Infusion Dialogue | Straight Talk About IV Therapy and Vascular Access

To Bone or not to Bone

noreply@blogger.com (Kevin Stansbury) — Thu, 09 Feb 2012 00:19:00 +0000

Being a member of the INS and AVA I have learned a lot in and out of these organizations and received a lot of support from many. On the other hand their have been instances when certain nurses laugh at topics when attempting discuss alternatives to Infusion therapy. Infusion therapy can be done with more than just a peripheral IV catheter or a central venous access device such as a PICC line or Sub-clavian line.

These types of vascular access devices are great and have brought a lot of medical advances to the forefront; however, there is one device that is continually overlooked and even mocked; yet it has the same benefits and less complications than most if not all the other vascular access devices.

The recognition of the intraosseous (IO) vascular access device in fluid resuscitation and stabilization of patients has been underrated for quite some time. Intravenous therapy alone has made significant strides in the past forty years. The need to administer a wide variety of fluids and medications in to a patient and affect their circulatory system is critical in the resuscitation of patients in an emergent situation regardless of their underlying disease process. Rapid vascular access is required for many conditions to include but not limited to hypovolemic shock, trauma, anaphylactic shock, cardiac arrest and many more conditions.

There have been several “leading national and international organizations” that have published position statements as well as performed research studies to advance the cause of the IO. The IO has served to change the standard of care in the emergency room in regards to the quick need for vascular access, but also is making strides to the way we care for patients in the intensive care units (ICU’s) medical-surgical units, and beyond.
Among the leading organizations who state that the IO can play a significant role in the care of patients in need of resuscitation is the American Heart Association (AHA), addressing vascular access in cardiac arrest patients¹, the Infusion Nurses Society (INS)², the Emergency Nurses Association (ENA)³ and the American Association of Critical-Care Nurses (AACN) all endorsing the INS position statement.² The intraosseous device is recognized by these professional organizations due to the significant time savings that patients benefit from in emergency situation as well as the minimal complications in relation to central venous catheters and peripheral venous catheters.
The Intraosseous device allows healthcare professionals to decrease the time required to achieve access as well as administer necessary intravenous fluids and medications needed for resuscitation or stabilization of a patient throughout the different areas of nursing. The AHA came to the conclusion that a peripheral intravenous catheter (PIV) and an intraosseous device (IO) can administer equally and predictably the same pharmacological effects and in fact the IO device has a direct correlation to the central venous system and fluids and or medications can be sent to the central venous system within seconds not minutes.

To learn more about the IO devices, uses, and complications visit us at Central Valley Medical and Pedagogy to learn more.

References
1. American Heart Association (AHA). http://www.heart.org
2. Infusion Nurses Society (INS). http://ins1.org
3. Emergency Nurses Association (ENA) http://www.ena.org
4. Vidacare Corporation. EZ-IO. http://vidacare.com
5. Brown, Philips, Campbell, Miller, Proehl, and Youngberg. "Recommendations for the use of Intraosseous Vascular Access for Emergent and Non-Emergent Situations…." Journal of Infusion Nursing. 36.6 (2010): Print.
6. Waismed. Big-Gun. http://www.waismed.com
7. Pyng Medical. Fast1. http://www.pyng.com
8. Von Hoff DD, Kuhn JG, Burris HA, Miller LJ. Does intraosseous equal intravenous? A pharmacokinetic study Am J Emerg Med. 2008;26:31-8.
9. Phillips L, Proehl J, Brown L, et al. Recommendations for the use of intraosseous vascular access for emergent and nonemergent situations in various health care settings: a consensus paper. 2010. J Inf Nurs. 33:346-51.

Get Your Free Intraosseous Kit Now

noreply@blogger.com (Kevin Stansbury) — Thu, 26 Jan 2012 17:04:00 +0000

Get Your Free Intraosseous Kit Now

Infusion Therapy: 5 Things Nurses Should Know About CVAD’s

noreply@blogger.com (Kevin Stansbury) — Tue, 24 Jan 2012 20:11:00 +0000

Infusion Therapy: 5 Things Nurses Should Know About CVAD’s

Central Venous Access Devices (CVAD's)

First the nurse must know what a CVAD is and where it will be placed in the patient. A CVAD is a Central Venous Access Device. This may be a PICC line, Triple lumen, Groshong, or other type of centrally located vascular access device. CVAD’s are an essential part of Infusion Therapy and the nurse must learn and understand the differences in the types and locations of the devices as well as the infusates that will be administered through the devices.

