kay

Wow....that is not acceptable in any profession or walk of life. Like Sunstreak said - 'tis scary to think what else she may have forged in your name (or someone else's name) in the past or may do in the future if nothing is done about it now..... Whether or not you pursue this with an attorney, I would suggest you first pursue it with your employer, who I am sure will not take this lightly.

Maureen: >[/i] Medical Devices & Diagnostics - According to J&J, its Medical Devices & Diagnostics segment is the leading medical device business in the world. The segment encompasses suture and mechanical wound closure products, surgical equipment and devices, wound management and infection prevention products, interventional and diagnostic cardiology products, diagnostic equipment and supplies, joint replacements and disposable contact lenses. Pharmaceutical segment - The principal worldwide franchises in J&J's Pharmaceutical segment focus on anti-infective, antifungal, cardiovascular, contraceptive, dermatology, gastrointestinal, haemotology, pain management, psychotropic, urology, neurology, immunology and oncology pharmaceuticals. Consumer segment - The principal products in the Consumer segment are personal care and hygiene products, including oral and baby care products, first aid products, non-prescription drugs, sanitary protection products and skin and hair care products.

It's good PR and good business sense ! J & J get to be seen as a benevolent nurse-friendly company. And why not! They sell a lot of other medical supplies other than the obvious ones that spring to mind....

It is important to follow the infection control guidelines for the institution where YOU work! The precautions vary from one health care setting to another. The precautions required in a long term care setting (which would typically be focused only on handwashing with an antiseptic soap and (appropriate) use of gloves as a contact barrier would be very different from the precautions required in an intensive care unit or a neonatal unit (where precautions most likely would include isolation, use of masks, gowns and gloves). In both these examples, the precautions are appropriate...... Why the great difference in precautions in the different settings????? Being colonized with MRSA is not a disease nor is it an "infection" - it simply means that along with the many billions of other bacterial cells that are all over our bodies we just so happen to carry some Methicillin Resistant Staphylococcus Aureus bacteria. Heck, we don't even know which bacteria we are colonized with unless we do specific cultures! 30-40% of the population are colonised with run-of-the-mill, regular Staphylococcus bacteria (that are not antibiotic resistant). For the most part they live quite happily on our skin, inside our noses and pharynx BUT Staph is a bacteria that has the potential to cause an infection which is then treated by antibiotics. If a person is colonised by MRSA, there is that same potential for developing an infection. This person is not sick - there are no symptoms of being a carrier of Staphylococcus, antibiotic resistant or not....However, the problem is that IF an infection does develop, there is less choice of antibiotics to treat the infection and the very real fear is that the MRSA bacteria will eventually become resistant to the antibiotics we are using to treat it ( there have been a few documented cases now of Vancomycin Resistant Staph Aureus). Hence the need to control the spread of MRSA in settings where the population is at high risk of contracting an infection - in acute hospital settings where the rate of nosocomial infections is very high and where those high risk groups are - the immunosuppressed person, the elderly, the newborn, those with artificial ports of entry for infection (foleys, iv's, wounds, trachs etc etc ) which covers just about every patient in an acute care setting! :uhoh21: MRSA for the most part is transmitted on the hands of health care workers! (What does that tell us about handwashing!) For a healthy adult with intact skin, MRSA is not a grave health threat in itself - there's an awful lot of nastier pathogens out there to worry about. But we do need to take the appropriate precautions to prevent the spread of antibiotic resistant bacteria. You need to follow your institution's or unit's infection control guidelines because they have been developed according to the setting and the risks inherent in that particular setting. Sorry, my post got a bit long...........

Yes, the lactobacillus is a really good idea. :) We had such good results in a couple of our patients who continued to have frequent loose stools even after the C Diff was resolved that our new protocol now includes giving Lactobacillus to all patients who present with C Difficile.

A stool culture 48 hours post Flagyl will confirm whether or not the Flagyl was effective. If still positive, usually vancomycin is then given.

omg - can you imagine a dog chewing on it !!!! holey schmoley!

...maybe i should have added that the reason for keeping the dressing over the permacath dry is that if the dressing needs to be changed, it should be changed only under strict aseptic technique because of the seriousness of any potential infection through these sites fergie:quote i have seen many pts that have showered, washed the area and then put a bandaide over it without problems. some pts have problems with the sites no matter what one does. maybe and infection control nurse would shed some light on this.

