Archive for category: E-News

E-News

PIVC insertion in the ED can be reduced using multimodal approach

, /in /by

Peripheral intravenous cannula (PIVC) insertion in the emergency department can be reduced using a multimodal approach designed to support critical thinking and promote clinically appropriate peripheral intravenous cannula insertion and use.
The lead author of the study is Tracey Hawkins, Grad Cert (ENurse), in the Department of Emergency Medicine, Royal Brisbane and Women’s Hospital, Brisbane, Queensland, Australia.
The study, by Hawkins, et al, showed that multimodal intervention not only reduced PIVC placement in the ED, it also increased the percentage of PIVCs placed that were used. These findings suggest that this program benefits patients and health services alike, with potential for large cost savings. Ali Tann, BSN, RN, CEN a registered nurse in the emergency department at IU Health Methodist Hospital, Indianapolis, commented:
“Many PIVs are placed because we know that labs will be ordered, but may not be sure about fluids and/or meds and don’t want to stick the patient too many times. Simply stated, the more sticks the unhappier the patient. But ultimately, in order for PIV campaigns to be successful, there needs to be more consensus among the providers. In other words, if the gut works, use it!”

Medical Newshttps://tinyurl.com/y72ktac7

T2 Biosystems hosts integrated symposium at ECCMID 2019

, /in /by

T2 Biosystems, maker of rapid diagnostic technology to aid in the detection of blood stream infections to prevent sepsis, will host an integrated symposium at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) in Amsterdam, Monday, April 15, 16:00-18:00 CET. The symposium, “Rapid diagnostics direct from whole blood: a solution for fast and appropriate antimicrobial therapy”, will feature leading clinicians and users of T2Direct Diagnostics™ who will discuss integrating the Company’s T2Bacteria® and T2Candida® Panels in clinical practice, and the product’s potential to significantly improve antimicrobial stewardship and infectious disease management in clinical settings.
The panels are the first and only FDA-cleared and CE-marked tests that identify the most serious bacterial and fungal pathogens directly from blood sample in just three to five hours, without waiting for a positive blood culture —which can take one to six or more days. These capabilities allow for faster species identification, enabling the potential for faster targeted treatment, de-escalation of empiric therapy and improved patient outcomes.
All T2Direct DiagnosticsTM panels are run on the T2Dx® Instrument using a patient’s blood sample with validated clinical sensitivity of 91 to 96% and specificity of 98 to 99%. The direct from blood capability is enabled by the proprietary T2MR-powered T2Dx® Instrument which can detect organisms at concentrations as low as 1 CFU/mL. This represents a thousandfold increase in sensitivity compared to products that detect species from positive blood culture bottles where the number of cells is typically in the range of 10,000 to 10,000,000 CFUs/mL.
T2 Biosystems recently received FDA Breakthrough Designation for the T2ResistanceTM Panel, a diagnostic panel that can detect 13 resistance genes from both gram-positive and gram-negative pathogens from a single patient blood sample in 3 to 5 hours. The T2Resistance Panel is also run on the T2Dx instrument and is expected to be CE-marked and available in Europe by the end of 2019, and offered as a Research Use Only product in the United States before yearend.  
T2 Biosystems will showcase its latest innovations at ECCMID at Booth #1.22.

www.T2Biosystems.com

Researchers identify a potential new approach to treat HER2 positive breast cancer

, /in /by

Researchers at Mayo Clinic have identified an important new pathway by which HER2 positive breast cancers grow and have discovered that a dietary supplement called cyclocreatine may block the growth of HER2 positive breast cancer.
“The HER2 receptor tyrosine kinase, which functions as an ‘on’ or ‘off’ switch in cellular functions, is a key driver of breast cancer, and is overexpressed in about a quarter of all breast cancers,” says Taro Hitosugi, Ph.D., a pharmacologist at Mayo Clinic and corresponding author of the paper. “While drugs such as trastuzumab improved outcomes for some patients with HER2 positive breast cancer, some tumours are or may become resistant to this drug.”
Dr. Hitosugi and his colleagues decided to explore ways to resolve this unmet clinical need. Their strategy was to develop a treatment to target tumour mitochondrial energy metabolism, which is the process cancer cells use to manipulate energy during cell metabolism in order to grow.
The challenge for researchers was to determine which mitochondrial enzymes were activated by HER2 cancer cells. “We employed metabolomics and proteomics approaches to identify HER2-dependent metabolic events, and discovered that HER2 signalling activates mitochondrial creatine kinase 1,” says Dr. Hitosugi.
Dr. Hitosugi and his colleagues discovered that cyclocreatine, a dietary supplement used in sports drinks, effectively targets mitochondrial creatine kinase 1 enzyme and reduces cancer growth without toxicity. This finding was confirmed in mice models where a patient-derived, trastuzumab-resistant HER2 positive tumours were administered to the mice.
“Mitochondrial creatine kinase 1 may be a new drug target for the treatment of HER2 positive breast cancer,” says Matthew Goetz, M.D., director of the Mayo Clinic Breast Cancer research program. “Future clinical trials will be necessary to determine the effectiveness of this drug for HER2 positive breast cancer resistant to standard therapies.”