The following are 5 important topics that Nurses should be aware in relationship to their CVAD:
1. Nurses must get an order for a chest XRAY or use an alternative device to confirm Placement of the Distal Tip of the CVAD
The distal tip of the PICC line is best positioned in the Lower one thoird of the SVC
2. Ensure that if using a CVAD that the health care team and facility implements the Central Line Bundle Protocol
Using the Central line Bundles have be shown to saignificantly reduce CRBSI's
3. The health care provider should changes the administration tubing every 72-96 hours according to the INS standards and or hospital policy.
All nurses are encouraged to obtain a copy of the INS standards and use them in their daily practice
4. Nurses MUST wipe the Access Ports each and every time they are accessed
Access Port contamination is the #1 cause of central line blood stream infections
5. ALL Central line dressings should be changed every 7 days or PRN is dressing becomes visibly soiled or falls off.

To learn more about Vascular Access and Infusion Therapy Join Central Valley Medical and CVAN at the 25th Annual Scientific Meeting held by the AVA in San Jose California on October 3rd.
Also visit our website and enroll in one of our courses.

Infusion Therapy | Vascular Access Devices | BD Medical

noreply@blogger.com (Kevin Stansbury) — Tue, 24 Jan 2012 20:09:00 +0000

How Things Have Changed

Over the past two years I have taught a lot of students; both RN and LVN's. I have taught in the classroom and on the job. I have seen a lot of new equipment that has made our lives easy; however, this is so simple and I dumb founded that I did not think of it.
Before the BD Autogard Insyte and the B. Braun Introcan angiocatheter devices; we used straight 18 gauge and 20 gauge over-the-catheter needles without any safety device. There were not even safety shields. We were taught to stick the patient and throw the needle away immediately. We were to have the sharps container at the bedside or with close reach so you could dispose of the needle promptly.
However, statistics have shown us that this was not good practice and that as professionals we still left needles lying around or threw them in the trash by accident. Then the CDC and NIOSH decided to enact the 2001 Needlestick Safety Act that mandates that all employers provide a needless system and or devices with a safety feature built into it.
Today, it is probably safe to say that most facilities use either the BD Autogard Insyte or the B. Braun Introcan. Both devices are nice; however, here at Central Valley Medical we are particularly found to the BD Autogard Insyte as it is easy to use, it is made from polyurethane, and it has a sharp bevel with the patented "insta-flash" technology. The only probably I have ever had is in the following figure.

Well, BD has solved this issue with the BD Autogard Inyte with Blood Control

If the hospital or providers will choose the BD Autogard Insyte with Blood Flow Control; the nurse can remove the needle and not have to worry about holding pressure, spilling, blood, or even bending the catheter. Using this device solves that issue with a small device inside the hub.
However, once the hub is used by either connecting intravenous tubing or a syringe; it will no longer control the backwards blood flow. It will only work at the initial intravenous puncture.

An alternate choice is the

BD Nexiva Closed IV Catheter System

This peripheral catheter is a closed system device and will soon become the preferred choice by most facilities. It will take some nurses a little while to get use too; especially if the nurse is left handed. This device is very nice in that the needle is remove from the device in one complete component and it is covered to prevent accidental needlestick injuries. Also, even if you forget to close the clamp you can see from the figure above it has a small, clear, cap that is inserted into the end of the extension tubing and thus it will not leak out.

This new closed system will eliminate the need for both catheter, j-loop tubing, and a clave. The medical provider can either attach the intravenous tubing directly to the extension tubing or add a clave to the end as well.

In either case; both devices handle well, are safe to use, and the cost is average or even better than most of its competitors. For more information visit:
http://www.bd.com/infusion/products/ivcatheters/iagbc/videos/

Infusion Therapy without Vascular Access might be Impossible

noreply@blogger.com (Kevin Stansbury) — Tue, 24 Jan 2012 19:59:00 +0000

This year the Association for Vascular Access (AVA) celebrated its 25th Anniversary in San Jose, CA. The AVA plus the Infusion Nurses Society equal a perfect marriage for infusion therapy as well a good thing for patients and health care professionals alike.

The AVA Scientific Meeting was a great experience and it provided a great deal of information as well as a preview of future technology in Infusion Therapy and Vascular Access.