Saran wrap is probably a good idea. We cut one of the clean plastic bags used to dispose of dirty dressings and apply it over the site, we then apply opsite roll all around to ensure a "waterproof" covering.The important thing is that it is "waterproof".

i would immediately suspect the aspirin as being the culprit if there is no other obvoius reason - bruising is a potential side effect of asa therapy. ....from tabers... aspirin causes prolongation of the bleeding time. a single dose of 65 mg approx. doubles the bleeding time of normal persons for a period of 4 to 7 days. this same antiplatelet effect can cause the undesired effects of intestinal bleeding and peptic ulceration. "taber's cyclopedic medical dictionary," copyright © 2001 by f. a. davis co., phil., pa

thank you so much. i had tried a search but didn't find this! thanks for your post--i never heard of this before! these exercises are often used in pvd :)

Does anyone know of a site where I can download how to do buerger-allen exercises - as a patient teaching tool.

i think that's the best idea i've ever heard for a uniform...i love it this is coming from someone who started nursing 30 years ago, in dresses with starched collars (agh) caps and aprons.... boy do i enjoy wearing my scrubs :chuckle

I'm curious to know how you dispose of retractable lancets in your facility? I have always assumed that even though they are a "safe" sharp item, after having been used and contaminated with blood they should be disposed of in the sharps container along with any other kind of needle or sharp. Recently I have seen some of the agency nurses who work occassionally with us throwing them in the garbage cans in patients rooms; when I questioned this practice, I was told that this is what they do in other facilities that they work in. One nurse said that this was sanctioned by the infection control nurse in one of our big city hospitals..... I have searched on the internet but found no recommendations on how to dispose of these retractable lancets. Tomorrow I will try to call the public health department for their recommendations. ....nothing in this life is foolproof :uhoh21: and although I really like the lancet we use for it's safety features I wonder how often the retractable spring/coil might fail ...so, personally I will continue to dispose of them in a sharps container

As you have already noticed , the aquacel turns into a gel after absorbing wound exudate - it is very absorbant and used for draining wounds. If you can tape the lower edge of the dressing and make an occlusive dressing, you could try leaving the dressing 2 or 3 days (if the aquacel is dry when you change the dressing, soak it off gently and consider another dressing type at that point).

Very interesting article!

great photos! :) the wound looks nice and clean with healthy granulation tissue. looks like you are doing a good job. :balloons: i would pack with aquacel or aquacel silver (the silver has antimicrobial properties and you mentioned in your first post that was what the home care nurse had suggested). as aquacel (or any other hyrofibre or alginate dressing) is very absorbant and suitable only if the wound is still draining, once the drainage decreases then you need to reevaluate the treatment. (assuming you still have drainage at this stage). it is good that you are using the 3m skin protector, protects the skin and also helps the dressing to stay in place. can you tape the bottom edge of the dressing and to try to make it more occlusive? i have been wringing out the gauze and fluffing it, packing tight at the top because there is a pocket under the scar and packing loosely through the bottom don''t pack tightly, if there is a pocket - cut a "tail" into your strip of aquacel and insert it gently with the help of the wooden end of a sterile q-tip. good luck, let us know how it's healing!

saline soaked gauze is really only appropriate if the goal is to apply a wet-to-dry dressing to debride a wound - rarely used nowadays since we have access to a plethora of superior dressings... i agree with gwenith, your home-care nurse seems to know what she's doing; let her continue to evaluate the wound and change the treatment to suit the characteristics of the wound as the wound progresses. sounds if she is up-to-date on wound care practice (can't say the same for the surgeon's nurse) :imbar also, do you have any tips you can share about packing a wound like this? that would be great! nursing school is only 3 years off in the future :chuckle ...never force a packing tightly into a wound, pack loosely....

I heard a news report this week that after DNA analysis of tissues extracted from these victims buried in the permafrost, they believe that particular flu virus was the same type of avain flu virus that is currently hitting Asia thus the reason for such a high death toll as we humans have no immunity to this type of virus

Although the montgomery type dsg is a good idea, the problem in this area is contamination with stool (problem is worse if the patient is frequently incontinent or has antibiotic related diarrhea!) I had a patient with the same problem, every time he had a BM it went straight into the wound. He was 97 and healed relatively quickly! The trick is to keep the wound clean and good nutrition........ (of course your patient has diabetes as an added problem!) One alternative treatment for this wound could be irrigate thoroughly with NS at least BID and after each BM (or diaper change) pat dry and apply thick layer of flamazine cover with telfa non-adhesive dressing (or abd pad) no tape - the telfa will remain covering the flamazin loosely keeping the wound in contact with the flamazine This allows you to apply whatever other ointment or cream to treat the other skin problems on the surrounding intact skin without worrying that your tape will not adhere to skin covered in i.e. canestan. If you find there is slough or fibrin in the wound bed - mix equal parts of a hydrogel with the flamazine before applying. The hydrogel will debride the slough, the flamazine acts as an antimicrobial as well as promoting wound healing. The most important thing is to keep the area as clean as possible, this treatment does not take long to do - no fancy, complicated dressings involved... Make sure patient has enough protein to promote healing! Good Luck Kay (wound care nurse)

Hate to disillusion you BUT.....as a nurse, I am unionized - so is housekeeping. Guess who is obliged to clean up blood, vomit, feces etc.......Yep, the nurse. Only after nursing has cleaned up the various body fluids, excreta etc can we ask housekeeping to "disinfect" the area. And yes the union is HIGHLY effective- don't dare try to break that rule LOL.