Mayo Clinichttps://tinyurl.com/y73252og

GB £30 (€33.3) million global cardiovascular challenge launched

, /in /by

The British Heart Foundation (BHF) launched end of August the Big Beat Challenge, a unique research funding award that will bring together world-leading researchers and innovators to identify and solve any of the biggest problems in heart and circulatory disease.
Unveiled at this year’s European Society of Cardiology Congress in Munich, the £30 million award will be one of the largest and most ambitious of its kind; a challenge to scientists, clinicians, innovators and entrepreneurs to look beyond incremental gains and accelerate breakthroughs that could transform lives across the globe.
For more than half a century, BHF-funded researchers have pioneered world-leading efforts to understand the causes of heart and circulatory diseases and develop new methods of prevention, diagnosis and treatment. Despite huge progress, the burden of heart and circulatory diseases continues to rise. Around the world, 18 million people die from heart and circulatory diseases each year. The WHO expects this to rise to 23 million by 2030.
The Big Beat Challenge will push the international research community to identify a real world challenge, significant unmet need or opportunity for game-changing innovation in heart and circulatory science or medicine. A problem or opportunity, which if solved or seized at scale, would mean major progress towards real patient benefit.
Proposals must be transformative, clinically relevant, and with a multi-disciplinary approach that couldn’t be done without funding on this scale. Ideas could transform the lives of a few, or provide a smaller but important change for many.
The winning team can come from any country, sector or discipline, working on a scale above and beyond traditional research schemes to achieve a truly revolutionary breakthrough in any heart or circulatory disease.
The BHF is assembling an international, multi-disciplinary, expert advisory panel to oversee the Big Beat Challenge. A call for outline applications will open at the end of 2018 and close in mid-2019. Shortlisted applications with the most promising ideas will be given seed funding, and teams will then have around six months to develop their final proposals. These full applications will then be peer-reviewed and the winning research programme recommended by the panel.
Professor Sir Nilesh Samani, Medical Director at the BHF: “We’ve made great progress over the last 60 years in understanding and tackling many heart and circulatory diseases, and I am proud that BHF-funded research has made a substantial contribution to this success. But heart and circulatory diseases remain a major health problem worldwide, still causing 1 in 3 deaths globally.
“The time is right for a radical approach. With recent advances in areas all the way from genome editing to artificial intelligence, we have an unprecedented opportunity to exploit new ways of doing research that moves beyond incremental gains and accelerates breakthroughs.
“This will be one of the largest awards of its kind. It is without borders and without boundaries. The winning project will be truly transformative, and something that simply couldn’t happen without funding on this scale. The ideas can tackle any heart or circulatory condition using any approach. All we ask is that you think big.”
bhf.org.uk/BigBeatChallenge

Sink traps are surprising source of antibiotic-resistant bacteria in ICU

, /in /by

During a nationwide outbreak of healthcare-associated infections of an antibiotic-resistant bacteria, an Israeli hospital traced repeated infections of patients in its intensive care unit (ICU) to an unexpected source—sink traps, according to a study.
“Understanding the source of these resistant bacteria and how they were being spread was essential to effectively intervening and preventing the further spread,” said Gili Regev-Yochay, MD, lead author of the study and Director of the Infection Prevention & Control Unit at Sheba Medical Center at Tel HaShomer in Israel. “While we were unable to prevent the sink traps from being colonized, by changing our behaviour associated with the sinks we have prevented the spread of these infections.”
From January 2016 to May 2017, 32 cases of OXA-48 Carbapenemase-producing Enterobacteriaceae (CPE) were detected, with all but the first two traced to the same bacteria. Most cases were initially detected through routine screening, 11 developed clinical infections, and three deaths were directly attributed to these infections.
The infection control team work closely with staff from the ICU—including clinicians, cleaning staff, a pharmacist and social worker—to systematically trace the source of CPE contamination to 22 sinks in the 16-bed ICU. Frequent decontamination of the sinks using different techniques only temporarily eliminated bacteria. However, decontamination combined with the adoption of sink contamination prevention guidelines eliminated new infections.  
CPE is usually spread from one patient to another through contact with staff or objects moved from room to room. But increasingly, hospital water has been recognized as a source of carbapenem-resistant organisms, the authors said. Running water from a sink can create an aerosol contamination of bacteria that can spread at least a meter from the sink during handwashing, authors said. Effective guidelines used by researchers included limited use of sinks in patient rooms, only using sinks for hand washing when necessary, a ban on clinical waste disposal in sinks, and avoiding storage of materials near the sinks.
Initial sink decontamination efforts included routine cleaning with bleach and later with acetic-acid, but weekly sampling showed that these efforts were effective for only a short time. In one room with a contaminated sink, a self-disinfecting sink trap was installed, but the trap was removed after a patient in a neighbouring room acquired an infection from the same bacteria that was detected again in the new trap.