During this years meeting there were several nurses that presented their stories in regards to blood exposure from attempting to gain a vascular access device or blood for lab values. The following are some of those health care workers.

Healthcare personnel are at risk for blood exposure from bloodborne pathogens,
that include hepatitis B virus (HBV), hepatitis C virus (HCV), and human
immunodefi ciency virus (HIV). Exposures may occur through needlesticks or cuts
from other sharp instruments contaminated with an infected patient's blood. Exposure may also occur through contact via the eyes, nose, mouth, or skin.
"An estimated 385,000 percutaneous injuries (i.e., needlesticks, cuts, punctures and other injuries with sharp objects) occur in U.S. hospitals each year." (CDC) Prevention of bloodborne exposures requires healthcare personnel to use safer vascular access devices, improved work practices,and the use of personal protective equipment (PPE). One type of device that is great is the new BD Autogard Insyte with Blood Control.

This new vascular access device allows the healthcare professional to access the patients vein without the concern of blood flowing through the catheter and makes it easy for the nurse to attached the injection port or extension tubing.
Changes in peripheral intravenous catheter technology have us moving away from catheters that spills blood out of the hub to using cathetrs with blood flow technology and even closed system devices.

Remember to Always Wear your PPE

3 for $36! 100mL Hand Therapies at Crabtree & Evelyn Today!

References

BD Medical
Association for Vascular Access
Center for Disease Control
Infusion Nurses Society

Vascular Access Devices-So many to choose from with infusion therapy

noreply@blogger.com (Kevin Stansbury) — Tue, 24 Jan 2012 19:50:00 +0000

Vascular Access Devices

Think about this for a while; at any given time; more than half to three quarters of all patients receive some form of intravenous care or medication during their hospital stay. Intravenous therapy can range from normal saline to total parenteral nutrition, chemotherapy, electrolytes, antibiotics, narcotics or a combination of these parenteral therapies. Nurses are currently infusing several hundred various types of medications, intravenous solutions, and/or blood products. Patient venous access may vary from poor vascular integrity, poor circulation, good vascular integrity, and excellent blood flow or a combination of each the aforementioned.
Nurses must have a good understanding of why everyday peripheral intravenous therapy fails. It is often that the characteristics of the intravenous medications and/or solutions provided to the patient and through their given vascular access device that the primary factor venous access devices do not last longer than 24-48 hours in most cases; specifically peripheral venous access devices (PIV). The drug compositions in a lot of medications we are infusing today have a high osmolarity as well as high Ph level. What does that mean for you, the everyday floor/staff nurse? It means a lot for you and the patient. It is important, to evaluate and understand the drug pH and osmolality when selecting a venous access device to complete patient’s intravenous therapy as this can help prevent complications and as well as extend the lifetime of the catheter.

Types of Peripheral Venous Access Devices (PVAD) or (PIV)

Peripheral IV Catheters (PIV)

There are a couple of main companies that provide peripheral intravenous catheters; BD Medical and B Braun.

BD Medical

(BD Medical Nexiva)
BD Medical provides the BD Autogard Insyte over-the-needle catheters which range in gauges 14g to 24g and lengths of 0.75 to 1.88 inches. The Autogard Insytes 18g to 22g catheters are suitable for use with power injectors rated for a maximum of 300 psi.”(BD)
Materials: BD Vialon biomaterial-“BD Vialon biomaterial is a unique, proprietary biomaterial, developed especially for vascular access” (BD) and it softens as it sits in the vessel. (BD)

B Braun

B Braun provides “B Braun Introcan Safety IV Catheter” (B Braun). The Introcan ranges in size from a 14g to 24g as well as the lengths range from 0.55in-2.5in.

Retractable Technologies, Inc

Retractable Technologies, Inc states that their product the VanishPoint IV Catheter:

minimizes exposure to the contaminated needle
allows for one-handed activation
integrated safety mechanism
once activated, the needle is safely retracted through disposal
easy to use

To learn more about this and other topics download our vascular access information kit today. Central Valley Medical, LLC, would like to thank you for downloading our E-Book (Vascular Access Devices and Infusion Therapy are a Perfect Match). At the end of this E-Book is a course evaluation. Please fill it out with your NAME and License number and you will receive 1 CE Contact hour free. Just Fax it back to (559) 354-0991 or email it to Onlinecampus@central-valley-med.com

