing dialysis in the intensive care unit. Read More

    Using Facial Recognition Technology to Continuously Monitor Patient Safety in the ICU

    A team of Japanese scientists has used facial recognition technology to develop an automated system that can predict when patients in the intensive care unit (ICU) are at high risk of unsafe behaviour such as accidentally removing their breathing tube, with moderate (75%) accuracy. The new research, being presented at this year's Euroanaesthesia congress (the annual meeting of the European Society of Anaesthesiology) in Vienna, Austria (1-3 June), suggests that the automated risk detection tool has the potential as a continuous monitor of patient's safety and could remove some of the limitations associated with limited staff capacity that make it difficult to continuously observe critically-ill patients at the bedside.  Read More

    AI Gives Reliable Coma Outcome Prediction

    After cardiac arrest and resuscitation, some patients will still be in a coma and treated at an intensive care unit. Their prospects are uncertain. Clinicians seek a reliable method to predict their outcomes. Researchers of the University of Twenty and the Medisch Spectrum Twenty hospitals have developed a learning network that is capable of interpreting EEG patterns. Artificial intelligence (AI) can give a reliable outcome prediction, providing a valuable extra source of information for decision-making. The researchers present their approach in Critical Care Medicine. Read More

    Pressure Injuries at Time of ICU Admission Tied to Longer Stays

    William T. McGee, M.D., from the Baystate Medical Center in Springfield, Massachusetts, and colleagues retrospectively analyzed inpatient data from 2,723 adult patients in a 24-bed medical-surgical intensive care unit in a large level I trauma center from 2010 to 2012. The authors sought to evaluate the association between pressure injuries and length of stay and mortality.The researchers found that 6.6 percent of patients had a pressure injury at admission. Compared with patients without a pressure injury at admission, patients with a pressure injury had a longer mean unadjusted stay (15.6 versus 10.5 days) and higher in-hospital mortality rate (32.2 percent versus 18.3 percent). The association between pressure injuries and mean increase in length of stay remained with adjustment for other variables (mean difference, 3.1 days).  Read More

  • June 12, 2019

    Sedation and Controlled Paralysis Do Not Improve Survival of ICU Patients with ARDS

    Reversibly paralyzing and heavily sedating hospitalized patients with severe breathing problems do not improve outcomes in most cases, according to a clinical trial conducted at dozens of North American hospitals. The trial -- which was stopped early due to futility -- settles a long-standing debate in the critical care medicine community. Read More

    Patients Give More ‘5-Star’ Ratings to Hospitals with Fewer Services

    Compared to smaller facilities, hospitals that provide complex care for critical illness or serious injury may find it harder to make patients happy, a U.S. study suggests. Patients may be more likely to give top ‘5-star’ ratings to hospitals that don’t offer many commonly sought-after services like emergency rooms and intensive care units, the study found. In an effort to help patients find high quality care, the U.S. Centers for Medicare and Medicaid Services (CMS) publishes hospital rankings based on patients’ experiences, on a website called Hospital Compare. Research to date hasn’t offered a clear picture of how much patients’ ratings, on a scale of 1 to 5, might help people find the best place to go for care, researchers note in JAMA Internal Medicine.  Read More

    Post-ICU Depressive Symptoms Correlate With Income, Education, and Function

    Researchers of a study published in CHEST found that moderate to severe depressive symptoms after a stay in an intensive care unit (ICU) are associated with decreased income, lower education, and higher functional dependence. Moreover, age correlates curvilinearly with symptom severity. Read More

    Reducing Inpatient Falls and Injury Rates by Integrating New Technology with Workflow Redesign

    By integrating a novel patient-observer technology into a redesigned clinical workflow, the neuroscience unit at Mission Hospital in Asheville, North Carolina, achieved a 23% reduction in falls and a 12% reduction in fall-related injuries over a 1-year pilot period. Furthermore, the technology and clinical workflow was scaled to two additional units and, collectively, the three units achieved a 40% reduction in fall-related injuries. These results supported scaling the solution to a total of five inpatient units, effectively expanding the number of patients capable of being monitored from six (during the pilot period) to 164.  Read More

