...Clostridium difficile, also known as "CDF/cdf", or "C. diff", is a species of Gram-positive bacteria of the genus Clostridium that causes severe diarrhea and other intestinal disease when competing bacteria in the gut flora have been wiped out by antibiotics. Clostridia are anaerobic, spore-forming rods. C. difficile is the most serious cause of antibiotic-associated diarrhea (AAD) and can lead to pseudomembranous colitis, a severe inflammation of the colon, often resulting from eradication of the normal gut flora by antibiotics. In a very small percentage of the adult population, C. difficile bacteria naturally reside in the gut. Other people accidentally ingest spores of the bacteria while they are patients in a hospital, nursing home, or similar facility. When the bacteria are in a colon in which the normal gut flora has been destroyed (usually after a broad-spectrum antibiotic such as clindamycin has been used), the gut becomes overrun with C. difficile. This overpopulation is harmful because the bacteria release toxins that can cause bloating and diarrhea, with abdominal pain, which may become severe. C. difficile infections are the most common cause of pseudomembranous colitis, and in rare cases this can progress to toxic megacolon, which can be life-threatening. Latent symptoms of C. difficile infection often mimic some flu-like symptoms and can mimic disease flare in patients with inflammatory bowel disease-associated colitis.[4] Mild cases of C. difficile...
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...Evidence-Based Practice March 17, 2015 Overview of Quantitative vs. Qualitative Articles Using two research studies selected from the list of articles provided. I choose A Bundle Strategy Including Patient Hand Hygiene to Decrease Clostridium difficile Infections (2014) and Impact of a Smoking Cessation Educational Program on Nurses' Interventions (2014). The purpose of this paper is to do an overview of both a quantitative and qualitative article. Review each selected article on learning about study design, by identifying information from each component of the study. Then evaluate the strengths and weaknesses of each study. Overview of Quantitative Article Research Question According to the article, A Bundle Strategy Including Patient Hand Hygiene to Decrease Clostridium difficile Infections (2014), the research question is, does patient hand hygiene included in the bundle strategy help decrease Clostridium difficile infections? According to information found in Chapter 3 (Adams, 2012), using the abstract of problem-solving, nursing process and research process, the information found in this study was impertinent to the outcome. Determining that hand washing does help decrease c-diff infections. Study Design The article, A Bundle Strategy Including Patient Hand Hygiene to Decrease Clostridium difficile Infections (2014), is a quantitative study, and non-experimental design gathers the information. Non-experimental design as defined in Chapter 6 (Adams,...
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...Patient Safety Policy Paper Metropolitan State University NURS-605-50 Spring 2012 Introduction Patient safety is a primary goal for all health care workers, especially Registered Nurses who are the primary care givers for many patients. To promote safety and well-being it is important to provide the best possible care to all patients without spreading hospital acquired infections to patients that were previously free from certain diseases. Clostridium difficile infections (CDI) are a common occurrence within health care settings and can cause many complications, increasing length of stay, and could even cause death. The goal of this paper is to provide a policy to make changes to the Intensive Care Unit (ICU) at Mercy Hospital in Coon Rapids, Minnesota. The ICU has struggled with preventing and eliminating the spread of CDI from patient to patient. The unit has implemented many changes to increase hand hygiene, improve cleaning techniques of equipment, and increase staff knowledge and awareness without improvement of the CDI rates. By reviewing policies provided by the Agency for Healthcare Research and Quality (AHRQ) there can be changes made to improve the CDI rates at Mercy Hospital. Policy changes can be implemented and staff can be educated on proper hygiene techniques and other policies that the AHRQ will provide. The ultimate goal is to eliminate hospital acquired CDI’s and with the policy changes this can be a possibility. Policy Implementation ...