References

Vascular Solutions. http://www.vascularsolutions.com/
IV-Therapy.net. “Micro-Introducer Technique for PICC Insertion A Sample Policy with Competency Checklist.” http://www.ivtherapy.net/
Galt Medical. “Microintroducer Kits.” http://www.galtmedical.com/.
Bard Access. “PowerGroshong* PICC.” http://www.bardaccess.com/.
Bard Access. “PowerPICC* Catheter.” http://www.bardaccess.com/.
Bard Access. “Maximum Barrier Kit.” http://www.bardaccess.com/.
Cook Medical. “Cook Spectrum® Central Venous Catheter.” http://www.cookmedical.com/.
Cook Medical. “Triple Lumen Polyurethane Central Venous Catheter.” http://www.cookmedical.com/.
Retractable Technologies, Inc. http://www.vanishpoint.com/Simple4.aspx?PageID=175

Infection Control is just as important in Infusion Therapy

noreply@blogger.com (Kevin Stansbury) — Tue, 24 Jan 2012 19:40:00 +0000

CHLORA-PREP ™ for infection Control

Every year, a lot of lives are lost due to the spread of infections in hospitals. Health care workers can take precautions to prevent the spread of infectious diseases. This is a vital part of nursing and as patient advocates it is our duty to follow these steps as a part of infection control.
Proper hand washing is the single most effective method to prevent the spread of infections in our hospitals. If you were a patient or one of your family members was a patient would you not be concerned then?
Don't be afraid to remind friends, family and other health care providers to wash their hands before getting close, performing a procedure, or touching the patient before starting an IV.

DONT FORGET

Cover the coughs and sneezes
Using gloves, masks and protective clothing
Making tissues and hand cleaners available to everyone
Following hospital policies and procedures when working with paitents in regards to blood, body fluids, or other possible contaminated items

ChloraPrep ™ is an antiseptic cleanser that contains 2% chlorhexidine gluconate in a 70% isopropyl alcohol solution. The solution is sterile and contained within a glass ampoule which is housed within a plastic applicator is produced in a varity if styles and shapes.
ChloraPrep is available in a range of applicators containing either 0.67ml, 1.5ml, 3ml, 10.5ml or 26ml of solution and is indicated for the disinfection of skin prior to invasive procedures.

ChloraPrep Sepp^® 0.67 mL Applicator
260449 ChloraPrep Sepp 0.67 mL Applicator

ChloraPrep Frepp^® 1.5 mL Applicator

260299 ChloraPrep Frepp 1.5 mL Applicator

ChloraPrep Swabstick 1.75 mL and 5.25 mL Applicators

260100 ChloraPrep Swabstick 1.75 mL Applicator (single)
260103 ChloraPrep Swabstick 5.25 mL Applicator (triple)

ChloraPrep 3 mL Applicator

260415 Hi-Lite Orange^® Tint
260400 Clear

ChloraPrep 10.5 mL Applicator

260715 Hi-Lite OrangeTint
260725 Scrub Teal^®Tint
260700 Clear

ChloraPrep 26 mL Applicator

260815 Hi-Lite Orange Tint
260825 Scrub Teal Tint
260800 Clear

Central vascular access device (CVAD) site care and dressing changes should include the following:

removal of the existing dressing
cleansing of the catheter where it meets the skin
Use the appropriate antiseptic solution(s),
replacement of the stabilization device if used
application of a sterile dressing
Chlorhexidine solution is preferred for skin antisepsis

These are the recommendation of the Infusion Nurses Society and have been set in the 2011 INS Infusion Therapy Standards of practice.
For More information of this type of cleanser visit Carefusion.com; also following us on Facebook.

References

Carefusion
CDC.gov
IHI
INS

Intravenous Mucomyst (Acetylcysteine) for Acetaminophen Overdose

noreply@blogger.com (Kevin Stansbury) — Tue, 24 Jan 2012 19:37:00 +0000

Remember the days in the Intensive Care Unit (ICU) when giving patient Mucomyst to help break up that thick , yucky, stuff? Or working in the emergency room (ER) and maybe the night shift receives an aecatminophen overdose. They would pull out the Mucomyst and give the patient some orally to help protect the liver.