  • June 5, 2019

    Placards Do Not Improve Hand Hygiene Adherence

    Hand hygiene placards posted in a Denver hospital — including one that featured an image of two eyes looking directly at the viewer with a reminder to clean their hands — did not result in measurable improvements in hand hygiene adherence among health care workers, researchers reported. “Hospitals around the country are struggling to address hand hygiene adherence, but there are no nationally adopted standards for hand hygiene measurement and improvement, and an optimal combination of elements in hand hygiene ‘bundles’ remains unclear,” Sarah A. Stella, MD, associate professor of medicine and hospital medicine at the University of Colorado School of Medicine, told Infectious Disease News. “Infection preventionists often utilize visual cues and reminders in an attempt to influence behavior without evidence that they are effective.” Read More

    In-Hospital Delirium Increases Postoperative Cognitive Dysfunction Risk in Older

    New research indicates that older patients who develop delirium— an acute attentional deficit that waxes and wanes —right after surgery are more likely to show signs of postoperative cognitive dysfunction one month later. But the study, published in the Online First edition of Anesthesiology, the peer-reviewed medical journal of the American Society of Anesthesiologists (ASA), also found that the number of patients still showing signs of postoperative cognitive dysfunction decreased steadily and significantly at two and six months after surgery. Delirium is a common postoperative complication in older surgical patients and has been associated with cognitive decline, increased risk of dementia, and a host of other negative outcomes. Additionally, delayed or incomplete cognitive recovery can complicate recuperation for older surgical patients.   Read More

    Intelligent ICU for Autonomous Patient Monitoring Using Pervasive Sensing and Deep Learning

    Currently, many critical care indices are not captured automatically at a granular level, rather are repetitively assessed by overburdened nurses. In this pilot study, we examined the feasibility of using pervasive sensing technology and artificial intelligence for autonomous and granular monitoring in the Intensive Care Unit (ICU). As an exemplary prevalent condition, we characterized delirious patients and their environment. We used wearable sensors, light and sound sensors, and a camera to collect data on patients and their environment. We analyzed collected data to detect and recognize patient’s face, their postures, facial action units and expressions, head pose variation, extremity movements, sound pressure levels, light intensity level, and visitation frequency. Read More

    Long-Term Mortality Risk Highest Among Young Patients After ICU Discharge

    Although aging was associated with an increased risk for mortality in the 3 years following hospital ICU discharge, long-term mortality was highest among young patients after standardizing for age and sex, according to a study published in JAMA Network Open. “The benefit of ICU admission for elderly patients has been questioned because it may lead to unnecessary invasive care and avoidable health care expenditure,” Alice Atramont, MD, MSc, of Caisse Nationale d’Assurance Maladie (CNAM) in Paris, France, and colleagues wrote. “In France, the number of ICU beds per 100,000 population is at the European mean, with no financial barriers to access ICU care because of a national health insurance system offering universal coverage for the French population. However, there are few wide-scale population-based studies that document short-term and long-term outcomes of adult patients after ICU discharge across all age strata.  Read More

  • May 28, 2019

    Risk Factors for Delirium in the Hospital Setting

    Acute confusional state, also known as delirium or encephalopathy, is so common in hospitals that it’s almost seen as routine by many hospital staff. Between 14 to 56 percent of all hospitalized patients develop confusion. Intubated patients in the intensive care unit have an even higher rate, reaching about 82 percent. While delirium is all too familiar to hospital workers, it is deeply unnerving and distressing to friends and family members. Read More

    Trans-Catheter Aortic Valve Replacement Can Improve Outcomes in Low-Risk Surgical Patients

    For patients with aortic stenosis that cannot be treated with medication, surgical (SAVR) and transcatheter (TAVR) aortic valve replacement can offer effective treatment. A new study, one of two on the topic released today at the American Association for Thoracic Surgery's 99th Annual Meeting, examines, for the first time, the effects of TAVR with a balloon-expandable valve for low-risk patients.950 patients with severe symptomatic aortic stenosis and low surgical risk participated in the randomized trial.  Read More

    Closed ICU Model May Reduce Hospital-Acquired Infections

    A closed intensive care unit (ICU) model, whereby a patient is evaluated and admitted under an intensivist and orders involving patient care are written by the ICU team, is associated with a reduction in certain types of hospital-acquired infections, according to a study presented at the American Thoracic Society 2019 International Conference. Read More