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...Review Quantitive and qualitative studies in research are an important aspect of the nursing profession. Researching and reviewing quantitive and qualitative articles is a process of systematic examination of materials to enhance, validate and learn new knowledge (Schmidt and Brown, 2012, p. 67). As Schmidt and Brown (2012) state, quantitive research design is used to predict relationships and explain relationships and causality whereas qualitative research design gives meaning to events of phenomenon’s (p.72). The purpose of this paper is to identify and interpret research questions, study designs, sample sizes and representativeness, the strengths and weakness of the designs, as well as results of data analysis of both quantitive and qualitative research designs. Overview of Quantitive Design Using the Research Study “A Bundle Strategy Including Patient Hand Hygiene to Decrease Clostridium difficile Infections.” Research Question The basis of a research question is to pose an interrogatory question that describes the variables and population of the research study (Schmidt & Brown, 2012, p. 72). In the article “A Bundle Strategy Including Patient Hand Hygiene to Decrease Clostridium difficile Infections.”, (Pokrywka et al., 2014), Pokrywka et al. (2014) present the research question; will the effect of an expanded bundle strategy, to include patient hand hygiene, make an impact on the rate of Clostridium difficile (C. difficile) of hospitalized patients? This question...
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...spurious has led to some relaxation of concern. This may, however, be premature. While we have completed the usual influenza season in the Northern Hemisphere, the season is just beginning in the southern latitudes. Furthermore, previous pandemics have come in waves, with the second or third wave sometimes being associated with more severe disease than the original portion of the epidemic. While this was not true of the 1968 pandemic, it was true in 1957-1959 and, especially, in 1918. In fact, concern has been raised about the possible recombination of S-OIV with avian influenza, with the potential for significantly enhance virulence in a virus with a high degree of human-to-human transmissibility. ■ References: 1. Newman AP, et al. Human case of swine influenza A (H1N1) triple reassortant virus infection, Wisconsin. Emerg Infect Dis. 2008;14:14702. Shinde V, et al. Triple-reassortment swine influenza A (H1)...
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...Clostridium Difficile Ebony G Williams Hodges University MLS 2500 Professor Christine Sanders April 6, 2011 Abstract Clostridium Difficile is now considered to be one the most important causes of health care-associated infections. C. diff infections are also emerging in the community and in animals used for food, and are no longer viewed simply as unpleasant complications that follow antibiotic therapy. Since 2001, the prevalence and severity of C. diff infection has increased significantly, which has led to research on C. diff. This research summarizes C. diff background, causes, symptoms, infection occurs, diagnosis, treatment, and prevention. This will give the reader some type of aspect about C.diff. Clostridium Difficile Clostridium difficile also known as C. diff is a specific kind of bacterial infection that causes mild very severe forms of diarrhea and colitis. It is a bacteria, not a virus. The infection is often called Clostridium difficile-associated disease (CDAD) or Clostridium difficile infection (CDI) to describe a number of related illness, such as diarrhea, colitis, and perforation of the colon (). C. diff produces a toxin that causes the diarrhea and colitis. C. diff is a spore forming bacteria. A spore is a hard shell that certain types of bacteria like C. diff can wear to protect themselves in harsh environments for long periods of time (). The spores can make C. diff more difficult to treat and easier to become more contagious to others...
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...Clostridium the most common food-borne diseases worldwide resulting from the contamination food. It is one of the most common causes of reported food-borne diseases in the United States. Although several Staphylococcal enterotoxins (SEs) have been identified, SEA, a highly heat-stable SE, is the most common cause of SFD worldwide. Outbreak investigations have found that improper food handling practices in the retail industry account for the majority of SFD outbreaks. However, several studies have documented prevalence of S. aureus in many food products including raw retail meat indicating that consumers are at potential risk of S. aureus colonization and subsequent infection. Presence of pathogens in food products imposes potential hazard for consumers and causes grave economic loss and loss in human productivity via food-borne disease. Symptoms of SFD include nausea, vomiting, and abdominal cramps with or without diarrhea. Preventive measures include safe food handling and processing practice, maintaining cold chain, adequate cleaning and disinfection of equipment, prevention of cross-contamination in home and kitchen, and prevention of contamination from farm to fork. This paper provides a brief overview of SFD, contributing factors, risk that it imposes to the consumers, current research gaps, and preventive measures. Clostridium difficile was first described as part of the normal microbiota in stool samples from healthy infants in 1935 (59)...