Mucomyst

USES: can be give by inhalation, acetylcysteine is used to help thin and loosen mucus in the airways due to certain lung diseases (such as emphysema, bronchitis, cystic fibrosis, pneumonia). This effect helps you to clear the mucus from your lungs so that you can breath easier.
May also be given by mouth (orally), used to prevent liver damage from acetaminophen overdose.
Working in the Emergency room (ER), nurses must be familiar with intravenous medications. One medication that stands out is intravenous (IV) Acetadote. This medication is also given orally for acetaminophen overdose as well; however, oral medications can take longer to take effect and often these patients may not have the time.

What is Acetylcysteine(Acetadote)?

Acetylcysteine(Acetadote) is currently the only FDA-approved IV acetylcysteine for acetaminophen overdose.
Acetadote, was introduced into the United States in 2004 and is used in more than 3,000 emergency rooms across the U.S. It has been proven to be a safe and effective treatment for acetaminophen overdose when administered within 8-10 hours post-ingestion

Acetaminophen Overdose

According to the data provided by the American Association of Poison Control Centers (AAPCC), acetaminophen was involved in more than 187,000 poisoning exposures in the United States in 2009, including more than 100,000 cases of acetaminophen in combination with other medications.²

CONTRAINDICATIONS

Patients who may have had a previous anaphylactic reaction to acetylcysteine should avoid this medication.

WARNINGS AND PRECAUTIONS

Acute flushing and erythema of the skin and serious anaphylactoid reactions may occur

Use with caution in patients with asthma or history of bronchospasm

Adjust total volume for patients less than 40 kg and for those requiring fluid restriction

Acetadote should be used with caution in patients with asthma or where there is a history of bronchospasm.

Indications for Use

View Webcast on IV Acetadote

Intravenous Acetadote, should be administered intravenously within 8 to 10 hours after the known ingestion of a potentially hepatotoxic quantity of acetaminophen. This treatment is indicated to prevent or lessen the injury to the patients liver.
For best results it is important to administer the first intravenous dose within 8 hours. The longer the time frame from ingestion the less likely the treatment will work effectively.

Safety Information

Acetadote should be used with extreme caution in patients who may suffer from asthma, COPD, or where there is a history of bronchospasm. "In the literature, the most frequently reported adverse reactions attributed to IV acetylcysteine administration were rash, urticaria and pruritus. The frequency of adverse reactions has been reported to be between 0.2% and 20.8%, and they most commonly occur during the initial loading dose of acetylcysteine."²

References

Bronstein AC, Spyker DA, Cantilena JR, et al. 2009 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 27th Annual Report. Clin Tox 2010; 48:979-1178.
Acetadote (Acetylcysteine). http://www.acetadote.net/home.php
Cumberland Pharmaceuticals.http://www.cumberlandpharma.com/

Central Venous Access Device (CVAD) In the Emergency Room

noreply@blogger.com (Kevin Stansbury) — Tue, 24 Jan 2012 19:14:00 +0000

Over the past two to three decades we have really grown in the health care industry in the fact that we have developed and advanced the infusion and vascular therapy industry by leaps and bounds with the PICC line, Mid-line, and peripheral intravenous catheters. However, as nurses we have not kept us with the pace of technology in regards to our education and skills sets. This may seem harsh yet numbers do not lie and with this in mind it is a simple fix.

Practice, Practice, Practice.

Still many years later we continue to have one in four medications errors in our hospitals as well as approximately 45 000-164 000¹ patients get an infection in their central venous access devices (CVAD).

(CDC.gov)

Most of the infections in our patients CVAD’s occur the intensive care units (ICU).

Who is responsible for these infections and errors? We are as nurses. Whether you are a new graduate nurse or a nurse with a lot of experience it is still our duty and calling to advocate and protect our patients even if that means from us. Our patients deserve better and we must be diligent in perfecting our skills to the best of our ability by continuing our training and education, practicing, and ensuring we follow the standards of care.

The Infusion Nurses Society (INS) Standards of Infusion Care states that “infection prevention and surveillance protocols shall be in accordance with organizational policies, procedures, and/or practice guidelines and local, state, and federal rules and regulations.²”

(photo Courtesy of Free Digital Photos.net and Renjith Krishnan)
The INS continues on the say that health care works should also use personal protective equipment (PPE) during all infusion procedures that may potentially expose the health care worker to blood and body fluids as well as protect the patient from the same.
In order to help prevent a CVAD infection the health care provider should use “Maximal sterile barrier” protections. Appropriate hand hygiene is also essential as hand hygiene is the single most effective method in preventing infections.
Nurses in the emergency room (ER) should also understand how to care and provide maintenance for CVAD's as they are becoming more prevalent as well as more and more hospitals are contemplating using PICC teams including for patients in the ER. ER nurses are under a lot of stress and work often at a fast pace; however, this is not reason not to follow procedures as best of your ability as possible.
To learn more about CVAD's and care and maintenance as an ER nurse stayed tuned for Central Valley Medical's articles,classes, and webinars on caring for patients in the ER with Peripheral Venous Access Device (PVAD's) and CVAD's.

