NEW TB TEST – DIAGNOSIS WITHIN 2 HOURS

Posted by KAREN A. BENSON, PH.D., MS, MN, RN | Published: SEPTEMBER 7,

2010
Tuberculosis (TB) kills about 1.8 million people a year and increasingly is caused by
bacteria that are resistant to one or more drugs. The best current test – growing
bacteria in a lab dish from a mucus samples – takes a week or more to provide
results. A new test can reveal in less than two hours, with very high accuracy,
whether someone has the disease and if it is resistant to the main drug, Rifampin
(Rifadin or Ramactane), currently used for treating it. The test is simple and can be
done with only 15 minutes of manual labor. The test works by putting a sample into a
machine that amplifies the DNA from a mucus sample and checking for bits of
bacterial genes.

This rapid test can be a big help in clinics where diagnosis of a drug-resistant strain
while someone is still there on the first visit enables proper treatment right away. This
can be a powerful tool as well in third world countries where patients may not be
diagnosed and treated before the disease has spread.

The World Health Organization will meet with experts to review results of studies of
this test and plan steps for moving forward. Cepheid, a California-based diagnostics
company; the University of Medicine and Dentistry in New Jersey, and the Foundation
for Innovative New Diagnostics, a Swiss-based non-profit group supported by the
Gates Foundation collaborated with the United State government to develop this test.
The study of the test is available online
at:http://www.nejm.org/doi/full/10.1056/NEJMoa0907847
Posted in General News | Tagged Infectious Disease, TB | Comments closed

Source: http://www.wsnaweb.org/nursing-practice-update/
Retrieved : January 7, 2011

Decreasing Disruptions Reduces Medication Errors

By Debra Wood, RN, contributor

Reducing distractions during medication administration cut errors in half at one

California hospital, and now nurses are spreading the concept, sharing with other
facilities safer medication-pass processes.

“It’s so simple and it came from front-line nursing staff,” said Becky Richards, RN, BSN,
MA, adult clinical services director at Kaiser South San Francisco Medical Center and a
leader of the initiative.
Nurses on the hospital’s quality forum recognized a need to reduce medication errors and
began brainstorming ideas. The facility put into place special procedures, such as double-
checks on morphine drips, insulin and other high-alert medications.

“We felt there needed to be a safeguard in place as the nurse went through the entire
process of medication administration,” said Richards, who suggested wearing a vest
when passing meds, something she had donned to decrease distractions for a different
purpose at another facility.

The nurses agreed and a med-surg orthopedic floor with a high error rate volunteered to
pilot the vests in 2006.

Initially, the hospital ordered bright orange, construction-style vests off the Internet,
which the nurses thought looked “cheesy.” They also found them hot and resisted sharing
them with fellow nurses.

“They felt it was demeaning,” Richards said.

But of even greater concern, despite education about not interrupting nurses during med
passes, the vests seemed to attract attention. The hospital tried again on a renal floor, with
separate medication rooms. But again, it just didn’t seem to click. “We were really
thinking about abandoning the whole idea, because the nurses did not like it,” Richards
said.

But when the medication administration data came in at the end of the year, the hospital
found that during the four and five months after the pilot finished, those two units
combined had a 47 percent decrease in errors. The units had not done anything else to
reduce errors, just the education about no distractions and the vests.

“At that point we knew we could not turn our backs on our patients,” Richards said.

The quality forum nurses tweaked the program, finding more attractive neon yellow vests
and reaching out to the medical staff, housekeeping and other departments for support.

Kaiser South San Francisco kicked off the new program hospital-wide in April 2007,
with the exception of oncology, which refused to participate, writing letters and signing a
petition. The hospital decided not to play hardball.

“We were blown away in May. The hospital experienced a 20 percent decrease in
medication errors, even though one unit refused to participate,” Richards said. “And that
was the only unit that experienced an increase from their previous month’s error rate.”

One by one, Richard said, the oncology nurses joined the no-distraction program.
Kaiser South San Francisco shared its results with other Kaiser facilities through the
company’s Sidney R. Garfield Health Care Innovation Center. Nurses suggested wearing
a sash, instead of a vest, if the nurse preferred, and Kaiser hospitals throughout the region
kicked off the “MedRite” process in March 2008. Richards said she could not release the
rate of improvement but that it exceeded South San Francisco’s results, something she
attributes to the other facilities’ receiving a more complete package.

In addition to decreasing distractions, the MedRite program includes verifying the five
rights, checking allergies and the MAR, washing hands, turning down the television
volume, turning up the lights, educating the patient about the medication and
documenting.

“It may seem like more work but, in my experience, it has brought a safer culture into
nursing,” said Suzi Kim, RN, BSN, a staff nurse at Kaiser West Los Angeles.

In addition to reducing errors, nurses find medication passes go more quickly, Richards
said.

“It’s a more focused process,” Kim said. Without interruptions, “we can think clearly.”

Patients and families often ask about the sash. Kim said some will joke about it, inquiring
if she’s a pageant queen or a girl scout. But she receives positive feedback once she
explains the purpose.

The Institute for Healthcare Improvement highlighted the medication-pass distraction

program at its 2007 Fall Harvest, celebrating the improvement work of more than 3,600
hospitals by “harvesting” the ideas, innovations and best practices they are using to
improve care and reduce harm.

“As Harry Truman said so many years ago, it’s amazing what you can accomplish when
you don’t care who gets the credit,” Richards said.

© 2010. AMN Healthcare, Inc. All Rights Reserved.

Source:

http://www.nursezone.com/Nursing-News-Events/more-news.aspx?ID=18693

Retrieved: January 7, 2011