SHEA
www.shea-online.org/index.php/journal-news/press-room/press-release-archives/626-sink-traps-are-surprising-source-of-antibiotic-resistant-bacteria-in-icu

2018 International Hospital Federation Award winners revealed

, /in /by

The winners and merit awardees of the 2018 International Hospital Federation (IHF) Awards were revealed October 10th at the Awards Ceremony held at the 42nd World Hospital Congress at the Brisbane Convention and Exhibition Centre in Australia.
The IHF Awards, which celebrates and recognizes hospitals and healthcare organizations with demonstrable excellence, innovations, and outstanding achievements in the healthcare industry, attracted 160 entries from 118 organizations in 33 countries. Twenty-seven entries came out on top and were selected as finalists from which the eventual winners and merit awardees were chosen in the IHF / Dr Kwang Tae Kim Grand Award and Excellence Awards in Corporate Social Responsibility, Leadership and Management in Healthcare, and Quality & Safety and Patient-centered Care.
The Gold Award of the prestigious IHF / Dr Kwang Tae Kim Grand Award was bestowed to Dental Health Services Victoria from Australia for their program “Value-based healthcare: A new approach to improve oral health outcomes”.
Fundación Cardioinfantil Instituto de Cardiologia from Colombia took home the Gold Award of the IHF/Bionexo Excellence Award for Corporate Social Responsibility for their project “Give a Life”.
The University of Utah Health from the USA came out victorious as the Gold Award winner of the IHF/EOH Excellence Award for Leadership and Management in Healthcare for “Value Driven Outcomes (Implementation of Data Driven Approach to Manage Utilization of Resources and Improve Quality of Care)”.
Finally, for the IHF/Austco Excellence Award for Quality & Safety and Patient-centered Care, the Gold Award was given to Metro South Health, Queensland Health form Australia for their project “Gestational Diabetes Mellitis (GDM) App and Interactive Clinician Portal (Internet Based)”.
“This year’s winners and merit awardees are proof of how organizations across the globe are pursuing excellence, improving service delivery and moving healthcare forward, ” said Dr Lawrence Lai, Chair of the IHF Awards Committee.
“Congratulations to all the winners and merit awardees! When exceptional achievements and initiatives are awarded, it not only recognizes that their work is being valued but also brings to light programs and projects that others can emulate. More importantly, by sharing and learning from winning projects, it can inspire other hospitals and healthcare leaders to work together to strive for excellence.”
Winners of the Gold Awards presented their winning projects in a special concurrent session right after the Awards Ceremony while Silver, Bronze and Merit Awardees shared their excellent work by poster display at the World Hospital Congress exhibition.
Photos and more information about each of the winning projects will be made available shortly at the IHF web page. Health service providers aiming to deliver better and more efficient health services are encouraged to visit the page to be inspired by outstanding projects this year and IHF Award winning projects in previous years.

https://www.ihf-fih.org/

Mom’s voice may help babies sleep better in the NICU

, /in /by

Infants in the NICU were more likely to stay asleep during recordings of their mothers reading, finds new research.
Babies who spend their first days or weeks of life in the Neonatal Intensive Care Unit may not sleep as soundly as those who go home.
Now, researchers are examining whether one simple difference could help soothe these infants to sleep: the sound of their mother’s voice.
When they were played recordings of their mothers reading children’s books, babies in the NICU slept better and woke up less often, according to a new abstract presented at the annual meeting for Sleep Medicine.
“In the hospital, we take care of babies who are not in their usual environment, which can hinder their ability to have normal sleep,” says lead author Renée Shellhaas, M.D., M.S., a pediatric neurologist at University of Michigan C.S. Mott Children’s Hospital.
“Even though we do our best to make the ICU as quiet an environment as possible, there are hospital disruptions that are unavoidable. Alarms, monitors, ventilators, bedside care and even just the building’s heating and cooling noises may be disruptive. We designed this study to see how the sound environment in the NICU potentially influences sleep and to see if there are relatively simple interventions that may make a difference.”
“What we found was that babies in the NICU were more likely to stay asleep when the recordings of their mothers’ voices played than they were without them.”
"If we can find simple tools to help babies in the unit get higher quality sleep, they could make a big difference to infants’ health and development, especially for those who must stay in the hospital for an extended time."
 