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...people do not realize how many germs are contained on the average doctors/nurses uniform and explains that “superbugs” could possibly transport into public places such as restaurants and public transit. The infection called “Clostridium difficile” (C. diff) is a good example of such a “bug.” McCaughey, who is chair of the Committee to Reduce Infection Deaths, builds her case by citing reliable sources and studies. For example, she indicates that the National Hospital Survey released in November warns that “C. Diff” infections are spreading rapidly and that “nearly half a million people a year in the U.S.” have become infected. McCaughey also gives statistics from the University of Maryland that 65% of professionals confessed that they wash their uniform less than one time per week and the other 15% change their uniform less than once a month. McCaughey demonstrates ethos throughout her article by constantly giving the reader factual information on clostridium difficile. McCaughey points out that C. diff is difficult to contain within a hospital environment and states that it “contaminates virtually every surface.” Even “after routine cleaning, 78% of surfaces still had C. diff” and only “scrubbing it with bleach removed it.” She references yet another study which shows that “more than 20% of nurses' uniforms had C. diff on them at the end of a shift.” Because these individuals are wearing their uniforms out to public places, it is logical to assume that...
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...Diane Scott My rationale for choosing this subject is since many people in the hospital have a compromised immune system and they need to be protected from opportunistic infections. As a nursing student, I am responsible for making sure that I do not cause cross contamination. My question is “What are evidence based methods to prevent opportunistic infections in patients with a compromised immune system?” Since one of my sources addresses neutropenia, it is necessary to explain the disorder and how it relates to my question. Information about neutropenia was obtained from an article named Neutropenia: A Diagnostic Approach from the Western Journal of Medicine. The two authors are doctors and this article is based on evidence-based case review. Neutropenia is a somewhat common condition in which the level of neutrophils in the blood is abnormally low (Montgomery and Munshi, 2000, para. 1). An immune system becomes compromised when it does not have an adequate number of neutrophils and my question concerns patients who have a compromised immune system. Some causes of neutropenia include chemotherapy, viral or bacterial infections, adverse drug reactions and autoimmune disorders, such as AIDS (Montgomery and Munshi, 2000). Another source is a peer reviewed article named Neutropenia: State of the Knowledge Part II. The main author of this article is Nirenberg, but she had input from five other authors. This article is from the Oncology Nursing Forum which...
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...Pathogen Case Study Michael Earley History of present illness A 54 year old male seen at local emergency department for altered mental status and diarrhea. While in the E.D, patient had a large bloody bowel movement. He has been having three to four loose bowel movements a day along with severe abdominal pain, tenderness, loss of appetite and fever. Patient is seen as being hypotensive and blood pressure has been unstable. Interim History Patient was recently admitted to the I.C.U for opioid overdose, with acute respiratory failure requiring intubation. He received antibiotics as aspiration could not be ruled out. Also did grow strep from the endotracheal tube. Was initially on Vancomycin/Cipro which was changed to Zosyn and eventually titrated down to Augmentin which he completed that course at home. Patient was also placed on i.v steroids due to his c.o.p.d and sent home on dose of prednisone which he also completed that dose at home. On that admission, patient was also hypotensive despite fluid resuscitation and required pressors. Patient also had a G.I bleed and was on a Protonix drip. Lastly, patient was hydrated with D5 ½ normal saline and also given PO Vancomycin 125 mg Q6 hrs., and IV Flagyl, 500 mg Q8 hrs. Questions Q.- What diagnosis would you give based on patient history and microscopic view above? A.- Clostridium Difficile Q.- What are the causative agents of your diagnosis? A.- Staph. Aureus, Candida species, Clostridium perfringens Q.- What was...
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...Nosocomial Infections By princessbec76 | Studymode.com Section 1: Infections in Healthcare Settings Essay. Nosocomial infections, hospital acquired infections, are an on-going concern to healthcare professionals. These infections are one of the major causes of death in hospitalised patients and are a significant burden on not only the patient’s and the public’s health (as organisms causing nosocomial infections can be transmitted to the community through discharged patients, staff and visitors) but also the economy. A nosocomial infection is an infection acquired at least 72 hours after being admitted into hospital for any reason other than the infection or one which develops amongst hospital staff. Infections are also identified as nosocomial if they appear in a patient within 30 days after their discharge from hospital. Non nosocomial infections, community acquired infections, are infections acquired anywhere other than the hospital. The most common places where non nosocomial infections occur are schools, day care centres and sports facilities. They are spread through skin to skin contact, cuts and grazes, overcrowding and poor hygiene. The illnesses or infections can be the same, for example, pneumonia or gastroenteritis but it is the setting that they are contracted in which differentiate the two infections. Nosocomial infections occur worldwide and affect both wealthy, developed countries as well as the poorer ones with scarce resources. A survey conducted by the World...