    New Algorithm Uses Disease History to Predict Intensive Care Patients' Chances of Survival

    Researchers from the University of Copenhagen and Rigshospitalet have used data on more than 230,000 intensive care patients to develop a new algorithm. Among other things, it uses disease history from the past 23 years to predict patients' chances of survival in intensive care units. Every year, tens of thousands of patients are admitted to intensive care units throughout Denmark. Determining which treatment is best for the individual patient is a great challenge.  Read More

  • May 16, 2019

    Outside Temperature Impacts MDRO Incidence in Climate-Controlled ICUs

    Even in climate-controlled health care units, the outside temperature can influence the indoor temperature, and these changes may impact the incidence of multidrug-resistant organisms, or MRDOs, researchers reported in Infection Control & Hospital Epidemiology. “It remains unclear why seasonality and associations with high temperatures are detected even in hospitals or hospital units with climate control,” Dayanna Conislla Limaylla, MSc, from the post-graduate program in collective health at São Paulo State University, and colleagues wrote. “To fill these gaps in our knowledge, we conducted a prospective ecological study in a teaching hospital in Brazil.” Read More

    A 1-2 Punch: How Alarm Surveillance Increases Safety and Reduces Fatigue

    An often-cited study at Johns Hopkins Hospital found that there is a daily average of 350 alarms per bed in hospital critical care units. That means that all day (and night) long, critical care nurses are fielding hundreds of audible alarms from infusion pumps, cardiac monitors, ventilators, and other bedside machines. These nearly constant alarms compete for a nurse’s attention and are not prioritized by criticality. Worst of all, the majority of the messages aren’t relevant or actionable. All the noise can lead to deadly consequences should a caregiver become desensitized and assume an alarm is false or misdirected.  Read More

    Sleep Quality, Wakefulness May Predict Successful Weaning from Mechanical Ventilation

    Critically ill patients who have higher levels of wakefulness and the same depth of sleep in both the left and right hemispheres of their brains are more likely to experience successful weaning from mechanical ventilation, according to a study published in the American Journal of Respiratory and Critical Care Medicine. “Patients under mechanical ventilation in intensive care units frequently suffer from severe sleep deprivation and, as a consequence, exhibit abnormal patterns of sleep or wakefulness, which explain in part the frequent development of delirium,” Laurent Brochard, MD, PhD, director of the critical care medicine division at the University of Toronto. Read More

    New Approach in Managing Patients With Septic Shock

    Sepsis remains the most common cause of vasodilatory shock worldwide. The mainstay of haemodynamic treatment of septic shock is fluid resuscitation followed by vasopressors where fluids alone are insufficient to achieve target blood pressure.This article, published in the journal Critical Care, proposes the concept of “broad spectrum vasopressors” as a new approach to the initial management of septic shock. Based on this strategy, patients with septic shock are started on multiple vasopressors with a different mechanism of action simultaneously while the vasopressor sensitivity is assessed. Read More

  • May 8, 2019

    How Well-Designed Tech Can Help Medical Professionals Avoid Burnout

    Right now, technology is diminishing clinician and patient experience. It could and should be improving them.How should doctors and nurses spend their time? Ideally, talking with patients about their pain and progress, examining their illnesses and injuries, and planning their treatment. But, that’s a shrinking part of clinicians’ days. Luckily, it's a reversible trend.A study by the University of Wisconsin last year determined that primary care physicians spend more than half of their working hours on administration such as updating health records, ordering tests and inputting billing codes. Read More

    Hospital ICU Patients with Non-Brain-Related Injuries May Have Undetected Cognitive Deficits

    A new study led by Western University and Lawson Health Research Institute has found that most patients entering hospital intensive care units (ICU) for non-brain-related injuries or ailments also suffer from some level of related cognitive dysfunction that currently goes undetected in most cases.The findings were published today in the influential scientific journal, PLOS ONE. Many patients spend time in the ICU for reasons that have nothing to do with a known brain injury, and most health care providers and caregivers don't have any evidence to believe there is an issue with the brain. For example, a patient may have had a traumatic injury that does not involve the brain, yet still requires breathing support to enable surgeons to fix damaged organs, they may have issues with their heart or lungs, they may contract a serious infection, or they may simply be recovering from a surgical procedure like an organ transplant that has nothing directly to do with their brain. Read More