University of Michigan C.S. Mott Children’s Hospitallabblog.uofmhealth.org/rounds/moms-voice-may-help-babies-sleep-better-nicu

Prevention and treatment of ICU acquired delirium requires personalized approach

, /in /by

A population heath study from the Regenstrief Institute and Indiana University Center for Aging Research has determined that haloperidol, the drug most commonly used to treat delirium in hospital medical and surgical intensive care units (ICUs), did not benefit elective thoracic surgery ICU patients when given prophylactically, with the possible exception of those who have had surgery to remove their oesophagus. The study results indicate the need for a personalized approach to delirium in the ICU.
The work is the first to evaluate the use of the antipsychotic drug haloperidol to reduce post-operative delirium in elderly patients undergoing elective non-cardiac thoracic surgery.
Researchers found no differences in delirium incidence or severity between haloperidol and placebo in patients who had undergone elective non-cardiac thoracic surgery except in the small number of study participants who were admitted to the ICU after removal of the oesophagus, a procedure known as oesophagectomy. Removal of this organ is a treatment for oesophageal cancer.
“Our work suggests that just as you can’t lump all cancer patients together for treatment, you can’t put all delirium patients in the same bucket,” said Regenstrief Institute investigator Babar A, Khan, M.D., M.S., who led the new study. “We need a personalized approach to delirium, focusing on people at higher risk of developing this complication.”
He notes that while elective surgery patients typically are healthier than other ICU patients, they are very much at risk of delirium. He counsels those considering elective surgery to consult with their primary care clinicians and their surgeon to weigh the significant risks of delirium with the benefits of the proposed procedure.
“Because we now know that haloperidol, the most commonly used drug to treat ICU delirium doesn’t, with possibly few exceptions, work, we need to focus on non-pharmacological therapies and vigilantly curtail administration of drugs that are harmful to the brain, especially the aging brain,” said Dr. Khan.
Approximately five million Americans are admitted to a surgical or medical ICU annually. Delirium, a sudden and serious change in brain function causing confusion, occurs in as many as three quarters of those treated in the ICU. Causes include sepsis, metabolic problems such as liver and kidney disease as well as drugs that injure the brain.
Individuals who experience delirium are more likely to have longer hospital stays and hospital-associated complications. They also have a greater likelihood of dying in the hospital for up to a year after their hospital stay than ICU patients who did not experience delirium. They are also more likely to lose physical functioning and experience cognitive impairment.

Regenstrief Institute
www.regenstrief.org/article/icu-acquired-delirium-requires-personalized-approach/

New or worsened bedsores tied to poorer inpatient rehab outcomes

, /in /by

A new study from the University at Buffalo has shown that the presence of new or worsened bedsores is an effective indicator of the quality of care for rehab patients.
The study is the first to examine whether this metric is, in fact, associated with outcome of care in inpatient rehabilitation settings.
New or worsened bedsores is a quality metric instituted as part of the Patient Protection and Affordable Care Act (ACA). The ACA requires that medical institutions be evaluated on their quality of care.
Bedsores, also known as pressure ulcers, cost the U.S. healthcare system between $9.1 billion (€7.8 billion) and $11.6 billion (€9.9 billion) per year, according to the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality, the lead federal agency charged with improving the safety and quality of the nation’s health care system.  
Previous studies have shown an association between the presence of bedsores and a variety of outcomes for patients in acute care hospitals and long-term care facilities. However, the association between pressure injury development and rehabilitation outcomes hasn’t been examined previously.
Margaret DiVita, who conducted the research as a doctoral student in epidemiology at UB, is now an associate professor at SUNY Cortland.
Using data from the Uniform Data System for Medical Rehabilitation, she examined the records for nearly 500,000 Medicare patients discharged between January 2013 and September 2014 — after this mandated measure of quality was implemented.
“We looked at how good a proxy measure of quality the new or worsened pressure ulcer measure was, in particular to see if it was associated with poorer outcomes for rehabilitation patients,” said Jo Freudenheim, the paper’s senior author and chair of the Department of Epidemiology and Environmental Health in the UB School of Public Health and Health Professions.
“We found that it was indeed associated with lower quality outcomes: less gain in function during treatment, and lower likelihood of leaving rehab to go to a community setting,” Freudenheim added.
“The focus of this paper is on an important question for the regulation of medical care. How do you measure whether someone is getting good care? In this case we were focused on the inpatient rehab facilities,” Freudenheim said. “We looked at one of the ways that quality is measured as part of the ACA—whether patients get a new pressure ulcer during their stay or, if they have one already, if it gets worse during their stay.”  
While outcomes were poorer for those with new or worsened pressure ulcers, more than half of these patients were able to be discharged to a community setting. “A pressure injury prior to admission or greater likelihood of developing worse pressure injury are not appropriate grounds for denial of access to inpatient rehabilitation care,” the researchers write.  
Compared to the control group, patients with a new or worsened bedsore tended to have a lower change score on the Functional Independence Measure (FIM), a basic indicator of patient disability, and to have, on average, longer rehabilitation stay. In this study, about 1 percent of patients experienced new or worsened bed sores during their rehabilitation stay.  