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...A hospital-acquired infection (HAI) or nosocomial infection is an infection whose development is favored by a hospital environment, such as one acquired by a patient during a hospital visit or one developing among hospital staff. In the United States, the Centers for Disease Control and Prevention estimated roughly 1.7 million hospital-associated infections, from all types of microorganisms, including bacteria, combined, cause or contribute to 99,000 deaths each year. In Europe, where hospital surveys have been conducted, the category of Gram-negative infections are estimated to account for two-thirds of the 25,000 deaths each year. Nosocomial infections can cause severe pneumonia and infections of the urinary tract, bloodstream and other parts of the body. Many types are difficult to attack with antibiotics, and antibiotic resistance is spreading to Gram-negative bacteria that can infect people outside the hospital. HAI is sometimes expanded as healthcare-associated infection to emphasize that infections can be correlated with health care in various settings (not just hospitals). Nosocomial infections are commonly transmitted when hospital officials become complacent and personnel do not practice correct hygiene regularly. Also, increased use of outpatient treatment in recent decades means that a greater percentage of people who are hospitalized today are likely to be seriously ill with more weakened immune systems than in the past. Moreover, some medical procedures bypass...
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...some circumstances normal microbiota can make us sick or infect people we contact. For instance, when some microbiota leave their habitat, they can cause disease. ” (Tortora, Funke, and Case 17) In my experience of working in a hospital on the medical-surgical floor, I have become very familiar with the opportunist infection formally know as Clostridium Diffcile and informally known as C. diff. C. Diff is an infection that affects the colon and causes the patient to have irretractable diarrhea and can even cause inflammation of the colon that can sometimes be lethal. C. diff is very common in the elderly and patients on multiple antibiotics which causes the natural bacteria in the colon to be irradiated allowing opportunistic bacteria to invade. The New York Times reported that “Two factors typically lead to the infection: taking antibiotics, which make the intestine vulnerable, followed by exposure to the bacteria or their spores in a hospital, clinic or nursing home that has not been properly disinfected. Spores can survive for weeks or maybe even months outside the body, and it takes bleach or other strong disinfectants to kill them. Many people recover once they stop taking antibiotics, but some become severely ill and require treatment with different antibiotics to get rid of C. difficile. Even then, 20 percent relapse, and some suffer intestinal damage that can be fatal or can require surgery to remove part of the intestine.” (Grady) C. diff is really difficult to treat...
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...WHO Guidelines on Hand Hygiene in Health Care: a Summary First Global Patient Safety Challenge Clean Care is Safer Care a WHO Guidelines on Hand Hygiene in Health Care: a Summary © World Health Organization 2009 WHO/IER/PSP/2009.07 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: bookorders@who.int). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: permissions@who.int). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable...
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...Cocco-bacillus: Listeria monocytogenes, Lactobacillus spp ● Small, pleomorphic: Corynebacterium spp ● Branching filaments: Nocardia spp, Streptomyces spp Gram-negative cocci Aerobic ● Diplococcus: Neisseria meningitidis, N. gonorrhoeae, Moraxella catarrhalis ● Cocco-bacillus: Haemophilus influenzae, Acinetobacter Anaerobic: Veillonella spp. Gram-negative rods Aerobic Lactose fermenting (Lactose positive): ● Enterobacter spp, Escherichia coli, Klebsiella spp ● Citrobacter spp*, Serratia spp* Non lactose-fermenting (Lactose negative): ● Oxidase (-): Acinetobacter spp, Burkholderia spp, E. coli, Proteus spp, Salmonella spp, Shigella spp, Serratia spp*, Stenotrophomonas maltophilia ● Oxidase (+): P. aeruginosa, Aeromonas spp. Anaerobic ● Large: Clostridium spp Anaerobic: Bacteroides spp, Fusobacterium spp, Prevotella spp. ● Small, pleomorphic: P. acnes, Actinomyces spp *Serratia and Citrobacter spp can appear initially as non-lactose fermenting due to slow fermentation. Interpretations of Key Phrases ● ● ● ● ● ● ● ● “Gram positive cocci in clusters” may suggest Staphyloccocus species. "Gram positive cocci in pairs and chains" may suggest Streptococcus species or Enterococcus species. “Gram negative coccobacilli” may suggest Haemophilus species. “Lactose-positive gram negative rods” may...
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