    Drug-Free MRSA Treatment to be Tested in Clinical Studies

    Researchers have identified a drug-free approach to treating MRSA using blue light and hydrogen peroxide.“We found that blue light bleaches a pigment residing in the membrane of S. aureus,” Ji-Xin Cheng, professor of biomedical engineering and electrical and computer engineering at Boston University, told Infectious Diseases in Children. “This increases the permeability of the membrane, allowing hydrogen peroxide to enter bacteria and kill them.” Cheng and colleagues wrote that drug-free treatments for MRSA are needed because antibiotic resistance is outpacing the development of new antibiotics. Read More

    Intensive Care Cocoon Hospital Bed Aims to Relieve ICU Delirium in PatientsIntensive Care Cocoon Hospital Bed Aims to Relieve ICU Delirium in Patients

    A new intensive care cocoon developed by a Brisbane hospital aims to reduce "absolutely petrifying" delirium that occurs in up to 80 per cent of patients being treated in a hospital intensive care unit (ICU). ICU delirium is caused by multiple factors, but is exacerbated by the noise, light, and sleep deprivation experienced in an ICU. Former ICU patients say their lengthy stays in hospital left them with psychological scars long after they healed physically. The aim of the ICU cocoon is to provide a calmer and more secluded stay in hospital, using noise-cancelling technology and video screens. ICU delirium is a serious condition that results in an acute change in the mental state of critically ill patients, with disturbances to their consciousness, attention, cognition and perception. Read More

  • May 2, 2019

    Self-Care ‘Critically Important’ to Avoid Compassion Fatigue, Prevent Burnout

    Self-care is critically important for health care providers to avoid compassion fatigue and prevent burnout, according to a presenter at HOPA Ahead 2019. “The work we do exposes us to tremendous amounts of suffering and ‘what-if’ questions,” Justin N. Baker, MD, FAAP, FAAHPM, Baker, MD, FAAHPM, FAAP, chief of the division of quality of life and palliative care, director of the hematology/oncology fellowship program and full member of the department of oncology at St. Jude Children’s Research Hospital, said during a presentation. “The personal and professional impact of chronic patient death is profound. If we don’t talk about self-care, and if we don’t contemplate what the impact of doing this work every day has on each of us, we won’t be able to help [our patients].” Read More

    Taming Building Automation System Alarm Fatigue

    In hospitals all over the country, there exist extremely robust building automation systems (BAS), designed to provide constant monitoring of critical equipment. They are screaming for help, and no one is paying attention. It isn’t due to negligence or apathy. It is due to a condition known as alarm fatigue. Alarm fatigue is caused by two major oversights at the infancy of installation and design of the system. Read More

    Nebulized Antibiotics: What is Their Place in ICU infections?

    Inhaled antibiotics have been used as adjunctive therapy for patients with pneumonia, primarily caused by multidrug resistant (MDR) pathogens . Most studies have been in ventilated patients, although non-ventilated patients have also been included (but not discussed in this review), and most patients have had nosocomial pneumonia. Aerosolized antibiotics are generally added to systemic therapy, and have shown efficacy , primarily as salvage therapy for failing patients and as adjunctive therapy after an MDR gram-negative has been identified. An advantage to aerosolized antibiotics is that they can achieve high intra-pulmonary concentrations that are potentially effective , even for highly resistant pathogens, and because they are generally not well- absorbed systemically, it is possible to avoid some of the toxicities of systemic therapy. Read More

    Bathing Patients with an Antiseptic Reduces Bloodstream Infections

    Research Medical Center’s Dr. Olevia Pitts, center, explains the bathing protocol to a surgical patient. A common practice at hospitals is to ensure all patients bathe once a day with common soap and water to ward off infections. A 2013 study HCA participated in found bathing intensive-care unit patients with soap containing the antiseptic chlorhexidine cut the incidence of central line bloodstream infections by 44%. Read More