References

Center for Disease Control. http://www.cdc.gov/. 2011
Infusion Nurses Society. SOC. http://www.ins1.org/. 2011.
Free Digital Photos.Net. http://freedigitalphotos.net/. 2011
Cath Matters. Catheter Education. http://www.cathmatters.com/. 2011

Legal Matters Regarding Infusion and Vascular Access Therapy

noreply@blogger.com (Kevin Stansbury) — Tue, 24 Jan 2012 19:10:00 +0000

Nurses have long been charged with caring for patients in different settings. Some work in the ICU, ER, LTC, or even doctors’ offices. What is so puzzling is that some nurses seem to fail to realize that no matter what setting they are in; a patient is still a patient. Standard procedures, tasks, skills, and critical thinking do not change much from area to area.

Granted there are more advanced skill sets and the need for higher critical thinking in the specialty areas; however, if the nurse will remember the “5 Medication Administration Rights.” As well as the fact that every patient may at some point need the nurse to perform life saving skills such as cardiopulmonary resuscitation (CPR).
Rule #1: DON’T PANIC
If you Panic you will forget everything that you have learned and the patient will suffer.
A senior investigator with the Department of Consumer Affairs testified at a hearing on a complaint that the board of registered nursing received in regards to a patient injured by a nurse who was performing a task related to infusion therapy.
Patient A
Patient A was admitted to the ICU with a diagnosis of hypokalemia, (low potassium) with a serum potassium level of 3.0 mmol/L. A normal serum potassium level is typically between 3.5 to 4.5 mmol/L. On December 19, 2007, at 6:39 a.m., Patient A's physician ordered four doses of intravenous (IV) potassium supplementation which was to be administered over one hour increments starting at 7:30 a.m. The nurse caring for Patient A was aware of the physician's order of Potassium Supplementation; however, the healthcare provider did not administer the IV medication to Patient A's until 11:10AM. This is almost four hours later.
At approximately 10:30 a.m.; the PYXIS system used by the nurse and hospital system had flagged Patient A's MAR because the Potassium Supplementation had not been administered on time. When asked why the medication was not given, the nurse stated that the medication was not yet available and he had not contacted the pharmacy. The nurse also informed his supervisor that he checked for the Potassium in the refrigerator; however, it was not available. The nurse then went on to tell a DPH surveyor he was going to wait to administer the dose because the peripherally inserted central catheter line (PICC line) had not been inserted and that he was aware that Potassium Supplementation was an important medication, but did not believe that the medication was an emergency, nor was it necessary to rush since the doctor did not write in his order; “give stat.” The nurse went on to state that another reason the infusion was not started was due to the fact that the patient’s peripheral intravenous catheter (PIV) had infiltrated causing an extravasation.
The issues here are too many to count. However, the important questions to ask in this type of situation are:

Why did the nurse fail to contact the ordering physician in regards to the infiltration, extravasation, as well as the need for a central line in order to administer the medication correctly and in a timely manner?
Why did the provider not call the pharmacy right away?
Did the nurse attempt another viable route to give the medication needed for the patient?

Caring for patients is a noble and courageous undertaking. On the other hand the nurse should use critical thinking skills as well as common sense in order to protect the patient. To learn more about this case and others visit us here at Central Valley Medical as well as the BRN.

California Code of Regulations, title 16, section 1442, states:

As used in Section 2761 of the code, 'gross negligence' ·includes an extreme departure from the standard of care which, under similar circumstances, would have ordinarily been exercised by a competent registered nurse. Such an extreme departure means the repeated failure to provide nursing care as required or failure to provide care or to exercise ordinary precaution in a single situation which the nurse knew, or should have known,cou1d have jeopardized the client's health or life...'

