fridae13 447 Views
Joined: Feb 6, '05;
Posts: 2 (0% Liked)
nosocromial infections. let me relate a little story of a time when i noticed that all the foleys on my floor had pseudomonas. not resistant, not terrible but the vector was a NA who used a 24hr urine bottle to empty the foleys. There was not a toilet in every room as it was the oldest part of the hospital. She had devised a means to save steps. This is how easy it is to transmit when your co-workers are more interested in saving time and steps.
Ototoxicity secondary to mycins and Observations on poor infection control
Have some experience with toxicity. In the early 80's. a 24yo diabetic on erythromycin c/o hearing loss. An alert staff nurse thought 'mycin, hearing loss, toxicity?' The research we read told us that immediately stopping the mycin on the first sign of hearing loss would probably make the damage reversable. Indeed. the patient quickly regained her hearing after we dc'd the drug. Happily, this early warning sign saved her from permanent kidney damage.
Remember that old nursing care plan intervention to test hearing before administration of mycins? On what planet is instant audiometry ordered or available? LOL But I never forgot it in 25 yrs. We were doing peaks and troughs in the 80's on the diabetic floor especially when vanco came along.. Renal damage in a diabetic at that time was inevitable over time.and we monitored for it .
On another note. I have been the unhappy observer of inadequate isolation for years and this week I am leaving the LTC facility I work at for many issues including the fact that the "infection control nurse" feels she doesn't need to tell the CNAs when a pt has MRSA in his foley and C-diff in his stool, Oh. she states, the aides are really good with universal precautions there's no need to alarm anybody, Isolation signs are not posted, pt was not moved to a private rm, the aides are very angry. I feel they had the right to know what they were dealing with. The housekeeping was not stepped up. The side rails still appear dirty. Gowns were not provided, no isolation cart. etc etc. They did put a smallsign at the pts door "check with nurse" and feel that hippa laws prevent anyone involved to know about the pt' s infection to protect his privacy. They also don't want the visitors, families and residents from finding out that these problems are present in the facility. It's only a matter of time , in my opinion, until their luck runs out and a resistant infection will rampage through this >330 bed Veteran's home, But I am no longer welcome there cause I ask too many questions. They keep telling me that acute care is different, But the resistant bacteria, I maintain, can be just as deadly regardless of the level of care. I just shudder every day. It's time to go back to acute care for me cause I just can't even begin to make a change at the "Home" and will certainly be fired if I persist!
in reply to:
Again, I thank God your son made it through unscathed. What a scare for a mom to have to experience. Did they know about drawing blood for troughs and peaks when this happened, as they routinely do now?
I remember in nursing school; working Peds, there were always kids who'd ended up with some degree of deafness due to Gentamicin; they did draw levels in those days, but I guess by the time the high levels showed up, the damage had already occurred, and was irreversible. Or, maybe it was an unavoidable side effect in those days; I don't know.[/QUOTE]
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