  • April 18, 2019

    Antibiotics Unnecessary in Coagulase-Negative Staphylococci Catheter-Related BSI

    Study findings indicated that withholding antimicrobial therapy in CoNS-CRBSI is neither associated with short-term complications nor with long-term recurrences. Patients not receiving antibiotics for catheter-related bloodstream infections (CRBSI) with coagulase-negative Staphylococci (CoNS) after catheter removal experience similar short-term complications and long-term recurrences to patients receiving ≥5 days of antibiotic therapy, according study results published in Antimicrobial Resistance & Infection Control. Read More

    ICU Patients with Non-Brain-Related Injuries May Suffer Undetected Cognitive Dysfunction

    Many patients spend time in the ICU for reasons that have nothing to do with a known brain injury, and most health care providers and caregivers don't have any evidence to believe there is an issue with the brain. For example, a patient may have had a traumatic injury that does not involve the brain, yet still requires breathing support to enable surgeons to fix damaged organs, they may have issues with their heart or lungs, they may contract a serious infection, or they may simply be recovering from a surgical procedure like an organ transplant that has nothing directly to do with their brain. Read More

    Study Provides Insight Into Use of Critical Care Resources

    A study by Massachusetts General Hospital (MGH) investigators has found wide variation in the use of different hospital units—intensive care or general medical units—to deliver a type of advanced respiratory support called non-invasive ventilation. The team's report published in Critical Care Medicine found no differences in length of stay or in-hospital deaths among patients with chronic obstructive pulmonary disease (COPD) receiving this treatment that were associated with whether they were treated on a general medical unit or an intensive care unit (ICU). Read More

    Study Says Hospital Acquired Infections Can Make Patients ‘Feel Like Lepers’

    Healthcare associated infections such as MRSA cause more than just physical distress for patients, according to a recent analysis. The study, published in the American Journal of Infection Control, a journal of the Association of Professionals in Infection Control and Epidemiology, found many patients had emotional responses to diagnoses of hospital acquired infections, including “feeling dirty,” “having the plague” or “feeling like a leper.” Researchers at Glasgow Caledonian University in Scotland conducted a meta-synthesis of qualitative research, according to a news release on the study. Read More

  • January 17, 2019

    Oral, Gut Decontamination Does Not Reduce Bloodstream Infections in ICU

    Results of a randomized clinical trial showed that selective oral or digestive tract decontamination is not associated with reductions in ICU-acquired bloodstream infections caused by multidrug-resistant gram-negative bacteria among patients receiving mechanical ventilation with moderate to high antibiotic resistance prevalence. Read More

    New Study Compares Performance of Real-Time Infectious Disease Forecasting Models

    In what the authors believe is the first documented comparison of several real-time infectious disease forecasting models by different teams across many seasons, five research groups report this week that a majority of models consistently showed higher accuracy than historical baseline models. Read More

    New AI Can Detect Urinary Tract Infections

    New AI developed at the University of Surrey could identify and help reduce one of the top causes of hospitalisation for people living with dementia: urinary tract infections (UTI). UTI is an infection of any part of the urinary system, from the kidneys to the bladder. The symptoms include pain in the lower part of the stomach, blood in urine, needing to urinate suddenly or more often than usual and changes in mood and behaviour. Read More

    CDC: Flu Cases Hit 7 Million in the United States

    The flu season is picking up steam, with about 7 million Americans having been struck by a strain of the flu virus, health officials said Friday. Almost half of those individuals went to a doctor, while 69,000 to 84,000 people have been hospitalized for flu-related illness, the U.S. Centers for Disease Control and Prevention said in a new release. As of Jan. 5, 15 states and New York City were reporting high flu activity, and it was widespread in 30 states. The influenza A strain H1N1 remains the most common type of flu. This strain has been circulating and was pandemic in 2009 and in 1918. Read More

  • January 10, 2019

    How Common Pain Relievers May Promote Clostridium Difficile Infections

    Clostridium difficile causes the most common and most dangerous hospital-born infections in the United States and around the world. People treated with antibiotics are at heightened risk because those drugs disturb the microbial balance of the gut, but observational studies have also identified a link between severe C. difficile infections and use of NSAIDs, or non-steroidal anti-inflammatory drugs.  Read More

    Plumbing Contamination Linked with Cluster of Infections from Rare Sphingomona Species