Hob Spot and SEO

noreply@blogger.com (Kevin Stansbury) — Thu, 03 Mar 2011 12:32:00 +0000

Central Valley Medical has decided to step things up a notch. We have taken on HubSpot's 30 day Free trial to see if we can improve our website, web presence, and search rankings.

Hub Spot has a 30 day free trial as well as a wealth of free resources to help build your web site, optimize your SEO, and improve Inbound Marketing.

Central Valley Medical is thankful for the help Hub Spot has provided and we hope to continue our relationship in order to improve our services for our clients.

noreply@blogger.com (Kevin Stansbury) — Wed, 16 Feb 2011 04:10:00 +0000

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noreply@blogger.com (Kevin Stansbury) — Fri, 04 Feb 2011 05:50:00 +0000

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Where were We?

noreply@blogger.com (Kevin Stansbury) — Thu, 23 Dec 2010 08:26:00 +0000

According to a report released by the Department of Health and Human Services, one out of every seven hospitalized Medicare patients is harmed by some type of medical error.

Where were We? Where were the nursings caring for these patients? Why so many errors? What is it that we are donig or not doing that would cause this many errors?

The report cites a variety of "adverse events" or causes for treatment errors, including excessive bleeding after surgery, urinary tract infections linked to catheters and incorrect medications. Researchers estimate that these types of adverse events contribute to 15,000 deaths per month or 180,000 deaths each year, according to the report. -CNN

Medical errors are responsible for injury in as many as 1 out of every 25 hospital patients; an estimated 48,000-98,000 patients die from medical errors each year. Errors in health care have been estimated to cost more than $5 million per year in a large teaching hospital, and preventable health care-related cost the economy from $17 to $29 billion each year.-ahrq.gov

The study found that most of the patients' problems stemmed from a variety of issues, including:

Medication errors, including those that lead to excessive bleeding
Patient care errors, such as intravenous fluid overload
Surgical errors
Infections

So, what do we need to do to prevent these medical errors?

First, take your time. Check the chart against the medical orders and if they are not clear; clarify the orders with the MD to ensure the orders are written correctly.

Next talk with the patient and ensure that the procedure you are performing is necessary for that particular patient and their diagnosis.

Lastly, do not forget the patients seven rights.

Right Medication
Right Patient
Right Dose
Right Time
Right Route
Right Documentation
Right to Refuse

Obesity-Will you be a statistic?

noreply@blogger.com (Kevin Stansbury) — Sat, 27 Nov 2010 06:20:00 +0000

American use to be the Shining Star, the promise land, the beacon; but now we are more like the bacon.

Our divorce rates are up, our job loss rates are up, as well as our waist lines. For the past 42 years we have been chasing the dream but we have not been paying for it. Now the rooster has come to rest and soon the piper will be calling.

We are in debt over our necks, our weight from birth to grave is atrocious, and China is knocking at the door. I treated a child in the emergency room about two or three days ago and she was less than a year old and weighed almost 40 pounds.

Her glucose levels were through the roof both in her urine and blood. All her parents could think about was their other child who they had no one to watch and did not grasp the understanding of the severity of this child's situation.

"Obesity in general nearly doubles the risk of developing kidney stones, but the degree of obesity doesn’t appear to increase or decrease the risk one way or the other, a new study from Johns Hopkins shows.(Johns Hopkins Medicine, 2/10/10)"
These children did not ask to be born; we brought them into this world and it is our responsibility to ensure they are health and safe.

There are plenty of resources for the health care professional to use in order to maintain his or her skills. Of course, we cannot know everything; but if you do not even attempt to try, you surely will fail.

"Three out of four Americans will be overweight or obese by 2020, and disease rates and health care spending will balloon, unless governments, individuals and industry cooperate on a comprehensive strategy to combat the epidemic, the study by the Organization for Economic Cooperation and Development said."(GREG KELLER, Associated Press)

So please, use the resources available for you, your patients, and your community. How are we to preach to our patients if we ourselves do not follow what we preach?

Welcome to Central Valley Medical's Blog

noreply@blogger.com (Kevin Stansbury) — Wed, 24 Nov 2010 11:37:00 +0000

Central Valley Medical Blogspot is dedicated to the health and welfare of the patients and their families in California's Central Valley as well as a spot for healthcare professionals to discuss patient care and obtain educational resources.

Central Valley Medical offers IV Therapy, Basic EKG Recognitions, CPR, and Special Education.

Please post your comments and discussions on our blog and be sure to visit us at:
Central Valley Medical