University at Buffalohttps://tinyurl.com/yb6n56yn

ICU patients who survive respiratory condition may suffer from prolonged post-intensive care syndrome

, /in /by

Patients who survive acute respiratory distress syndrome (ARDS) often leave a hospital intensive care unit with debilitating mental, physical, or cognitive problems that may limit their quality of life.
Now, a new study of 645 ARDS survivors by researchers at Intermountain Medical Center, Johns Hopkins University, and the University of Utah, has identified subgroups of ARDS survivors who suffer what’s been called post-intensive care syndrome, a collection of symptoms that can linger for years.
ARDS is a potentially life-threatening injury to the lungs that occurs most often in an intensive care unit among critically-ill patients with pneumonia or other infections, although it can have other causes.
For many ARDS patients, the primary symptom is shortness of breath so severe they require lung life-support therapies in order to breathe. ARDS can kill, and older patients are especially vulnerable.
Many ARDS survivors leave the hospital with an array of challenges that form post-intensive care syndrome. The survivors may live with long-term effects, including permanent lung damage and different degrees of physical, cognitive, and mental health problems.
During the last quarter-century, the symptoms of post-intensive care syndrome have been increasingly recognized and understood. Critical care specialists say between half and two-thirds of ARDS survivors struggle with it after they’re released from the hospital.
To that end, researchers at Intermountain Medical Center and Johns Hopkins University have been seeking common threads among survivors, focusing on combinations of impairments, including physical health, mental health, and brain function. The study builds on previous research by the team.
Researchers say the threads within survivor subgroups may help them better identify factors that increase risk, and could potentially lead to tailored treatments to bolster patients’ recovery.
In the study of ARDS survivors six months out of intensive care, the researchers found four different patient subgroups:

  • those with mildly impaired physical and mental health (22% of patients)
  • those with moderately impaired physical and mental health (39%)
  • those with severely impaired physical health and moderately impaired mental health (15%)
  • those with severe physical and mental health impairments (24%).

According to the research, physical and psychological injuries tend to go hand in hand. Cognitive impairment is independent of those two, however.
The study found people who have worse physical problems have worse symptoms of anxiety, depression, or post-traumatic stress disorder. The one exception was a small but distinct group (15% of all survivors) who had severe physical limitations, but only moderately severe mental health problems.
Researchers speculate that could mean those individuals already had some chronic physical challenges before developing ARDS and were more accustomed to living with physical limitations.
“It’s also possible that group might have more resilience, so they’re better able to respond to the new physical disability, which is consistent with other recent studies suggesting that improving resilience may help ARDS survivors,” Dr. Brown said.
The study noted that six months after leaving intensive care, about half of the subjects in the study still weren’t living independently, even though 91 percent of them had done so prior to contracting ARDS. Instead, they lived in nursing homes or with relatives.

Intermountain Healthcarehttps://tinyurl.com/ycfcnl8s

Latest issue of International Hospital

April 2024

Digital edition
All articles Archived issues

Free subscription

View more product news

Get our e-alert

The medical devices information portal connecting healthcare professionals to global vendors

Sign in for our newsletter

Beukenlaan 137
5616 VD Eindhoven
The Netherlands
+31 85064 55 82
info@interhospi.com

PanGlobal Media IS not responsible for any error or omission that might occur in the electronic display of product or company data.