    Health care-associated infection (HAI) rates are down overall in the United States but remain a problem in health care settings. In 2015 there were an estimated 687,000 HAIs in US acute care hospitals, and 72,000 hospital patients with HAIs died during their hospitalizations. Although surgical site infections, pneumonia, and Clostridium difficile infections account for most HAIs, the NEJM study detailed a cluster of infections caused by waterborne Sphingomonas species, including S koreensis, an uncommon gram-negative bacterium that was first documented as a human pathogen in a 2015 study. Read More

    Characteristics of Skin, Soft Tissue Infections Requiring High-Level Care

    Data published in the Annals of Emergency Medicine identified a limited number of simple clinical characteristics that appear to identify skin and soft tissue infections that require high-level inpatient services. A noncurrent review of existing records identified emergency department patients treated for skin and soft tissue infections. The presence or absence of select criteria was recorded for each case, along with whether the patient needed high-level care (defined as intensive care unit admission, operating room surgical intervention, or death as the primary outcome). Recursive partitioning was then applied to identify the principal criteria associated with high-level care. Read More

    ICU Stethoscopes Harbor DNA from Nosocomial Bacteria

    Stethoscopes are often used on multiple patients, and have been considered as vectors for hospital-based bacterial contamination. In this study, the authors used molecular methods to investigate the bacterial status of stethoscopes used in medical ICUs, even those that are used only once, and whether conventional methods of cleaning stethoscopes effectively decontaminate them and, if not, what microbes may be found on them. Read More

  • November 8, 2018

    How Hospitals Can Prevent Dementia in ICU Patients

    A checklist that focuses on pain assessment and exercise can help reduce intensive care unit patients' risk of developing long-term mental effects, such as dementia and confusion, NPR reports. Four things to know: 1. Following the checklist can cut a patient's risk of mental impairment after an ICU stay by 25 percent to 30 percent, said Eugene Wesley Ely, MD, professor of medicine at Vanderbilt University School of Medicine in Nashville, Tenn. This post-ICU condition is different than memory problems that may arise after heart surgery and general anesthesia in the elderly. Read More

    Oral, Gut Decontamination Does Not Reduce Bloodstream Infections in ICU

    Results of a randomized clinical trial showed that selective oral or digestive tract decontamination is not associated with reductions in ICU-acquired bloodstream infections caused by multidrug-resistant gram-negative bacteria among patients receiving mechanical ventilation with moderate to high antibiotic resistance prevalence. [Selective decontamination of the digestive tract (SDD)] and [selective oropharyngeal decontamination (SOD)] are routinely used in ICUs in the Netherlands, but their use has not been widely adopted in other countries, mainly because of limited efficacy data in settings with higher levels of antibiotic resistance and concern about emergence of antibiotic resistance, although the latter is not supported by meta-analyses,” Bastiaan H. Wittekamp, MD, PhD, of University Medical Center Utrecht in the Netherlands, and colleagues wrote in JAMA. Read More

    Shoe Sole and Floor Contamination: A New Consideration in the Environmental Hygiene Challenge for Hospitals

    It sounds like the beginnings of a riddle: What do we wear and walk on daily but never truly think about, especially in terms of pathogen transmission? Shoe soles and healthcare facility floors are the workhorses of the environment, and yet their capacity for aiding and abetting infectious agents remains unclear. Recent research seems to confirm what common sense already tells us -- that items which contact the floor are contaminated and could serve as vectors; despite daily cleaning of high-touch surfaces such as floors, it has already been shown that bacterial and viral contamination returns rather quickly. Read More

    Machine-Learning System Could Aid Critical Decisions in Sepsis Care

    Researchers from MIT and Massachusetts General Hospital (MGH) have developed a predictive model that could guide clinicians in deciding when to give potentially lifesaving drugs to patients being treated for sepsis in the ER. Sepsis is one of the most frequent causes of admission, and one of the most common causes of death, in the intensive care unit. But the vast majority of these patients first come in through the ER. Treatment usually begins with antibiotics and intravenous fluids, a couple liters at a time. If patients don’t respond well, they may go into septic shock, where their blood pressure drops dangerously low and organs fail. Then it’s often off to the ICU, where clinicians may reduce or stop the fluids and begin vasopressor medications, such as norepinephrine and dopamine, to raise and maintain the patient’s blood pressure. Read More